Skip to main content

Advertisement

Log in

Operative Therapie des Nierenzellkarzinoms

Operative treatment of renal cell carcinoma

  • Übersichten
  • Published:
Der Urologe Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Literatur

  1. 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

    Google Scholar 

  2. 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/

  3. 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

    Article  PubMed  Google Scholar 

  4. Heidenreich A, Ravery V (2004) European Society of Oncological Urology. Preoperative imaging in renal cell cancer. World J Urol 22(5):307–315

    Article  PubMed  Google Scholar 

  5. 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

    PubMed  CAS  Google Scholar 

  6. 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

    Article  PubMed  CAS  Google Scholar 

  7. 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

    Article  PubMed  Google Scholar 

  8. 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

    Article  PubMed  CAS  Google Scholar 

  9. 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

    Article  PubMed  Google Scholar 

  10. 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

    Article  PubMed  CAS  Google Scholar 

  11. 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

    Article  PubMed  Google Scholar 

  12. 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

    Article  PubMed  Google Scholar 

  13. 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

    PubMed  CAS  Google Scholar 

  14. 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

    PubMed  CAS  Google Scholar 

  15. 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

    Article  PubMed  CAS  Google Scholar 

  16. Chan DY, Cadeddu JA, Jarrett TW et al (2001) Laparoscopic radical nephrectomy: cancer control for renal cell carcinoma. J Urol 166(6):2095–2099

    Article  PubMed  CAS  Google Scholar 

  17. 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

    Article  PubMed  CAS  Google Scholar 

  18. Portis AJ, Yan Y, Landman J et al (2002) Long-term followup after laparoscopic radical nephrectomy. J Urol 167(3):1257–1262

    Article  PubMed  Google Scholar 

  19. 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

    Article  PubMed  Google Scholar 

  20. 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

    Article  PubMed  Google Scholar 

  21. 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

  22. 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

    Article  PubMed  Google Scholar 

  23. 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

    Google Scholar 

  24. 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

    Article  PubMed  Google Scholar 

  25. 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

    Article  PubMed  Google Scholar 

  26. 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

    Article  PubMed  Google Scholar 

  27. 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

    Article  PubMed  Google Scholar 

  28. 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

    Article  PubMed  Google Scholar 

  29. Flanigan RC, Mickisch G, Sylvester R (2004) Cytoreduktive nephrectomy in patients with metastatic renal cancer: a combined analysis. J Urol 171:1071–1076

    Article  PubMed  Google Scholar 

  30. Pouliot F, Shuch B, Larochelle JC et al (2010) Contemporary management of renal tumors with venous tumor thrombus. J Urol 184(3):833–841

    Article  PubMed  Google Scholar 

  31. Kavolius JP, Mastorakos DP, Pavlovich C et al (1998) Resection of metastatic renal cell carcinoma. J Clin Oncol 16(6):2261–2266

    PubMed  CAS  Google Scholar 

  32. Mickisch G (2002) Principles of nephrectomy for malignant disease. BJU Int 89(5):488–495

    Article  PubMed  CAS  Google Scholar 

  33. 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

    Article  PubMed  Google Scholar 

  34. Lam JS, Belldegrun AS, Figlin RA (2006) Adjuvant treatment for renal cell carcinoma. Expert Opin Pharmacother 7:705–720

    Article  PubMed  CAS  Google Scholar 

  35. 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

    Article  PubMed  Google Scholar 

  36. 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

    Article  PubMed  Google Scholar 

  37. Amin C, Wallen E, Pruthi RS et al (2008) Preoperative tyrosine kinase inhibition as an adjunct to debulking nephrectomy. Urology 72:864–868

    Article  PubMed  Google Scholar 

  38. Thomas AA, Rini BI, Stephenson AJ et al (2009) Surgical resection of renal cell carcinoma after targeted therapy. J Urol 182(3):881–886

    Article  PubMed  Google Scholar 

  39. 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

    Article  PubMed  Google Scholar 

  40. 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

    Article  PubMed  Google Scholar 

  41. Firek P, Brehmer B, Richter S, Heidenreich A (2010) Metastasenresektion nach meoadjuvanter Systemtherapie mit Multi-Tyrosinknaseinhibitoren beim metastasierten Nierenzellkarzinom. Urol 49(Suppl 1):52

    Google Scholar 

  42. 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

    PubMed  CAS  Google Scholar 

Download references

Interessenkonflikt

Keine Angaben

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. Heidenreich.

Rights and permissions

Reprints 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

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s00120-011-2670-z

Schlüsselwörter

Keywords

Navigation