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  • Kanker Ginjal

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    Safira Nurrezki
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    This document summarizes renal tumors. It describes that renal cell carcinoma (RCC) is the most common type of malignant renal tumor, accounting for 78% of cases. RCC typically presents in males aged 60-70 years and risk factors include smoking, obesity, and von Hippel-Lindau disease. Staging of RCC is important and is typically done using CT or MRI imaging to determine if the cancer is confined to the kidney or has spread locally or metastasized to distant organs. Treatment options include radical nephrectomy for localized disease or chemotherapy, targeted therapy, ablation, or embolization for advanced or metastatic RCC. Prognosis depends on stage, with 5-year survival rates

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    This document summarizes renal tumors. It describes that renal cell carcinoma (RCC) is the most common type of malignant renal tumor, accounting for 78% of cases. RCC typically presents in males aged 60-70 years and risk factors include smoking, obesity, and von Hippel-Lindau disease. Staging of RCC is important and is typically done using CT or MRI imaging to determine if the cancer is confined to the kidney or has spread locally or metastasized to distant organs. Treatment options include radical nephrectomy for localized disease or chemotherapy, targeted therapy, ablation, or embolization for advanced or metastatic RCC. Prognosis depends on stage, with 5-year survival rates

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    48 views22 pages

    Kanker Ginjal

    Uploaded by

    Safira Nurrezki
    This document summarizes renal tumors. It describes that renal cell carcinoma (RCC) is the most common type of malignant renal tumor, accounting for 78% of cases. RCC typically presents in males aged 60-70 years and risk factors include smoking, obesity, and von Hippel-Lindau disease. Staging of RCC is important and is typically done using CT or MRI imaging to determine if the cancer is confined to the kidney or has spread locally or metastasized to distant organs. Treatment options include radical nephrectomy for localized disease or chemotherapy, targeted therapy, ablation, or embolization for advanced or metastatic RCC. Prognosis depends on stage, with 5-year survival rates

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
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    of 22

    Renal tumour

    Bernard S. Tjandra
    Bedah Urologi
    Benign : Haemangioma Fibroma (Jaringan ikat)
    Adenoma Lipoma

    Malignant :
    - Congenital - Nephroblastoma (Wilms) 10 %

    - Acquired - Parenchymal Carcinoma 78 %*


    Fibrosarcoma
    Liposarcoma 2%
    - Renal pelvis 10 %
    Transitional cell
    Squamous cell
    Renal cell carcinoma
    (Hypernephroma, Clear cell, Grawitz)
    - Common in males (1.5 : 1)
    - Peak incidence 60 – 70 years
    - Highest in N America, Australia, Europe
    - Multiple cases 19 %
    - Incidence 11 per 100.000 (The Netherlands)
    - Present with metastatic 20 – 30 %
    Etiology

    • Cigarette
    • Obesity
    • Oestrogen
    • Viruses
    • Von Hippel-Lindau (40 %)
    • Chronic dialysis
    • Hereditair ?
    Pathology / Histology

    Subtypes
    Clear cell
    Papillary (chromophilic, eosinophilic)
    Chromophobic (kromophob lebih ganas daripada
    clear cell)
    Oncocytic
    Collecting duct (Bellini)
    Stage !!!!

    1 Small, within the capsule


    2 Cortex not broken
    3a. Perirenal fat
    3bV1. Renal vein
    3bV2. Vena cava (5 – 9 %)
    4. Involvement of adjacent
    organs

    Pake pemeriksaan Ct / MRI


    TNM 2002

    • T1 Tumour < 7 cm, limited to the kidney


    • T2 Tumour > 7 cm, limited to the kidney
    • T3 Tumour extends into major veins or
    directly invades adrenal / perinephric
    • T4 Tumour directly invades beyond gerota
    Clinical manisfestations

    • No symptoms (45 %)
    • Haematuria, abdominal pain, flank mass (trias)
    • Varicocele
    • Bone pain
    • Pyrexia, weight loss, anorexia, anaemia
    • Erythrocytosis
    • Hypercalcaemia
    Laboratory
    • Urine
    • Blood (Hb, ESR)
    • IVU (stippled calcification, distortion)
    • USG of the kidneys
    • Chest X-ray
    • CT- abdomen using contrast (penting)
    • Bone scan
    • Selective renal arteriography (neovasculature) Buat tau
    • Vena cavography udah
    nyebar
    kemana
    IVU
    USG

    cyst
    C.T of whole abdomen
    C.T. Scan
    Tumor Thrombus In The Vena Cava
    C.T. Scan
    Lymph Nodes Metastasis
    M.R.I
    Treatment
    • Radical nephrectomy with / - out lymphadenectomy (20 – 40 %
    develop metastases) : masih di dalam parenkim ginjal. Kapsul diangkat.

    • Chemotheraphy
    - Vinblastine
    - Interleukin-2 + alpha interferon +
    5-fluorouracil.
    - Sorafenib, Sunitinib
    • Cryoablation (-20 c)
    • Embolization

    Tidak ada radioterapi


    Modern approaches

    • Biological and immune-based therapies


    (response rates 15 – 25 %)

    Vascular endothelial growth factor (VEGF) Avastin

    Staehler, EAU update 2007


    Clear cell type
    Prognosis

    5 – year survival rate


    stage 1 50 – 60 %
    stage 2 30 – 40 %
    stage 3 15 – 30 %
    stage 4 3 – 8%
    Cryoablation
    Recurrence rate 6 – 12.5 %

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