Relapse or Stage IV Kidney Cancer

Question 1

Prior to cytoreductive nephrectomy in select patients, what diagnostic exam will you consider doing?

Answer 1

CONSIDER TISSUE SAMPLING

Question 2

Aside from cytoreductive nephrectomy, systemic therapy is preferred in what histology of kidney cancer?

Answer 2

CLEAR CELL HISTOLOGY WITH POOR RISK FEATURES

Question 3

If the mass is surgically unresectable, what is the next step?

Answer 3

TISSUE SAMPLING

Question 4

What are the THREE options for clear cell histology cases?

Answer 4

1. CLINICAL TRIAL
2. METASTASECTOMY OR SBRT OR ABLATIVE TECHNIQUES FOR OLIGOMETASTATIC DISEASE
3. BEST SUPPORTIVE CARE (PALLIATIVE RT, BISPHOSPHONATES, RANKL INHIBITORS FOR BONY METS)

Question 5

What are the options for oligometastatic disease in clear cell histology?

Answer 5

METASTASECTOMY
EBRT
ABLATIVE TECHNIQUES

Question 6

For disease progression in clear cell histology, what are the options?

Answer 6

CLINICAL TRIAL

BEST SUPPORTIVE CARE

Question 7

For non clear cell histology, what is the preferred treatment option?

Answer 7

CLINICAL TRIAL

Question 8

For non clear cell histology with oligometastatic disease, what are the options available?

Answer 8

METASTASECTOMY
ABLATIVE TECHNIQUES
SBRT AND BEST SUPPORTIVE CARE

Question 9

For disease progression in non clear cell histology, what are the options?

Answer 9

CLINICAL TRIAL

BEST SUPPORTIVE CARE