TY  - EJOU
AU  - Bleumer, Ivar 
AU  - Mulder, Pieter H. M. de 
AU  - Mulders, Peter F. A. 

TI  - The role of adjuvant therapy in non-metastatic RCC
T2  - Canadian Journal of Urology

PY  - 2006
VL  - 13
IS  - Suppl.2
SN  - 1488-5581

AB  - Renal cell carcinoma (RCC) presents as localized disease
in 54% of the cases. For these patients, surgery is the
primary curative treatment. Unfortunately, up to 65%
of all patients show recurrent disease. For metastatic
RCC non-specific immunotherapy is currently the
treatment of choice. Nevertheless, several new modalities,
e.g. WX-G250, oncophage and anti-angiogenic
compounds like sunitinib and sorafenib are being explored
with favorable results. Still, their place in the primary
treatment of advanced RCC has yet to be determined.
Because of the high percentage of recurrent disease, there
is a need to identify these patients with conventional and
molecular risk factors. Furthermore, adjuvant therapy
to reduce risk of recurrence of RCC following
nephrectomy is of clinical relevance.<br/>
A review of recent literature was performed on the topics
prognostic models, risk factors and adjuvant treatment
for non-metastasized RCC.<br/>
Combining classical risk factors for progression of RCC
has shown to be effective for stratifying patients into risk
groups. The UCLA integrated staging system (UISS) is
the currently the only validated prognostic model.
Whether molecular markers are able to better identify
high-risk patients is still under investigation. Adjuvant
therapy has been explored in the treatment for RCC and
the use of non-specific cytokine regimens has so far not
shown to be effective in the adjuvant setting. More
specific therapies, e.g. WX-G250, oncophage and antiangiogenic drugs are clinically active in patients with
advanced RCC. Large randomized clinical trials with
these drugs are currently ongoing to evaluate their effect
in patients with localized RCC.
KW  - renal cell carcinoma
KW  -  adjuvant therapy
KW  -  prognostic models
KW  -  risk factors

DO  -