Contemporary management of renal cell carcinoma:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2003
|
| Schriftenreihe: | The urologic clinics of North America
30,3 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XVI S., S. 423 - 668 zahlr. Ill., graph. Darst. |
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| adam_text | (.O.VIT.MmRARY MA AC;i MI . l Ol: Kl NAI. CM.I. CARCINOMA
CONTENTS
Preface xv
Samir S. Taneja
The Basic Biology and Immunobiology of Renal Cell Carcinoma:
Considerations for the Clinician 423
Robert G. Uzzo, Paul Cairns, Tahseen Al Saleem, Gary Hudes, Naomi Haas,
Richard E. Greenberg, and Vladimir Kolenko
Renal cell carcinoma (RCC) is a heterogeneous disease from its very inception. Epithelial
tumors of the kidney exhibit significant differences in their genetic and antigenic de¬
rangements. These biologic differences are reflected in the disparate clinical course of af¬
fected patients. A working knowledge of the basic biology of RCC is essential for
clinicians who manage this disease. This article reviews the basic molecular and immu¬
nobiology of RCC before discussing three specific and relevant translational questions:
What does the basic biology of RCC tell us about emerging early detection methods?
What might the basic biology tell us about prognosis and patient counseling? What does
the basic biology teach us about therapeutic approaches?
The Genetic Basis of Renal Cell Carcinoma 437
Christian P. Pavlovich, Laura S. Schmidt, and John L. Phillips
The recognition of hereditary forms of renal cancer and the development of high
throughput genetic analysis have led to the identification of genes responsible for famil¬
ial renal epithelial tumors of differing histologies and cytogenetic features. Some of these
genes (VHL) are known to have an important role in sporadic renal neoplasia. This ar¬
ticle describes the various epithelial renal tumors most commonly encountered by the
urologist, the molecular and cytogenetic distinctions between them, and the hereditary
syndromes that predispose to these tumors. Consideration of these syndromes is impor¬
tant for proper treatment when one encounters patients with multiple renal tumors, tu¬
mors at an early age of onset, or patients with a positive family history of renal cell
carcinoma.
Tumor Antigens and Markers in Renal Cell Carcinoma 455
Peter Mulders, Ivar Bleumer, and Egbert Oosterwijk
The investigated tumor markers in renal cell carcinoma (RCC) may show additional
prognostic value over classical prognostic factors such as stage and grade. These markers
can be used for better patient selection, a more accurate individualization of treatment,
and improved follow up. Tumor antigens that are specific to RCC and that induce a
VOLUME 30 • NUMBER 3 • AUGUST 2003 vii
specific immune response can be used for vaccine treatment modalities. This article pre¬
sents an overview and insight into the use of tumor markers and antigens in RCC.
Prognostic Factors in Renal Cell Carcinoma 467
James A. Kontak, and Steven C. Campbell
Renal cell carcinoma (RCC) remains a major source of morbidity and mortality, with ap¬
proximately 40% of patients eventually dying of cancer progression. Prognosticators for
adverse events are vitally important for a rational approach to the management of RCC.
In addition, reliable predictive factors are essential for stratification of patients into clin¬
ical trials and can provide an important reference point for comparison of data from dif¬
ferent institutions and various treatment protocols. This article reviews the clinical,
laboratory, and pathologic findings that are now established prognostic factors for
RCC and highlights the more recent innovative efforts to integrate these parameters
and thereby improve the predictive power for patients with this disease.
Current Staging of Renal Cell Carcinoma 481
Bradley C. Leibovich, Allan J. Pantuck, Matthew H.T. Bui, Ken Ryu Han,
Amnon Zisman, Robert Figlin, and Arie Belldegrun
Most ( 80%) cancers involving the kidney are renal cell carcinoma (RCC). One third of
patients diagnosed with kidney cancer have evidence of metastatic disease at the time of
diagnosis, and as many as half of patients treated for localized disease eventually re¬
lapse. As is true for any other malignancy, one must determine which tumor features,
patient factors, and laboratory techniques will provide diagnostic and prognostic infor¬
mation for patients with RCC. This article focuses on the history and rationale of the cur¬
rent staging systems for RCC as well as the potential for improvements by the addition
of other clinical, pathologic, and molecular prognostic markers.
Renal Imaging for Diagnosis and Staging of Renal Cell Carcinoma 499
Gary M. Israel and Morton A. Bosniak
Radiologic evaluation of renal masses has rapidly progressed from conventional angio
graphy and intravenous urography to CT and MRI. As more patients are imaged for var¬
ious reasons, the incidental detection of renal masses has increased. Although most of
these lesions are benign cysts, neoplastic disease is also uncovered and may require sur¬
gery. The ability to characterize these lesions accurately, to determine their appropriate
management, and to stage renal malignancies has been afforded by continuously im¬
proving imaging techniques. This article reviews the use of CT and MRI in the diagnosis
and staging of malignant renal disease and its differentiation from nonsurgical renal
masses.
