{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:55:45Z","timestamp":1791435345100,"version":"4.3.3"},"reference-count":21,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,8,2]],"date-time":"2019-08-02T00:00:00Z","timestamp":1564704000000},"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":["Journal of Cardiac Surgery"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Renal cell carcinoma (RCC) with tumor thrombus extending into the inferior vena cava (IVC) occurs in 4%\u201010% of cases. Within this subset, pulmonary tumor embolism (PTE) appears in approximately 0.9%\u20102.4% of cases. We wanted to review our experience in managing patients with RCC with IVC involvement and a preoperative diagnosis of PTE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of seven patients presented at our center between January, 2005 and January, 2015 with RCC, IVC involvement, and PTE (diagnosed either by chest computerized tomography angiography or preoperative transesophageal echocardiogram). Each patient underwent a radical nephrectomy and tumor thrombectomy using an organ transplant\u2010based approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Surgical removal of the PTE was performed in three patients (tumor embolectomy in two cases, right lower lobe resection in one case); the PTEs in four patients were considered to be too small to undergo surgical resection. PTE pathology found neoplastic cells in each patient that had surgical removal. No postoperative complications were observed in any of the seven patients. All four patients who were metastasis\u2010free preoperatively (with 2\/4 having tumor embolectomy performed) developed distant metastasis; median time\u2010to\u2010developing metastatic disease was 6.5\u2009months. With a median follow\u2010up of 19\u2009months, three deaths because the disease have occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although RCC with IVC tumor thrombus complicated by PTE may not be catastrophic in most cases, it appears to be associated with an increased risk of developing metastatic disease. In addition, as the PTEs appear to contain neoplastic cells, pulmonary artery embolectomy at the time of nephrectomy should be performed whenever possible.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocs.14182","type":"journal-article","created":{"date-parts":[[2019,8,2]],"date-time":"2019-08-02T20:15:05Z","timestamp":1564776905000},"page":"1018-1023","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Pulmonary tumor embolization as early manifestation in patients with renal cell carcinoma and tumor thrombus: Perioperative management and outcomes"],"prefix":"10.1155","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1467-0385","authenticated-orcid":false,"given":"Giuseppe","family":"Serena","sequence":"first","affiliation":[{"name":"Department of Surgery, Miami Transplant Institute, University of Miami Miller School of Medicine Jackson Memorial Hospital  Miami Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Servicio de Urologia Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey J.","family":"Gaynor","sequence":"additional","affiliation":[{"name":"Department of Surgery, Miami Transplant Institute, University of Miami Miller School of Medicine Jackson Memorial Hospital  Miami Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Salerno","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, University of Miami Miller School of Medicine Jackson Memorial Hospital  Miami Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Verzaro","sequence":"additional","affiliation":[{"name":"Department of Surgery IDI\u2010IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetano","family":"Ciancio","sequence":"additional","affiliation":[{"name":"Department of Surgery, Miami Transplant Institute, University of Miami Miller School of Medicine Jackson Memorial Hospital  Miami Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,2]]},"reference":[{"key":"e_1_2_8_1_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)61970-0"},{"key":"e_1_2_8_1_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2007.05.009"},{"key":"e_1_2_8_1_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)38235-6"},{"key":"e_1_2_8_1_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2008.10.036"},{"key":"e_1_2_8_1_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2010.07.028"},{"key":"e_1_2_8_1_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.1987.tb04832.x"},{"key":"e_1_2_8_1_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)64452-7"},{"key":"e_1_2_8_1_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.11.025"},{"issue":"1","key":"e_1_2_8_1_10_1","first-page":"e19","article-title":"Inferior vena cava resection and reconstruction: Technical considerations in the surgical management of renal cell carcinoma with tumor thrombus","volume":"32","author":"Gonz\u00e1lez J","year":"2014","journal-title":"Urol Onc: Semin Orig Invest"},{"key":"e_1_2_8_1_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(97)70164-8"},{"key":"e_1_2_8_1_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-011-9480-z"},{"key":"e_1_2_8_1_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2042.2011.02926.x"},{"key":"e_1_2_8_1_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2009.04.021"},{"key":"e_1_2_8_1_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2009.06.009"},{"issue":"5","key":"e_1_2_8_1_16_1","first-page":"345","article-title":"Metastasis of circulating tumor cells: Favorable soil or suitable biomechanics, or both? 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