title: [Surgical innovations and therapeutic strategies in the management of renal cell carcinomas].
abstract: In recent years, the management of renal cell carcinomas has changed significantly and is now based on two concepts: preservation of renal function in localized forms and control of angiogenesis in metastatic forms. The main ways of research in the diagnostic strategy is to develop new tools to identify more precisely the lesions discovered by imaging, thanks to biological or molecular markers as micro-RNA, and to predict renal function after surgery. Surgical indications for partial nephrectomy are now only limited by technical feasibility. In this regard, tolls like the RENAL nephrometric score help to evaluate the risk of total nephrectomy or the duration of clamping. Furthermore, the important development of robotically assisted surgery provides very promising results. In advanced forms of renal cell carcinomas, recent advances have led to a considerable prolongation of recurrence-free survival, but overall survival remains the same with 40 % of specific mortality. New targeted therapies have paved the way for a new approach and studies expected in the coming years could change the therapeutic strategies and lead to a new staging of patients.
authors: Service d'Urologie Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalo-Universitaire Est, Faculté de Médecine Pierre et Marie Curie, Université Paris VI, Paris, France.
authors: F
authors: F
authors: Audenet
authors: M
authors: M
authors: Rouprêt