Zusammenfassung
Das Nierenzellkarzinom repräsentiert den 5. häufigsten bösartigen Tumor des Menschen. Zum Zeitpunkt der Diagnose weisen 20% der Patienten bereits Metastasen auf. Weitere 20–30% der Patienten entwickeln im postoperativen Verlauf systemische Metastasen. Trotz Fortentwicklungen der medikamentösen Therapieoptionen stellt die dem individuellen Tumorbefund adäquate Tumorchirurgie die einzige kurative Therapiemöglichkeit dar.
Abstract
Renal cell carcinoma represents the fifth most frequent malignant tumor in humans. At the time of diagnosis, 20% of the patients already manifest metastases. A further 20–30% of the patients develop systemic metastases in the postoperative course. Despite continued advances in pharmacological treatment options, cancer surgery tailored to the individual tumor findings constitutes the only curative treatment option.
Literatur
Hock LM, Lynch J, Bajaj KC (2002) Increasing incidence of all stages of kidney cancer in the last 2 decades in the United States: an analysis of surveillance, epidemiology and end results program data. J Urol 1671:57–60
Ries LAG, Melbert D, Krapcho M et al (2008) SEER Cancer Statistics Review, 1975–2005, National Cancer Institute. http://seer.cancer.gov/csr/1975_2005/
Ljungberg B, Hanbury DC, Kuczyk MA et al (2007) European Association of Urology Guideline Group for renal cell carcinoma. Renal cell carcinoma guideline. Eur Urol 51:1502–1510
Heidenreich A, Ravery V (2004) European Society of Oncological Urology. Preoperative imaging in renal cell cancer. World J Urol 22(5):307–315
Studer UE, Scherz S, Scheidegger J et al (1990) Enlargement of regional lymph nodes in renal cell carcinoma is often not due to metastases. J Urol 144(2 Pt 1):243–245
Ohlmann CH, Ozgür E, Schrader AJ et al (2006) Detection of circulating tumor cells in patients with renal cell carcinoma by reverse transcriptase polymerase chain reaction for G250/MNCA-9: results of a prospective trial. Urol Oncol 24(4):287–293
Ito A, Satoh M, Ohyama C et al (2002) Adrenal metastasis from renal cell carcinoma: significance of adrenalectomy. Int J Urol 9(3):125–128
Siemer S, Lehmann J, Kamradt J et al (2004) Adrenal metastases in 1635 patients with renal cell carcinoma: outcome and indication for adrenalectomy. J Urol 171(6 Pt 1):2155–2159
Alamdari FI, Ljungberg B (2005) Adrenal metastasis in renal cell carcinoma: a recommendation for adjustment of the TNM staging system. Scand J Urol Nephrol 39(4):277–282
Kuczyk M, Wegener G, Jonas U (2005) The therapeutic value of adrenalectomy in case of solitary metastatic spread originating from primary renal cell cancer. Eur Urol 48(2):252–257
Antonelli A, Cozzoli A, Simeone C et al (2006) Surgical treatment of adrenal metastasis from renal cell carcinoma: a single-centre experience of 45 patients. BJU Int 97(3):505–508
Blom JH, van Poppel H, Maréchal JM et al (2009) EORTC Genitourinary Tract Cancer Group. Radical nephrectomy with and without lymph-node dissection: final results of European Organization for Research and Treatment of Cancer (EORTC) randomized phase 3 trial 30881. Eur Urol 55(1):28–34
Carl P, Klein U, Gebauer A, Schmiedt E (1977) The value of lymphography for the TNM classification of renal carcinoma. Eur Urol 3(5):286–288
Giuliani L, Giberti C, Martorana G, Rovida S (1990) Radical extensive surgery for renal cell carcinoma: long-term results and prognostic factors. J Urol 143(3):468–473
Blom JH, van Poppel H, Marechal JM et al (1999) Radical nephrectomy with and without lymph node dissection: preliminary results of the EORTC randomized phase III protocol 30881. EORTC Genitourinary Group. Eur Urol 36(6):570–575
Chan DY, Cadeddu JA, Jarrett TW et al (2001) Laparoscopic radical nephrectomy: cancer control for renal cell carcinoma. J Urol 166(6):2095–2099
Ono Y, Kinukawa T, Hattori R et al (2001) The long-term outcome of laparoscopic radical nephrectomy for small renal cell carcinoma. J Urol 165(6 Pt 1):1867–1870
Portis AJ, Yan Y, Landman J et al (2002) Long-term followup after laparoscopic radical nephrectomy. J Urol 167(3):1257–1262
