Renal cell carcinoma natural history, complications, and prognosis

Revision as of 18:36, 24 August 2015 by Shanshan Cen (talk | contribs)
Jump to navigation Jump to search

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul; Serge Korjian; Rim Halaby, M.D. [2]

Renal cell carcinoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Renal cell carcinoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural history, Complications and Prognosis

Diagnosis

Staging

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Renal cell carcinoma natural history, complications, and prognosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Renal cell carcinoma natural history, complications, and prognosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Renal cell carcinoma natural history, complications, and prognosis

CDC on Renal cell carcinoma natural history, complications, and prognosis

Renal cell carcinoma natural history, complications, and prognosis in the news

Blogs on Renal cell carcinoma natural history, complications, and prognosis

Directions to Hospitals Treating Renal cell carcinoma

Risk calculators and risk factors for Renal cell carcinoma natural history, complications, and prognosis

Overview

Common complications of renal cell carcinoma include hypertension, hypercalcemia, budd-chiari syndrome, hepatic vein thrombosis, polycythemia, renal failure, metastasis. Prognosis is generally poor, and the 5-year mortality of renal cell carcinoma is approximately 73.2%.

Natural History

Complications

The following are possible complications of the primary tumor and its spread, associated paraneoplastic syndromes, or metastasis:

Prognosis

The presence of the following factors may correlate with a poorer prognosis in renal cell carcinoma[1][2][3]:

Other prognostic scoring include the tumor-mode-metastasis (TNM) staging system and the Fuhrman nuclear grade.[1][4][5]

Survival

  • Patients with metastatic renal cell carcinoma have a median age of survival reaching approximately 13 months. Available medical therapy, however, may significantly prolong survival of patients with metastatic disease.[1]
  • Between 2004 and 2010, the 5-year relative survival of patients with kidney cancer was 73.7%.[6]
  • When stratified by age, the 5-year relative survival of patients with kidney cancer was 78% and 65% for patients <65 and ≥ 65 years of age respectively.[6]
  • The survival of patients with kidney cancer varies with the stage of the disease. Shown below is a table depicting the 5-year relative survival by the stage of kidney cancer:[6]
Stage 5-year relative survival (%), (2004-2010)
All stages 72.4%
Localized 91.8%
Regional 64.7%
Distant 12.1%
Unstaged 32.2%
  • Shown below is an image depicting the 5-year conditional relative survival (probability of surviving in the next 5-years given the cohort has already survived 0, 1, 3 years) between 1998 and 2010 of kidney cancer by stage at diagnosis according to SEER. These graphs are adapted from SEER: The Surveillance, Epidemiology, and End Results Program of the National Cancer Institute.[6]

5-year conditional relative survival (probability of surviving in the next 5-years given the cohort has already survived 0, 1, 3 years) between 1998 and 2010 of kidney cancer by stage at diagnosis according to SEER

The following table summarizes the 5-year survival of patients according to cancer staging[1][7]:

Five-Year Survival of Various Stages of Renal Cell Carcinoma[1][7]
Stage Tumor Characteristics Five-Year Survival
Stage I Tumor < 7 cm in greatest dimension, limited to kidney 95%
Stage II Tumor > 7 cm in greatest dimension, limited to kidney 88%
Stage III Tumor in major veins or adrenal glands, tumor within Gerota's fascia, or 1 regional lymph node involved 59%
Stage IV Tumor beyond Gerota's fascia or > 1 regional lymph node involved 20%
Adapted from Cohen HT, McGovern FJ. Renal-cell carcinoma. N Engl J Med. 2005; 353:2477-90.

References

  1. 1.0 1.1 1.2 1.3 1.4 Cohen HT, McGovern FJ (2005). "Renal-cell carcinoma". N Engl J Med. 353 (23): 2477–90. doi:10.1056/NEJMra043172. PMID 16339096.
  2. Motzer RJ, Mazumdar M, Bacik J, Berg W, Amsterdam A, Ferrara J (1999). "Survival and prognostic stratification of 670 patients with advanced renal cell carcinoma". J Clin Oncol. 17 (8): 2530–40. PMID 10561319.
  3. Motzer RJ, Bacik J, Schwartz LH, Reuter V, Russo P, Marion S; et al. (2004). "Prognostic factors for survival in previously treated patients with metastatic renal cell carcinoma". J Clin Oncol. 22 (3): 454–63. doi:10.1200/JCO.2004.06.132. PMID 14752067.
  4. Zisman A, Pantuck AJ, Dorey F, Said JW, Shvarts O, Quintana D; et al. (2001). "Improved prognostication of renal cell carcinoma using an integrated staging system". J Clin Oncol. 19 (6): 1649–57. PMID 11250993.
  5. Patard JJ, Kim HL, Lam JS, Dorey FJ, Pantuck AJ, Zisman A; et al. (2004). "Use of the University of California Los Angeles integrated staging system to predict survival in renal cell carcinoma: an international multicenter study". J Clin Oncol. 22 (16): 3316–22. doi:10.1200/JCO.2004.09.104. PMID 15310775.
  6. 6.0 6.1 6.2 6.3 Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.
  7. 7.0 7.1 Javidan J, Stricker HJ, Tamboli P, Amin MB, Peabody JO, Deshpande A; et al. (1999). "Prognostic significance of the 1997 TNM classification of renal cell carcinoma". J Urol. 162 (4): 1277–81. PMID 10492179.