Renal Cell Carcinoma Questions & Answers

Updated: May 21, 2019
  • Author: Kush Sachdeva, MD; Chief Editor: E Jason Abel, MD  more...
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Questions & Answers

Overview

What is renal cell carcinoma (RCC)?

What are the signs and symptoms of renal cell carcinoma (RCC)?

Which lab studies are performed in the workup of renal cell carcinoma (RCC)?

Which imaging studies are performed in the evaluation and staging of renal cell carcinoma (RCC)?

What are the treatment options for renal cell cancer (RCC)?

What is the prevalence of renal cell carcinoma (RCC) and how is it characterized?

What is the role of surgery in the treatment of renal cell carcinoma (RCC)?

What is the first-line therapy for metastatic renal cell carcinoma (RCC)?

Which agents are used in second-line therapy for renal cell carcinoma (RCC)?

What is the tissue of origin for renal cell carcinoma (RCC)?

What are the hereditary syndromes associated with renal cell carcinoma (RCC)?

What is von Hippel-Lindau (VHL) syndrome (disease)?

What is the prevalence of renal cell carcinoma in von Hippel-Lindau (VHL) syndrome (disease)?

What is the role of the VHL gene in the pathogenesis of renal cell carcinoma (RCC)?

What is hereditary papillary renal carcinoma (RCC)?

What are familial renal oncocytoma and Birt-Hogg-Dube syndrome?

What is hereditary renal cell carcinoma (RCC)?

What is the role of smoking in the etiology of renal cell carcinoma (RCC)?

What is the role of obesity in the etiology of renal cell carcinoma (RCC)?

What are the occupational exposure risk factors for renal cell carcinoma (RCC)?

Which NSAIDs increase the risk of renal cell carcinoma (RCC)?

How does long-term dialysis affect the risk for renal cell carcinoma (RCC)?

Which genetic disorders are associated with renal cell carcinoma (RCC)?

What is the incidence of renal cell carcinoma (RCC) in the US?

What is the incidence of renal cell carcinoma (RCC) in Europe?

What is the median age at diagnosis of renal cell carcinoma (RCC)?

What is the prognosis of renal cell carcinoma (RCC)?

What are the survival rates for renal cell carcinoma (RCC)?

What are the T stage 5-year disease-specific survival rates in patients with renal cell carcinoma (RCC)?

What is the survival rate of renal cell carcinoma (RCC) with regional lymph node involvement?

What is the survival rate of patients with stage IV renal cell carcinoma (RCC)?

What are the factors for predicting survival in patients with metastatic renal cell carcinoma (RCC)?

What are the factors associated with increased survival in patients with metastatic renal cell carcinoma (RCC)?

When is obesity a favorable prognostic factor in renal cell carcinoma (RCC)?

How should patients with a family history of genetic syndromes for renal cell carcinoma (RCC) be counseled?

What information should be given to patients at high risk for renal cell carcinoma (RCC)?

Presentation

What is the patient history associated with renal cell carcinoma (RCC)?

How frequency are the individual components of the classic triad of renal cell carcinoma (RCC) present?

What are the nonspecific signs and symptoms of renal cell carcinoma (RCC)?

Which paraneoplastic syndromes are comorbid with renal cell carcinoma (RCC)?

What causes the paraneoplastic conditions of renal cell carcinoma (RCC)?

What should be included in the physical exam of suspected renal cell carcinoma (RCC)?

Which physical findings suggest renal cell carcinoma (RCC)?

What systems are used to stage renal cell carcinoma (RCC)?

What is the Robson staging system for renal cell carcinoma (RCC)?

What is the TNM classification for renal cell carcinoma (RCC)?

How are primary tumors (T) defined in the TNM staging of renal cell carcinoma (RCC)?

How are regional lymph nodes (N) defined in the TNM staging of renal cell carcinoma (RCC)?

How is distant metastasis (M) defined in the TNM staging of renal cell carcinoma (RCC)?

How is the AJCC stage determined for renal cell carcinoma (RCC)?

