Landmarks in the diagnosis and treatment of renal cell carcinoma
Landmarks in the diagnosis and treatment of renal cell carcinoma
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DOI：
10.1038/nrurol.2014.194
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发表时间：
2014-09-01
影响因子：
15.3
通讯作者：
Finelli, Antonio
中科院分区：
文献类型：
--
作者：
Bhatt, Jaimin R.;Finelli, Antonio
最常见的肾癌是肾细胞癌（RCC），其起源于肾实质。在过去的二十年中，RCC的全球发病率每年增加2%。RCC是最致命的常见泌尿系统癌症：尽管诊断进展，20-30%的患者存在转移性疾病。对RCC遗传基础的更清晰理解导致了对这种化学抗性癌症的免疫和靶向治疗。尽管在晚期疾病中取得了有希望的结果，但总体缓解率和持久的完全缓解是罕见的。手术仍然是主要的治疗方式，特别是对于器官局限性疾病，在晚期和转移性疾病中具有选择性作用。越来越多地通过活检、微创干预和监测来管理较小的肿瘤。未来的承诺多模式，综合和个性化的护理，进一步了解疾病导致新的治疗方案。
The most common renal cancer is renal cell carcinoma (RCC), which arises from the renal parenchyma. The global incidence of RCC has increased over the past two decades by 2% per year. RCC is the most lethal of the common urological cancers: despite diagnostic advances, 20-30% of patients present with metastatic disease. A clearer understanding of the genetic basis of RCC has led to immune-based and targeted treatments for this chemoresistant cancer. Despite promising results in advanced disease, overall response rates and durable complete responses are rare. Surgery remains the main treatment modality, especially for organ-confined disease, with a selective role in advanced and metastatic disease. Smaller tumours are increasingly managed with biopsy, minimally invasive interventions and surveillance. The future promises multimodal, integrated and personalized care, with further understanding of the disease leading to new treatment options.