chapter 50 - Treatment of Advanced Renal Cell Carcinoma
نویسنده
چکیده
Renal cell carcinoma (RCC) is a term that includes a variety of cancers arising in the kidney and comprises several histologically, biologically, and clinically distinct entities (Linehan et al, 2007, 2009). An estimated 58,240 new cases of cancer arising in the kidney or renal pelvis were diagnosed in 2010 in the United States (Jemal et al, 2010). Approximately one third of all newly diagnosed RCC patients present with synchronous metastatic disease and an additional 20% to 40% of patients with clinically localized disease at diagnosis will eventually develop metastases (Skinner et al, 1971; Rabinovitch et al, 1994; Bukowski, 1997). Metastatic RCC is almost always fatal, with 10-year survival rates of less than 5% (Bukowski, 1997; Motzer et al, 1999, 2000; Motzer and Russo, 2000; Négrier et al, 2002); patients with metastatic disease account for the majority of deaths (approximately 13,000 a year in the United States) related to RCC (Jemal et al, 2010). Advances in our understanding of the genetic and molecular defects underlying the individual subtypes of RCC have led to the development of novel agents designed to reverse or modulate aberrant pathways contributing to renal oncogenesis. These “targeted” therapeutic strategies have largely supplanted other treatment modalities in the initial management of metastatic clear cell kidney cancer; however, surgery, irradiation, and cytokine therapy remain appropriate choices in the management of selected patients with advanced clear cell RCC. Although agents effective in clear cell RCC are often used in patients with other subtypes of RCC there is scant evidence from prospective studies demonstrating benefit in non–clear cell RCC variants. More recently, elucidation of aberrant oncogenic pathways in papillary, chromophobe, and other variants of RCC has paved the way for evaluation of targeted therapeutic approaches in these histologic subtypes (Linehan et al, 2009). PROGNOSTIC FACTORS
منابع مشابه
Three cases of pleural metastasis of renal clear cell carcinoma diagnosis: cases report
Background: Malignant pleural effusion is common in patients with advanced malignant tumor. The aim of this study is to analyze the characteristics of pleural metastasis of renal clear cell carcinoma, pleural effusion under medical thoracoscopy and the diagnostic value of interventional thoracoscopy-guided biopsy, and to improve the understanding of pleural metastasis of renal clear cell carcin...
متن کاملImpact of Prolonged Fraction Delivery Time Modelling Stereotactic Body Radiation Therapy with High Dose Hypofractionation on the Killing of Cultured ACHN Renal Cell Carcinoma Cell Line
Introduction: Stereotactic body radiotherapy delivers hypofractionated irradiation with high dose per fraction through complex treatment techniques. The increased complexity leads to longer dose delivery times for each fraction. The purpose of this study is to investigate the impact of prolonged fraction delivery time with high-dose hypofractionation on the killing of cultured ACHN cells.Method...
متن کاملHereditary leiomyomatosis and renal cell carcinoma (HLRCC syndrome): a case report
Recently multiple cutaneous leiomyomas, uterine leiomyoimatosis and renal cancer have been described as a cancer syndrome with autosomal dominant pattern of inheritance.We report a 79-year-old man who presented with multiple hyperkertotic erythematous nodules on his right leg with histological diagnosis of pilar leiomyoma. In his past medical history several systemic co...
متن کاملMetastatic Renal cell Carcinoma Presenting as a clear-cell Tumor in Tongue: A Case Report
Introduction: Metastatic lesions of the oral cavity are extremely rare, accounting for approximately 1% of all malignant oral tumors. The most common primary sources of metastatic tumors in the oral region are, from the most to the least common, the breast, lung, kidney, bone, and colon. Renal cell carcinoma accounts for nearly 3% of all adult malignancies. It usually metastasizes to the lungs,...
متن کاملQuick Score and H-Score Assessment of P504s (AMACR) Expression in Renal Cell Carcinoma (RCC) and Relation with Histologic Grade
Background and Aims: P504S (AMACR) is a mitochondrial enzyme expressed in renal cell carcinoma. Some of immunohistochemical markers in renal cell tumors are independent prognostic factor and show relation with histologic grading. AMACR expression increases with higher histological grading in different tumors; however, in RCC it is not obvious. In this study, we tried to investigate if ...
متن کامل