Kidney Ca: Robotic partial, radical nephrectomy on the rise

July 11, 2018

Active surveillance in selected patients with localized renal masses 4 cm to 7 cm and a patient-derived xenograft system for predicting response to targeted and immune therapies in patients with metastatic RCC were among other noteworthy kidney cancer studies presented at AUA 2018.

Active surveillance in selected patients with localized renal masses 4 cm to 7 cm and a patient-derived xenograft system for predicting response to targeted and immune therapies in patients with metastatic RCC were among other noteworthy kidney cancer studies presented at AUA 2018. The take-home messages were presented by Brian Keith McNeil, MD, of SUNY Downstate Medical Center, Brooklyn, NY.

  • Utilization and regional dissemination of minimally invasive (robotic) surgery for partial and radical nephrectomy are increasing.
  • A downtrend in preoperative kidney function predicts development of stage 4 chronic kidney disease after radical or partial nephrectomy for kidney cancer.
  • Researchers from Memorial Sloan Kettering Cancer Center, New York validated their preoperative nomogram for predicting 12-year probability of metastatic recurrence in patients undergoing surgery for localized renal cell carcinoma and introduced genomics into the nomogram after showing KDM5C mutation was independently associated with metastatis-free survival.
  • Isolated involvement of renal sinus fat, perinephric fat, and renal venous invasion in patients with pathologic T3aN0/NxM0 clear cell RCC carry similar prognostic weight, but the presence of two or more of these features is associated with increased risk for worse outcomes.
  • Active surveillance may be reasonable for selected patients with localized renal masses 4 cm to 7 cm.
  • Findings of a study evaluating perioperative outcomes for patients with 4- to 7-cm renal masses undergoing microwave ablation, partial nephrectomy, or radical nephrectomy suggests that microwave ablation may be a good option for patients refusing surgery.
  • Findings from two independent studies showed that cytoreductive nephrectomy may improve survival in patients with RCC and isolated brain metastasis.
  • A patient-derived xenograft system predicted response to targeted and immune therapies in patients with metastatic RCC.
  • Findings from the safety lead-in of a phase II trial showed neoadjuvant stereotactic ablative radiation for inferior vena cava thrombus in patients with RCC was safe and may improve metastasis-free survival.