[Surgical treatment for renal cell carcinoma]

Metastatic or locally advanced renal cell carcinoma is refractory to chemotherapy and radiotherapy. Surgical treatment is the mainstay of treatment in these cases. The concept of surgical treatment of renal cell carcinoma was discussed by classifying the procedures into four categories: 1) radical nephrectomy; 2) nephron sparing surgery, such as partial nephrectomy and enucleation for small renal cancer detected incidentally by ultrasonography and CT; 3) extended surgery for cases having IVC tumor thrombus or with invasion of neighboring organs; and 4) surgery for metastatic disease. New therapies such as LAK, alpha-Interferon and IL-2 do not improve the 20% response rate. Gene therapy using appropriate vectors for introduction of IL-2. Interferon or GM-CSF genes to renal cancer cells is still at an experimental stage.