泌尿科医生在晚期肾细胞癌治疗管理中的角色演变。

Evolving Role of Urologists in the Management of Advanced Renal Cell Carcinoma.

机构信息

Division of Urology, Department of Surgery, McMaster University, McMaster Institute of Urology, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Room G334, Hamilton, Ontario L8N 4A6, Canada.

出版信息

Urol Clin North Am. 2020 Aug;47(3):271-280. doi: 10.1016/j.ucl.2020.04.006.

DOI:10.1016/j.ucl.2020.04.006

PMID:32600530

Abstract

Advanced renal cell carcinoma is not uncommon, but necessitates a multidisciplinary approach for optimal treatment. Targeted therapy has increased the likelihood of urologists managing patients in all disease stages. Neoadjuvant therapy is currently experimental. Systemic therapy for metastatic disease demonstrates survival benefits. The role of cytoreductive nephrectomy and adjuvant therapy is dependent on patient selection. Management of advanced renal cell carcinoma involves continued optimization of available agents and biomarker development. This article reviews the role of the urologist in medical and surgical therapies, including prognostication, management of locally advanced and metastatic disease, and provides the most recent clinical trial data.

摘要

晚期肾细胞癌并不罕见，但需要多学科方法来实现最佳治疗。靶向治疗增加了泌尿科医生在所有疾病阶段管理患者的可能性。新辅助治疗目前仍处于试验阶段。转移性疾病的系统治疗显示出生存获益。细胞减瘤性肾切除术和辅助治疗的作用取决于患者的选择。晚期肾细胞癌的治疗涉及对现有药物的不断优化和生物标志物的开发。本文回顾了泌尿科医生在医学和手术治疗中的作用，包括预后、局部晚期和转移性疾病的管理，并提供了最新的临床试验数据。