الفهرس 
Epidemiology of Renal Cell CarcinomaOnly 14 pages are availabe for public view
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Abstract
Renal cell carcinoma (RCC) represents about 2 – 3% of malignancies. RCC present mainly in sporadic cases and sometimes in inherited form like, Von Hipple Lindu. There are Numbers of risk factors associated with development of RCC including smoking, obesity, renal replacement therapy and analgesics e.g. phenactin. Clear cell carcinoma is predominant pathological type represent about 85%. Computed Tomography is considered the modality of choice in imaging of a renal mass. Many prognostic factors have been studied to evaluate their benefit to determine the prognosis, survival, guidelines of treatment and follow up for RCC e.g. tumor grade, histological subtype, TNM staging, tumor necrosis, serum calcium level, hemoglobin level and performance status. Radical nephrectomy is standard curative line of treatment either open or laparoscopic with comparable outcome in localized renal tumor. Partial nephrectomy is considered in selected patients. Surgery may play rule in treatment of metastatic RCC as metastasectomy and palliative nephrectomy to control symptoms e.g. hematuria. Radiofrequency ablation and Cryotherapy are noninvasive techniques alternative to surgery in small size renal tumor and peripherally located mainly in elderly patient with comorbidities who cannot withstand surgery. High intensity focused ultrasound and photodynamic therapy are still considered experimental. Cytotoxic chemotherapy is generally considered ineffective in metastatic RCC. Immunotherapy IL–2 and INF-alfa can be used in treatment of metastatic RCC with response rate about 15%. IL-2 is considered the only treatment that can produce durable remission when used for selected patients. Advances in the era of targeted therapy provide variety of options in treatment of metastatic RCC and considered now to be standard treatment which include; monoclonal antibody e.g. bevacizumab, signal transduction inhibitors e.g. sunitinib, sorafenib and pazopanib and mTOR inhibitors e.g. temsirolimus and everolimus. The rarities of non-clear RCC limit definitive randomized studies for appropriate treatment so modeling treatment choices for such patients on clear cell disease is a reasonable strategy. Temsirolimus is considered the only agent with activity in non-clear RCC. Host immune system is suggested to play an important role for tumor rejecting cell-mediated immune responses in RCC which result in development of new promising lines of treatment like tumor vaccines and allogeneic bone marrow transplant.