title: [Principal value of surgical therapy in the renal cell cancer, chances of the biological treatment].
abstract: Renal cell cancer belongs to the most malignant tumours in urology; the incidence in the Czech Republic is highest world. Surgical treatment is the first method of choice both in localized and metastatic renal cell cancer due to its chemo and radioresistance. Cytoreductive nephrectomy in case of metastatic renal cell cancer can prolong the overall survival. Lymfogenic propagation is rare, but involvement of lymphatic retroperitoneal nodes is the most unfavourable risk factor. Patients with vein tumour thrombus profit from the radical surgical treatment; the most important thing is the removal of whole tumour thrombus. Miniinvasive methods in treatment of renal cell cancer are getting more and more popular nowadays. Partial nephrectomy is a method of choice in the treatment of small suitable localised renal cell cancers. Adjuvant therapy is not indicated in localised renal cell cancer. Immunotherapy was the most convenient method of treatment generalised renal cell cancer in the last decade of 20th century. Understanding of signalling pathways for growth factors in angiogenesis was the cue for targeted therapy. This method pushes back immunotherapy. Unfortunately targeted therapy fails to cure patients with generalized renal cell cancer; it can only stabilize disease and prolong the overall survival.
authors.affiliation: Univerzita Karlova v Praze, 1. lékarská fakulta, Urologická klinika VFN. romansobotka@atlas.cz
authors.forename: Roman
authors.initials: R
authors.lastname: Sobotka
authors.forename: Tomás
authors.initials: T
authors.lastname: Hanus
authors.forename: Milada
authors.initials: M
authors.lastname: Zemanová
mesh_terms: D001691:Biological Therapy; D002292:Carcinoma, Renal Cell / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery / Q000628:therapy*