Abstract
Renal cell carcinoma (RCC) is the most common type of kidney cancer, and its incidence has continued to increase in the United States. Well-defined risk factors include smoking, obesity, and hypertension. There have been significant developments in the management of RCC over the past decade, pertaining to both patients with localized disease and those with advanced disease. In particular, agents targeting the vascular endothelial growth factor and mammalian target of rapamycin pathways have considerably improved survival for patients with metastatic disease. This review covers the epidemiology and pathogenesis of RCC, management of both localized and advanced disease, selection and sequencing of systemic therapy, non–clear cell RCC, and new targets and future directions for RCC. Figures show the morphologic features of RCC, the pathogenesis of RCC, and a huge primary RCC occupying a substantial part of the abdominal cavity. Tables include a summary of clinical and molecular characteristics of hereditary RCC syndromes and randomized phase III trials of approved first-line treatments in metastatic RCC. This review contains 3 highly rendered figures, 2 tables, and 59 references.
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