Objective: Identification of tactics and results of radical surgical treatment of patients with renal cell carcinoma with intraluminal venous invasion. Material and methods: over a 10-year period, records of case histories and outpatient records of 76 patients with the presence of tumor masses in the lumen of the inferior vena cava, with the upper level up to the diaphragm, which underwent expanded nephrectomy with thrombectomy from the inferior vena cava were analyzed. The operative approach was determined on the basis of the cranial level of the caval tumor localization established during preoperative diagnostic studies. Results: long-term follow-up established for all patients. 17 patients lived with metastases from 5 to 36 months. The average survival time after surgery is 32 months. One- and three-year survival rates were respectively 75 and 51%. Conclusions: all patients managed to achieve a reduction in the clinical manifestations of the disease and prolonged survival.