Renal Cell Cancer

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Investigations

CT - RCC causing back pain 2.jpg

  • Image above - This CT scan shows a large mass (an inoperable renal cell cancer) that caused severe back pain.


Prognosis

For patients with resectable disease, cure is possible. For patients with unresectable or recurrent and metastatic disease, renal cell cancer becomes a palliative illness. In recent years, with the advent of effective treatments such as sunitinib and sorafenib, people are living longer.

Some of the negative prognostic factors include:

  • A poor performance score (AKPS of 70 or less)
  • Biochemical abnormalities, including
    • A raised LDH > 1.5 times normal
    • A raised corrected calcium (> 2.5)
    • A low haemoglobin (below the lower limit of normal)
  • No previous nephrectomy (that is, locally advanced disease that could not be resected as opposed to recurrent disease post surgery)

Certain histological sub-types of renal cell cancer are associated with a poor prognosis too. Patients with sarcomatoid features generally have a poorer prognosis. In one study, approximately 20% of patients with this cancer had a partial response to treatment, 50% had a stable disease and 30% had progressive disease, with a overall median survival of 5 months.[1]

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References

  1. Golshayan et al. Metastatic sarcomatoid renal cell carcinoma treated with vascular endothelial growth factor-targeted therapy. Clin Oncol. 2009; 27(2):235.