tailieunhanh - Renal Cancer Methods and Protocols

In 1999 it was estimated that renal cell carcinoma (RCC) would account for 29,990 new cancer cases diagnosed in the United States (61% in men and 39% in women), and lead to 11,600 deaths. RCC accounts for 2–3% of all malignancies in adults and causes of all cancer deaths in the United States annually (1). Approx 4% of all RCC cases are bilateral at some point in the life of the patient. Data from over 10,000 cases of renal cancer entered in the Connecticut Tumor Registry suggests an increase in the incidence of renal cancer from 1935–1989; in women the incidence increased from to . | M E T- H O D S I N M O L E C U L A R Me D I C I N ETM Renal - Cancer. 0 - Methods and Protocols v 1 Renal Cell Carcinoma Clinical Features and Management Paul Russo 1. Introduction In 1999 it was estimated that renal cell carcinoma RCC would account for 29 990 new cancer cases diagnosed in the United States 61 in men and 39 in women and lead to 11 600 deaths. RCC accounts for 2-3 of all malignancies in adults and causes of all cancer deaths in the United States annually 1 . Approx 4 of all RCC cases are bilateral at some point in the life of the patient. Data from over 10 000 cases of renal cancer entered in the Connecticut Tumor Registry suggests an increase in the incidence of renal cancer from 1935-1989 in women the incidence increased from to in 100 000 and in men from to in 100 000 2 . Factors implicated in the development of RCC include cigarette smoking exposure to petroleum products obesity diuretic use cadmium exposure and ionizing radiation 3-9 . In the last 20 yr the surgical management of RCC has evolved. Radical nephrectomy is no longer considered the only approach to RCC and modifications in the radical nephrectomy relating specifically to adrenalectomy and regional lymphnode dissection are now widely accepted. In the last 10 yr reports from major centers have shown the effective application of partial nephrectomy or nephronsparing surgery in the treatment of small incidentally discovered renal tumors. In the last 5 yr advances in endosurgical instrumentation have allowed dedicated investigators to explore laparoscopic and laparoscopically assisted nephrectomy as alternatives to open surgical techniques. Finally the limits of operative treatment for advanced cases of RCC are being explored including the role of surgery in locally recurrent RCC in renal tumors involving the inferior vena cava and in the treatment of patients with metastatic disease. From Methods in .