Perioperative management of patients with renal cell carcinoma with high level of IVC tumor thrombus invasion revisited

We have read with great interest the recent report regarding the perioperative management and outcomes of 8 patients with renal cell carcinoma with level IV inferior vena cava (IVC) tumor thrombus extension [1]. The authors should be commended for their clinical skills in addressing this challenging and complex problem. However, we would like to draw the authors' and readers' attention to several points of great importance, both clinical and academic.

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