OBJECTIVE: To investigate the safety and efficacy of radical left nephrectomy with inferior vena cava cancer embolism removal and to evaluate its prognosis and therapeutic value. METHODS: From October 2014 to January 2015, we retrospectively analyzed the clinical data of 3 patients with left kidney cancer with inferior vena cava thrombosis who underwent radical left nephrectomy plus inferior vena cava thrombosis removal. Among them, 2 cases were male and 1 case was female, with an average age of 53 (43-61) years. All three patients were clearly diagnosed with renal cancer and inferior vena cava thrombosis by CT and/or MRI examination before surgery. During the operation, the left renal artery was isolated and ligated first, then the right lobe of the liver was free and turned to the left to reveal the inferior vena cava, and the inferior vena cava was free up to 50px above the upper end of the cancer thrombus and down to 50px below the opening of the right renal vein, then the inferior vena cava, the right renal vein and the upper end of the inferior vena cava were sequentially blocked to complete the inferior vena cava dissection and retrieval of the thrombus, and the inferior vena cava incision was successively sutured to open the blood flow. The cancer embolus and the left renal vein were pushed to the left side along with the whole left kidney. Postoperative follow-up was routine. After surgery, routine blood tests, liver and kidney functions, chest X-ray and abdominal ultrasound were repeated every 3 months, and abdominal and chest CT were repeated every 6 months. he Chaohong, Department of Urology, Henan Cancer Hospital Results: All 3 patients completed the surgery successfully. The operation time was 120-180 min, mean 152 min; bleeding volume was 360-2000 ml, mean 1126 ml; blood transfusion was 1000-1700 ml, mean 1350 ml in 2 patients. no cancer thrombus detachment occurred in all 3 patients during the perioperative period. Postoperatively, all patients recovered well without significant complications and were discharged from the hospital 11-16 days after surgery (average 13 days). The postoperative pathology was clear cell carcinoma of the left kidney (Fuhrman grade II in 2 patients and Fuhrman grade III in 1 patient) combined with inferior vena cava thrombosis. The clinical stage was T3bN0M0. 1 patient started oral antitumor therapy with sunitinib (Sotan) 10 days after surgery for 2 months. 1 patient started interferon therapy 3 times a week for 12 weeks 11 days after surgery. The other 1 patient had no postoperative adjuvant therapy. All three patients had normal renal function, and no recurrence or metastasis was detected in any of them. Conclusion: CT and MRI can accurately determine the location of cancer thrombus in patients with renal cancer with inferior vena cava cancer thrombus, and help to determine the level of cancer thrombus intraoperatively. For patients with left renal cancer combined with inferior vena cava thrombosis without lymph nodes and distant metastases, radical left nephrectomy with inferior vena cava thrombosis removal is a safe and effective surgical method. During the operation, the left renal artery was ligated first, the right lobe of the liver was fully freed and turned to the left, and the inferior vena cava was exposed and blocked in sequence, which can effectively avoid the dislodgement of the cancer embolus and improve the safety of the operation. Keywords: renal tumor; inferior vena cava; cancer embolus; prognosis