Perspective Chapter: An Update on Renal Cell Carcinoma

Abstract

Incidence and mortality of renal cell carcinoma (RCC) significantly vary worldwide. While RCC incidence has been increasing, its mortality rate has been decreasing. Smoking, obesity, hypertension, chronic kidney disease (CKD), ethnicity, location, and other environmental factors are reported to be associated with RCC. With the use of the improved diagnostic methods, including ultrasound, contrast-enhanced ultrasound (CEUS), computed tomography (CT) scan, magnetic resonance imaging (MRI), and positron emission tomography (PET)/CT scan, the detection rate of RCC has significantly increased over the past decade. We have witnessed innovation in surgical techniques and robotic platforms with integration of imaging approaches, and urologists are now able to maximize functional and oncologic outcomes in nephron preservation and complication-free recovery. Thus, the paradigm in the surgical treatment of RCC has transformed and will continue to change in the future. In addition, targeted therapy, immunotherapy, and combination therapy are adopted to treat patients with advanced RCC. In recent years, the combination of immune checkpoint inhibition and antiangiogenic therapy is a very attractive combined therapeutic strategy for advanced/metastatic RCCs. Biomarkers, including epigenetic markers for RCC, have been increasing, which will be helpful to discover new therapeutic targets and related inhibitors for the treatment of advanced RCC.