Urol. praxi, 2011; 12(2): 80-90

Renal carcinoma - current situation and integration of mini-invasive techniques (vertebroplasty, cementoplasty,

MUDr.Ivan Kolombo, FEBU¹, MUDr.Radko Kříž², prof.MUDr.Josef Vymazal, DrSc.², MUDr.Jiří Poněšický¹, MUDr.Jiří Weichet², MUDr.Jaroslav Porš³, MUDr.Iva Zemanová⁴, MUDr.Richard Pabišta⁵, MUDr.Martina Poršová⁵, MUDr.Michal Toběrný¹, MUDr.Stanislav Černohorský¹, MUDr.Pavel Beňo¹, MUDr.Josef Kašík¹, MUDr.Slavomír Blažej¹, MUDr.Jan Tobiáš¹, MUDr.Jan Zaplatílek⁵, MUDr.Leoš Gronka³, MUDr.Milan Bartůněk¹

¹ Centrum robotické chirurgie a urologie, Nemocnice Na Homolce, Praha

² Radiodiagnostické oddělení, Nemocnice Na Homolce, Praha

³ Urologická poradna, Městská nemocnice, Turnov

⁴ Patologicko-anatomické oddělení, Nemocnice Na Homolce, Praha

⁵ Urologické oddělení, Nemocnice Mladá Boleslav

selective embolization and radiofrequency ablation), biological therapy and conventional surgical treatment

Renal cell carcinoma (RCC) is the most malignant urological tumour and the incidence of RCC in the Czech Republic is currently highest

in the world. Basic treatment modality for localized disease is surgical therapy. But significant number of patients are still primarily

diagnosed in advanced or metastatic stage of disease. Complex care and interdisciplinary approach with integration of surgery and

systemic medication with best supportive care on individual basis is optimal method of treatment for a patients with advanced or

metastatic RCC. In recent years also minimally invasive methods for treatment of metastases has become an established and important

equivalent to conevtional surgical procedures in some cases. Especially for high-risk and polymorbid patients we used for example

radiofrequency ablation. Systemic therapy for metastatic RCC with new two antiangiogenics drugs: an oral tyrosine kinase/multikinase

or mTOR (mammalian target of rapamycin) inhibitors sunitinib (Sutent®), sorafenib (Nexavar®), bevacizumab (Avastin®), temsirolimus

(Torisel®), everolimus (Afinitor®), pazopanib (Votrient®) is more effective than previous immunotherapy with cytokines (interleukin-2

and interferon-alpha). Bone metastases of RCC can lead to debilitating skeletal complicatinons. Zoledronic acid (Zometa®) significantly

delays the onset and reduces the incidence of skeletal-related events and demonstrated trends for longer overall survival in these patient

populations. Vertebroplasty and cementopasty are new safe and effective alternative for traditional orthopaedic surgery methods. This

review article summarize new knowledge and current trends for a treatment of advanced or metastatic RCC.

Keywords: kidney cancer, targeted therapy, biological treatment, antiangiogenics drugs, tyrosine kinase inhibitor, sunitinib (Sutent®), sorafenib (Nexavar®), bevacizumab (Avastin®), temsirolimus (Torisel®), everolimus (Afinitor®), pazopanib (Votrient, immunotherapy, cytokines, interleukin-2, interferon-alpha, zoledronic acid (Zometa®), surgery, nephrectomy, vertebroplasty, cementoplasty, selective embolization, metastasectomy, radiofrequency ablation

Published: April 1, 2011  Show citation