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Review
. 2016 Sep 5;113(35-36):590-6.
doi: 10.3238/arztebl.2016.0590.

The Diagnosis, Treatment, and Follow-up of Renal Cell Carcinoma

Christian Doehn  1 , Viktor Grünwald, Thomas Steiner, Markus Follmann, Heidrun Rexer, Susanne Krege
Affiliations
Review

The Diagnosis, Treatment, and Follow-up of Renal Cell Carcinoma

Christian Doehn et al. Dtsch Arztebl Int. .

Abstract

Background: In 2014, 15 500 persons in Germany were given the diagnosis of renal cell carcinoma. This disease is the third most common cancer of the urogenital system. The mean age at diagnosis is 68 years in men and 71 in men.

Methods: Pertinent publications up to 2014 were retrieved by a systematic literature search and reviewed in a moderated, formalized consensus process. Key questions were generated and answered by the adaptation of existing international guidelines, on the basis of an independent literature review, and by expert consensus. Representatives of 30 medical specialty societies, patient self-help groups, and other organizations participated in the process.

Results: The search for guidelines yielded 80 hits, 23 of which were judged by DELBI to be potentially relevant; 7 were chosen for adaptation. Smoking, obesity, and hypertension increase the risk of renal cell carcinoma. Its 5-year survival rate is 75% for men and 77% for women. Renal cell carcinoma accounts for 2.6% of all deaths from cancer in men and 2.1% in women. Nephrectomy and partial nephrectomy are the standard treatments. Locally confined tumors in clinical stage T1 should be treated with kidney-preserving surgery. Minimally invasive surgery is often possible as long as the surgeon has the requisite experience. For patients with metastases, overall and progression-free survival can be prolonged with VEGF and mTOR inhibitors. The resection or irradiation of metastases can be a useful palliative treatment for patients with brain metastases or osseous metastases that are painful or increase the risk of fracture.

Conclusion: Minimally invasive surgery and new systemic drugs have expanded the therapeutic options for patients with renal cell carcinoma. The search for new predictive and prognostic markers is now in progress.

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Figures

eFigure
eFigure
Our literature searches identified a total of 2372 relevant abstracts. Among these publications, 321 were selected as full texts for further evaluation. Finally, 23 publications met the inclusion criteria defined a priori for the assessment of the relative efficacy and safety of systemic treatments
See this image and copyright information in PMC

Comment in

  • Renal Cell Carcinoma as an Occupational Disease.
    Triebig G. Triebig G. Dtsch Arztebl Int. 2017 Mar 3;114(9):160. doi: 10.3238/arztebl.2017.0160a. Dtsch Arztebl Int. 2017. PMID: 28351469 Free PMC article. No abstract available.
  • In Reply.
    Doehn C, Weikert S. Doehn C, et al. Dtsch Arztebl Int. 2017 Mar 3;114(9):160. doi: 10.3238/arztebl.2017.0160b. Dtsch Arztebl Int. 2017. PMID: 28351470 Free PMC article. No abstract available.

References

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