Kidney Flashcards Preview

Oncology > Kidney > Flashcards

Flashcards in Kidney Deck (15)
Loading flashcards...
1
Q

What are the types of Kidney cancer? Incidence?

A

Clear cell (80%),
Papillary (12%),
Chromophobe (5%),
Other (3%): oncocytic, collecting duct, medullary and unclassified.

2
Q

Histologic and molecular features of Clear Cell, Papillary and Chromophobe?

A

Clear cell: compact nests of cells with clear cytoplasm, del 3p, VHL hypermethylation, 5q+, 8p-, 9p-, 14q-
Papillary: variable portions of papillae, tubulopapillae and tubules, trisomy 7 & 17. y-, 12+, 16+, 20+, rare MET mutations
Chromophobe: large polygonal cells with reticulated cytoplasm, atypical nuclear with perinuclear halo, eosinophilic cytoplasm, loss of chromosome Y, 1, 2, 6, 10, 13, 17 & 21

3
Q

Common risk factors?

A

smoking,
obesity,
cadmium, asbestos and petroleum products,
CKD and cystic renal disease

4
Q

Three factors in prognosis (measured by) for UCLA Integrated Staging System: UISS ?

A
  • extent of disease (TNM)
  • nuclear differentiation (Furhman grade)
  • performance status (ECOG)
5
Q

Staging workup for RCC?

A

CT C/A/P w contrast;

optional: bone scan & MRI brain

6
Q

What dose radical nephrectomy in RCC include?

A

kidney,
perinephric fat,
regional nodes,
adrenal gland

7
Q

What is staging system summary?

A

I: 7cm
III: 1 node or invasion into veins or perinephric tissue
IV: >1 node or invasion into adrenal, beyond Gerota’s fascia, distal met

8
Q

Majority of recurrences for RCC occur within? Surveillance?

A

3 years, scans q 6 for 3 years, then annually

9
Q

Important negative factors in risk stratification, original + new? Catergories?

A
  • KPS 1.5
  • Ca >10
  • anemia
  • no nephrectomy or recurrence in
10
Q

Tx for limited or locally advanced RCC?

A

Nephrectomy followed by surviellance

11
Q

Tx for metastatic RCC first line?

A
  • Select: IL-2 (only if lung limited, good PFS & clear cell histology)
  • Good or Int (OS): Pazopanib (22.9), Sunitinib (26.4) or Bev + IFN (23.3)
  • Poor:(OS): Temsirolimus (10.9) or Sunitinib
12
Q

Tx for metastatic RCC second line?

A

-Good or Int (OS): Nivolumab (25), Cabozantinib (PFS: 7.4), Axitinib (20.1), Sorafenib, Sunitinib or Pazopanib

13
Q

Is there a role for debulking nephrectomy?

A

Yes

14
Q

What do you give for metastatic non-clear cell RCC?

A

Temsirolimus, Sunitinib or Sorafenib

15
Q

New dx of RCC: questions to ask for considering hereditary workup?

A
  • age