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 Alexandros Lekas, MD, PhD, FEBU

 Urologist Surgeon Andrologist
 Doctor of Medicine, University of Athens
 Fellow of the European Board of Urology
 Postgraduate in Germany, Ammerland Klinik
 University of Gottingen

 

 

 

 

 

 

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Kidney cancer

karkinosnefrou 4Kidney cancer usually occurs in the sixth to seventh decade of life and a male to female ratio of 3:2.

The more than half the cases involve patients who are diagnosed at an annual random testing volume in the kidney, which is usually at an early stage.

The survival in most cases exceeds 90%.

Causes

-> Exposure to carcinogens (tobacco, oil, cadmium, metals, lime)
-> Hypertension
-> Obesity
-> Disorders kidney disease (von Hippel-Lindau, horseshoe kidney, polycystic kidney disease adult)

Histological Types

-> Intracellular type (70-80%)
-> Chromaffin (10-15%)
-> From chromophobic cells (5%)
-> Bellini Carcinoma (1%)

 

Treatment

Treatment depends on the stage of the disease and is mainly surgical.

i. Radical Nephrectomy

When the tumor is located in the upper pole of the kidney, the treatment of choice is radical nephrectomy, namely the removal of all of the kidney and adrenal ipsilateral. The operation can be made open, laparoscopic or even robotically with minimal post-operative pain.

ii. Partial Nephrectomy (open - laparoscopic - robotics)

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iii. Cryotherapy

In open surgery or even better laparoscopically, forward needle or needles in the tumor where the use of argon gas induce melt web so deep and 1cm. The achieved low temperature causes destruction of tumor cells and the method is characterized by major success with minimal complications.

iv. Ablation (RFA - Radio Frequency Ablation)

With this method the electrodes are placed percutaneously with ultrasonography or axial control which using RF may cause thermal injury to cancer cells, with a success rate of over 85%.

v. High Frequency Ultrasound (HIFU - High Intensity Frequency Ultrasound)

This method is performed under general anesthesia and causes thermal injury using high frequency ultrasound, with a small but success rate of almost 50%.

vi. Treatment of metastases

In the past immunotherapy, chemotherapy, radiotherapy or combinations thereof are used without encouraging results. In recent years newer drugs targeting angiogenic factors have very good results (Sunitinib, Sorafenib, Everolimus).

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