Onconephrology: Renal cancer

Abstract

Renal cancer (RC) ranks eighth among the most prevalent oncopathologies, making it one of the most widespread types of cancer. Over the last decade, there has been an average annual increase in morbidity of 2 percent. RC is a collective term that encompasses parenchymal tumors and pelvis tumors with distinct histologic characteristics. Renal cancer can appear in intact kidneys and cause additional damage except for the actual tumor process, or in patients with previously affected kidneys. The main treatment option for renal cell carcinoma (RCC) is surgery, which can be performed through various approaches, including open-access surgery, laparoscopic surgery, and robotic-assisted surgery. These surgical techniques enable the performance of radical nephrectomy, partial nephrectomy, and cytoreductive nephrectomy. The selection of the surgical method and the extent of the intervention fall within the expertise of oncourologists. Anti-angiogenic drugs, including tyrosine kinase inhibitors, humanized monoclonal antibodies, and immune checkpoint inhibitors, as well as mTOR inhibitors, are commonly utilized in the treatment of advanced-stage RCC (II-IV) or its relapse. However, it is important to note that these drugs possess considerable nephrotoxicity. Therefore, kidney status plays a crucial role in determining the appropriate treatment options, the dosage of antitumor drugs, and the potential nephrotoxicity associated with them, thereby becoming the main limiting factor affecting the quality and duration of life for RCC patients. The present review focuses on the analysis of recent data concerning the issues mentioned above, primarily in relation to RCC, and provides recommendations for the investigation and treatment of this specific category of patients.