KIDNEY CANCER

1
KIDNEY CANCER

• Shahid Waheed, M.D.

2
Incidence

• Approximately 30,000 cases of renal cancer with
  over 11,000 deaths.

3
Epidemiology

• Gender and Age
• Twice as common in men than in women
• Mostly diagnosed in fourth to sixth decade of
  life
• More common in Northern European population

4
Risk Factors

• Smoking
• Obesity
• Renal dialysis

5
Genetic Factors

• Genetic factors that link increased risk of renal
  cancers
• Chromosomal abnormalities, short arm of
  chromosome 3
• Associated malignancy
• If patient has another malignancy like
  lymphoma
• Vonhippel-Lindau disease is associated with
  retinal angiomas, CNS hemangioblastoma and renal
  cell carcinoma.

6
Signs and Symptoms

• Hematuria
• Fever
• Weight loss
• Erythrocytosis

• Liver dysfunction
• Hypercalcemia
• Incidental finding of lytic lesions on routine
  chest x-ray

7
Diagnosis

• CT scan
• Ultrasonography
• MRI
• Renal arteriography
• Percutaneous cyst puncture

8
Pathology

• Clear cell
• Granular cell
• Sarcomatoid variant

9
Staging

• Tx Primary tumor cannot be assessed.
• TC No evidence of primary tumor.
• T1 Tumor less than 7 cms in greatest dimension
  limited to the kidney.
• T2 Tumor more than 7 cms in greatest dimension
  limited to the kidney.
• T3 Tumor extends into major veins or invades
  adrenal gland or perinephric tissue but not
  beyond Greotas fascia.

10
Prognostic Factors

• Natural history of renal cell carcinoma is highly
  variable, 5-year survival rates of tumors limited
  to renal tissue T1, T2 are more than 80.
• Renal vein involvement or nodal involvement
  decrease 5-year survival to 10-25.
• Patients with metastatic disease, 1-year survival
  rate 0-20.

11
Treatment Options

• Surgery is best option radical nephrectomy is
  the established therapy for localized renal
  carcinoma

12
Treatment Options

• Other treatments include
• Radiation therapy for renal cell carcinoma
• Chemotherapy not effective
• Treatment with interleukin II and interferon can
  be used and at times renal cell carcinoma will
  respond
• Interleukin II has resulted in 14 remission
  rate, 5 complete response and 9 partial
  response approved by FDA