The purpose of this study is to detail the preoperative evaluation, surgical procedures, and postoperative care of renal cell carcinoma (RCC) patients having radical nephrectomy (RN) and inferior vena cava (IVC) thrombectomy. In non-metastatic RCC patients with IVC thrombus, RN and IVC thrombectomy is the recommended treatment strategy. All patients must have a thorough preoperative workup that includes high-quality imaging, blood work, and relevant consultations. The goal of the surgery is to remove the whole tumor burden, which demands a skilled surgical team for such a difficult treatment and is naturally associated with a high risk of perioperative morbidity and death.

Preoperative CT or MRI scans are required for surgical planning. The degree of the tumor thrombus largely determines the surgical strategy. The open method has been the standard, although, in certain circumstances, minimally invasive and robotic approaches are being used by qualified surgeons.