Actas urologicas espanolas · 2010
[Treatment of locally advanced renal tumors].
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Sánchez Zalabardo D, Millán Serrano J A, De Pablo Cárdenas A, Cuesta Alcalá J A
Аннотация
INTRODUCTION: Locally advanced renal tumors show a high progression rate after surgery. Surgical treatment of renal tumors has some unique characteristics related to involvement of the adrenal gland, vena cava, or regional lymph nodes.
OBJECTIVE: To review the current treatment of locally advanced renal tumors.
MATERIALS AND METHODS: A review is made of both the different drugs used and the different therapeutic possibilities in these tumors.
RESULTS: Systemic treatment with angiogenesis inhibitors may improve the natural history of these patients. Systemic treatment may be administered before surgery or as an adjuvant to surgical treatment. Early studies showed a decrease in tumor mass when treatment is administered before surgery, but no prospective randomized studies providing adequate evidence for recommending neoadjuvant treatment are available.
CONCLUSIONS: Availability of systemic treatment with angiogenesis inhibitors may open an important field in the treatment of these tumors in both the neoadjuvant setting and as adjuvants to surgery, but no sufficiently solid scientific evidence as to recommend their use is currently available. Randomized studies with sunitinib and sorafenib will probably suggest the adequate approach to be used when their final results are reported.
OBJECTIVE: To review the current treatment of locally advanced renal tumors.
MATERIALS AND METHODS: A review is made of both the different drugs used and the different therapeutic possibilities in these tumors.
RESULTS: Systemic treatment with angiogenesis inhibitors may improve the natural history of these patients. Systemic treatment may be administered before surgery or as an adjuvant to surgical treatment. Early studies showed a decrease in tumor mass when treatment is administered before surgery, but no prospective randomized studies providing adequate evidence for recommending neoadjuvant treatment are available.
CONCLUSIONS: Availability of systemic treatment with angiogenesis inhibitors may open an important field in the treatment of these tumors in both the neoadjuvant setting and as adjuvants to surgery, but no sufficiently solid scientific evidence as to recommend their use is currently available. Randomized studies with sunitinib and sorafenib will probably suggest the adequate approach to be used when their final results are reported.
Предметные рубрики MeSH
AdrenalectomyAngiogenesis InhibitorsAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedAntineoplastic AgentsBenzenesulfonatesBevacizumabCarcinoma, Renal CellChemotherapy, AdjuvantClinical Trials as TopicCombined Modality TherapyHumansIndolesIntracellular Signaling Peptides and ProteinsKidney NeoplasmsLymph Node ExcisionNeoadjuvant TherapyNeoplasm ProteinsNephrectomyNiacinamidePhenylurea CompoundsProtein Kinase InhibitorsProtein Serine-Threonine KinasesProtein-Tyrosine KinasesPyridinesPyrrolesSirolimusSorafenibSunitinibTOR Serine-Threonine Kinases