DDX

When is a diagnosis of renal cell carcinoma (RCC) considered based on radiographic findings?

How should a renal mass of indeterminate etiology be monitored?

Which disorders should be included in the differential diagnosis of renal cell carcinoma (RCC)?

What are the signs and symptoms of spinal cord compression in renal cell carcinoma (RCC)?

What are the differential diagnoses for Renal Cell Carcinoma?

Workup

How is renal cell carcinoma (RCC) detected?

What should be included in the lab studies for renal cell carcinoma (RCC)?

Which imaging studies should be performed in the evaluation and staging of renal cancer (RCC)?

How are benign renal masses differentiated from renal cell carcinoma?

What is the role of contrast-enhanced CT scanning in the workup of renal cell carcinoma (RCC)?

What is the role of excretory urography in the workup of renal cell carcinoma (RCC)?

What is the role of renal arteriography in the workup of renal cell carcinoma (RCC)?

What is the role of positron emission tomography (PET) in the workup of renal cell carcinoma (RCC)?

What is the role of bone scans in the workup of renal cell carcinoma (RCC)?

Which lab studies are performed in the initial workup of renal cell carcinoma (RCC)?

What is the imaging procedure of choice for diagnosis and staging of renal cell cancer?

What are the American Urological Association (AUA) guidelines for imaging in the workup of renal cell carcinoma (RCC)?

What are the National Comprehensive Cancer Network (NCCN) guidelines for the initial workup for renal cell carcinoma (RCC)?

How is multidetector CT imaging used in the workup of renal cell carcinoma (RCC)?

What are the histologic subtypes of renal cell carcinoma (RCC)?

What are the histologic characteristics of clear cell carcinoma in renal cell carcinoma (RCC)?

What are the histologic characteristics of renal oncocytoma in renal cell carcinoma (RCC)?

What are the histologic characteristics of collecting duct carcinoma in renal cell carcinoma (RCC)?

Which procedures are performed in the workup of renal cell carcinoma (RCC)?

What is the role of percutaneous cyst puncture in the workup of renal cell carcinoma (RCC)?

Treatment

What is the basis for treatment selection in renal cell carcinoma (RCC)?

What are the American Urological Association (AUA) recommendations for treatment selection in renal cell carcinoma (RCC)?

What are the treatment options for renal cell carcinoma (RCC)?

What is the role of chemotherapy in the treatment of renal cell carcinoma (RCC)?

Which immune modulators are used in the treatment of renal cell carcinoma (RCC)?

What is the role of surgery in the treatment of metastatic renal cell carcinoma (RCC)?

What is the efficacy of resection in the treatment of renal cell carcinoma (RCC)?

What is the role of active surveillance in the treatment of renal cell carcinoma (RCC)?

When is enrollment in clinical trials indicated for the treatment of renal cell carcinoma (RCC)?

What is the role of surgical resection in the treatment of renal cell carcinoma (RCC)?

What is the NCCN treatment recommendations for a T1a renal mass in renal cell carcinoma (RCC)?

What is the AUA treatment recommendations for a T1 renal mass in renal cell carcinoma (RCC)?

When is ablation most effective for the treatment of renal cell carcinoma (RCC)?

What is the role of radical nephrectomy in the treatment of renal cell carcinoma (RCC)?

What are the indications for adrenalectomy in the treatment of renal cell carcinoma (RCC)?

When is en bloc excision of adjacent structures during surgery for renal cell carcinoma (RCC) indicated?

What are the common surgical approaches used in the treatment of renal cell carcinoma (RCC)?

What is the prevalence of lymph node involvement in renal cell carcinoma (RCC)?

What are the recommendations of treatment of enlarged lymph nodes in renal cell carcinoma (RCC)?

What is the prevalence of inferior vena cava involvement in renal cell carcinoma (RCC)?

How is renal vein and inferior vena cava involvement managed in renal cell carcinoma (RCC)?

What is the role of laparoscopic nephrectomy in the treatment of renal cell carcinoma?

When is palliative nephrectomy considered in the treatment of renal cell carcinoma (RCC)?

