EAU指南之肾细胞癌(RCC)的治疗重点分析.pptx

Guidelines on renal cell carcinoma EAU-Guidelines-Renal-Cell-Cancer-2015-v2 1、Introduction 2、Treatment of localised RCC 3、Treatment of locally advanced RCC 4、Treatment of advanced/metastatic RCC 5、Systemic therapy for advanced/metastatic RCC Definition Renal Cell Carcinoma, RCC Renal cell carcinoma is a kidney cancer that originates in the lining of the proximal convoluted tubule. RCC is the most common type of kidney cancer in adults. Epidemiology 我国目前研究[1] 马建辉等收集了中国大陆1988～2002年15年间数据较齐全的11个研究单位的资料，1988～1992、1993～1997、1998—2002年3个时间段我国肾和泌尿系统其他恶性肿瘤的发病率分别为4.26／10万、5.40／10万、6.63／10万人口，发病率呈现逐年上升趋势。我国上海、南京、广州分别排在第245(4.8／10万)、273(3.2／10万)、282(2.3／10万)。 America[2] Renal cell carcinomas represent about 3% of all newly diagnosed visceral cancers in the United States and account for 85% of renal cancers in adults. Approximately 30,000 new cases /year and 12,000 deaths from the disease. [1]马建辉,李呜,张思维等.中国部分市县肾癌及泌尿系其他恶性肿瘤发病趋势比较研究[J].中华泌尿外科杂志,2009,30(8):511-514.DOI:10.3760/cma.j.issn.1000-6702.2009.08.002. [2]Jemal A, et al: Cancer statistics, 2008. CA Cancer J Clin 2008; 58:71. Risk factors[1] [2] The most significant risk factor ? tobacco (Cigarette smokers have double the incidence of renal cell carcinoma) ? pipe and cigar smokers are also more susceptible. Additional risk factors obesity (particularly in women) hypertension; unopposed estrogen therapy; exposure to asbestos, petroleum products, and heavy metals. [1]McLaughlin JK, Lipworth L: Epidemiologic aspects of renal cell cancer. Semin Oncol 2000; 27:115. [2] Moore LE, et al: Lifestyle factors, exposures, genetic susceptibility, and renal cell cancer risk: a review. Cancer Invest 2005; 23:240. Diagnosis 1.Symptoms Physical examination:Physical examination has a limited role in RCC diagnosis ? Palpable abdominal mass; ? Palpable cervical lymphadenopathy; ? Non-reducing varicocele and bilateral lower extremity oedema, which suggests venous involvement. 2.Imaging investigations Guidelines on Renal Cell Carcinoma. Eu