Ulteriori informazioni
The management of advanced renal cell carcinoma is still problematic. Surgery, although the therapy of choice for locally advanced renal tumors, is still controversial as the treatment for metastases. The role of surgery in the management of patients with pulmonary, bony, and liver metastasis is one of the subject matters discussed in this book. Our results with series of patients undergoing resection of metastases from the lung, bone, and liver show that surgery may be appropriate in selected patients with a good performance status, although most of them certainly cannot be cured by this procedure alone, i.e., in the absence of effective adjuvant therapies. As recent developments show, new strategies for immunotherapy of renal cell carcinoma represent a modest advance over traditional approaches in the treatment of this cancer, such as chemo- and radiotherapy. Clinical trials employing recombinant interferon-a and interleukin 2 produced response rates in up to 30% of patients treated, as evidenced by the European Immunotherapy Trials Program. The adverse reactions and the lack of efficacy in the majority of patients warrants the search for new immunotherapeutic approaches.
Sommario
I Clinical Research.- The Role of Nephrectomy in Metastatic Renal Cell Carcinoma.- Possibilities and Limitations of Surgery for Liver Metastases of Renal Cell Cancer.- The Role of Bone Surgery for Immunotherapy in Disseminated Renal Cell Cancer.- Survival After Lung Surgery for Metastatic Renal Cancer.- Partial Nephrectomy for Renal Cell Carcinoma: Clinical and Biological Considerations.- Investigation of the Tumor Capsule in Renal Cell Carcinoma and Its Significance for Treatment.- Interleukin-2 Therapy: Report on 129 Patients and Three Different Schedules.- Response According to Site of Metastases in Patients with Metastatic RCC (Renal Cell Carcinoma) During Treatment with Interferon Alpha in Combination with 5-Fluorouracil.- II Basic Research.- Molecular Mapping of the Human 3p Region.- Molecular Analysis of Different Loci on Chromosomes 3, 5, and 17 in Sporadic Renal Cell Carcinoma.- Expression of Immediate Early Transcription Factors in Human Renal Cell Tumors.- Characterization and Functional Significance of the von Hippel-Lindau Gene in Renal Cell Carcinomas.- In Situ Expression of Cytokines in Renal Cell Carcinoma.- Tumor-Infiltrating Lymphocytes in Renal Cell Carcinoma: Phenotype, Function, and T-Cell Receptor Usage.- Immunological Approaches to Reverse Multidrug Resistance: The Concept of Molecular Targeting.- Therapeutic Applications of Monoclonal Antibodies in Combination with Cytokines in Renal Cell Carcinoma.- Tools for Vaccination and Immunotherapy: Internal-Image Anti-idiotype Antibodies Resembling the Renal Cell Carcinoma Associated Antigen G250.- Laser Photodynamic Therapy of Xenotransplanted Human Renal Cell Carcinoma.
Riassunto
The management of advanced renal cell carcinoma is still problematic. Surgery, although the therapy of choice for locally advanced renal tumors, is still controversial as the treatment for metastases. The role of surgery in the management of patients with pulmonary, bony, and liver metastasis is one of the subject matters discussed in this book. Our results with series of patients undergoing resection of metastases from the lung, bone, and liver show that surgery may be appropriate in selected patients with a good performance status, although most of them certainly cannot be cured by this procedure alone, i.e., in the absence of effective adjuvant therapies. As recent developments show, new strategies for immunotherapy of renal cell carcinoma represent a modest advance over traditional approaches in the treatment of this cancer, such as chemo- and radiotherapy. Clinical trials employing recombinant interferon-a and interleukin 2 produced response rates in up to 30% of patients treated, as evidenced by the European Immunotherapy Trials Program. The adverse reactions and the lack of efficacy in the majority of patients warrants the search for new immunotherapeutic approaches.
