Interventional treatment of kidney cancer

  Kidney cancer is the most common type of renal parenchymal tumor. Its incidence occupies the second place among urological tumors. It accounts for 80-90% of adult renal malignant tumors, mostly occurring in elderly people around 6o years old, and more in men than women. Pathologically, it is divided into clear cell carcinoma and granular cell carcinoma. Most patients have no obvious clinical symptoms in the early stage of kidney cancer. Therefore, patients are often diagnosed in stage II or III. Therefore, it is more difficult to perform radical surgery. Surgical resection is the first choice of treatment for kidney cancer, but the masses of middle and late stage kidney cancer are large in size, rich in blood supply and wide in infiltration, so surgical resection is difficult in operation and bleeding is also more in the operation. In contrast, blood-rich tumors are the best indications for selective renal artery chemoembolization.  In 1971, Lang et al. first used selective renal artery chemoembolization for the treatment of renal cancer. Since then, the method has been widely used to treat kidney cancer. Its main functions are: (1) as a preoperative preparation for kidney cancer, reducing intraoperative bleeding and improving the success rate of tumor resection; (2) reducing the chance of tumor metastasis and enhancing the immune function of the body; (3) as a palliative treatment for unresectable kidney cancer, creating an opportunity for surgery after embolization.  The results of selective renal artery chemoembolization as preoperative adjuvant therapy for intermediate and advanced renal cancer show that it can cause extensive necrosis and volume reduction of tumor, reduce intraoperative bleeding, easy to peel, and improve the success rate of radical resection of the affected kidney. In addition, clinical studies have shown that necrotic tumor cells after embolization can also produce antigen, which has the effect of stimulating the human immune system to produce anti-tumor factors, which not only prolongs the possible tumor recurrence time, but also improves the survival rate of patients.  For kidney cancer with less blood supply, insensitive to chemotherapy and larger size, we mostly use percutaneous lung puncture chemical destruction treatment, or radioactive particle implantation, which can reduce tumor load and control complication symptoms in a short time. It has prolonged the survival time and improved the quality of life for many patients who lost the chance of surgery.