What is the role of interleukin-2 (IL-2) in the treatment of renal cell carcinoma (RCC)?

What is the efficacy of interleukin-2 (IL-2) in the treatment of renal cell carcinoma (RCC)?

What are the toxic effects associated with interleukin-2 (IL-2) for treatment of renal cell carcinoma (RCC) and how are they managed?

What is the mechanism of action for interferons used to treat renal cell carcinoma (RCC)?

What is the role of interferons in the treatment of renal cell carcinoma (RCC)?

Which molecular-targeted agents are FDA-approved for treatment of renal cell carcinoma (RCC)?

What are the National Comprehensive Cancer Network (NCCN) preferred regimens for systemic therapy in renal cell carcinoma (RCC)?

What is the role of nivolumab (Opdivo) in the treatment of renal cell carcinoma (RCC)?

What is the optimal sequence for use of targeted agents in the treatment of renal cell carcinoma (RCC)?

What are the National Comprehensive Cancer Network (NCCN) guidelines for first-line therapy to treat predominantly clear cell renal cell carcinoma (RCC)?

What are the National Comprehensive Cancer Network (NCCN) guidelines for second-line therapy to treat predominantly clear cell renal cell carcinoma (RCC)?

What is the role of sunitinib (Sutent) in the treatment of renal cell carcinoma (RCC)?

What is the efficacy of sunitinib to treat renal cell carcinoma (RCC)?

What are the adverse effects of sunitinib in the treatment of renal cell carcinoma (RCC)?

What is the role of bevacizumab in the treatment of renal cell carcinoma (RCC)?

What is the role of pazopanib (Votrient) in the treatment of renal cell carcinoma (RCC)?

What is the efficacy of pazopanib (Votrient) in the treatment of renal cell carcinoma (RCC)?

What is the role of temsirolimus (Torisel) in the treatment of renal cell carcinoma (RCC)?

What is the efficacy of temsirolimus (Torisel) in the treatment of renal cell carcinoma (RCC)?

What are the adverse effects of temsirolimus in the treatment of renal cell carcinoma (RCC)?

What is the role of lenvatinib (Lenvima) in the treatment of renal cell carcinoma (RCC)?

What is the role of everolimus (Afinitor) in the treatment of renal cell carcinoma (RCC)?

What is the efficacy of everolimus for the treatment of renal cell carcinoma (RCC)?

What are the adverse effects of everolimus in the treatment of renal cell carcinoma (RCC)?

What is the efficacy of nivolumab (Opdivo) in the treatment of renal cell carcinoma (RCC)?

What is the role of cabozantinib (Cabometyx) in the treatment of renal cell carcinoma (RCC)?

What is the efficacy of cabozantinib (Cabometyx) in the treatment of renal cell carcinoma (RCC)?

What is the role of sorafenib (Nexavar) in the treatment of renal cell carcinoma (RCC)?

What is the efficacy of sorafenib in the treatment of renal cell carcinoma (RCC)?

What is the mechanism of action for sorafenib in the treatment of renal cell carcinoma (RCC)?

What is the recommended dose of sorafenib to treat renal cell carcinoma (RCC)?

What are the adverse events of sorafenib treatment for renal cell carcinoma (RCC)?

What is the role of axitinib (Inlyta) in the treatment of renal cell carcinoma (RCC)?

What is the role of lapatinib in the treatment of renal cell carcinoma (RCC)?

What is the role of molecular therapy in the treatment of early-stage renal cell carcinoma (RCC)?

What is the efficacy of chemotherapy in the treatment of renal cell carcinoma (RCC)?

Which chemotherapy agents have been used in the treatment of renal cell carcinoma (RCC)?

Why is renal cell carcinoma (RCC) refractory to most chemotherapeutic agents?

What are experimental approaches to treatment of renal cell carcinoma (RCC)?

What is the efficacy of lenalidomide (Revlimid) for the treatment of renal cell carcinoma (RCC)?

What is the role of vaccines in the treatment of renal cell carcinoma (RCC)?

What is the role of autologous vaccine therapy in the treatment of renal cell carcinoma (RCC)?

