Objective To assess the diagnosis of vena caval throm-0.158) were identified as having any prognostic value during univariate or multivariate statistical analysis. bosis (VCT) in patients with renal cell carcinoma (RCC) as an independent indicator of prognostic impor-The presence of regional lymph node (P<0.001) or distant metastases (P=0.009) was an independent tance and when combined with additional tumour characteristics in a controlled multivariate analysis.prognostic variable for patients with RCC, with a significant decrease in long-term survival (13 and 14 Patients and methods The clinical course of 53 patients (41 men and 12 women, mean age 60 years, range months for patients with lymph node and distant metastases, respectively). 35-79) with RCC and VCT was compared with that of a control group of 47 patients (37 men and 10Conclusion A radical surgical approach is essential as standard therapy for the treatment of patients with women, mean age 57 years, range 32-76) with RCC but no neoplastic extension into the vena cava.RCC and neoplastic extension into the vena cava. Because they have a significantly decreased life expectResults With a follow-up of 1-154 months and a mean long-term survival of 32 and 35 months, respectively, ancy, asymptomatic patients with lymph node or distant metastases should be treated conservatively. for patients with and without VCT, neither the propagation of the tumour into the vena cava (P=0.391)Keywords Renal cell carcinoma, intracaval thrombus, prognostic value, multivariate analysis nor the cranial extension of the thrombosis (P= VCT or extensive cranial propagation also decreased the