The Role of Radiotherapy for Adult Renal Cell Carcinoma

1992 ◽  
Vol 59 (6) ◽  
pp. 71-74
Author(s):  
S. Dal Fior ◽  
A. Bordin ◽  
T. Iannone
Keyword(s):  
Renal Cell Carcinoma ◽  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Metastatic Disease ◽  
Local Control ◽  
Renal Cell ◽  
Survival Rates ◽  
Long Survival ◽  
Radiotherapy Techniques

In this paper the most important articles about the role of radiotherapy for renal cell carcinoma (CPR) are reviewed. Both pre- and post-operative radiotherapy do not seem to improve the survival rates, nor perhaps the local control in comparison with surgery. But trials have been limited and with evident bias: patients were staged without stratification for prognostic factors (grading and lymphonode metastases in particular) and radiotherapy techniques were often incorrect because of too frequent early and late damage. The role of radiotherapy for treating the metastatic disease is undisputed Particularly for patients with a single metastasis, because of the possibility of long survival if adequately controlled.

Role of Surgery for Locally Advanced and Metastatic Renal Cell Carcinoma

2011 ◽  
Vol 9 (9) ◽  
pp. 985-993 ◽  
Author(s):  
Robert Torrey ◽  
Philippe E. Spiess ◽  
Sumanta K. Pal ◽  
David Josephson
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Metastatic Disease ◽  
Renal Cell ◽  
Locally Advanced ◽  
Disease Stage ◽  
Disease Characteristics ◽  
Multimodal Management

Both locally advanced and metastatic renal cell carcinoma (RCC) present a challenge in terms of their optimal management. This article reviews the literature and evaluates the role of surgery in the treatment of advanced RCC. Surgery is the optimal treatment for locally advanced RCC and minimal, resectable, metastatic disease. Patients with metastatic disease, and some forms of locally advanced disease, may also benefit from multimodal management with local surgical therapy and systemic treatment using either immunotherapy or targeted therapy. Regardless of the disease stage, patients with locally advanced or metastatic RCC represent heterogenous patient populations with different disease characteristics and risk factors. Individualization of care in the setting of a sound oncologic framework may optimize the risk/benefit ratio within individual patient cohorts.

scholarly journals The Current Role of Lymph Node Dissection in the Management of Renal Cell Carcinoma

2011 ◽  
Vol 2011 ◽  
pp. 1-5
Author(s):  
Joseph Edmund Jamal ◽  
Thomas William Jarrett
Keyword(s):  
Renal Cell Carcinoma ◽  
Lymph Node ◽  
Cell Carcinoma ◽  
Lymph Node Dissection ◽  
Metastatic Disease ◽  
Renal Cell ◽  
Node Dissection ◽  
Regional Lymph Nodes ◽  
Renal Masses

The role of lymph node dissection remains controversial in the surgical management of renal cell carcinoma. Incidental renal masses are being diagnosed at increasing rates due to the routine use of CT scans. Despite the increase in incidental diagnosis of renal masses, 20% to 30% of patients present with metastatic disease. Currently, surgeons do not routinely perform lymph node dissection unless there is gross evidence of lymphadenopathy, as patients without clinical evidence of lymphadenopathy rarely have positive nodes at the time of surgery. Patients with metastatic disease to the regional lymph nodes have a poor overall prognosis. However, some evidence supports a therapeutic benefit of lymphadenectomy in these patients. Further, the staging information gained from diagnosing lymph node involvement may allow for the use of new agents to treat metastatic disease and effect outcomes.

Prognostic factors in patients with pancreatic metastases from renal cell carcinoma (PM-RCC): Room for thinking about the role of surgery?

2014 ◽  
Vol 32 (15_suppl) ◽  
pp. e15563-e15563
Author(s):  
Matteo Santoni ◽  
Alessandro Conti ◽  
Camillo Porta ◽  
Linda Cerbone ◽  
Giuseppe Procopio ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Pancreatic Metastases

scholarly journals Prognostic Value of Thyroid Hormone Ratio in Patients With Advanced Metastatic Renal Cell Carcinoma: Results From the Threefour Study (Meet-URO 14)

2021 ◽  
Vol 11 ◽  
Author(s):  
Marco Maruzzo ◽  
Elena Verzoni ◽  
Maria Giuseppa Vitale ◽  
Michele Dionese ◽  
Sebastiano Buti ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Prognostic Factors ◽  
Thyroid Hormone ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Progression Free Survival ◽  
Free Survival ◽  
Line Setting

