title: The Diagnosis, Treatment, and Follow-up of Renal Cell Carcinoma.
abstract: BACKGROUND
  In 2014, 15 500 persons in Germany were given the diagnosis of renal cell carcinoma. This disease is the third most common cancer of the urogenital system. The mean age at diagnosis is 68 years in men and 71 in men.
  
  
  METHODS
  Pertinent publications up to 2014 were retrieved by a systematic literature search and reviewed in a moderated, formalized consensus process. Key questions were generated and answered by the adaptation of existing international guidelines, on the basis of an independent literature review, and by expert consensus. Representatives of 30 medical specialty societies, patient self-help groups, and other organizations participated in the process.
  
  
  RESULTS
  The search for guidelines yielded 80 hits, 23 of which were judged by DELBI to be potentially relevant; 7 were chosen for adaptation. Smoking, obesity, and hypertension increase the risk of renal cell carcinoma. Its 5-year survival rate is 75% for men and 77% for women. Renal cell carcinoma accounts for 2.6% of all deaths from cancer in men and 2.1% in women. Nephrectomy and partial nephrectomy are the standard treatments. Locally confined tumors in clinical stage T1 should be treated with kidney-preserving surgery. Minimally invasive surgery is often possible as long as the surgeon has the requisite experience. For patients with metastases, overall and progression-free survival can be prolonged with VEGF and mTOR inhibitors. The resection or irradiation of metastases can be a useful palliative treatment for patients with brain metastases or osseous metastases that are painful or increase the risk of fracture.
  
  
  CONCLUSIONS
  Minimally invasive surgery and new systemic drugs have expanded the therapeutic options for patients with renal cell carcinoma. The search for new predictive and prognostic markers is now in progress.
authors.affiliation: Urologikum Lübeck, Department of Hematology, Hemostaseology, Oncology and Stem Cell Transplantation, Hannover Medical School, Department of Urology, HELIOS Klinikum Erfurt GmbH, German Guideline Program in Oncology/German Cancer Society, MeckEvidence, Schwarz, Department of Urology, Urologic Onkology and Pediatric Urology, Kliniken Essen-Mitte/Evangelische Huyssens-Stiftung.
authors.forename: Christian
authors.initials: C
authors.lastname: Doehn
authors.forename: Viktor
authors.initials: V
authors.lastname: Grünwald
authors.forename: Thomas
authors.initials: T
authors.lastname: Steiner
authors.forename: Markus
authors.initials: M
authors.lastname: Follmann
authors.forename: Heidrun
authors.initials: H
authors.lastname: Rexer
authors.forename: Susanne
authors.initials: S
authors.lastname: Krege
mesh_terms: D000359:Aftercare / Q000592:standards; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000175:diagnosis* / Q000628:therapy*; D000066491:Clinical Decision-Making; D003131:Combined Modality Therapy / Q000592:standards; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008495:Medical Oncology / Q000592:standards*; D009392:Nephrectomy / Q000592:standards*; D009398:Nephrology / Q000592:standards; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents