Recent Advances in the Management of Localized and Locally Advanced Renal Cell Carcinoma: A Narrative Review

Abstract

Sohail Dhanji, Luke Wang, Franklin Liu, Margaret F Meagher, Ava Saidian, Ithaar H Derweesh Department of Urology, University of California San Diego School of Medicine, La Jolla, CA, USACorrespondence: Ithaar H Derweesh, Department of Urology, University of California San Diego School of Medicine, 3855 Health Sciences Drive, Mail Code: 0987, La Jolla, CA, 92037, USA, Tel [phone], Fax [phone], Email [email protected]: To review the current status of surgical and procedural treatments for renal cell carcinoma (RCC), focusing on oncological and functional outcomes, and the use of techniques for advanced disease over the last 10 years.Findings: Partial nephrectomy (PN) has become the reference standard for most T1 and T2 masses. In cT2 RCC, PN exhibits oncological equivalence and improved functional outcomes compared to radical nephrectomy (RN). Additionally, emerging data suggest that PN may be used to treat cT3a RCC. The robot-assisted platform is increasingly used to treat locally advanced RCC. Studies suggest safety and feasibility of robotic RN and robotic inferior vena cava tumor thrombectomy. Additionally, single-port robot-assisted laparoscopic approaches are comparable to multiport approaches in select patients. Long-term data show that cryoablation, radiofrequency ablation, and microwave ablation are equipotent in management of small renal masses. Emerging data suggest that microwave may effectively treat cT1b masses.Keywords: renal cell carcinoma, cryoablation, nephrectomy, microwave ablation, partial nephrectomy, radiofrequency ablation

Keywords

• carcinoma
• renal cell
• cryoablation
• nephrectomy
• microwave ablation
• partial nephrectomy
• radiofrequency ablation