Surgical Management of Recurrences of Renal Cell Carcinoma

Abstract

In recent decades the detection of new cases of renal cell carcinoma (RCC) has remained unchanged. This tumor accounts for 2-3% of all cancer diagnoses in humans. Standard methods of surgical treatment are being improved towards less invasive resection methods; this let's achieving the outcomes comparable to traditional nephrectomy in oncological practice. In some cases the risk factor of developing locoregional recurrence still remains after surgical treatment for renal cancer. The limited role of systemic therapy and radioresistance sets hopes on surgical removal of the recurrent tumor. Unfavorable prognostic factors such as the volum of recurrence, the presence of sarcomatoid histological elements, an increased level of serum alkaline phosphatase and lactate dehydrogenase were identified in the materials of several recent studies. The time of recurrence appearance and a forehand surgeries hould be defined as one of the independent predictors as it reported by other several studies. The open laparotomic, laparoscopic and robotic methods of tumor removal, as well as the extents of renal segments of repeated resection are discussed depending on the size of the recurrent tumor and the extent of the previous opetations. At the present stage of the development of minimally invasive surgery, with its problem-solving abilities which are very essential in treating the relapsed high-risk patients.