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• W2100893307 endingPage "iv328" @default.
• W2100893307 startingPage "iv319" @default.
• W2100893307 abstract "Renal cell carcinoma (RCC) accounts for 3% of all malignancies in man and is the third most common urological cancer after prostate and bladder cancer. The incidence of RCC is increasing with about 31 500 new cases annually in the USA and 20 000 in Europe. The annual death rate due to metastatic disease (mRCC) is 12 000 and 8 000 in the USA and Europe, respectively. The accidental diagnosis of RCC has increased due to the extensive use of ultrasonography, leading to an earlier diagnosis and probably better prognosis. Today about 70–80% of patients present with localized disease of whom approximately 50% will develop metastatic disease. According to the Surveillance, Epidemiology and End Results (SEER) data, the 5-year survival of localized disease is 89% (54% of all patients), 61% in regionally advanced disease and only 9% in the case of metastatic disease [1]. The tumour mainly affects adults aged 50–70 years with a male to female ratio of 1.6:1 [2]. Several risk factors have been described for RCC. Tobacco smoking doubles the risk of RCC and there is a positive linear relation between body weight and the risk for RCC, especially in women. Other factors associated with higher risk for RCC are exposure to asbestos or chemicals, thiazide and urinary tract infections. The majority of RCC is adenocarcinomas originating from the proximal tubular cells, but malignant tumours can also arise from other structures such as the collecting duct and the epithelium of the pyelum. Most adenocarcinomas are of the clear cell type and are considered the most sensitive subtype for systemic therapy. At the onset of RCC there are only a few early warning signs. The classical triad of Virchow [2a], consisting of an abdominal mass together with flank pain and macroscopic haematuria, is nowadays only seen in approximately 5% of patients with RCC. At presentation, the disease may be accompanied by non-specific signs such as fatigue, weight loss, malaise, fever and/or night sweats. The primary treatment consists of a radical nephrectomy and in selected cases a partial nephrectomy. The role of nephrectomy in metastatic patients will be discussed later The occurrence of spontaneous regressions is considered very low, i.e. less than 1%. Two recently published studies indicate that sometimes these figures may be as high as 7% [3, 4]. This paper provides an overview of the systemic treatment of RCC. Hormonal treatment and chemotherapy" @default.
• W2100893307 created "2016-06-24" @default.
• W2100893307 creator A5006807426 @default.
• W2100893307 creator A5032541182 @default.
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• W2100893307 date "2004-10-01" @default.
• W2100893307 modified "2023-10-10" @default.
• W2100893307 title "Current treatment of renal cell carcinoma" @default.
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