Three dimensional Image Reconstruction for Preplanning of Renal Surgery 515
Ithaar H. Derweesh, Brian Herts, and Andrew C. Novick
The diagnosis of renal cell carcinoma has improved owing to an increased sensitivity in
detecting smaller tumors at an earlier stage that are amenable to local excision. Conse¬
quently, the indications for nephron sparing surgery have expanded with the detection
of such lesions, which are often asymptomatic. Helical CT and three dimensional volume
rendering can be combined into a single noninvasive test to delineate renal tumors
and normal and complex renal anatomy before nephron sparing surgery. The authors
experience suggests that three dimensional spiral CT can assist in the planning of
nephron sparing surgery by helping to determine the resectability of the mass and by
depicting its relationship to the renal vasculature and collecting system.
viii CONTENTS
The Role of Partial Nephrectomy for Renal Cell Carcinoma
in Contemporary Practice 529
Alan M. Nieder and Samir S. Taneja
The role of partial nephrectomy for renal cell carcinoma continues to evolve in contem¬
porary practice. Originally restricted to patients with a substantial risk of renal failure,
the indications for partial nephrectomy now include selected individuals with tumors
smaller than 7 cm and a normal contralateral kidney. Long term, cancer specific survival
data for patients undergoing elective partial nephrectomy now mirror outcome data for
patients undergoing radical nephrectomy, with a decreased risk of chronic renal insuffi¬
ciency. Ultimately, the indications will continue to evolve as surgeons become more fa¬
miliar with the techniques of laparoscopic radical nephrectomy and laparoscopic partial
nephrectomy.
Laparoscopic Radical Nephrectomy: Oncologic Efficacy 543
Kenneth Ogan, Jeffrey A. Cadeddu, and Michael D. Stifelman
Laparoscopic radical nephrectomy has evolved tremendously over the past decade to
the point where it should be considered the standard of care for localized renal tumors
not amenable to nephron sparing surgery. The benefits of decreased postoperative pain,
shortened hospital stay, quicker convalescence, and improved cosmesis have been
proved in numerous studies. Now, long term oncologic results of laparoscopic radical
nephrectomy have demonstrated equivalent outcomes to open radical nephrectomy.
Minimally Invasive Nephron sparing Surgery 551
Inderbir S. Gill
The status of minimally invasive nephron sparing surgery is presented herein. Various
approaches, presented in their order of current stature based on available data, include
laparoscopic partial nephrectomy, renal cryotherapy, radiofrequency ablation, and extra
corporeal high intensity focused ultrasound. Newer technologies being investigated in
the laboratory are discussed briefly, and the potential of minimally invasive nephron
sparing surgery is explored.
The Role of Cytoreductive Nephrectomy in the Management of Metastatic
Renal Cell Carcinoma 581
Christopher G. Wood
This review examines the evidence for and against initial cytoreductive radical nephrect¬
omy as a treatment approach to patients with metastatic renal cell carcinoma. Single in¬
stitution series and the results of randomized phase III trials that have addressed
cytoreductive nephrectomy are examined, with the goal of determining the indications,
contraindications, and evidence for patient benefit.
Cytokine based Therapy for Metastatic Renal Cell Cancer 589
Barbara J. Gitlitz and Robert A. Figlin
Renal cell carcinoma (RCC) has been the model for the development of immune based
therapies. These therapeutic biologic molecules include cytokines such as the interleu
kins and interferons. Over the last two decades, practitioners have become more facile
with the clinical use of these cytokines for the treatment of metastatic RCC. Although
the response rates are modest, the reproducible durable remissions seen with the cyto¬
kines underlie their therapeutic development. Their use has been examined in several
clinical trials, mainly phase I and phase II. Phase III trials have also been completed
or are ongoing, with the potential to answer salient therapeutic questions.
CONTENTS ix
Chemotherapeutic Strategies for Renal Cell Carcinoma 601
Matthew I. Milowsky and David M. Nanus
Metastatic renal cell carcinoma (RCC) is a disease that is highly resistant to systemic che¬
motherapy. Responses to combination chemotherapy have been reported in patients
with collecting duct carcinoma and the sarcomatoid variant of renal cancer. Clinical trials
combining chemotherapy with biologic response modifiers have not resulted in signifi¬
cant advances in the treatment of RCC. Patients with advanced local or metastatic RCC
should be offered investigational therapeutic options. The identification of novel agents
with significantly improved antitumor activity remains a high priority in the treatment
of this disease.
