Renal Cell Cancer

Question 1

MC sex?

Answer 1

Male

Question 2

Which type is most common?

Answer 2

Clear cell RCC

Question 3

Classic triad?

Answer 3

Hematuria
Abdominal mass
Flank pain

Question 4

Other symptoms of RCC (not triad)?

Answer 4

HTN
Hypercalcemia
Nonspecific symptoms
Paraneoplastic syndrome

Question 5

RFs ?

Answer 5

Smoking
Obesity + loop diuretics
Renal transplant (risk increases 80 TIMES)
Von Hippel Lindau

Question 6

What does von hippel lindau cause?

Answer 6

Angiogenesis and proliferation

Question 7

Staging?

Answer 7

TNM

Question 8

Imaging?

Answer 8

USG
CT
MRI –> best if infiltration of IVC

Question 9

Management of early stage?

Answer 9

SURGERY (only cure!!)

- nephrectomy, ablation,

Question 10

Adjuvant tx to surgery?

Answer 10

NOT BENEFICIAL!!!!

Question 11

Management of advanced stage?

Answer 11

Surgery + systemic tx

Question 12

Which systemic tx used in advanced stage?

Answer 12

Cytokines
Bevacizumab
Sunitinib
Everolimus, temsirolimus
Chemotx (gemcarbo)

Question 13

Mechnism of everolimus?

Answer 13

mTOR inhibitors

Question 14

Which chemotx in advanced stage?

Answer 14

GemCarbo,Gemcis

–> NB CISPLATIN is nephrotoxic!!!!

Question 15

Where does metastasis go in RCC?

Answer 15

Heart
Skin
Urogenital tract

Question 16

What are Heng criteria?

Answer 16

Performance status
Hb
Calcium
Platelets
Neutrophils

Question 17

Side effects of sunitinib?

Answer 17

Hypertension
Hand-foot syndrome
Myelosuppression