Cancer of the Kidney
Summary of Key Points
• Renal cell carcinoma (RCC) accounts for 3% of malignancies in adults.
• Cigarette smoking (in more than 20% of cases) and obesity (in more than 30%) are established causal factors for RCC.
• Four percent of cases of RCC arise from hereditary syndromes.
• Different subtypes of RCC are characterized by distinct clinical behavior, genetic abnormalities, and molecular signatures.
• Clear cell RCC is the most common histologic subtype, representing approximately 70% of all sporadic RCCs.
• The von Hippel-Lindau tumor suppressor gene is genetically and epigenetically altered in more than 75% of sporadic cases of clear cell RCC.
• Prognosis for RCC is dependent on tumor histologic type, grade, and stage.
• Nephron-sparing surgery has become the gold standard, when feasible.
• Follow-up guidelines for resected RCC include history, physical examination, periodic metabolic panels, and abdominal and chest computed tomography (CT) studies 4 to 6 months after surgery.
