Current and Future Trends in the Treatment of Renal Cancer

Kidney cancer, of which renal cell cancer (RCC) is the most common form, accounts for just under 2% of newly diagnosed malignancies worldwide. When detected early, surgery is the most efficacious treatment for patients with nonmetastatic, localised RCC, but for patients with large tumours, regional lymph node involvement, or inferior vena cava (IVC) tumour thrombus, complete tumour resection can be challenging and surgical resection alone is often insufficient to prevent disease recurrence. For patients who experience recurrence or develop metastatic disease, treatment options are limited and the prognosis is extremely poor. In this article, treatment options for different types of patients with RCC are deliberated. For patients with IVC tumour thrombus, the various approaches and use of embolisation are discussed. Immunotherapy and novel, targeted agents are examined as treatment options for patients with metastatic disease. For patients medically unsuitable for radical surgery, other alternatives including nephron-sparing surgery (partial nephrectomy, cryoablation, and radiofrequency ablation) and observation with supportive care are discussed.