Volume 15, Number 1Review ArticlesPhysiologic and Anesthetic Considerations in Octogenarians Undergoing Laparoscopic Partial NephrectomyManagement ReviewNaeem A SoomroElizabeth ToddNikhil VasdevThe number of small renal tumors detected is increasing as imaging becomes both more available and advanced, and as the population ages, with a greater proportion of patients in their 80s emerging with small and treatable renal tumors. The technique of laparoscopic partial nephrectomy is emerging and becoming ever more popular in some centers, and is potentially a safer alternative for the elderly due to improved postoperative pain, shorter hospital stay with faster return to preoperative activities, and lower rates of morbidity and mortality. We present a systematic review of the physiologic and anesthetic considerations in octogenarians undergoing the procedure, highlighting special considerations and the need for expertise throughout the multidisciplinary team when dealing with these patients, in order to minimize risk and optimize outcome. [ Rev Urol. 2013;15(1):23-31 doi: 10.3909/riu0565] © 2013 MedReviews®, LLCRenal cell carcinomaRadical nephrectomyLaparoscopic partial nephrectomyRenal tumorOctogenarian
Volume 16, Number 3Review ArticlesRole of Chemokines in Renal Cell CarcinomaSystematic ReviewHari Siva Gurunadha Rao TunuguntlaJaspreet S PariharWith new frontiers of pharmaceutical therapies focusing on tumor growth and angiogenesis, understanding the interaction between immune system and tumor microenvironment has become ever more important. Chemokines and chemokine receptors appear to play an integral role in tumor characteristics. Evidence suggests CXCR4, CXCL5, CXCR7, and stromal derived factor-1 appear to be crucial in survival, growth, and metastasis of renal cell carcinoma. As the role of chemokines in renal cancer is becoming more evident, further research will lead to a better understanding of tumor biology and the development of new therapeutic targets to help improve survival. [Rev Urol. 2014;16(3):118-121 doi: 10.3909/riu0608] © 2014 MedReviews®, LLCRenal cell carcinomaCytokinesChemokineOncocytoma
Volume 16, Number 3Case ReviewOccult Renal Cell Carcinoma Manifesting as Nasal Mass and EpistaxisRajeev MathurVishwas BahetiJanak SinghSher Singh YadavMetastasis of renal cell carcinoma (RCC) to the nasal cavity and paranasal sinuses is rare, with fewer than 50 cases described in the literature. Nasal metastasis as the initial presentation of RCC is even rarer. Metastases to the nasal cavity usually represent advanced disease with poor outcome. The authors report a case of metastatic RCC presenting with right nasal cavity mass and epistaxis, followed by a brief review of the relevant literature. [Rev Urol. 2014;16(3):145-148 doi: 10.3909/riu0607] © 2014 MedReviews®, LLCRenal cell carcinomaNasal metastasisEpistaxis
Volume 18, Number 3Review ArticlesPerioperative Considerations in Metastatic Renal Cell CarcinomaManagement UpdateJim AsheadShanmugasundaram Gowrie-MohanPaul NathanDamian HanburyTim LaneKate FlavinPatients with metastatic renal cell carcinoma are complex, with the potential for significant complications, and require extensive pre-, peri-, and postoperative management. This article discusses, in depth, the necessary considerations in the treatment of these patients. [Rev Urol. 2016;18(3):133-142 doi: 10.3909/riu0697] © 2016 MedReviews®, LLCRenal cell carcinomaRadical nephrectomyCytoreductive nephrectomyMetastasis
Volume 22, Number 1Review ArticlesActive Surveillance for Small Renal MassesManagement ReviewPhillip M PierorazioJoseph G CheaibShagnik RayActive surveillance (AS) is a safe and reasonable management strategy for many patients with small renal masses (SRM) suspicious for a clinical T1a renal cell carcinoma based on excellent metastasis-free and cancer-specific survival. However, the expansion of robotic extirpation of SRM has outpaced the adoption of AS, resulting in the possibility of overtreatment for select patients with SRM, especially the elderly and comorbid. In this review of AS for SRM, with a focus on the Delayed Intervention and Surveillance for Small Renal Masses (DISSRM) Registry, we detail the rationale behind AS, review lessons learned from the past decades of literature, and offer suggestions for appropriate patient selection and follow-up. An improved understanding of the data supporting AS will empower physicians and patients to more comfortably pursue AS to avoid overtreatment and provide individualized care to patients with SRM. [Rev Urol. 2020;22(1):9–16] © 2020 MedReviews®, LLCRenal cell carcinomaSmall renal massActive surveillanceRenal mass biopsyChest imaging
Volume 22, Number 3Case ReviewFrom Radical to Partial Nephrectomy in the Setting of Solitary Functioning Kidney: Neoadjuvant Treatment of Renal Cell CarcinomaDavid D WatsonA J FarhaShaker DakhilK James KallailNicole G FarhaImmunotherapy has revolutionized the treatment of metastatic renal cell carcinoma (RCC). This case evaluates the use of neoadjuvant immunotherapy for localized RCC in a patient with solitary functioning kidney. A retrospective chart review was conducted between September 2019 and January 2020 on a single patient. Before treatment, the tumor was 7 cm × 8 cm × 8.5 cm. The patient trialed nivolumab + ipilimumab then cabozantinib. The tumor shrunk to 6.3 cm × 5.5 cm and was removed via partial nephrectomy. This case demonstrates the efficacy of immunotherapy in neoadjuvant treatment of RCC. Expansion of guidelines could allow for patients with RCC to undergo partial nephrectomy. [Rev Urol. 2020;22(3):126-129] © 2020 MedReviews®, LLCRenal cell carcinomaImmunotherapyNeoadjuvant immunotherapySolitary kidney