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Books > Medicine > Clinical & internal medicine > Diseases & disorders > Oncology
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Renal Cell Carcinoma (Hardcover)
Loot Price: R6,439
Discovery Miles 64 390
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Renal Cell Carcinoma (Hardcover)
Expected to ship within 12 - 19 working days
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Kidney cancer is the 10th most common cancer in Europe with overall
mortality rates increasing until the late 1980s and early 1990s and
thereafter, stabilised. Until recently, renal cell carcinoma (RCC)
was thought to represent a monomorphic disease; however, modern
genetic characterisation has demonstrated different subtypes with
specific cell types and molecular metabolism. Imaging diagnostic
methods are basic for staging and for new treatment strategies.
Moreover, tumour biopsy has been reintroduced in the diagnostic
armamentarium, mainly in patients with small masses but also when
disseminated tumours need to be treated with new target therapies.
Although TNM stage, Fuhrman grade and Eastern Oncology Group (ECOG)
performance status are the most recognised prognostic factor in
RCC, active research continues to determine new prognostic factors
to classify different risks for death from RCC. Laparoscopy has
gained widespread popularity because of a less morbidity and a
faster post-operative convalescence. Partial laparoscopic
nephrectomy is a demanding operation that can be made depending on
the experience of the surgeon, the size or location of the tumour
in the kidney. New robotic approaches are being introduced for
nephron sparing surgery. Conversely, cardiac bypass can be
necessary for resection of tumours with thrombus extending into the
inferior vena cava above the level of hepatic veins. With the
advent of modern ablative energies (cryotherapy or radiofrequency)
for renal tumours in selected patients with percutaneous or
laparoscopic techniques, it is now possible to achieve long cancer
specific survival with decreased morbidity. A need for
standardisation of follow-up after surgery with lifelong protocols
has been recognised in last years. Finally, angiogenesis inhibitors
have demonstrated a high probability of disease control in patients
with metastatic renal carcinomas. Their indication as adjuvant in
local advanced tumours as well as the role of nephrectomy in
patients with metastatic disease is being evaluated in current
clinical trials.
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