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Management of Localized and Locally Advanced RCC

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A Guide to Management of Urological Cancers

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Abstract

Renal cell carcinoma (RCC) management is one of the most evolving domains in urooncology care. The tumour is typically labelled as internist tumour and most often they are detected incidentally on a routine screening. RCCs typically arise from the proximal tubular epithelium of the nephron and hence mostly are cortical in location. RCCs grow slowly and can present as localized or locally advanced or even metastatic stage. RCCs located within the covering layer of kidney, i.e., renal capsule are localized RCC. Locally advanced RCCs are the ones having any of the following characteristics: extending into major veins, invading the adrenal gland, extending into the peri-renal or peri-pelvic fat, or invading beyond the Gerota fascia. To understand this, let us first briefly revise the anatomical coverings of kidneys (Fig. 3.1). The fat pad outside the Gerota fascia is known as pararenal fat. The fat pad between the Gerotafascia and renal capsule is known as perirenal fat. The fat pad in the renal hilum and the sinus spaces is known as peripelvic or sinus fat pad. Invasion by a renal mass of anyone of these spaces and/or contiguous involvement of an adrenal gland qualifies as a locally advanced tumour.

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Authors and Affiliations

  1. Department of Urology, PGIMER, Chandigarh, India

    Ravimohan Suryanarayan Mavuduru

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  1. Department of Urology, All India Institute of Medical Sciences, New Delhi, Delhi, India

    Prabhjot Singh

  2. Department of Urology, All India Institute of Medical Sciences, New Delhi, Delhi, India

    Brusabhanu Nayak

  3. Department of Urology, All India Institute of Medical Sciences, New Delhi, Delhi, India

    Sridhar Panaiyadiyan

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Mavuduru, R.S. (2023). Management of Localized and Locally Advanced RCC. In: Singh, P., Nayak, B., Panaiyadiyan, S. (eds) A Guide to Management of Urological Cancers. Springer, Singapore. https://doi.org/10.1007/978-981-99-2341-0_3

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