New clinical features in renal cell carcinoma

In 1883 Grawitz published the first description of a kidney tumor, which he termed a hypernephroma. Much later the more appropiate name renal cell carcinoma (RCC) was introduced. At the moment RCC accounts for 2-3% of all adult cancers. Between 1989, the year of the first report of the netherlands cancer registry, and 1992 the total number of patients with RCC in the Netherlands increased from 1278 to 1438. For males the incidence increased from 11.6 to 12.5 per 100.000 and for females from 6.3 to 6.6 per 100.000. The pre-operative diagnostic work-up in patients with a clinical suspicion of RCC has changed, especially during the last decade due to the introduction of ultrasound, CT and MRI. Also the surgical therapy improved from a simple nephrectomy to a radical transabdominal or thoracoabdominal nephrectomy with regional or extended lymphnode dissection. Even patients with caval tumor thrombus involvement up to the right atrium can be managed often succesfully with extensive surgery. Nephron-sparing surgery, entailing complete local resection of a renal tumor while the largest possible amount of normal functioning parenchyma in the involved kidney remains in situ and vital, is an accepted treatment for RCC when preservation of functioning renal parenchyma is mandatory. For less demanding indications its applicability is under study.... Zie: Summary.