Renal cell carcinoma

Renal cell carcinoma represents a significant challenge to surgeons and oncologists treating urologic malignancies. Diagnostically, it is critically important to identify the precise extent of the tumor prior to therapeutic intervention. Therapeutically, a number of controversies continue to be debated, including the role of renal-conserving surgery and the role of surgery in patients with metastatic disease. New research is beginning to identify factors involved in the multidrug-resistant properties of these tumors that may allow us, in the future, to treat these tumors more effectively with systemic chemotherapy. Utilizing immunotherapy in the form of autolymphocytes, interferon, interleukin-2, or combinations of these regimens, a number of exciting advances have been made in the treatment of metastatic renal cell carcinoma. This review examines the most recent literature on each of the above-mentioned aspects in the treatment of this difficult and challenging tumor.