Abstract：Late-stage renal cell carcinoma (RCC), also known as metastatic RCC (mRCC), developed distant metastases through hematogenous or lymphatic approaches, and its prognosis is very poor. mRCC resists to radio- or chem-o-therapy and cytoreductive surgery can only serve as an assistant treatment. In view of the fact that RCC is immunoactive and vascular-rich neoplasm, its therapeutic strategy largely depends on cytokine therapy and anti-angiogenesis target therapy. Our goal is to summarize the mechanism of mRCC metastasis and its therapeutic strategy.
[1]Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin, 2011,61(2):69-90. [2]Escudier B, Porta C, Schmidinger M, et al. Renal cell carcinoma: Esmo clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2014,25 Suppl 3:49-56. [3]李鸣, 何志嵩, 高江平, 等. 多中心肾癌临床特征分析. 中华泌尿外科杂志, 2010,(2):77-80. [4]Flanigan RC, Mickisch G, Sylvester R, et al. Cytoreductive nephrectomy in patients with metastatic renal cancer: A combined analysis. J Urol, 2004,171(3):1071-1076. [5]Oudard S, George D, Medioni J, et al. Treatment options in renal cell carcinoma: Past, present and future. Ann Oncol, 2007,18 Suppl 10:25-31. [6]Linehan WM, Srinivasan R, Schmidt LS. The genetic basis of kidney cancer: A metabolic disease. Nat Rev Urol, 2010,7(5):277-285. [7]张旭,李宏召,马鑫,等. 肾脏的应用解剖. //张旭.泌尿外科腹腔镜手术学.北京:人民卫生出版社,2008:41. [8]郭应禄,周利群,译. 肾脏的淋巴系统. //郭应禄.坎贝尔-沃尔什泌尿外科学.9版.北京:北京大学医学出版社,2009:30-31. [9]Blackley SK, Ladaga L, Woolfitt RA, et al. Ex situ study of the effectiveness of enucleation in patients with renal cell carcinoma. J Urol, 1988,140(1):6-10. [10]Matsumoto T, Claesson-Welsh L. VEGF receptor signal transduction. Sci STKE, 2001, 2001(112):re21. [11]胡伟国, 郑民华. 血管内皮生长因子c、d与肿瘤淋巴管转移. 诊断学理论与实践, 2006,5(1):3. [12]Gupta K, Miller JD, Li JZ, et al. Epidemiologic and socioeconomic burden of metastatic renal cell carcinoma (mrcc): A literature review. Cancer Treat Rev, 2008,34(3):193-205. [13]Motzer RJ, Bacik J, Schwartz LH, et al. Prognostic factors for survival in previously treated patients with metastatic renal cell carcinoma. J Clin Oncol, 2004,22(3):454-463. [14]Coppin C, Porzsolt F, Awa A, et al. Immunotherapy for advanced renal cell cancer. Cochrane Database Syst Rev, 2005,(1):CD001425. [15]Romo de Vivar Chavez A, de Vera ME, Liang X, et al. The biology of interleukin-2 efficacy in the treatment of patients with renal cell carcinoma. Med Oncol, 2009,26 Suppl 1:3-12. [16]Motzer RJ, Hutson TE, Tomczak P, et al. Phase III randomized trial of sunitinib malate (SU11248) versus interferon-alfa (IFN-{alpha}) as first-line systemic therapy for patients with metastatic renal cell carcinoma (mRCC). J Clin Oncol, 2006 ASCO Annual Meeting Proceedings (Post-Meeting Edition), 24, 18S. [17]Ratain MJ, Eisen T, Stadler WM, et al. Phase Ⅱ placebo-controlled randomized discontinuation trial of sorafenib in patients with metastatic renal cell carcinoma. J Clin Oncol, 2006,24(16):2505-2512. [18]Escudier B, Szczylik C, Eisen T, et al. Randomized phase III trial of the Raf kinase and VEGFR inhibitor sorafenib (BAY 43–9006) in patients with advanced renal cell carcinoma (RCC) (abst). J Clin Oncol, 2005,23(16S):LBA4510. [19]Rini BI, Wilding G, Hudes G, et al. Phase Ⅱ study of axitinib in sorafenib-refractory metastatic renal cell carcinoma. J Clin Oncol, 2009,27(27):4462-4468. [20]Hutson TE, Davis ID, Machiels JP, et al. Efficacy and safety of pazopanib in patients with metastatic renal cell carcinoma. J Clin Oncol, 2010,28(3):475-480. [21]Sternberg CN, Davis ID, Mardiak J, et al. Pazopanib in locally advanced or metastatic renal cell carcinoma: Results of a randomized phase Ⅲ trial. J Clin Oncol, 2010,28(6):1061-1068. [22]Escudier B, Pluzanska A, Koralewski P, et al. Bevacizumab plus interferon alfa-2a for treatment of metastatic renal cell carcinoma: A randomised, double-blind phase Ⅲ trial. Lancet, 2007,370(9605):2103-2111. [23]Motzer RJ, Hudes GR, Curti BD, et al. Phase Ⅰ/Ⅱ trial of temsirolimus combined with interferon alfa for advanced renal cell carcinoma. J Clin Oncol, 2007,25(25):3958-3964. [24]Motzer RJ, Escudier B, Oudard S, et al. Efficacy of everolimus in advanced renal cell carcinoma: A double-blind, randomised, placebo-controlled phase Ⅲ trial. Lancet, 2008,372(9637):449-456. [25]Dabestani S, Marconi L, Hofmann F, et al. Local treatments for metastases of renal cell carcinoma: A systematic review. Lancet Oncol, 2014,15(12):e549-561. [26]Campbell SC, Flanigan RC, Clark JI. Nephrectomy in metastatic renal cell carcinoma. Curr Treat Options Oncol, 2003,4(5):363-372. [27]Wood CG. The role of cytoreductive nephrectomy in the management of metastatic renal cell carcinoma. Urol Clin North Am, 2003,30(3):581-588. [28]Choueiri TK, Xie W, Kollmannsberger C, et al. The impact of cytoreductive nephrectomy on survival of patients with metastatic renal cell carcinoma receiving vascular endothelial growth factor targeted therapy. J Urol, 2011,185(1):60-66. [29]Zielinski H, Szmigielski S, Petrovich Z. Comparison of preoperative embolization followed by radical nephrectomy with radical nephrectomy alone for renal cell carcinoma. Am J Clin Oncol, 2000,23(1):6-12.
