title: International consultation on urologic diseases and the European Association of Urology international consultation on locally advanced renal cell carcinoma.
abstract: BACKGROUND
  Although an ever-increasing number of patients are being incidentally diagnosed with small renal masses, there is still a sizable portion of patients with renal cell carcinoma (RCC) who present with locally advanced or metastatic disease. Those with locally advanced disease present a challenge because they may be difficult to distinguish from those with organ-confined disease at the time of diagnosis. However, this distinction is important because they may require a different management strategy. These advanced RCC patients include those with venous tumour thrombi, extracapsular tumour extension, adjacent organ involvement, as well as nodal disease.
  
  
  METHODS
  A thorough literature search of the following terms was undertaken: advanced renal cell carcinoma, renal cell carcinoma venous tumour thrombi, renal cell carcinoma extra-capsular extension, renal cell carcinoma nodal metastasis, and locally recurrent renal cell carcinoma. An international expert panel convened by the International Consultation on Urologic Diseases and the European Association of Urology reviewed these articles.
  
  
  RESULTS
  Review of the available literature allowed for assessment of the level of evidence for the diagnosis, management, and therapy of locally advanced RCC with the ultimate goal of providing a synthesis of this information with a consensus statement from leaders in the field.
  
  
  CONCLUSIONS
  Despite the advances in prognostic markers and targeted molecular therapies for RCC, currently the only curative treatment for locally advanced RCC is aggressive surgical resection.
authors.affiliation: UT Southwestern Medical Centre, Dallas, TX, USA.
authors.forename: Vitaly
authors.initials: V
authors.lastname: Margulis
authors.forename: Viraj A
authors.initials: VA
authors.lastname: Master
authors.forename: Nicholas G
authors.initials: NG
authors.lastname: Cost
authors.forename: Bradley C
authors.initials: BC
authors.lastname: Leibovich
authors.forename: Steven
authors.initials: S
authors.lastname: Joniau
authors.forename: Markus
authors.initials: M
authors.lastname: Kuczyk
authors.forename: Peter F
authors.initials: PF
authors.lastname: Mulders
authors.forename: Ziya
authors.initials: Z
authors.lastname: Kirkali
authors.forename: Manfred P
authors.initials: MP
authors.lastname: Wirth
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Hirao
authors.forename: Sudhir
authors.initials: S
authors.lastname: Rawal
authors.forename: Tsung Wen
authors.initials: TW
authors.lastname: Chong
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Wood
mesh_terms: D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods; D018579:Patient Selection; D011379:Prognosis; D016896:Treatment Outcome