Introduction: Renal cell carcinoma (RCC) with venous thrombus extension (VTE) represents a great therapeutic challenge, being essential an adequate pre-surgery planning to make surgery more predictable. 3D models are printed copies of patients´ radiological images that enhance anatomy understanding and may improve surgical planning. Our aim is to determine if surgery planning based on 3D models in comparison with the conventional surgery planning, allows a more predictable surgery. Methods: Multicenter clinical trial on 66 patients diagnosed with RCC and TTV who underwent a nephrectomy with thrombectomy. Patients were randomized 1:1 to the 2 study groups: 1) surgery planning with conventional images; 2) surgery planning with 3D models. Each urologist answered a questionnaire before and after the surgery and a Kappa index was used to measure the agreement between surgery planning and the surgery itself in the two study groups. Results: Agreement grade between surgery planning and surgery (Kappa index) 3D Images Kappa Index Interpretation Kappa Index Interpretation Surgical technique Thrombectomy 1,0 Perfect agreement 0,2 Fair agreement Reconstruction 1,0 Perfect agreement 0,7 Substantial agreement Vascular control 1,0 Perfect agreement 0,4 Fair agreement Human resources General surgeon 1,0 Perfect agreement 0,5 Moderate agreement Vascular Surgeon 0,9 Almost perfect agreement 0,4 Fair agreement Cardiac Surgeon 1,0 Perfect agreement 1,0 Perfect agreement Pre-surgery procedures Cava Filter 1,0 Perfect agreement < 0 None agreement Embolization 1,0 Perfect agreement 0,2 Fair agreement Conclusions: Surgery planning with 3D models was more predictive than surgery planning with conventional images in RCC with VTE. SOURCE OF Funding: Pfizer
