Renal cell cancer treatment: the Latin American Cooperative Oncology Group (LACOG) and the Latin American Renal Cancer Group (LARCG) surgery-focused consensus update.
Stênio de Cássio Zequi, Anderson de Oliveira Galvão, André Costa Matos, Gilberto Laurino Almeida, Marcelo Esteves Chaves Campos, Marcelo Langer Wroclawski, Thiago Camelo Mourão, Wagner Eduardo Matheus, Arie Carneiro, Augusto Modesto de Sousa Neto, Aurus Meneses, Breno Dauster, Daher Cezar Chade, Deusdedit Cortez Vieira da Silva Neto, Éder Silveira Brazão, Eduardo Café Cardoso Pinto, Eliney Faria, Felipe de Almeida E Paula, Felipe Lott, Fernando Korkes, Fernando Meyer, Francisco Hidelbrando Alves Mota Filho, Frederico Mascarenhas, Giuliano Betoni Guglielmetti, Guilherme Antônio Veloso Coaracy, Gustavo Cardoso Guimarães, Gustavo Franco Carvalhal, Jonatas Luiz Pereira, Leandro Koifman, Lucas Fornazieri, Lucas Nogueira, Lucas Teixeira Batista, Luciano Alves Favorito, Luiz Henrique Araújo, Marcos Lima de Oliveira Leal, Marcos Tobias-Machado, Mauricio Cordeiro, Mauricio Murce Rocha, Nilo Jorge Carvalho Leão Filho, Rafael Ribeiro Meduna, Renato Beluco Corradi, Ricardo de Lima Favaretto, Roberto Machado, Rodolfo Borges Dos Reis, Roni de Carvalho Fernandes, Victor Espinheira Santos, Vladmir Pinheiro De Oliveira, Walter Henriques da Costa, Wilson F S Busato, Andrey Soares
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引用次数: 0
Abstract
Renal cell carcinoma (RCC) represents 2.2% of all malignancies worldwide; however, its mortality rate is not negligible. Surgery is the primary treatment for most nonadvanced cases, with its indications and techniques evolving over the years. To provide an update on RCC management in Brazil, focusing on surgery. The Latin American Cooperative Oncology Group-Genitourinary Section and the Latin American Renal Cancer Group gathered a panel of Brazilian urologists and clinical oncologists to vote on and discuss the best management of surgically resectable RCC. The experts compared the results with the literature and graded them according to the level of evidence. For small renal masses (SRMs; less than 4 cm), biopsy is indicated for specific/select cases, and when intervention is needed, partial nephrectomy should be prioritized. Radical nephrectomy and ablative techniques are exceptions for managing SRMs. Patients with small tumors (less than 3 cm), slow tumor growth, or a risk for surgery may benefit from active surveillance. Localized carcinoma up to 7 cm in diameter should be treated preferably with partial nephrectomy. Lymphadenectomy and adrenalectomy should be performed in locally advanced cases if involvement is suspected by imaging exams. Patients with venous tumor thrombi usually require surgical intervention depending on the extent of the thrombus. Neoadjuvant therapy should be considered for unresectable cases. Even in the era of targeted therapy, cytoreductive nephrectomy still has a role in metastatic disease. Metastasectomy is indicated for most patients with resectable disease. This consensus presents recommendations for surgical treatment of RCC based on expert opinions and evidence from the medical literature. Surgery remains the best curative option for nonadvanced cases, and it still has a role for select patients with metastatic disease.
期刊介绍：
Therapeutic Advances in Urology delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of urology.
The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in urology, providing a forum in print and online for publishing the highest quality articles in this area. The editors welcome articles of current interest across all areas of urology, including treatment of urological disorders, with a focus on emerging pharmacological therapies.
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