Author/Editor		Rajer, Mirjana
Title		Kidney cancer
Translated title		Rak ledvic
Type		članek
Source		Radiol Oncol
Vol. and No.		Letnik 41, št. 2
Publication year		2007
Volume		str. 64-71
Language		eng
Abstract		Background. The purpose of this paper is to present the epidemiology, diagnostic workup and treatment of renal cell carcinoma (RCC) with an emphasis on the Slovenian epidemiological data. RCC represents 2 of all cancers and is the third most comrrcon genitourinary tract tumour. It most frequently occurs among people of ages, between 50 and 60 years. Male patients are more prone to it than female. A number of environmental, occupational and genetic factors have been found to be associated with the development of RCC. Patients often have nonspecific symptoms and this is the reason why for half of them the disease is already metastatic when diagnosed. The most common sites of metastases are lungs (75%), followed by soft tissues (36%), bones (20%), liver (18%), skin (8%) and central nerve system (8%). In the evaluation of RCC multiple diagnostic procedures are needed with obligatory image diagnostics. Conclusions. Radical nephrectomy is still the mainstream treahnent of localized disease. Nephron sparing techniques have been used in cases, where radical operation would result in an anephric patient. Efficient adjuoant therapy has not been discovered yet. Until recently interpherone and interleukin were the only known effective treatments for metastatie disease, but now new and more efficient biologic agents are being discovered. The most important prognostic factor for survival is stage at the beginning of treatment. The 5-year survival rate is 95% for patients with stage I disease, 88% for stage II, 59% for stage III and 20% for stage IV.
Summary		Izhodišča. Namen prispevka je prikazati trenutno stanje na področju diagnostike in zdravljenja raka ledvic (RL), s poudarkom na slovenskih epidemioloških podatkih. Rak ledvic predstavlja 2% vseh rakov in je tretji najpogostejši rak genitourinarnega področja. V veliki večini prizadene ljudi med 50 in 60 letom starosti. Pogostejši je pri moških kakor pri ženskah. Z nastankom RL maj bi bili povezani številni dejavniki tveganja. Še najmočneje je dokazana povezava s kajenem tobaka. Ostali pomembni dejavniki tveganja so še hipertenzija, debelost in kronična ledvična odpoved. V polovici primerov pridejo bolniki na prvi pregled k zdravniku, ko je bolezen že napredovala, saj RL pogosto ne spremljajo značilni simptomi. RL najpogosteje metastazira v pljuča (75%), nato v mehka tkiva (36%), kosti (20%), jetra (18%), kožo (8%) in centralni živčni sistem (8%). V diagnostiki prevladujejo slikovne metode. Zaključki. Lokalizirano bolezen zdravimo kirurško z radikalno nefrektomijo. Ohranitvena operacija je indicirana, ko bi odstranitev celotne ledvice privedla bolnika do dialize. Do danes še ni bila odkrita učinkovita dopolnilna terapija po operaciji. Metastatsko bolezen zdravimo z interferonom in interlevkinom, prihajajo pa vedno nova in učinkovitejša biološka zdravila. Najpomembnejši prognostični dejavnik za preživetje je stadij bolezni ob začetku zdravljenja. Petletno preživetje bolnikov z RL je 95% za stadij I, 88% za stadij II, 59% za stadij III in 20% za stadij IV.
Descriptors		KIDNEY NEOPLASMS CARCINOMA, RENAL CELL NEPHRECTOMY SURVIVAL ANALYSIS