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Renal Cell Carcinoma PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Renal Cell Carcinoma” by Dr.Amit Gupta.

This medical PowerPoint presentation is about renal cell carcinoma (RCC), a type of kidney cancer that arises from the cells of the proximal tubules of the kidney. RCC is the most common type of kidney cancer in adults, accounting for approximately 90% of cases. The exact causes of RCC are not yet fully understood, but certain risk factors such as smoking, obesity, hypertension, and exposure to certain chemicals and substances have been identified.

Symptoms of RCC may include blood in the urine, pain in the back or side, a mass or lump in the abdomen, weight loss, and fatigue. Treatment options for RCC may include surgery, radiation therapy, chemotherapy, targeted therapy, immunotherapy, and clinical trials. The choice of treatment depends on the stage of the cancer, the patients overall health, and other factors.

Regular screenings and early detection are important in improving the prognosis and outcome of RCC. If you have any concerns or symptoms related to kidney cancer, its important to speak with your healthcare provider for proper evaluation and management.

Tags : Renal Cell Carcinoma, kidney cancer, Nephrology, Nephrology PowerPoint presentation

Published on : Jun 07, 2023 | Views : 4357 | Downloads : 8

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Slide 1-

Renal Cell Carcinoma Dr.Amit Gupta Associate Professor Dept. of Surgery
Slide 2-

Epidemiology Male predominance (M:F 1.5:1). Most common in sixth to eighth decades; peak incidence in sixth decade Metastatic disease in 30% at diagnosis, and eventually in 50% (lung, liver, bone, distant LN, adrenal, brain, opposite kidney, soft tissue) Most sporadic RCCs are unilateral and unifocal
Slide 3-

Stage at diagnosis is the most important prognostic factor Predominant histologic type: adenocarcinoma arising from tubular epithelium Adenocarcinoma subtypes: clear cell (75–85%) chromophilic/ papillary (10–15%) chromophobe (5–10%) oncocytic (rare) Sarcomatoid (1–6%; poor prognosis)
Slide 4-

Papillary (chromophilic) renal cell carcinoma extending into the collecting system
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Risk factors Tobacco , urban environmental toxins (cadmium/ asbestos/ petrols), obesity, high dietary fat intake, acquired cystic renal disease from renal failure Association with von Hippel-Lindau disease: autosomal dominant loss of 3p >70% chance developing RCC (almost all clear cell histology) risk of developing multiple other benign and malignant tumors (retinal angiomas, CNS hemangioblastomas, pheochromocytoma , pancreatic cancer)
Slide 6-

Familial Renal Cell Carcinoma Syndromes
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Pathology Round to ovoid Circumscribed by a pseudo capsule of compressed parenchyma and fibrous tissue Nuclear features can be highly variable
Slide 8-

Fuhrman's Classification System for Nuclear Grade
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Diagnosis Common signs and symptoms: hematuria (80%) flank pain (45%) flank mass (15%) classic triad of prior three only present in 10% normocytic/normochromic anemia, fever, weight loss Less common signs and symptoms: hepatic dysfunction without mets Polycythemia hypercalcemia (occurs in 25% of patients with RCC mets)
Slide 10-

Paraneoplastic syndromes in 20% of patients with RCC
Slide 11-

Diagnosis Labs: CBC, LFT, BUN/Cr, LDH, urinalysis Imaging: CT abdomen MRI abdomen if CT suggests IVC involvement Metastatic evaluation: Chest X ray Bone scan or MRI brain only if clinically indicated
Slide 12-

CT scan shows right renal tumor with perinephric stranding suggesting invasion of the perinephric fat
Slide 13-

Contrast inferior venacavogram in patient with a right renal tumor shows involvement of the subdiaphragmatic vena cava
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PET: equivocal findings on conventional imaging Percutaneous renal biopsy or aspiration: limited role
Slide 15-

Staging AJCC 7th Edition
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Prognostic Factors For RCC
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Management Stage I-III Nephrectomy Open radical nephrectomy, but laparoscopic gaining popularity Nephron sparing surgery via partial nephrectomy, if possible (open or laparoscopic) Possible to spare adrenal gland in ~75% cases No role for adjuvant chemo/immunotherapy
Slide 20-

No widely accepted role for neoadjuvant or adjuvant radiotherapy. Retrospective data suggest possible utility in select cases: Positive surgical margins Locally advanced disease with perinephric fat invasion and adrenal invasion (IVC/renal vein extension alone does not increase local recurrence significantly) LN+ Unresectable (pre-op RT)
Slide 21-

Stage IV Cytoreductive nephrectomy: improved survival with nephrectomy followed by interferon alpha vs. interferon alpha alone
Slide 22-

Systemic therapy Immunotherapy (IL-2, interferon alpha, or combination) High dose IL-2 only FDA approved treatment for Biologic agents show promise in recent trials Bevacizumab Sorafenib or sunitinib Temsirolimus Consider chemo (gemcitabine ± 5-FU or capecitabine) Focal palliation of metastases RT alone Metastasectomy Combination of both