(泌尿系统疾病课件）18.Tumors of Urinary system.ppt

Palliative / supportive care Pain, bleeding Analgesic medications XRT to sites of painful mets (esp bone mets) XRT for cord compression Angioinfarction (renal art embolization) No survival benefit but can relieve Sx “Clot colic” Ureteral stents hydration HyperCa, fatigue, fever, decr appetite NSAIDs, bisphosphonates, hydration, appetite stimulants Prognostic factors(localized) Size of tumor7cm Fuhrman grading ≥3 Lymph node(+) With hemorrhage or necrosis within tumor Non-clear cell type Invasion into caval wall Tumor thrombus extending above diaphragm Prognostic factors (Metastatic) MSKCC scor