KIDNEY CANCER: NEW CONCEPTS IN EVALUATION AND MANAGEMENT
Authors:
M. L. Blute; P. R. Russo; R. Bukowski
Authors‘ workplace:
Cancer Center of Excellence University of Massachusetts Medical School
Published in:
Urol List 2010; 8(2): 6-10
Overview
Renal cancer effects more than 57,000 Americans each year and it is estimated that more than 13,000 will die of this disease in the U. S. this year. The rate of increase in incidence is 2.5 % a year and kidney cancer is now one of the top 10 malignancies in U. S. according to the American Cancer Society. This rate of increase is unlike any other GU malignancy. We now know that there is a number of different subtypes each associated with a specific genetic defect that accounts for the phenotype of each. No GU malig nancy has undergone as significant change in approach to localized or metatstatic disease in the last decade. New concepts in understanding the impact of partial vs radical nephrectomy in management of small renal masses in terms of cancer control and preservation of long-term renal function has resulted in paradigm shift away from radical nephrectomy to nephron sparing surgery. Understanding the genetic basis of kidney cancer has lead to development of targeted therapies for patients with advanced kidney cancer. Integrating these novel drugs in the management of advanced kidney cancer has initiated trials in the neoadjuvant and adjuvant setting. How cytoreductive surgery and metastasectomy are sequenced with targeted therapy is now an intensive area of clinical research.
Key words:
kidney cancer, small renal masses, cytoreductive nephrectomy, targeted therapy
Sources
1. Lau WK, Blute ML, Weaver AL et al. Matched comparison of radical nephrectomy vs nerve-sparing surgery in patients with unilateral renal cell carcinoma and a normal contralateral kidney. Mayo Clinic Proc 2000; 75: 1236–1242.
2. Leibovich BC, Blute ML, Cheville JC et al. Nephron sparing surgery for appropriately selected renal cell carcinoma between 4 and 7 cm results in outcome similar to radical nephrectomy. J Urol 2004; 171(3): 1066–1070.
3. Thompson RH, Leibovich BC, Lohse CM et al. Complications of contemporary open nephron sparing surgery: A single institution experience. J Urol 2005; 174(3): 855–858.
4. Go AS, Chertow GM, Fan D et al. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 2004; 351(13): 1296–1305.
5. Huang WC, Levey AS, Serio AM et al. Chronic kidney disease after nephrectomy in patients with renal cortical tumors: A retrospective cohort study. Lancet Oncol 2006; 7(9): 735–740.
6. Guinan P, Sobin LH, Algaba F et al. TNM staging of renal cell carcinoma: Workgroup No 3 Union Int’l Contre le Cancer (UICC) and the American Joint Committee on Cancer (AJCC). Cancer 1997; 80: 992–993.
7. Zisman A, Pantuck AJ, Dorey F et al. Improved prognostication of renal cell carcinoma using an integrated staging system. J Clin Oncol 2001; 19(6): 1649–1657.
8. Motzer RJ, Bacik J, Murphy BA et al. Interferon-alfa as a comparative treatment for clinical trials of new therapies against advanced RCC. J Clin Oncol 2002; 20(1): 289–296.
9. Thompson RH, Leibovich BC, Lohse CM et al. Dynamic outcome prediction in patients with clear cell re - nal cell carcinoma treated with radical nephrectomy. The D-SSIGN Score. J Urol 2007; 177(2): 477–480.
10. Thompson RH, Kuntz SM, Leibovich BC, et al. Tumor B7-H1 is associated with poor prognosis in renal cell carcinoma patients with long-term follow-up. Cancer Res 2006; 66(7): 3381–3385.
11. Kattan MW, Reuterr V, Motzer RJ et al. A postoperative prognostic nomogram for RCC. J Urol 2001; 166: 63.
12. Motzer RJ, Mazumdar M, Bacik J et al. Survival and prognostic stratification of 670 patients with advanced RCC. J Clin Oncol 1999; 17(8): 2530.
13. Pantuck AJ, Zisman A, Bellegrun AS. The changing natural history of RCC. J Urol 2001; 166: 1611.
14. Frank I, Blute ML, Cheville JC et al. An outcome prediction model for patients with clear cell renal cell carcinoma treated with radical nephrectomy based on tumor stage, size, grade, and necrosis: The SSIGN score. J Urol 2002; 168(6): 2395-2400.
15. Eggener SE, Yossepowitch O, Pettus JA et al. Renal cell carcinoma recurrence after nephrectomy for localized disease: Predicting survival from time of recurrence. J Clin Oncol 2006; 24(19): 3101–3106.
16. Leibovich BC, Cheville JC, Lohse CM et al. A scoring algorithm to predict survival for patients with metastatic clear cell renal cell carcinoma: A stratification tool for prospective clinical trials. J Urol 2006; 174(5): 1759–1763.
