Leveridge Michael J, Jewett Michael A S
Assistant Professor, Department of Urology, Kingston General Hospital, Queen's University, Kingston, ON;
Can Urol Assoc J. 2011 Jun;5(3):195-203. doi: 10.5489/cuaj.10148.
Renal cell carcinoma (RCC) diagnosis and management have undergone significant shifts in the recent past. The increasing rate of diagnosis of small renal masses, often in patients at high risk of morbidity with operative treatment, has led to studies, trials and discoveries in renal mass biopsy, active surveillance and minimally invasive thermal ablation. At the other end of the disease spectrum, targeted systemic therapies for metastatic RCC have supplanted cytokine-based treatment, with significant benefits to progression and survival. Recent reviews and trials have also cemented the role of partial nephrectomy as standard surgical management for most low-stage masses, and the roles of regional lymphadenectomy and adrenalectomy concomitant with nephrectomy have been clarified. This review aims to highlight recent evidence that has emerged in the management of this complicated oncologic issue.
肾细胞癌(RCC)的诊断和治疗在最近发生了重大转变。小肾肿块的诊断率不断上升,这些患者往往在接受手术治疗时具有较高的发病风险,这促使了对肾肿块活检、主动监测和微创热消融的研究、试验和发现。在疾病谱的另一端,转移性RCC的靶向全身治疗已取代基于细胞因子的治疗,在疾病进展和生存方面具有显著益处。最近的综述和试验也巩固了部分肾切除术作为大多数低分期肿块标准手术治疗的作用,同时明确了肾切除术同期区域淋巴结清扫术和肾上腺切除术的作用。本综述旨在强调在这个复杂的肿瘤问题管理中出现的最新证据。