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Renal cell carcinoma: basic biology and clinical behavior
J R Franklin1, R Figlin, A Belldegrun
1Department of Surgery, UCLA Kidney Cancer Program, USA.
Seminars in Urologic Oncology
|November 1, 1996
Summary
Renal cell carcinoma (RCC) incidence is rising, with molecular genetics improving understanding of familial and sporadic forms. Immunotherapy shows promise for advanced disease, but other treatments remain limited.
Area of Science:
- Oncology
- Molecular Genetics
- Cancer Epidemiology
Background:
- Renal cell carcinoma (RCC) incidence is increasing, posing a significant mortality risk.
- Advances in imaging (ultrasonography, CT) lead to more incidental renal tumor diagnoses.
- Conflicting evidence exists regarding early diagnosis trends and changes in RCC's natural history.
Purpose of the Study:
- To review the current understanding of renal cell carcinoma (RCC) molecular genetics.
- To explore the role of environmental factors and genetic disturbances in RCC.
- To assess prognostic factors and treatment modalities for RCC.
Main Methods:
- Review of current literature on renal cell carcinoma (RCC) epidemiology, genetics, and treatment.
- Analysis of molecular and genetic findings related to RCC classification.
- Evaluation of prognostic markers and therapeutic outcomes.
Main Results:
- The von Hippel-Lindau (VHL) gene and chromosome 3p regions are crucial for understanding RCC genetics.
- Molecular and genetic distinctions are being made between RCC cell types.
- Environmental factors like smoking require further investigation for their link to genetic disturbances.
- Current prognostic factors and molecular markers (e.g., p53, epidermal growth factor) lack convincing evidence.
- Surgery is primary for organ-confined RCC; immunotherapy offers durable responses in advanced cases.
Conclusions:
- Understanding RCC molecular genetics, particularly VHL and chromosome 3p, is advancing disease knowledge.
- Further research is needed to link environmental factors to RCC genetic changes.
- Immunotherapy presents a promising avenue for advanced renal cell carcinoma treatment.