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Treatment of Renal Cell Carcinomas

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Urological Cancer Management

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Abstract

Small renal masses (SRMs) are defined as lesions ≤4 cm in dimension, i.e. T1a. They are an increasingly common clinical scenario for practising urologists and physicians, and contemporary epidemiological studies indicate that SRMs account for nearly one half of all renal masses diagnosed. SRMs are biologically heterogeneous with 20 % being benign lesions, while 20–30 % others are potentially aggressive at the time of diagnosis [1] (Fig. 16.1).

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Notes

  1. 1.

    National Comprehensive Cancer Network.

References

  1. Rao K, Royce PL. Incidentally detected small renal masses – investigation and management. Aust Fam Physician. 2011;40(10):776–82.

    PubMed  Google Scholar 

  2. Campbell SC, Novick AC, Belldengrun A, et al. Guidelines for the management of the Clinical stage 1 Renal Mass. J Urol. 2009;182(4):1271–9.

    Google Scholar 

  3. Chawla SN, Crispen PL, Hanlon AL, Greenberg RE, Chen DY, Uzzo RG. The natural history of observed enhancing renal masses: meta-analysis and review of the world literature. J Urol. 2006;175(2):425–31.

    Article  PubMed  Google Scholar 

  4. Kunkle DA, Crispen PL, Chen DY, Greenberg RE, Uzzo RG. Enhancing renal masses with zero net growth during active surveillance. J Urol. 2007;177(3):849–53; discussion 853–4.

    Article  PubMed  Google Scholar 

  5. Kunkle DA, Crispen PL, Li T, Uzzo RG. Tumour size predicts synchronous metastatic renal cell carcinoma: implications for surveillance of small renal masses. J Urol. 2007;177(5):1692–6; discussion 1697.

    Article  PubMed  Google Scholar 

  6. Pierorazio PM, Hyams ES, Mullins JK, Allaf ME. Active surveillance for small renal masses. Rev Urol. 2012;14(1–2):13–9.

    PubMed Central  PubMed  Google Scholar 

  7. McGahan JP, Browning PD, Brock JM, Tesluk H. Hepatic ablation using radiofrequency electrocautery. Invest Radiol. 1990;25:267–70.

    Article  CAS  PubMed  Google Scholar 

  8. Ahrar K, Ahrar JU, Javadi S, Pan L, Milton DR, Wood CG, Matin SF, Stafford RJ. Real-time magnetic resonance imaging-guided cryoablation of small renal tumours at 1.5 T. Invest Radiol. 2013;48(6):437–44.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Truesdale CM, Soulen MC, Clark TW, Mondschein JI, Wehrenberg-Klee E, Malkowicz SB, Wein AJ, Guzzo TJ, Stavropoulos SW. Percutaneous computed tomography-guided renal mass radiofrequency ablation versus cryoablation: doses of sedation medication used. J Vasc Interv Radiol. 2013;24(3):347–50.

    Article  PubMed  Google Scholar 

  10. Ljungberg B, Bensalah K, Bex A, et al. Guidelines on renal cell carcinoma. EAU update. Apr 2014. http://uroweb.org/wp-content/uploads/10-Renal-Cell-Carcinoma_LR.pdf.

  11. Margulis V, Sánchez-Ortiz RF, Tamboli P, Cohen DD, Swanson DA, Wood CG. Renal cell carcinoma clinically involving adjacent organs: experience with aggressive surgical management. Cancer. 2007;109(10):2025–30.

    Article  PubMed  Google Scholar 

  12. Robson CJ. Radical nephrectomy for renal cell carcinoma. J Urol. 1963;89:37–42.

    CAS  PubMed  Google Scholar 

  13. Colombo Jr JR, Haber GP, Aron M, Cocuzza M, Colombo R, Kaouk J, Gill IS. Oncological outcomes of laparoscopic radical nephrectomy for renal cancer. Clinics (Sao Paulo). 2007;62(3):251–6.

    Article  Google Scholar 

  14. Fan X, Xu K, Lin T, Liu H, Yin Z, Dong W, Huang H, Huang J. Comparison of transperitoneal and retroperitoneal laparoscopic nephrectomy for renal cell carcinoma: a systematic review and meta-analysis. BJU Int. 2013;111(4):611–2.

    Article  PubMed  Google Scholar 

  15. Lane BR, Tiong HY, Campbell SC, Fergany AF, Weight CJ, Larson BT, Novick AC, Flechner SM. Management of the adrenal gland during partial nephrectomy. J Urol. 2009;181(6):2430–6.

