The earliest renal biopsies were obtained by open surgical techniques performed by urologists or transplant surgeons, or by pathologists at the time of autopsy. In 1951, physicians in Copenhagen published the first clinical report of percutaneous renal biopsy.1 They placed patients in a seated position and used intravenous pyelogram (IVP) as the imaging guide. Not surprisingly, both the yield and quality of biopsy tissue samples were low by contemporary standards, with only about half to two-thirds of specimens permitting histologic examination.
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Perspectives on the Evolution in Treating Kidney Cancer- Monty Pal and Jaime Landman
Monty Pal and Jaime Landman discuss the value of collaboration with multiple disciplines to effectively manage patients diagnosed with kidney cancer. They provide a historical overview of the treatment of kidney cancer bringing the conversation to revolutionary advances, adding their view on the impact of survival in this patient population.

Sumanta (Monty) Kumar Pal, MD, is an internationally recognized leader in the area of genitourinary cancers, including kidney, bladder, and prostate cancer. He is the Co-director of City of Hope's Kidney Cancer Program and is the head of the kidney and bladder cancer disease. Dr. Pal sits on the Editorial Board for clinical genitourinary cancer and is a reviewer for multiple journals including The Journal of Clinical Oncology, The Journal of Urology, European Urology, and many others.

Jaime Landman, MD, director of the UCI Health Center for Urological Care, is an internationally recognized urologist and expert in diseases and conditions of the kidneys, including kidney stones and benign and malignant tumors. He is experienced in all forms of minimally invasive kidney surgery, including robot-assisted surgery and percutaneous cryoablation. Dr. Landman, who founded the UCI Health Ablative Oncology Center, has performed more than 2,000 advanced minimally invasive kidney procedures. He is dedicated to improving the techniques and technology associated with minimally invasive surgery.

The earliest renal biopsies were obtained by open surgical techniques performed by urologists or transplant surgeons, or by pathologists at the time of autopsy. In 1951, physicians in Copenhagen published the first clinical report of percutaneous renal biopsy.1 They placed patients in a seated position and used intravenous pyelogram (IVP) as the imaging guide. Not surprisingly, both the yield and quality of biopsy tissue samples were low by contemporary standards, with only about half to two-thirds of specimens permitting histologic examination.

Published Date: September 2018
A 62-year-old man presents with a one-week history of hematuria. Ultrasound and computed tomography identify a 7-cm exophytic anterior left renal tumor, adenopathy, and two
small lung nodules. No bone or central nervous system lesions are detected. His Eastern Cooperative Oncology Group (ECOG) performance-status (PS) and Memorial Sloan-Kettering Cancer Center (MSKCC) scores are 1. The patient asks whether to undergo cytoreductive nephrectomy. What do you tell him?

Urologists are primed to acquire the knowledge to use targeted agents and immuno-oncologic (IO) therapies for the treatment of advanced and metastatic renal cell carcinoma (RCC). Toxicities are manageable given appropriate patient/caregiver education, on-call, and nursing support, and multi-disciplinary care with consulting specialists.



The rapid spread of COVID-19 has had dramatic effects throughout the world on healthcare systems with impacts far beyond the patients actually infected with the disease. Patients with severe kidney cancer must rely on data and recommendations as to who can safely defer treatment until after the pandemic is over versus those that should be treated without delay.
Read MoreCancers of the kidney and renal pelvis comprise the sixth most common newly diagnosed tumors in men, the tenth most common in women in the United States, and account for an estimated 65,340 people new diagnoses and 14,970 cancer-related deaths in 2018 in the United States. Despite ongoing stage migration as a result of widespread use of axial abdominal imaging for non-specific abdominal complaints,
Read MoreWith the widespread dissemination of abdominal imaging, there has been a stage migration in kidney cancer. However, this appears to have plateaued since 20071. There remains a significant proportion (~16%) of patients newly diagnosed with renal cell carcinoma who presented with advanced-stage disease and a further subset of those with localized disease are at high risk of recurrence.
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