Hi, Thanks for writing in. It appears that your renal cell cancer is involving the renal vein and probably the inferior vena cava which carries blood from legs to heart. Previous reports have shown that total surgery of tumor affords the best chance of cure and long-term survival when no distant metastases are present. Presently surgery is offered even in the presence of disease spread. It does not matter if you have disease spread or not. With the advances in immunotherapy, survival is higher in your case if aggressive surgery is combined with immunotherapy. Please do not worry.