Partial versus radical nephrectomy for renal cell carcinoma

2018 ◽  
Vol 2 (2-3) ◽  
pp. 69-77
Author(s):  
Kenar D Jhaveri ◽  
Phillip Pierorazio ◽  
Susie L Hu
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Cell Carcinoma ◽  
Kidney Disease ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Complex Disease ◽  
Disease Risk ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Chronic Kidney Disease Risk

Chronic kidney disease risk is increased among patients with renal cell carcinoma, particularly for those with preexisting chronic kidney disease (including proteinuria) but also for those with comorbidities such as diabetes mellitus, hypertension, and obesity. Among those with small renal masses without complex disease, partial nephrectomy should be prioritized given favorable pathologic prognosis and mortality related to cardiovascular disease or chronic kidney disease. Nephrologists should actively participate in a multidisciplinary team to help formulate individualized treatment which will help preserve residual kidney function where possible.

scholarly journals MP39-01 CHARACTERIZING RECURRENT AND LETHAL SMALL RENAL MASSES IN CLEAR CELL RENAL CELL CARCINOMA USING SOMATIC MUTATIONS

2017 ◽  
Vol 197 (4S) ◽  
Author(s):  
Brandon Manley ◽  
Ed Reznik ◽  
Maria Becerra ◽  
Jozefina Casuscelli ◽  
Daniel Tennenbaum ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Somatic Mutations ◽  
Clear Cell ◽  
Small Renal Masses ◽  
Cell Renal Cell Carcinoma ◽  
Renal Masses

Treating the Two Extremes in Renal Cell Carcinoma: Management of Small Renal Masses and Cytoreductive Nephrectomy in Metastatic Disease

2014 ◽  
pp. e214-e221 ◽  
Author(s):  
Dae Y. Kim ◽  
Christopher G. Wood ◽  
Jose A. Karam
Keyword(s):  
Renal Cell Carcinoma ◽  
Targeted Therapy ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Mass ◽  
Cytoreductive Nephrectomy ◽  
Renal Cell Carcinomas ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Renal Mass Biopsy

OVERVIEW: The incidental renal mass represents a heterogeneous group that contains both benign and malignant pathologies. The majority of renal cell carcinomas are discovered incidentally, without the presence of symptoms directly related to the mass, and are closely associated with the term small renal masses because of the discovery before the onset of symptoms. In general, small renal masses are defined as 4 cm or smaller, and may account for greater than half of renal cell carcinoma diagnosis. The use of renal mass biopsy may offer additional pathological information but the clinician must be reminded of the technical and diagnostic limitations of renal mass biopsy. Patient-dependent factors, such as life expectancy and comorbidities, guide the management of small renal masses, which include active surveillance, partial nephrectomy, radical nephrectomy, and ablative techniques (cryoablation and radiofrequency ablation). Partial nephrectomy has demonstrated durable oncologic control for small renal masses while preserving renal function and, if feasible, is the current treatment of choice. In the other extreme of the renal cell carcinomas spectrum and in the presence of metastatic disease, the removal of the renal primary tumor is termed cytoreductive nephrectomy. Two randomized trials (SWOG 8949 and EORTC 30947) have demonstrated a survival benefit with cytoreductive nephrectomy before the initiation of immunotherapy. These two studies have also been the motivation to perform cytoreductive nephrectomy in the targeted therapy era. Currently, there are two ongoing randomized prospective trials accruing to investigate the timing and relevance of cytoreductive nephrectomy in the contemporary setting of targeted therapy.

scholarly journals Geographic Variation of Chronic Kidney Disease Prevalence: Correlation with the Incidence of Renal Cell Carcinoma or Urothelial Carcinoma?

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Yit-Sheung Yap ◽  
Kai-Wen Chuang ◽  
Chun-Ju Chiang ◽  
Hung-Yi Chuang ◽  
Sheng-Nan Lu
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Cell Carcinoma ◽  
Kidney Disease ◽  
Urothelial Carcinoma ◽  
Cell Carcinoma ◽  
Late Stage ◽  
Renal Cell ◽  
Risk Groups ◽  
Incidence Rates ◽  
Geographic Variations

Background. The aim of this study is to evaluate whether geographic variations in the prevalence of late-stage chronic kidney disease (CKD) exist and are associated with incidence rates of renal cell carcinoma (RCC), upper tract urothelial carcinoma (UTUC), or lower tract urothelial carcinoma (LTUC).Methods. Prevalence rates of late-stage CKD for 366 townships (n>30) in Taiwan were calculated for 1,518,241 and 1,645,151 subjects aged 40 years or older in years 2010 and 2009, respectively. Late-stage CKD prevalence in year 2010 was used as a training set and its age-adjusted standardized morbidity rates (ASMR) were divided into three groups as defined <1.76%, 1.76% ≤ ASMR < 2.64%, and ≥2.64%, respectively. Year 2009, defined as the validation set, was used to validate the results.Results. The ASMR of late-stage CKD in years 2010 and 2009 were 1.76%, and 2.09%, respectively. Geographic variations were observed, with notably higher rates of disease in areas of the central, southwestern mountainside, and southeastern seaboard. There were no significant differences among different combined risk groups of RCC, UTUC, and LTUC incidence.Conclusion. The substantial geographic variations in the prevalence of late-stage CKD exist, but are not correlated with RCC, UTUC, or LTUC incidence.

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