    Article  PubMed  Google Scholar 

  16. Blom JH, van Poppel H, Maréchal JM, Jacqmin D, Schröder FH, de Prijck L, Sylvester R, EORTC Genitourinary Tract Cancer Group. Radical nephrectomy with and without lymph-node dissection: final results of European Organization for Research and Treatment of Cancer (EORTC) randomized phase 3 trial 30881. Eur Urol. 2009;55(1):28–34.

    Article  PubMed  Google Scholar 

  17. Gill IS, Kavoussi LR, Lane BR, Blute ML, Babineau D, Colombo Jr JR, Frank I, Permpongkosol S, Weight CJ, Kaouk JH, Kattan MW, Novick AC. Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumours. J Urol. 2007;178(1):41–6.

    Article  PubMed  Google Scholar 

  18. Marszalek M, Meixl H, Polajnar M, Rauchenwald M, Jeschke K, Madersbacher S. Laparoscopic and open partial nephrectomy: a matched-pair comparison of 200 patients. Eur Urol. 2009;55(5):1171–8.

    Article  PubMed  Google Scholar 

  19. Tugcu V, Bitkin A, Sonmezay E, Polat H, Ilbey YO, Taşçi AI. Transperitoneal versus retroperitoneal laparoscopic partial nephrectomy: initial experience. Arch Ital Urol Androl. 2011;83(4):175–80.

    PubMed  Google Scholar 

  20. Li W, Cheng Y, Cheng Y, Ren H, Han N. Clinical efficacy of radical nephrectomy versus nephron-sparing surgery on localized renal cell carcinoma. Eur J Med Res. 2014;19(1):58. doi:10.1186/s40001-014-0058-4. Published online Nov 6, 2014.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Badalato GM, Kates M, Wisnivesky JP, Choudhury AR, McKiernan JM. Survival after partial and radical nephrectomy for the treatment of stage T1bN0M0 renal cell carcinoma (RCC) in the USA: a propensity scoring approach. BJU Int. 2012;109(10):1457–62.

    Article  PubMed  Google Scholar 

  22. Thompson RH, Lane BR, Campbell SC, et al. Every minute counts when the renal hilum is clamped during partial nephrectomy. Eur Urol. 2010;58(3):340–5.

    Article  PubMed  Google Scholar 

  23. Aboumarzouk OM, Stein RJ, Eyraud R, Haber GP, Chlosta PL, Somani BK, Kaouk JH. Robotic versus laparoscopic partial nephrectomy: a systematic review and meta-analysis. Eur Urol. 2012;62(6):1023–33.

    Article  PubMed  Google Scholar 

  24. Marszalek M, Carini M, Chlosta P, et al. Positive surgical margins after nephron-sparing surgery. Eur Urol. 2012;61:757–63.

    Article  PubMed  Google Scholar 

  25. Yilmaz H, Ciftci S, Ozkan L, Saribacak A, Yildiz K, Dillioglugil O. Gross intraoperative evaluation (GIE): a reliable method for the evaluation of surgical margins at partial nephrectomy. Int J Clin Exp Med. 2014;7(3):792–8.

    PubMed Central  PubMed  Google Scholar 

  26. Steinestel J, Steffens S, Steinestel K, Schrader AJ. Positive surgical margins in nephron-sparing surgery: risk factors and therapeutic consequences. World J Surg Oncol. 2014;12:252.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Borghesi M, Brunocilla E, Schiavina R, Martorana G. Positive surgical margins after nephron-sparing surgery for renal cell carcinoma: incidence, clinical impact, and management. Clin Genitourin Cancer. 2013;11(1):5–9.

    Article  PubMed  Google Scholar 

  28. Mootha RK, Butler R, Laucirica R, Scardino PT, Lerner SP. Renal cell carcinoma with infrarenal vena caval tumour thrombus. Urology. 1999;54:561–5.

    Article  CAS  PubMed  Google Scholar 

  29. Wotkowicz C, Wszolek MF, Libertino JA. Resection of renal tumours invading Vena cava. Urol Clin North Am. 2008;35:657–71.

    Article  PubMed  Google Scholar 

  30. Nouh MA, Inui M, Kakehi Y. Renal cell carcinoma with IVC thrombi; current concepts and future perspectives. Clin Med Oncol. 2008;2:247–56.

