Contents

1.Overview

2. Epidemiology and etiology

2.1 Epidemiology

2.2 Etiology

2.2.1 Genetic factors

2.2.2 Smoking

2.2.3 Obesity

2.2.4 Hypertension and antihypertensive agents

2.2.5 Acquired cystic renal disease (ACRD) associated with long-term dialysis of end-stage renal disease

2.2.6 Others

3. Histopathology

3.1 Gross pathology

3.2 Classification of RCC

3.3 Pathological grading of RCC and papillary RCC

3.4 Clinical staging of RCC

4. Diagnosis

4.1 Clinical manifestations

4.2 Laboratory test

4.3 Imaging examination

4.3.1 Chest X-ray

4.3.2 Ultrasonography

4.3.3 CT

4.4 MRI

4.5 Positron emission tomography (PET)

4.6 Radionuclide bone scan

4.7 Dynamic renal scan

4.8 Needle core biopsy of renal tumor

5. Prognostic assessment of advanced/metastatic RCC

6. Treatment of RCC

6.1 Surgery

6.1.1 Radical nephrectomy

6.1.2 NSS for RCC

6.1.3 Other surgery related issues

6.2 Interventional therapy for RCC

6.2.1 Artery embolization treatment for RCC

6.2.2 Ablation therapy

6.2.3 Other ablation technologies for renal cancer

6.3 Active surveillance

6.4 Drug treatment

6.5 Traditional Chinese medicine treatment

6.6 Radiotherapy

6.7 Common adverse events and managements of targeted therapy

6.7.1 Hypertension

6.7.2 Hematological toxicity of targeted therapy for RCC

6.7.3 Hand-foot syndrome and dermal toxicity

6.7.4 Adverse events of gastrointestinal tract of targeted therapy for RCC

6.7.5 Hypothyroidism

6.7.6 Liver toxicity of targeted therapy for RCC

6.7.7 Interstitial lung disease

6.7.8 Cardiotoxicity

6.8 Treatment of localized RCC

6.9 Treatment of locally advanced RCC

6.10 Treatment of advanced/metastatic RCC

6.10.1 Surgical treatment

6.10.2 Systemic treatment

6.10.3 Palliative radiotherapy

6.10.4 Treatment principles for metastasis of special sites

7. Follow-up

7.1 Postoperative follow-up

7.2 Follow-up of patients with local treatments for RCC

7.3 Follow-up of advanced patients

Renal cell carcinoma (RCC), originating from the renal tubular epithelium, is a malignant tumor accounting for 80%−90% of renal malignancies. The most common histopathological type of RCC is clear cell carcinoma, followed by papillary RCC and chromophobe RCC, and then the rare type such as collecting ductal carcinoma. In China, the incidence of renal cancer is second next to bladder cancer in the urinary system.

With the development of medical imaging, early detection of RCC is gradually increasing. Radical nephrectomy or nephron-sparing surgery (NSS) can achieve satisfactory outcomes for localized renal cancer. According to statistics, the number of patients with advanced diseases at the time of diagnosis has dropped from 30% a few years ago to 17% currently. With the development of targeted therapy and new immunotherapeutic drugs, the efficacy for advanced renal cancer has been gradually improved.

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