Guidelines on Renal Cell Cancer

Mickisch, G.; Carballido, Joaquı́n; Hellsten, Sverker; Schulze, Harald; Mensink, H. J. A.

doi:10.1159/000049783

Cited by 109 publications

(59 citation statements)

References 30 publications

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“…To meet the requirements for a multidisciplinary approach, the panel has recently been reinforced by several experts, including a medical oncologist, pathologists, radiologists, a methodologist, biostatisticians, and members of patient advocacy groups. The EAU RCC guidelines were first published in 2000 [1], with a subsequent full update in 2006 and partial updates in 2007,2008,2009,2010 [2], and 2013. The current 2014 document presents a full-text update and is fundamentally different from the versions published previously.…”

Section: Introductionmentioning

confidence: 99%

EAU Guidelines on Renal Cell Carcinoma: 2014 Update

Ljungberg¹,

Bensalah²,

Canfield³

et al. 2015

European Urology

2,694

1,914

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Context: The European Association of Urology Guideline Panel for Renal Cell Carcinoma (RCC) has prepared evidence-based guidelines and recommendations for RCC management. Objectives: To provide an update of the 2010 RCC guideline based on a standardised methodology that is robust, transparent, reproducible, and reliable. Evidence acquisition: For the 2014 update, the panel prioritised the following topics: percutaneous biopsy of renal masses, treatment of localised RCC (including surgical and nonsurgical management), lymph node dissection, management of venous thrombus, systemic therapy, and local treatment of metastases, for which evidence synthesis was undertaken based on systematic reviews adhering to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Relevant databases (Medline, Cochrane Library, trial registries, conference proceedings) were searched (January 2000 to November 2013) including randomised controlled trials (RCTs) and retrospective or controlled studies with a comparator arm. Risk of bias (RoB) assessment and qualitative and quantitative synthesis of the evidence were performed. The remaining sections of the document were updated following a structured literature assessment. Evidence synthesis: All chapters of the RCC guideline were updated. For the various systematic reviews, the search identified a total of 10 862 articles. A total of 151 studies reporting on 78 792 patients were eligible for inclusion; where applicable, data from RCTs were included and meta-analyses were performed. For RCTs, there was low RoB across studies; however, clinical and methodological heterogeneity prevented data pooling for most studies. The majority of studies included were retrospective with matched or unmatched cohorts based on single or multi-institutional data or national registries. The exception was for systemic treatment of metastatic RCC, in which several RCTs have been performed, resulting in recommendations based on higher levels of evidence.

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Section: Introductionmentioning

confidence: 99%

EAU Guidelines on Renal Cell Carcinoma: 2014 Update

Ljungberg¹,

Bensalah²,

Canfield³

et al. 2015

European Urology

2,694

1,914

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“…The NCCN [9] and the EUA [13] guidelines have suggested that this drug can be used as a first line of treatment and the neoadjuvant setting should be investigated thoroughly.…”

Section: Discussionmentioning

confidence: 99%

Neoadjuvant Therapy for Locally Advanced Renal Cell Carcinoma with Sorafenib in a Reference Center in Mexico

Costilla-Montero¹,

Guadarrama-Benítez²,

Aragón-Castro³

et al. 2011

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Background: neo-adjuvant therapy is usually indicated in locally advanced tumors, the aim is to decrease the tumoral burden and enhance overall survival. Renal cell carcinoma is a chemo and radio resistant neoplasm and this type of approach is not as effective as in other solid tumors. On the other hand immunotherapy is indicated in metastatic disease, demonstrating a better overall survival. Sorafenib is an antiangiogenic drug approved for locally advanced or metastatic RCC. We postulated that it can be used in a neoadjuvant way to decrease the vascularization of selected tumors. Report of the Case: 57 years old male referred to our service with a right renal mass and metastatic disease to lumbar spine and suprarenal gland. He was treated with three months of sorafenib previous to the surgery. Results: the patient went into surgery three months after initiating the antiangiogenic drug, during the surgery we found less neo-formance vessels; the dissection was subjectively easier, due to peri-renal edema. The pathologic analysis of the specimen was renal cell carcinoma. Interestingly, 40% of central ischemic (coagulative) necrosis was found. Conclusion: there are no neoadjuvant drugs accepted for the treatment of renal cell carcinoma; using an antiagiogenic drug to decrease the vascular burden characteristic of this type of tumors could be a viable option in selected cases. We used a lower dose of the drug with an acceptable safety profile.

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“…4 For certain stages of some cancers including genitourinary cancers, cure is becoming a reality. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Although general opinion is that patients with poor-prognosis nonmetastatic prostate cancer cannot be cured, results from recent studies have prompted re-evaluation of this belief. The aim of this review is to examine the concept of cure in genitourinary cancers and focus on the role of adjuvant hormonal therapy in prostate cancer, with reference to re-examining the historical treatment paradigm, which considers androgen deprivation a palliative option.…”

Section: Introductionmentioning

confidence: 99%

Adjuvant androgen deprivation therapy augments cure and long-term cancer control in men with poor prognosis, nonmetastatic prostate cancer

Fleshner

Keane

Lawton

et al. 2007

Prostate Cancer Prostatic Dis

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Historically, adjuvant androgen deprivation therapy has been viewed as a palliative treatment option for patients with poor-prognosis non-metastatic prostate cancer. In addition, guidelines from bodies such as the European Association of Urology and American Society for Clinical Oncology do not specifically categorize adjuvant hormonal therapy as being curative in intent. We propose that adjuvant androgen deprivation therapy should now be classified as a treatment of curative intent in patients with poor-prognosis, non-metastatic prostate cancer. By applying a carefully considered definition of cure (based on long-term (10-to 15-year) disease-free survival curves) to the findings from randomized controlled clinical trials that have studied adjuvant hormonal treatments in nonmetastatic prostate cancer, we challenged whether this viewpoint should now be considered redundant. According to our review of relevant studies and our definition of cure, goserelin appears to augment cure in a sizeable proportion of men with poor-prognosis non-metastatic prostate cancer when given adjuvant to radical prostatectomy or radiotherapy. Across several trials, the relevant survival curves for the goserelin-treated population became indefinitely flat after long-term followup. This indicates that these patients have a mortality risk comparable to the general population without prostate cancer. On the basis of the evidence presented within this review, we believe that, given it can control disease for a long period of time, adjuvant goserelin should be reclassified as a treatment of curative intent for patients with poor-prognosis non-metastatic prostate cancer.

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Guidelines on Renal Cell Cancer

Cited by 109 publications

References 30 publications

EAU Guidelines on Renal Cell Carcinoma: 2014 Update

EAU Guidelines on Renal Cell Carcinoma: 2014 Update

Neoadjuvant Therapy for Locally Advanced Renal Cell Carcinoma with Sorafenib in a Reference Center in Mexico

Adjuvant androgen deprivation therapy augments cure and long-term cancer control in men with poor prognosis, nonmetastatic prostate cancer

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