    PubMed Central  PubMed  Google Scholar 

  31. Lawrentschuk N, Gani J, Riordan R, Esler S, Bolton DM. Multidetector computed tomography vs magnetic resonance imaging for defining the upper limit of tumour thrombus in renal cell carcinoma: a study and review. BJU Int. 2005;96:291–5.

    Article  PubMed  Google Scholar 

  32. Lawindy SM, Kurian T, Kim T, Mangar D, Armstrong PA, Alsina AE, Sheffield C, Sexton WJ, Spiess PE. Important surgical considerations in the management of renal cell carcinoma (RCC) with inferior vena cava (IVC) tumour thrombus. BJU Int. 2012;110(7):926–39.

    Article  PubMed  Google Scholar 

  33. Flanigan RC, Mickisch G, Sylvester R, Tangen C, Van Poppel H, Crawford ED. Cytoreductive nephrectomy in patients with metastatic renal cancer: a combined analysis. J Urol. 2004;171(3):1071–6.

    Article  PubMed  Google Scholar 

  34. Choueiri TK, Xie W, Kollmannsberger C, North S, Knox JJ, Lampard JG, McDermott DF, Rini BI, Heng DY. The impact of cytoreductive nephrectomy on survival of patients with metastatic renal cell carcinoma receiving vascular endothelial growth factor targeted therapy. J Urol. 2011;185(1):60–6.

    Article  PubMed  Google Scholar 

  35. Amiraliev A, Pikin O, Alekseev B, Kalpinksiy A. Treatment strategy in patients with pulmonary metastases of renal cell cancer. Interact CardioVasc Thorac Surg. 2012;15 suppl 1:SXIII–F068.

    Google Scholar 

  36. Staehler MD, Kruse J, Haseke N, Stadler T, Roosen A, Karl A, Stief CG, Jauch KW, Bruns CJ. Liver resection for metastatic disease prolongs survival in renal cell carcinoma: 12-year results from a retrospective comparative analysis. World J Urol. 2010;28(4):543–7.

    Article  PubMed  Google Scholar 

  37. Ballarin R, Spaggiari M, Cautero N. Pancreatic metastases from renal cell carcinoma: the state of the art. World J Gastroenterol. 2011;17(43):4747–56.

    Article  PubMed Central  PubMed  Google Scholar 

  38. Al-Busaidy SA, George K, Kamona A, Samarasinghe DS. Renal cell carcinoma: synchronous contralateral ureteric metastasis. Br J Med Surg Urol. 2011;4:86–8.

    Article  Google Scholar 

  39. Skolarikos A, Alivizatos G, Laguna P, de la Rosette J. A review of follow up strategies for renal cell carcinoma after nephrectomy. Eur Urol. 2007;51(6):1490–500.

    Article  PubMed  Google Scholar 

  40. Sahi C, Knox JJ, Clemons M, Joshua AM, Broom R. Renal cell carcinoma bone metastases: clinical advances. Ther Adv Med Oncol. 2010;2(2):75–83.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  41. Henry DH, Costa L, Goldwasser F, et al. Randomized, double-blind study of denosumab versus zoledronic acid in the treatment of bone metastases in patients with advanced cancer (excluding breast and prostate cancer) or multiple myeloma. J Clin Oncol. 2011;29(9):1125–32.

    Article  CAS  PubMed  Google Scholar 

  42. Fokas E, Henzel M, Hamm K, Surber G, Kleinert G, Engenhart-Cabillic R. Radiotherapy for brain metastases from renal cell cancer: should whole-brain radiotherapy be added to stereotactic radiosurgery?: analysis of 88 patients. Strahlenther Onkol. 2010;186(4):210–7.

    Article  PubMed  Google Scholar 

  43. Motzer RJ, Bacik J, Murphy BA, et al. Interferon-alfa as a comparative treatment for clinical trials of new therapies against advanced renal cell carcinoma. J Clin Oncol. 2002;20:289–96.

    Article  CAS  PubMed  Google Scholar 

  44. Heng DY, Xie W, Regan MM, et al. Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: results from a large, multicenter study. J Clin Oncol. 2009;27(34):5794–9.

    Article  CAS  PubMed  Google Scholar 

  45. Kwon WA, Cho IC, Yu A, et al. Validation of the MSKCC and Heng risk criteria models for predicting survival in patients with metastatic renal cell carcinoma treated with sunitinib. Ann Surg Oncol. 2013;20(13):4397–404.

    Article  PubMed  Google Scholar 

  46. Heng DY, Xie W, Regan MM, et al. External validation and comparison with other models of the International Metastatic Renal-Cell Carcinoma Database Consortium prognostic model: a population-based study. Lancet Oncol. 2013;14(2):141–8.

