Archivos españoles de urología
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To report on our experience in the treatment of renal cell carcinoma with vena caval or right atrial extension, with special reference to the level of involvement and the surgical technique indicated for each case. ⋯ Surgical treatment of renal cancer with vena caval extension is specially difficult depending on the level of involvement, which must therefore be determined with precision. MRI is an effective and noninvasive technique. Tumors with thrombus below the suprahepatic veins can be managed by the direct approach with cavotomy. The use of cardiopulmonary bypass is advocated for tumors with suprahepatic caval or atrial extension. Tumors with caval-atrial extension have a negative influence on survival.