{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T06:06:40Z","timestamp":1788588400179,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T00:00:00Z","timestamp":1624320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the outcomes of Japanese patients with renal cell carcinoma undergoing surgery for tumor thrombus invading the right atrium.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively evaluated 23 patients who underwent extracorporeal circulation\u2010assisted surgery at two institutions. Perioperative outcomes and survival rates were evaluated and compared between two groups of patients, which were set according to the use or not of deep hypothermic circulatory arrest. Data on systemic treatments were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age was 64\u00a0years; the majority of patients were fit according to the Charlson Comorbidity Index. Five (21.7%) patients had at least one distant metastasis, and 17 (73.9%) received systemic therapy. A total of 16 (69.6%) patients underwent deep hypothermic circulatory arrest. Baseline characteristics were comparable between groups. Patients who underwent deep hypothermic circulatory arrest had a non\u2010significant reduction in blood loss compared with those who did not undergo this procedure (1866.0 <jats:italic>vs<\/jats:italic> 3513.0\u00a0mL, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.102). The complication rate, both of any grade (43.8% <jats:italic>vs<\/jats:italic> 71.4%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.215) and grade \u22653 (6.3% <jats:italic>vs<\/jats:italic> 28.6%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.162), tended to be lower in patients who underwent deep hypothermic circulatory arrest. The mean 90\u2010day mortality rate was 8.7%, with no difference among groups (6.3% <jats:italic>vs<\/jats:italic> 14.3%, respectively; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.545). The overall median cancer\u2010specific and overall survival were both 64.4\u00a0months, and did not differ between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Renal cell carcinoma patients undergoing extracorporeal circulation\u2010assisted surgery and systemic therapy for right atrial tumor thrombus have acceptable long\u2010term survival rates. Outcomes are comparable regardless of the use of deep hypothermic circulatory arrest.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iju.14627","type":"journal-article","created":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T09:53:06Z","timestamp":1624355586000},"page":"1001-1007","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Surgery for renal cell carcinoma extending to the right atrium in Japanese institutions: Focusing on cardiopulmonary bypass with or without deep hypothermic circulatory arrest"],"prefix":"10.1111","volume":"28","author":[{"given":"Yudai","family":"Ishiyama","sequence":"first","affiliation":[{"name":"Department of Urology Tokyo Women\u2019s Medical University Medical Center East Tokyo Japan"},{"name":"Department of Urology Tokyo Women\u2019s Medical University Tokyo 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