BackgroundThyroid hormone impairment, represented as an alteration in levels of thyroid hormones and a lower fT3/fT4 ratio, has been correlated with a worse prognosis for both cancer and non-cancer patients. The role of baseline thyroid function in patients with metastatic renal cell carcinoma (mRCC) however, has not been studied yet.Materials and MethodsWe recorded clinical data, baseline biochemical results, and oncological outcomes from 10 Oncology Units in Italy. We stratified patients into three groups according to the fT3/fT4 ratio value and subsequently analyzed differences in progression-free survival (PFS) and overall survival (OS) in the three groups. We also performed univariate and multivariate analyses to find prognostic factors for PFS and OS.ResultsWe analyzed 134 patients treated with systemic treatment for mRCC. Median PFS in the low, intermediate, and high fT3/fT4 ratio group were 7.5, 12.1, and 21.7 months respectively (p<0.001); median OS in the three groups were 36.5, 48.6, and 70.5 months respectively (p =0.006). The low fT3/fT4 ratio maintained its prognostic role at the multivariate analysis independently from IMDC and other well-established prognostic factors. The development of iatrogenic hypothyroidism was not associated with a better outcome.ConclusionWe found that baseline thyroid hormone impairment, represented by a low fT3/fT4 ratio, is a strong prognostic factor in patients treated for mRCC in first line setting and is independent of other parameters currently used in clinical practice.

Prognostic factors and survial of advanced renal cell carcinoma with predominant sarcomatoid histology.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 400-400
Author(s):  
I. Park ◽  
J. Lee ◽  
J. Ahn ◽  
D. Lee ◽  
C. Song ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Metastatic Disease ◽  
Renal Cell ◽  
Clinical Course ◽  
Performance Status ◽  
Sarcomatoid Carcinoma ◽  
Response To Treatment ◽  
Pathologic Features

400 Background: Sarcomatoid renal cell carcinoma (SRCC) is known to have aggressive clinical course and poor response to treatment. Very limited data of clinical feature, prognostic factor, and survival are available for advanced disease with predominant sarcomatoid histology. We evaluated clinical features, response to treatment, and prognostic factors for survival. Methods: Between 2001 and 2010, 30 patients with metastatic or recurrent RCC with predominant sarcomatoid histology (sarcomatoid component 30% or more for resected kidney or exclusive sarcomatoid carcinoma on needle biopsy) were treated at our institution. We reviewed these patients' records to identify clinical and pathologic features which could affect survival. The role of nephrectomy and systemic therapy on patient outcome was also investigated. Results: There were 20 male and 10 female patients with a median age of 58 years (range, 43–83). Twenty patients had initially metastatic disease and 16 patients (53%) had ECOG performance status (PS) of 0–1. The most frequent metastatic site was lung (57%) followed by bone (43%) and distant lymph nodes (23%). Fourteen (70%) out of 20 patients with initially metastatic disease underwent primary nephrectomy and six patients also underwent metastasectomy. The median % of sarcomatoid component was 80% (range, 30–100%). All patients (N=10) who received immunotherapy had progressive disease as their best response and only one out of 5 patients treated with sunitinib or everolimus had a partial response. With a median follow-up duration of 22 months, the median survival was 3.6 months (95% CI, 0∼7.5) with 6-month survival rate of 43%. Only ECOG PS had impact on survival (P<0.001: ECOG=0, 14.1 months; ECOG=1, 7.4 months; ECOG=2, 3.2 months, and ECOG=3, 1.64 months). Survivals for initially metastatic disease were not significantly different whether patients underwent nephrectomy or not (2.0 months vs. 3.4 months, HR=0.62, 95% CI, 0.16–2.44 after correcting for potential prognostic factors). Conclusions: Patients with SRCC have a fulminant clinical course and the majority of patients had disease progression irrespective of any treatment. Only performance status dose have impact on overall survival. No significant financial relationships to disclose.

scholarly journals Cytoreductive Nephrectomy for Metastatic Renal Cell Carcinoma: A Review of the Historical Literature and Its Role in the Era of Targeted Molecular Therapy

ISRN Urology ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Muhammad Z. Aslam ◽  
P. N. Matthews
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Disease ◽  
Renal Cell ◽  
Potential Role ◽  
Standard Of Care ◽  
Molecular Therapy ◽  
Targeted Molecular Therapy ◽  
Cytoreductive Nephrectomy

Renal cell carcinoma presents with metastatic disease in approximately 30% cases. While surgical intervention remains the standard of care for organ confined disease, its role is limited in the management of metastatic disease. Over the last decade, cytoreductive nephrectomy prior to immunotherapy has demonstrated significant improvement in overall survival for appropriately selected patients. This review summarizes the evidence for the role of cytoreductive nephrectomy in combination with immunotherapy and discusses its potential role in the current era of targeted molecular therapy.

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