Prognostické faktory renálního karcinomu

Abstract

Renal cell carcinoma represents 2-3% of all adult malignancies and its incidence in the Czech Republic is one of the highest worldwide. Until late stages this disease often remains asymptomatic, which makes diagnosis difficult. Despite increasing proportion of small incidentally detected tumours on imaging, approximately one-third of patients is still diagnosed with advanced disease. Moreover, relapse occurs in up to 40% of patients after surgery for localized tumour.

Increased availability of imaging investigations allowing early detection of kidney carcinoma and advances in systemic treatment have favourably affected outcome of patients with the tumour. Nevertheless, among urological malignancies mortality of renal cell carcinoma remains upon the highest. The individual course of the disease and the response to systemic treatment are difficult to predict.

Number of prognostic factors of renal cell carcinoma have been identified, of which TNM classification and tumour grade remain the most important. Recently, several multivariate prognostic models are available enabling more accurate prediction of the disease course. In localized disease, they are useful in identifying patients at higher risk of recurrence and allow optimization of follow-up after surgery. In metastatic disease, they are routinely used to stratify patients into risk groups for targeted treatment. Constantly there is an effort to identify a suitable biomarker useful in early detection and assessing prognosis of renal cell carcinoma. Concurrently, it could improve the accuracy of stablished prognostic systems.

This text presents an overview of prognostic factors of renal cell carcinoma, including a summary of potential biomarkers.