How I Treat

Renal cell carcinoma (RCC) accounts for 3 % of malignant tumors and is the sixth leading cause of cancer death in the United States. An estimated 51,000 new renal tumors were diagnosed in 2006, with 13,000 deaths.1 It is most common in the sixth decade of life, and a male to female predominance of 1.6 to 1.0 is present. Current therapeutic approaches for treatment of patients with metastatic RCC utilize knowledge of histology, molecular abnormalities, clinical prognostic factors, and the effects of available agents. Histologic Subsets Epithelial RCC includes various histologic subtypes, each having unique morphologic and genetic characteristics. Clear-cell RCC is the most common, accounts for 70%, and arises from the proximal convoluted tubule. Importantly, 60 % to 80 % of sporadic clear-cell RCCs are associated with defects i