BackTable / Urology / Topic / Condition
Kidney cancer, also known as renal cell carcinoma, is among the top ten most common cancers in the world and includes any cancer derived from renal tubular epithelial cells. Clear cell, papillary, and chromophobe renal cell carcinoma are the major subtypes of kidney cancer. In the United States, the median age at diagnosis is 64 years, and men have higher incidence rates of kidney cancer than women. The risk of developing kidney cancer is increased with age, excess body weight, hypertension, and smoking. Chronic kidney disease, kidney transplantation, and acquired kidney cystic disease have been associated with kidney cancer.
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Kidney Cancer Diagnosis
Widespread use of imaging techniques, such as ultrasonography and CT scans, performed for a reason unrelated to cancer screening, have led to many incidental findings of renal cell carcinoma. Clear cell renal cell carcinoma often presents with exophytic growth, heterogeneity, or hemorrhage. Symptoms of hypercalcaemia, fever, and erythrocytosis may occur in kidney cancer patients with paraneoplastic syndromes. A diagnosis can be made with a renal core biopsy or a partial or radical nephrectomy specimen is used to confirm malignancy. Staging is assessed with CT imaging with contrast enhancement of the chest, abdominal cavity, and pelvis. MRI is useful for evaluating the extent of the tumor into the vena cava tumor thrombus. Laboratory tests, such as hemoglobin, leukocyte and platelet counts, lactate dehydrogenase levels, and serum-corrected calcium levels, are run for a prognosis.
Kidney Cancer Podcasts
Listen to leading physicians discuss kidney cancer on the BackTable Urology Podcast. Get tips, tricks, and expert guidance from your peers and level up your practice.
In this special episode, Dr. Phil Pierorazio (University of Pennsylvania) invites Dr. Rana McKay (UC San Diego) and Dr. Raquibul Hannan (UT Southwestern) about treatment options for renal cell carcinoma (RCC) patients in preparation for the 2022 International Kidney Cancer Symposium in Austin, Texas.
In this episode of BackTable Urology, Dr. Aditya Bagrodia speaks with urologist Dr. Karim Bensalah from the Universitaire de Rennes and medical oncologist Dr. Rana McKay from UC San Diego about adjuvant therapy for advanced kidney cancer.
Dr. Phillip Pierorazio from Penn Urology discusses the management of small renal masses. Listen to the full episode to hear about imaging modalities for small renal masses, distinguishing between cysts and solid tumors, ablation, enucleation, partial nephrectomy, and special considerations for von Hippel-Landau (VHL) patients.
Dr. Aditya Bagrodia interviews Dr. Vitaly Margulis, professor of urology at UT Southwestern Medical Center, about locally advanced kidney cancer. They discuss various topics including classification of locally advanced kidney cancers, various imaging modalities for staging cancer, special considerations for tumor-thrombus formation, targeted therapy vs. checkpoint inhibitors, and robotic vs. open nephrectomies.
Kidney Cancer Treatment
Kidney cancer treatment varies with the type and stage of the disease. Interventions for localized renal cell carcinoma include partial or radical nephrectomy, ablation, or active surveillance. Ablative therapies and active surveillance are often used for elderly patients or patients with competing health risks where surgery is not an option. Metastatic renal cell carcinoma can be managed with tyrosine kinase inhibitors, such as sunitinib, or immunotherapies, such as cytokines that enhance anti-tumor immune activity
Kidney Cancer Articles
Read our exclusive BackTable Urology Articles for quick insights on kidney cancer, provided by physicians for physicians.
Tumor thrombus formation is common in locally advanced kidney cancer, and can lead to bland thrombus, pulmonary emboli, and even Budd-Chiari syndrome. The risk of pulmonary emboli creates unique challenges during kidney cancer surgery.
Kidney cancer surgery can be aggressive or conservative, depending on various factors. This article discusses when to perform a partial vs. radical nephrectomy, the indications for lymph node dissection, and the viability of a robotic approach.
 Hsieh, J. J., Purdue, M. P., Signoretti, S., Swanton, C., Albiges, L., Schmidinger, M., Heng, D. Y., Larkin, J., & Ficarra, V. (2017, March 9). Renal cell carcinoma. Nature reviews. Disease primers. Retrieved December 3, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5936048/
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