Allogeneic Stem Cell Transplantation as Immunotherapy for Renal Cell
Carcinoma: From Immune Enhancement to Immune Replacement 611
Darrel Drachenberg and Richard W. Childs
Spontaneous regressions of metastatic RCC strongly suggest a proclivity of this tumor to
be regulated by the immune system and have led investigators to test allogeneic based
immunotherapy in this type of malignancy. Graft versus tumor effects are generated
against immunosensitive RCC following the transplantation of allogeneic donor T lym¬
phocytes. This article reviews the development and outcome of pilot immunotherapy
trials based on the use of an allogeneic immune system to treat metastatic RCC and de¬
scribes some of the early in vitro data implicating donor T cells as mediators of disease
regression.
Monoclonal Antibody based Therapy for Renal Cell Carcinoma 623
Egbert Oosterwijk, Chaitanya R. Divgi, Adrienne Brouwers, Otto C. Boerman,
Steven M. Larson, Peter Mulders, and Lloyd J. Old
Despite intensive efforts to develop an effective treatment, once renal cell carcinoma
(RCC) has metastasized, treatment options are limited. This tumor is not sensitive to
radiotherapy and is resistant to chemotherapy, and treatment with biologic response
modifiers (interleukin 2, interferon) leads to low response rates. Monoclonal antibodies
(mAb) selected for high tumor specificity might provide new treatment possibilities for
RCC. This article discusses general issues related to mAb treatment and reviews current
knowledge of the effect of mAb G250 treatment in patients with metastatic RCC. This
mAb recognizes a target molecule on virtually all clear cell RCCs and may be a valuable
and highly selective agent to attack RCC.
Tumor Vaccines: From Gene Therapy to Dendritic Cells—the Emerging
Frontier 633
Johannes Vieweg and Jens Dannull
Gene modified tumor cells have been employed in a vaccination setting to trigger ther¬
apeutic antitumor immunity against metastatic renal cell carcinoma. Recent studies sug¬
gest that dendritic cells may be even more potent, because these cells can efficiently
present tumor antigens to effector T cells, thereby circumventing the poor antigen pre¬
senting properties of tumor cells. Proof of concept studies using antigen loaded dendritic
cells have been performed, establishing clear evidence of vaccine safety and bioactivity
by stimulating immunologic and even clinical responses in cancer patients. Nevertheless,
key aspects of such vaccination remain undefined. The critical challenge remains to un¬
derstand fully the mechanisms of action and to further optimize dendritic cell vaccines to
produce effective, durable, and, ultimately, therapeutic antitumor responses.
x CONTENTS
The Craft of Urologic Surgery 645
Inderbir S. Gill
The Craft of Urologic Surgery: The T Pouch 647
John P. Stein and Donald G. Skinner
The flap valve T mechanism in the T pouch provides an effective and reliable antireflux
technique. The long term results of the T pouch are yet to be determined; however, initial
and early results have been excellent. This technique can be learned with a little experi¬
ence. The T mechanism is a versatile flap valve technique that can also be applied as a
continent mechanism in a cutaneous reservoir (double T pouch). Reconstructive sur¬
geons interested in lower urinary tract reconstruction should understand this concept
and technique to broaden their surgical armamentarium.
Index 663
CONTENTS xi
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| spelling | Contemporary management of renal cell carcinoma Samir S. Taneja, guest ed. Philadelphia [u.a.] Saunders 2003 XVI S., S. 423 - 668 zahlr. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier The urologic clinics of North America 30,3 Nierceltumoren gtt Carcinoma, Renal Cell Renal cell carcinoma Hypernephrom (DE-588)4161076-3 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Hypernephrom (DE-588)4161076-3 s DE-604 Taneja, Samir S. Sonstige (DE-588)156996596 oth The urologic clinics of North America 30,3 (DE-604)BV000001584 30,3 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=010539403&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Contemporary management of renal cell carcinoma The urologic clinics of North America Nierceltumoren gtt Carcinoma, Renal Cell Renal cell carcinoma Hypernephrom (DE-588)4161076-3 gnd |
| subject_GND | (DE-588)4161076-3 (DE-588)4143413-4 |
| title | Contemporary management of renal cell carcinoma |
| title_auth | Contemporary management of renal cell carcinoma |
| title_exact_search | Contemporary management of renal cell carcinoma |
| title_full | Contemporary management of renal cell carcinoma Samir S. Taneja, guest ed. |
| title_fullStr | Contemporary management of renal cell carcinoma Samir S. Taneja, guest ed. |
| title_full_unstemmed | Contemporary management of renal cell carcinoma Samir S. Taneja, guest ed. |
| title_short | Contemporary management of renal cell carcinoma |
| title_sort | contemporary management of renal cell carcinoma |
| topic | Nierceltumoren gtt Carcinoma, Renal Cell Renal cell carcinoma Hypernephrom (DE-588)4161076-3 gnd |
| topic_facet | Nierceltumoren Carcinoma, Renal Cell Renal cell carcinoma Hypernephrom Aufsatzsammlung |
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