What is the role of nonmyeloablative allogeneic stem cell transplantation (ASCT) in the treatment of renal cell carcinoma (RCC)?

What are the complications of nonmyeloablative allogeneic stem cell transplantation (ASCT) for the treatment of renal cell carcinoma (RCC)?

What is the role of megestrol and antiestrogens in the treatment of renal cell carcinoma (RCC)?

When is radiation therapy considered as the primary therapy for renal cell carcinoma (RCC)?

When is radiation therapy considered for palliative care in renal cell carcinoma (RCC)?

What is the role of radiation therapy in the treatment of brain metastasis in renal cell carcinoma (RCC)?

What is the role of renal artery embolization in the treatment of renal cell carcinoma (RCC)?

How is renal cell carcinoma (RCC) prevented?

When is active surveillance indicated in the treatment of renal cell carcinoma (RCC)?

What are the risks of active surveillance in the treatment of renal cell carcinoma (RCC)?

What is included in long-term monitoring for stage I and II renal cell carcinoma (RCC)?

What is included in long-term monitoring for stage III renal cell carcinoma (RCC)?

What is the frequency of spontaneous regression in renal cell carcinoma (RCC)?

What are the surveillance recommendations for patients with end-stage renal disease and renal cell carcinoma (RCC)?

What organization has released guidelines for surveillance of clinically localized renal cell carcinoma (RCC)?

What are the AUA guidelines for surveillance of clinically localized renal cell carcinoma (RCC)?

Guidelines

Who are the renal cell carcinoma guideline contributors?

What is the WHO updated classification of renal cell tumors?

What are the NCCN recommendations for the workup of renal cell carcinoma (RCC)?

What organizations have issued guidelines for the diagnosis and staging of renal cell carcinoma (RCC)?

According to AUA guidelines, which characteristics of the renal mass should be assessed in the diagnosis of renal cell carcinoma (RCC)?

What are the AUA guidelines for renal mass biopsy in the diagnosis of renal cell carcinoma (RCC)?

How are the National Comprehensive Cancer Network (NCCN) recommendations for renal cell carcinoma (RCC) categorized?

What is lymph node dissection indicated in the workup of renal cell carcinoma (RCC)?

What are the ESMO clinical practice guidelines for the diagnosis and staging of renal cell carcinoma (RCC)?

What are the AUA treatment guidelines for stage I renal mass in renal cell carcinoma (RCC)?

What are the NCCN recommendations for treatment of treatment stage I renal cell carcinoma (RCC)?

What are the ESMO recommendations for partial nephrectomy in the treatment of renal cell carcinoma (RCC)?

What are the AUA recommendations for active surveillance of renal cell carcinoma (RCC)?

When are the treatment guidelines for stage II and III renal cell carcinoma (RCC)?

What are the NCCN recommendations for the primary treatment of stage IV renal cell carcinoma (RCC)?

What are the NCCN recommendations for management of non-clear cell stage IV renal cell cancer (RCC)?

What are the NCCN recommendations for treatment of relapsed stage IV renal cell carcinoma (RCC)?

What are the NCCN recommendations for management of previously treated predominantly clear cell stage IV renal cell cancer (RCC)?

What is the NCCN recommended monitoring schedule for active surveillance in patients with pT1a renal cell carcinoma (RCC)?

What are AUA guidelines for follow-up following surgery for renal cell carcinoma (RCC)?

What are the AUA recommendations for management of asymptomatic metastatic renal cell carcinoma (RCC)?

What are NCCN postoperative guidelines for stage I renal cell carcinoma (RCC)?

What are NCCN postoperative guidelines for stage II and III renal cell carcinoma (RCC)?

What are NCCN postoperative guidelines for stage IV renal cell carcinoma (RCC)?

Medications

What are the goals of drug treatment for renal cell carcinoma (RCC)?

Which immune modulators are used in the treatment of renal cell carcinoma (RCC)?

Which medications in the drug class Antineoplastic Agents are used in the treatment of Renal Cell Carcinoma?