Maggio Giugno 2022 - In depth review

Renal cell carcinoma: an overview of the epidemiology, diagnosis, and treatment

Abstract

Renal cell carcinoma (RCC) is the most common type of urogenital cancer. It has a mortality rate of 30-40% and is more commonly seen in men than women. In addition to gender, other risk factors of RCC include obesity, hypertension, smoking, and chronic kidney disease. Following the improvements in diagnostic tests, such as CT and MRI imaging, the incidence of patients diagnosed with RCC has rapidly increased over the past decades. The most common type of RCC, based on histological and molecular subtypes, is clear cell carcinoma which occurs frequently due to mutations in the VHL gene. Nephron-sparing surgery is a selective technique to maintain kidneys in patients while radical nephrectomy and partial nephrectomy are used to remove small tumors. In addition to surgical approaches, adjuvant therapy and targeted therapy are applied in patients with metastatic RCC. In this review, we give an overview of the most recent research on RCC which would help physicians to better manage patients with RCC.

Keywords: renal cell carcinoma, kidney cancer, genetics

Introduction

Kidney cancer is the cause of 5% of malignancies and is the sixth most common cancer in men. It is also the cause of 3% of malignancies and the tenth most common cancer in women [1]. Renal cancer occurs mostly in European and North American populations. However, the occurrence rate of renal cancer is lower in Asia. According to the Global Cancer Statistics in 2020, the incidence and mortality of kidney cancer were 431,288 and 179,368, respectively. Renal cell carcinoma (RCC) rises from renal tubular epithelial cells and accounts for more than 90% of kidney cancers [2]. The death rate of RCC has been reported to be approximately 2% of all cancers in 2016 [3]. Furthermore, the incidence of RCC has increased in recent years [4] as a result of improved cross-section abdominal imaging [5]. Although RCC is the most common urogenital malignancy, most cases of RCC are diagnosed accidentally. Diagnosis of RCC at early stages is critical in treating patients and reducing death rates. However, optimal screening modalities and approaches have not been established yet [6]. Choosing the best therapeutic approach is necessary for improving the outcome of patients with RCC. Therefore, this article aimed to present the recent advances in the diagnosis, treatment, and molecular characterization of RCC which could help to identify the best modality to diagnose and treat RCC patients.

 

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