RCC Staging and Management

RCC Staging and Management

Understanding Cancer Staging and Grading

CANCER STAGING AND GRADING

TREATMENT FOR RCC

Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body. There are 2 main types of staging systems used for different types of cancer.

Number staging system

TNM staging system

The grade describes the appearance of the cancerous cells.

 The grading system that's usually used is as follows:

grade 1 – cancer cells that resemble normal cells and aren't growing rapidly

grade 2 – cancer cells that don't look like normal cells and are growing faster than normal cells

grade 3 – cancer cells that look abnormal and may grow or spread more aggressively

 Staging and grading the cancer will allow the doctors to determine its size, whether it has spread and the best treatment options.

SURGERY:

TNM STAGING

The primary treatment for localized RCC. The type of nephrectomy performed depends on the size and location of the tumor as well as the patient's overall health.

Radical nephrectomy: Removal of the entire kidney along with surrounding tissues and nearby lymph nodes.

Partial nephrectomy: Removal of only the tumor and a small margin of healthy tissue, preserving the rest of the kidney. This is preferred for smaller tumors or when preserving kidney function is important.

STAGE 3

Either of these conditions:

A tumor of any size is located only in the kidney. It has spread to the regional lymph nodes but not to other parts of the body (T1 or T2, N1, M0).

The tumor has grown into major veins or perinephric tissue and may or may not have spread to regional lymph nodes. It has not spread to other parts of the body (T3, any N, M0).

STAGE 1

The tumor is 7 cm or smaller and is only located in the kidney. It has not spread to the lymph nodes or distant organs (T1, N0, M0).

RADIOFREQUENCY ABLATION 

In Ablation surgeries, extreme temperatures are used to target and kill cancer cells. In radiofrequency ablation, a needle is inserted into the kidney tumour from the outside. The next step is to kill the cancer cells by sending an electrical current through them.  Cryoablation and radiofrequency ablation are common alternatives to surgery that may help certain people.

RADIATION AND CHEMOTHERAPY

STAGE 4

STAGE 2

The tumor is larger than 7 cm and is only located in the kidney. It has not spread to the lymph nodes or distant organs (T2, N0, M0).

CRYOABLATION

Radiation therapy and chemotherapy are generally not considered primary treatments for Renal Cell Carcinoma (RCC).

Traditional chemotherapy drugs, which target rapidly dividing cells, have limited effectiveness against RCC. RCC is relatively resistant to standard chemotherapy regimens, and these drugs are not typically used as first-line treatments.

However, in certain situations where RCC is aggressive, has metastasized extensively, or is not responding to other treatments, chemotherapy may be considered. Chemotherapy drugs like gemcitabine, 5-fluorouracil (5-FU), and capecitabine are sometimes used, although they are not as effective as targeted therapies or immunotherapy.

The tumor has spread to areas beyond Gerota's fascia and extends into the adrenal gland on the same side of the body as the tumor, possibly to lymph nodes, but not to other parts of the body (T4, any N, M0).

The tumor has spread to any other organ, such as the lungs, bones, or the brain (any T, any N, M1).

 It is a minimally invasive procedure that uses extreme cold temperatures to destroy (ablate) benign or malignant tumors. An extremely cold freezing agent (liquid nitrogen, liquid nitrous oxide, or compressed argon gas) is administered through a thin needle called a cryoprobe in a closed-loop system, freezing and destroying the abnormal tissue. The tissues targeted for destruction and the ice ball that grows around it during the treatment, are visualized using real-time image guidance, allowing a good approximation of the frozen tissue in the ablated area.