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Carcinoma de células renais com trombo venoso tumoral : casuística de 4 anos no HSM
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Resumo(s)
O carcinoma de células renais tem a particularidade de poder ter um crescimento venoso
tumoral. Este crescimento condiciona uma clínica particular, um diferente tratamento e
tem um significado prognóstico controverso. Neste trabalho foram avaliadas as
características dos carcinomas com trombo tumoral operados no HSM no período de 2012
a 2015. A existência de trombo relacionou-se com um maior número de diagnósticos
clínicos, um maior tamanho do tumor primário, uma maior multinodularidade, um maior
envolvimento ganglionar, uma maior participação da cirurgia vascular, um maior número
de complicações pós-operatórias e uma maior mortalidade pós-operatórios. A extensão
do envolvimento da veia cava inferior foi semelhante nos diferentes níveis da
classificação. Também foram analisadas as características mais relacionadas com a
existência de complicações pós-operatórias nas quais se destacam o diagnóstico clínico,
o tamanho, a extensão do trombo, o grau na classificação de Fuhrman e a presença de
adenopatias, para além de outros fatores relacionados com tratamento mais agressivo. Por
fim, foram analisados quais as variáveis mais relacionadas com uma maior extensão do
trombo tumoral destacando-se a multinodularidade e a presença de adenopatias, assim
como, a maior utilização da circulação extracorpórea e a participação da cirurgia vascular.
The renal cell carcinoma has the particularity of presenting, in some cases, a tumor venous growth. This growth conditions a particular clinical presentation, a different treatment and has a controversial prognostic significance. On this work, we evaluated the characteristics of the carcinoma with thrombus operated on the HSM from 2012 to 2015. The existence of thrombus is related to a higher number of clinical diagnosis, bigger primary tumor size, higher multinodularity, larger lymph node involvement, higher participation of vascular surgery, higher number of post-operatory complications and with higher post-operatory mortality. The extent of the involvement of the inferior vena cava was similar between its different classification levels. Furthermore we evaluated which characteristics were more related to the existence of post-operatory complications in which we highlight the clinical diagnosis, the size, the tumor extent, the Fuhrman classification level and the lymph node involvement, besides other characteristics related to a more aggressive treatment. At last, we analyzed which variables were related to a bigger level of extend of the tumor thrombus in which we highlight the multinodularity and the lymph node involvement as well as the utilization of extracorporeal circulation and the participation of the vascular surgery.
The renal cell carcinoma has the particularity of presenting, in some cases, a tumor venous growth. This growth conditions a particular clinical presentation, a different treatment and has a controversial prognostic significance. On this work, we evaluated the characteristics of the carcinoma with thrombus operated on the HSM from 2012 to 2015. The existence of thrombus is related to a higher number of clinical diagnosis, bigger primary tumor size, higher multinodularity, larger lymph node involvement, higher participation of vascular surgery, higher number of post-operatory complications and with higher post-operatory mortality. The extent of the involvement of the inferior vena cava was similar between its different classification levels. Furthermore we evaluated which characteristics were more related to the existence of post-operatory complications in which we highlight the clinical diagnosis, the size, the tumor extent, the Fuhrman classification level and the lymph node involvement, besides other characteristics related to a more aggressive treatment. At last, we analyzed which variables were related to a bigger level of extend of the tumor thrombus in which we highlight the multinodularity and the lymph node involvement as well as the utilization of extracorporeal circulation and the participation of the vascular surgery.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016
Palavras-chave
Carcinoma de células renais Trombose Neoplasias Urologia