Metastatic Renal Cell Carcinoma

By Dr Ananya Mandal, MD

Metastatic renal cell cancer is cancer that has spread beyond its site of origin in the kidney, to other organs in the body. The cancer first invades the blood vessels or fatty tissue surrounding the kidneys, before affecting nearby lymph nodes and eventually involving lymph nodes in other areas and organs such as the bones, lungs or brain.

In renal cell carcinoma, the risk of metastasis is high since most cases are not detected during the early stages, when the tumor is still small and confined to the kidney. Clinical symptoms of the disease are generally mild and nondescript until the cancer progresses and reaches a more advanced stage. Around 20% to 25% of patients diagnosed have already reached the metastatic phase of disease.

Once renal cell carcinoma has spread to other organs in the body, a patient’s 5-year survival estimate drops to 5-15%. The chances of survival may improve if any detectable cancer is removed from the kidney and any other affected organs, but generally, metastatic renal cell carcinoma cannot be cured and treatment is focused on slowing disease progression and alleviating symptoms.

In many other forms of cancer, patients respond to chemotherapy, but renal cell carcinoma is one of the few cancers that has a poor response to this treatment. The main treatment approaches used instead are described below:

  • Partial or complete nephrectomy, which is surgical removal of the kidney
  • Embolization, which is the deliberate occlusion of a blood vessel to prevent blood flow to a tumor
  • Targeted therapies such as sunitinib and pazopanib
  • Radiotherapy
  • Immunotherapy

Nephrectomy and interleukin-2 therapy is a standard approach in metastatic renal cell carcinoma. The patient response rate is low but a small percentage of people benefit.

Reviewed by , BSc

Further Reading

Last Updated: Sep 17, 2014

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