Renal Cell Carcinoma: Oncologist Point of View

Abstract

Kidney cancer is among the ten most frequently diagnosed cancers in the United States, with more than an estimated 65,000 new cases and 14,900 deaths in 2018 (Siegel et al., CA Cancer J Clin 68(4):284–296, 2018). Per the Surveillance, Epidemiology, and End Results Program database of the National Institutes of Health, the median age at diagnosis of kidney cancer is 64 years. It is more common in men than in women and among African Americans and American Indian and Alaska Native populations (SEER Cancer Stat Facts: Kidney and Renal Pelvis Cancer. National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/statfacts/html/kidrp.html). Kidney cancer’s incidence has increased on average 0.7% each year over the last 10 years, while death rates declined on average 0.9% each year over 2005–2014 (SEER Cancer Stat Facts: Kidney and Renal Pelvis Cancer. National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/statfacts/html/kidrp.html). Screening for the disease is not standard. Current 5-year survival rates are 76% overall, including 66.7% among patients with regional disease and 11.7% among patients with metastatic disease (SEER Cancer Stat Facts: Kidney and Renal Pelvis Cancer. National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/statfacts/html/kidrp.html). Renal cell carcinoma (RCC), the most common form of kidney cancer arising from the nephron and the subject of this chapter, occurs in approximately 90% of cases, and 70–80% of these are clear cell tumors. Other less common cell types with different histologic, molecular, and genetic alterations include papillary, chromophobe, translocation, Bellini duct (collecting duct), and medullary tumors.