Drăgan Anca, Sinescu Ioanel
Department of Cardiovascular Anaesthesiology and Intensive Care, Prof. C.C. Iliescu Emergency Institute for Cardiovascular Diseases, 258 Fundeni Road, 022328 Bucharest, Romania.
Department of Urological Surgery, Dialysis and Kidney Transplantation, Fundeni Clinical Institute, 258 Fundeni Road, 022328 Bucharest, Romania.
Diagnostics (Basel). 2023 May 30;13(11):1912. doi: 10.3390/diagnostics13111912.
Renal cell carcinoma, an aggressive malignancy, is often incidentally diagnosed. The patient remains asymptomatic to the late stage of the disease, when the local or distant metastases are already present. Surgical treatment remains the choice for these patients, although the plan must adapt to the characteristics of the patients and the extension of the neoplasm. Systemic therapy is sometimes needed. It includes immunotherapy, target therapy, or both, with a high level of toxicity. Cardiac biomarkers have prognosis and monitoring values in this setting. Their role in postoperative identification of myocardial injury and heart failure already have been demonstrated, as well as their importance in preoperative evaluation from the cardiac point of view and the progression of renal cancer. The cardiac biomarkers are also part of the new cardio-oncologic approach to establishing and monitoring systemic therapy. They are complementary tests for assessment of the baseline toxicity risk and tools to guide therapy. The goal must be to continue the treatment as long as possible with the initiation and optimisation of the cardiological treatment. Cardiac atrial biomarkers are reported to have also antitumoral and anti-inflammatory properties. This review aims to present the role of cardiac biomarkers in the multidisciplinary management of renal cell carcinoma patients.
肾细胞癌是一种侵袭性恶性肿瘤,常为偶然诊断。患者在疾病晚期之前通常无症状,此时局部或远处转移已经出现。手术治疗仍然是这些患者的首选,尽管治疗方案必须根据患者的特点和肿瘤的范围进行调整。有时需要全身治疗。它包括免疫治疗、靶向治疗或两者兼而有之,毒性较高。心脏生物标志物在这种情况下具有预后和监测价值。它们在术后识别心肌损伤和心力衰竭中的作用已经得到证实,以及它们在术前心脏评估和肾癌进展中的重要性。心脏生物标志物也是建立和监测全身治疗的新心脏肿瘤学方法的一部分。它们是评估基线毒性风险的补充检测方法和指导治疗的工具。目标必须是在启动和优化心脏治疗的同时尽可能长时间地继续治疗。据报道,心脏心房生物标志物还具有抗肿瘤和抗炎特性。本综述旨在介绍心脏生物标志物在肾细胞癌患者多学科管理中的作用。