    Article  PubMed Central  PubMed  Google Scholar 

  47. NCCN (National Comprehensive Cancer Network, Inc. 2014) Clinical Practice Guidelines in Oncology. Kidney Cancer. Version I. 2015.

    Google Scholar 

  48. Hanzly M, Aboumohamed A, Yarlagadda N. High-dose interleukin-2 therapy for metastatic renal cell carcinoma: a contemporary experience. Urology. 2014;83(5):1129–34.

    Article  PubMed  Google Scholar 

  49. Coppin C, Porzsolt F, Awa A, Kumpf J, Coldman A, Wilt T. Immunotherapy for advanced renal cell cancer. Cochrane Database Syst Rev. 2005;(1):CD001425.

    Google Scholar 

  50. Motzer RJ, Hutson TE, Tomczak P, et al. Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med. 2007;356:115–24.

    Article  CAS  PubMed  Google Scholar 

  51. Motzer RJ, Hutson TE, Cella D, et al. Pazopanib versus sunitinib in metastatic renal-cell carcinoma. N Engl J Med. 2013;369:722–31.

    Article  CAS  PubMed  Google Scholar 

  52. Escudier B, Bellmunt J, Négrier S, et al. Phase III trial of bevacizumab plus interferon alfa-2a in patients with metastatic renal cell carcinoma (AVOREN): final analysis of overall survival. J Clin Oncol. 2010;28(13):2144–50.

    Article  CAS  PubMed  Google Scholar 

  53. Rini BI, Halabi S, Rosenberg JE, Stadler WM, Vaena DA, Archer L, Atkins JN, Picus J, Czaykowski P, Dutcher J, Small EJ. Phase III trial of bevacizumab plus interferon alfa versus interferon alfa monotherapy in patients with metastatic renal cell carcinoma: final results of CALGB 90206. J Clin Oncol. 2010;28(13):2137–43.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  54. Motzer RJ, Escudier B, Tomczak P, et al. Axitinib versus sorafenib as second-line treatment for advanced renal cell carcinoma: overall survival analysis and updated results from a randomised phase 3 trial. Lancet Oncol. 2013;14(6):552–62.

    Article  CAS  PubMed  Google Scholar 

  55. 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):2271–81.

    Article  CAS  PubMed  Google Scholar 

  56. Motzer RJ, Escudier B, Oudard S, et al. Efficacy of everolimus in advanced renal cell carcinoma: a double-blind, randomised, placebo-controlled phase III trial. Lancet. 2008;372(9637):449–56.

    Article  CAS  PubMed  Google Scholar 

  57. Lee JL, Ahn JH, Lim HY, Park SH, et al. Multicenter phase II study of sunitinib in patients with non-clear cell renal cell carcinoma. Ann Oncol. 2012;23(8):2108–14.

    Article  PubMed  Google Scholar 

  58. Gordon MS, Hussey M, Nagle RB, et al. Phase II study of erlotinib in patients with locally advanced or metastatic papillary histology renal cell cancer: SWOG S0317. J Clin Oncol. 2009;27(34):5788–93.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  59. Shuch B, Bratslavsky G, Linehan WM, Srinivasan R, et al. Sarcomatoid renal cell carcinoma: a comprehensive review of the biology and current treatment strategies. Oncologist. 2012;17(1):46–54.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  60. Molina AM, Tickoo SK, Ishill N, et al. Sarcomatoid-variant renal cell carcinoma: treatment outcome and survival in advanced disease. Am J Clin Oncol. 2011;34(5):454–9.

    Article  PubMed Central  PubMed  Google Scholar 

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Authors and Affiliations

  1. Urology Department, The Royal Hospital, Muscat, Oman

    Santhosh Narayana Kurukkal & Salim Said Al-Busaidy (Senior Consultant and HOD)

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  1. Santhosh Narayana Kurukkal
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Correspondence to Santhosh Narayana Kurukkal .

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  1. Urology Department, The Royal Hospital, Muscat, Oman

    Said Abdallah Al-Mamari

  2. Urology Department, The Royal Hospital, Muscat, Oman

    Salim Said Al-Busaidy

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Kurukkal, S.N., Al-Busaidy, S.S. (2015). Treatment of Renal Cell Carcinomas. In: Al-Mamari, S., Al-Busaidy, S. (eds) Urological Cancer Management. Springer, Cham. https://doi.org/10.1007/978-3-319-16301-7_16

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