Robot-assisted Cavectomy Versus Thrombectomy for Level II Inferior Vena Cava Thrombus: Decision-making Scheme and Multi-institutional Analysis

Robot-assisted cavectomy (RAC) for inferior vena cava thrombus (IVCT) is safe and feasible in patients with extensive IVC wall invasion if the collateral blood vessels are well established. Selection of RAC or robot-assisted thrombectomy for IVCT can be based on preoperative IVCT imaging characteristics, including the presence of IVC wall invasion, the affected kidney, and establishment of the collateral circulation. IVC invasion and tumor grade were independent risk factors for progression-free survival, while body mass index, tumor type and grade, perirenal fat invasion, and lymph node metastasis were independent risk factors for overall survival.