17. Blute ML, Leibovich BC, Cheville JC et al. A protocol for performing extended lymph node dissection using primary tumor pathological features for patients treated with radical nephrectomy for clear cell renal cell carcinoma. J Urol 2004; 172(2): 465–469.
18. Pantuck AJ, Zisman A, Dorey F et al. Renal cell carcinoma with retroperitoneal lymph nodes. Impact on survival and benefits of immunotherapy. Cancer 2003; 97(12): 2995–3002.
19. Ljunberg B, Landberg G, Alamdari FI. Factors of importance for prediction of survival in patients with metastatic renal cell carcinoma, treated with or without nephrectomy. Scand J Urol Nephrol 2000, 34(4): 246–251.
20. Flanigan RC, Salmon SE, Blumenstein BA et al. Nephrectomy followed by interferon alfa-2b compared with interferon alfa-2b alone for metastatic renal cell cancer. New Engl J Med 2001; 345(23): 1655–1659.
21. Flanigan RC, Mickisch G, Sylvester R et al. Cyto reductive nephrectomy in patients with metastatic renal cancer: A combined analysis. J Urol 2004; 171(3): 1071–1076.
22. Mosharafa A, Koch M, Shalhav A et al. Nephrectomy for metastatic renal cell carcinoma: Indiana Uni - versity experience. Urology 2003; 62(4): 636–640.
23. Rackley R, Novick A, Klein E et al. The impact of adjuvant nephrectomy on multimodality treatment of metastatic renal cell carcinoma. J Urol 1994; 152: 1399–1403.
24. Figlin RA, Pierce WC, Kaboo R et al. Treatment of meta static RCC with nephrectomy, interleukin -2 and cyto kine primed or CD8 (+) selected tumor infiltrating lymphocytes from primary tumor. J Urol 1997; 158: 740–745.
25. Levy DA, Swanson DA, Slaton JW et al. Timely delivery of biological therapy after cytoreductive nephrectomy in carefully selected patients with metastatic renal cell carcinoma. J Urol 1998; 159(4): 1168–1173.
26. Linehan, WM, Walther MM, Zbar B. The genetic basis of cancer of the kidney. J Urol 2003; 170: 2163–2172.
27. Russo P, Snyder M, Vickers A et al. Cytoreductive nephrectomy and nephrectomy/complete metastasec tomy for renal cancer. ScientificWorldJournal 2007; 7: 768–778.
28. Russo P. Renal cell carcinoma: presentation, staging, and surgical treatment. Semin Oncol 2000; 27(2): 160–176.
29. Russo P, Goetzl M, Simmons R et al. Partial nephrectomy: The rationale for expanding the indications. Ann Surg Oncol 2002; 9(7): 680–687.
30. Lau WK, Blute ML, Weaver AL et al. Matched comparison of radical nephrectomy vs nephron-sparing surgery in patients with unilateral renal cell carcinoma and a normal contralateral kidney. Mayo Clinic Proc 2000; 75: 1236–1242.
31. Miller DC, Hollingsworth JM, Hafez KS et al. Partial nephrectomy for small renal masses. An emerging quality of care concern? J Urol 2006; 175: 853–857.
32. Dechet CB, Zincke H, Sebo TJ et al. Prospective analysis of computerized tomography and needle biopsy with permanent sectioning to determine the nature of solid renal masses in adults. J Urol 2003; 169(1): 71–74.
33. Motzer RJ, Hutson TE, Tomczak P et al: Sunitinib versus interferon alfa in metastatic renal-cell carcinoma.
N Engl J Med 2007; 356(2): 115–124.
34. Escudier B, Eisen T, Stadler WM et al: Sorafenib in advanced clear-cell renal-cell carcinoma. N Engl J Med 2007; 356(2): 125–134.
35. Hudes G, Carducci M, Tomczak P et al: Temsirolimus, interferon alfa, or both for advanced renal-cell carcinoma. N Engl J Med 2007; 356(22): 2271–2281.
36. Motzer RJ, Escudier B, Oudard S et al: Efficacy of everolimus in advanced renal cell carcinoma: a double- blind, randomized, placebo-controlled phase III trial. Lancet 2008; 372(9637): 449–456.
37. Escudier B, Pluzanska A, Koralewski P et al: Bevacizumab plus interferon alfa-2a for treatment of metastatic renal cell carcinoma: A randomized double-blind phase III trial. Lancet 2007; 370(9605): 2103–2111.
38. Rini BI, Halabi S, Rosenberg JE et al. Bevacizumab plus interferon alfa compared with interferon alfa monotherapy in patients with metastatic renal cell carcinoma: CALGB 90206. J Clin Oncol 2008; 26(33): 5422–5428.
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