Kidney cancer, as the name implies, is a cancer that occurs in the kidney, another common name for renal cell carcinoma (RCC). It originates in the epithelial cells of the renal tubules or collecting ducts of the kidney and has different pathological types. Generally speaking, according to the severity of the disease, renal cancer can be classified into limited renal cancer, locally progressive renal cancer, metastatic renal cancer and so on. The most important thing is that the company’s products and services are not only available in the market, but also in the market.
The TNM staging by the American Joint Committee on Cancer (AJCC) is the most widely used staging standard for kidney cancer. The TNM staging method for “limited kidney cancer” is T1-2N0M0 kidney cancer, as detailed in the table below.
The AJCC 2010 version of TNM staging for limited kidney cancer
| T – primary tumor | |
| T1 | |
| T1a | Tumor length diameter ≤4 cm, confined to the kidney. |
| T1b | Tumor length >4cm but ≤7cm, confined to the kidney. |
| T2 | |
| T2a | Tumor length >7cm but ≤10cm, confined to the kidney. |
| T2b | Tumor >10 cm in length, confined to the kidney. |
| N-regional lymph nodes | |
| No regional lymph node metastasis. | |
| M-Distant metastases | |
| No distant transfer. |
Treatment options for limited kidney cancer include:
- Radical nephrectomy
- Partial nephrectomy (surgery to preserve the kidney unit)
- Tumor enucleation
- Tumor ablation
- Watchful waiting
Surgery is the fundamental approach to the treatment of limited kidney cancer, curing most of these patients and allowing them to survive for a long time. The choice of surgical approach depends on many factors, including age, other health problems, anesthesia risks, and the size, location, and depth of infiltration of the tumor.
- In general, the larger the tumor, the more likely your doctor is to recommend radical nephrectomy.
- Unless total nephrectomy would put the patient at great risk of renal insufficiency leading to dialysis, in which case surgery that removes the tumor while preserving the kidney should be performed as much as possible.
- Tumor ablation generally destroys the tumor and some of the normal kidney tissue surrounding it in two ways: ultra-low temperature (cryoablation) and ultra-high temperature (radiofrequency ablation). These two approaches are relatively new and are best suited for patients who are <3 cm in diameter, exophytic, and who cannot tolerate surgery due to age or other reasons.
- Tumor enucleation is primarily used for familial hereditary renal cancer, which is usually multiple and relatively slightly less malignant and therefore requires as much normal kidney tissue as possible to be preserved.
- In addition, through strict and careful screening, a very small proportion of patients with small, isolated, and slow-growing tumors can be considered for follow-up observation therapy, but require regular imaging and close follow-up.
All of the above treatments have their own advantages and risks, but happen to complement each other. We recommend partial nephrectomy for smaller tumors; ablation can be considered for less malignant renal tumors in advanced age that cannot tolerate surgery; and larger tumors are generally treated with radical nephrectomy unless there is a risk of renal failure requiring dialysis (e.g., bilateral renal tumors, isolated kidneys, or renal insufficiency).