UroToday - Prevalence

November 20, 2009

November 2009

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Parenchyma

Prevalence

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General Considerations
This remains a surgical disease for the most part but the individual approach to each case has been modified by the greater incidence of smaller lesions noted at initial diagnosis and the advent of laparoscopic surgery which provides different treatment options. The molecular pathology of these lesions is better understood, yet advanced lesions remain difficult to treat by conventional cytoreductive or biological response modifier therapy.
Incidence
- There are approximately 30,000 new cases per year and 12,000 cancer related deaths
- Incidence is rising 6.1 to 9.3 per 100,000 over 20 years
- Mortality rate has not decreased even with greater detection of small tumors
  Lead time bias
  Short follow up
  Natural history of smaller lesions less aggressive?
- 25% of tumors present with advanced disease

References

Bostwick DG, Eble JN: Diagnosis and classification of renal cell carcinoma. Urol Clin N Am 26:627-635, 1999.
Caddeddu JA, Ono Y, Clayman RV, et al: Laparoscopic nephrectomy for renal cell cancer: Evaluation of efficacy and safety: A multicenter experience. Urology 52:773-777, 1998.
Levy DA, Slaton JW, Swanson DA, Dinney CP: Stage specific guidelines for surveillance after radical nephrectomy for local renal cell carcinoma. J Urol 15:1163-1167, 1998.
Montie JM: Lymphadenectomy for renal cell carcinoma. Semin Urol 7:181-185, 1989.
Motzer RJ, Bander NH, Nanus DM: Renal-cell carcinoma. N Engl J Med 335:865-875, 1996.
Novick AC: Renal-sparing surgery for renal cell carcinoma. Urol Clin North Am 20:277-282, 1993.
Sagalowsky AI, Kadesky KT, Ewalt DM, Kennedy TJ: Factors influencing adrenal metastasis in renal cell carcinoma. J Urol 151:1181-1184, 1994.
Skinner DG, Pritchett RT, Lieskovsky G, Boyd SD, Stiles QR: Vena caval involvement by renal cell carcinoma. Surgical resection provides meaningful long-term survival. Ann Surg 210:387-394, 1989.
Sufrin G, Cashon S, Golio A, Murphy GP: Paraneoplastic and serologic syndromes of renal adenocarcinoma. Semin Urol 7:158-171, 1989.
Yang JC, Topalian SL, Parkinson D, et al: Randomized comparison of high-dose and low-dose intravenous interleukin 2 for the therapy of metastatic renal cell carcinoma: An interim report. J Clin Oncol 12:1572-1576, 1994.