Renal cell carcinoma(RCC) is one of the ten most common malignancies.The prognosis of RCC is poor when the disease is in advanced stages,with five-year survival of less than 10%.However current assessment approaches a...Renal cell carcinoma(RCC) is one of the ten most common malignancies.The prognosis of RCC is poor when the disease is in advanced stages,with five-year survival of less than 10%.However current assessment approaches are limited in their ability to prognosticate and guide therapeutic decision-making.Cellular-mediated inflammatory response is increasingly being recognised to have an important role in carcinogenesis of RCC.Various inflammatory markers have been found to identify patients with RCC at high risk of recurrence and predict survival.Neutrophil-lymphocyte ratio(NLR) is a simple and inexpensive inflammatory marker that has been shown to be of value in the assessment of patients with RCC.An elevated pretreatment NLR has been found to be associated with reduced overall survival,recurrence-free survival and progress-free survival and risk of recurrence in localized RCC.In addition,lower pretreatment NLR has been demonstrated to be associated with better clinical response to systemic therapy including vascular endothelial growth factor inhibitors,among patients with metastatic RCC.However,NLR has not been found to differentiate whether small renal masses of less than 40 mm are benign or malignant.Further research is needed to determine the cut-offs for NLR to predict different clinical outcomes and how post-treatment NLR can be used.In addition,more work is also needed to evaluate combining NLR with other biomarkers in a model to predict patients' clinical outcome or response to treatment for RCC.展开更多
Nephrectomy is the treatment of choice for early stage renal cell carcinoma. However,radical nephrectomy is consistently associated with higher rates of newonset chronic kidney disease(CKD) than the general population...Nephrectomy is the treatment of choice for early stage renal cell carcinoma. However,radical nephrectomy is consistently associated with higher rates of newonset chronic kidney disease(CKD) than the general population,regardless of the method used in measuring renal function. The higher rates of CKD are associated with worsened survival because of increased risk of cardiovascular diseases and mortality. Comorbidities and adjacent non-neoplastic kidney diseases are important risk factors for the development of CKD after nephrectomy. Partial nephrectomy has become the standard of care for patients with stage 1a tumours(diameter < 4 cm) and an attractive option for those with stage 1b(diameter 4-7 cm). Therefore stratifying the risk of postoperative CKD before surgery is important and ongoing monitoring of kidney function after radical nephrectomy is needed in addition to oncological surveillance. More research is needed to better understand the risk of CKD after radical nephrectomy and develop effective strategies to optimize kidney function after such surgery.展开更多
文摘Renal cell carcinoma(RCC) is one of the ten most common malignancies.The prognosis of RCC is poor when the disease is in advanced stages,with five-year survival of less than 10%.However current assessment approaches are limited in their ability to prognosticate and guide therapeutic decision-making.Cellular-mediated inflammatory response is increasingly being recognised to have an important role in carcinogenesis of RCC.Various inflammatory markers have been found to identify patients with RCC at high risk of recurrence and predict survival.Neutrophil-lymphocyte ratio(NLR) is a simple and inexpensive inflammatory marker that has been shown to be of value in the assessment of patients with RCC.An elevated pretreatment NLR has been found to be associated with reduced overall survival,recurrence-free survival and progress-free survival and risk of recurrence in localized RCC.In addition,lower pretreatment NLR has been demonstrated to be associated with better clinical response to systemic therapy including vascular endothelial growth factor inhibitors,among patients with metastatic RCC.However,NLR has not been found to differentiate whether small renal masses of less than 40 mm are benign or malignant.Further research is needed to determine the cut-offs for NLR to predict different clinical outcomes and how post-treatment NLR can be used.In addition,more work is also needed to evaluate combining NLR with other biomarkers in a model to predict patients' clinical outcome or response to treatment for RCC.
文摘Nephrectomy is the treatment of choice for early stage renal cell carcinoma. However,radical nephrectomy is consistently associated with higher rates of newonset chronic kidney disease(CKD) than the general population,regardless of the method used in measuring renal function. The higher rates of CKD are associated with worsened survival because of increased risk of cardiovascular diseases and mortality. Comorbidities and adjacent non-neoplastic kidney diseases are important risk factors for the development of CKD after nephrectomy. Partial nephrectomy has become the standard of care for patients with stage 1a tumours(diameter < 4 cm) and an attractive option for those with stage 1b(diameter 4-7 cm). Therefore stratifying the risk of postoperative CKD before surgery is important and ongoing monitoring of kidney function after radical nephrectomy is needed in addition to oncological surveillance. More research is needed to better understand the risk of CKD after radical nephrectomy and develop effective strategies to optimize kidney function after such surgery.
