Renal cell carcinoma

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  • Harrison's Internal Medicine Chapter 90. Bladder and Renal Cell Carcinomas Bladder Cancer A transitional cell epithelium lines the urinary tract from the renal pelvis to the ureter, urinary bladder, and the proximal two-thirds of the urethra. Cancers can occur at any point: 90% of malignancies develop in the bladder, 8% in the renal pelvis, and the remaining 2% in the ureter or urethra. Bladder cancer is the fourth most common cancer in men and the thirteenth in women, with an estimated 67,160 new cases and 13,750 deaths in the United States predicted for the year 2007.

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  • Renal Cell Carcinoma Renal cell carcinomas account for 90–95% of malignant neoplasms arising from the kidney. Notable features include resistance to cytotoxic agents, infrequent responses to biologic response modifiers such as interleukin (IL) 2, and a variable clinical course for patients with metastatic disease, including anecdotal reports of spontaneous regression. Epidemiology The incidence of renal cell carcinoma continues to rise and is now nearly 51,000 cases annually in the United States, resulting in 13,000 deaths. The male to female ratio is 2:1.

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  • Clinical Presentation The presenting signs and symptoms include hematuria, abdominal pain, and a flank or abdominal mass. This classic triad occurs in 10–20% of patients. Other symptoms are fever, weight loss, anemia, and a varicocele (Table 90-4). The tumor can also be found incidentally on a radiograph. Widespread use of radiologic cross-sectional imaging procedures (CT, ultrasound, MRI) contributes to earlier detection, including incidental renal masses detected during evaluation for other medical conditions.

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  • Renal Cell Carcinoma: Treatment Localized Tumors The standard management for stage I or II tumors and selected cases of stage III disease is radical nephrectomy. This procedure involves en bloc removal of Gerota's fascia and its contents, including the kidney, the ipsilateral adrenal gland, and adjacent hilar lymph nodes. The role of a regional lymphadenectomy is controversial. Extension into the renal vein or inferior vena cava (stage III disease) does not preclude resection even if cardiopulmonary bypass is required.

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  • Metastatic Disease The primary goal of treatment for metastatic disease is to achieve complete remission with chemotherapy alone or with a combined-modality approach of chemotherapy followed by surgical resection of residual disease, as is done routinely for the treatment of germ cell tumors. One can define a goal in terms of cure or palliation on the basis of the probability of achieving a complete response to chemotherapy using prognostic factors, such as Karnofsky Performance Status (KPS) (...

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  • Despite the aberrant expression of cholinesterases in tumours, the question of their possible contribution to tumorigenesis remains unsolved. The identifica-tion in kidney of a cholinergic system has paved the way to functional studies, but details on renal cholinesterases are still lacking. To fill the gap and to determine whether cholinesterases are abnormally expressed in renal tumours, paired pieces of normal kidney and renal cell carcinomas (RCCs) were compared for cholinesterase activity and mRNA levels....

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  • Angiogenic switch in renal cell carcinoma (RCC) is attributed to the inactivation of the von Hippel–Lindau tumor suppressor, stabilization of hypoxia inducible factor-1 transcription factor and increased vascular endothelial growth factor.

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  • Until recently, surgical resection was considered the only option for treatment of kidney cancer, especially renal cell carcinoma. The disease is relatively resistant to both radiotherapy and chemotherapy, and although alternative systemic therapies such as interleukin- 2 immunotherapy and interferon have shown promise, objective response rates are still quite low. Minimally invasive therapies have piqued the interest of researchers by showing significant improvements in treatment and management of kidney cancer.

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  • Summarizing a decade of scientific advance and therapeutic innovation, Renal Tumor offers all physicians treating kidney cancer, as well as researchers, updated information concerning the epidemiology, biology, and treatment of renal cell carcinoma. Contributors to this book are from all over the world and are experts in their individual fields.

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  • Tham khảo tài liệu 'guidelines on - renal cell carcinoma', y tế - sức khoẻ, y dược phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả

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  • Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Radiation Oncology cung cấp cho các bạn kiến thức về ngành y đề tài: Stereotactic body radiation therapy for melanoma and renal cell carcinoma: impact of single fraction equivalent dose on local control...

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: An unusual cause of chyluria after radiofrequency ablation of a renal cell carcinoma: a case report...

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  • Pathogenesis The multicentric nature of the disease and high rate of recurrence has led to the hypothesis of a field defect in the urothelium that results in a predisposition to cancer. Molecular genetic analyses suggest that the superficial and invasive lesions develop along distinct molecular pathways in which primary tumorigenic aberrations precede secondary changes associated with progression to a more advanced stage.

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Solitary colonic metastasis from renal cell carcinoma presenting as a surgical emergency nine years post-nephrectomy

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  • Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Surgical resection of a renal cell carcinoma involving the ...

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài:Effect of arginase II on L-arginine depletion and cell growth in murine cell lines of renal cell carcinoma

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Renal cell carcinoma metastasis to the ciliary body responds to proton beam radiotherapy: a case report...

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Retroperitoneoscopic radical nephrectomy with a small incision for renal cell carcinoma: Comparison with the conventional method

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Atypical presentation of renal cell carcinoma: a case report...

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Lymphangitis carcinomatosa as an unusual presentation of renal cell carcinoma: a case report

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