Saika T, Ono Y, Hattori R et al (2003) Long-term outcome of laparoscopic radical nephrectomy for pathologic T1 renal cell carcinoma. Urology 62(6):1018–1023
Permpongkosol S, Chan DY, Link RE et al (2005) Long-term survival analysis after laparoscopic radical nephrectomy. J Urol 174(4 Pt 1):1222–1225
Go AS, Chertow GM, Fan et al (2004)Chronic kidney disease and the risk of death, cardiovascular events, and hospitilization; N Engl J Med 351:1296–1305
Huang WC, Levey AS, Serio AM et al (2006) Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol 7:735–740
Crépel M, Jeldres C, Perrotte P et al (2010) Nephron-sparing surgery is equally effective to radical nephrectomy for T1BN0M0 Renal Cell Carcinoma: A Population-based Assessment: Urology 75: 271–275
Poulakis V, Witzsch U, de Vries R et al (2003) Quality of life after surgery for localized renal cell carcinoma: comparison between radical nephrectomy and nephron-sparing surgery. Urology 62:814–817
Patard JJ, Shvarts O, Lam JS et al (2004) Sefety and efficacy of partial nephrectomy for all T1 tumors based on an international multicenter experience. J Urol 171: 2181–2185
Hellenthal NJ, Mansour AM, Hayn MH, Schwaab T (2011) Renal cell carcinoma in octogenarians: nephron sparing surgery should remain the standard of care. J Urol 185:415–420
Miller DC, Schonlau M, Litwin MS et al (2008) Urologic diseases in america project. Renal and cardiovascular morbidity after partial or radical nephrectomy. Cancer 112:511–520
Becker F, Siemer S, Hack M et al (2006) Excellent long term cancer control with elective nephron sparing surgery for selected renal cell carcinomas measuring more than 4 cm. Eur Urol 49:1058–1064
Flanigan RC, Mickisch G, Sylvester R (2004) Cytoreduktive nephrectomy in patients with metastatic renal cancer: a combined analysis. J Urol 171:1071–1076
Pouliot F, Shuch B, Larochelle JC et al (2010) Contemporary management of renal tumors with venous tumor thrombus. J Urol 184(3):833–841
Kavolius JP, Mastorakos DP, Pavlovich C et al (1998) Resection of metastatic renal cell carcinoma. J Clin Oncol 16(6):2261–2266
Mickisch G (2002) Principles of nephrectomy for malignant disease. BJU Int 89(5):488–495
Piltz S, Meimarakis G, Wichmann MW et al (2002) Long-term results after pulmonary resection of renal cell carcinoma metastases. Ann Thorac Surg 73(4):1082–1087
Lam JS, Belldegrun AS, Figlin RA (2006) Adjuvant treatment for renal cell carcinoma. Expert Opin Pharmacother 7:705–720
Patard JJ, Thuret R, Raffi A et al (2009) Treatment with sunitinib enabled complete resection of massive lymphadenopathy not previously amenable to excision in a patient with renal cell carcinoma. Eur Urol 55:237–239
Karakiewicz PI, Suardi N, Jeldres C et al (2008) Neoadjuvant sutent induction therapy may effectively down-stage renal cell carcinoma atrial thrombi. Eur Urol 53:845–848
Amin C, Wallen E, Pruthi RS et al (2008) Preoperative tyrosine kinase inhibition as an adjunct to debulking nephrectomy. Urology 72:864–868
Thomas AA, Rini BI, Stephenson AJ et al (2009) Surgical resection of renal cell carcinoma after targeted therapy. J Urol 182(3):881–886
Wood CG, Margulis V (2009) Neoadjuvant (presurgical) therapy for renal cell carcinoma: a new treatment paradigm for locally advanced and metastatic disease. Cancer 115(10 Suppl):2355–2360
Margulis V, Matin SF, Tannir N et al (2008) Surgical morbidity associated with administration of targeted molecular therapies before cytoreductive nephrectomy or resection of locally recurrent renal cell carcinoma. J Urol 180(1):94–98
Firek P, Brehmer B, Richter S, Heidenreich A (2010) Metastasenresektion nach meoadjuvanter Systemtherapie mit Multi-Tyrosinknaseinhibitoren beim metastasierten Nierenzellkarzinom. Urol 49(Suppl 1):52
Oosterling SJ, van der Bij GJ, Mels AK et al (2006) Perioperative IFN-alpha to avoid surgically induced immune suppression in colorectal cancer patients. Histol Histopathol 21(7):753–760
Interessenkonflikt
Keine Angaben
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Heidenreich, A. Operative Therapie des Nierenzellkarzinoms. Urologe 50 (Suppl 1), 208 (2011). https://doi.org/10.1007/s00120-011-2670-z
Published:
DOI: https://doi.org/10.1007/s00120-011-2670-z