When are the treatment guidelines for stage II and III renal cell carcinoma (RCC)?

Updated: May 21, 2019
  • Author: Kush Sachdeva, MD; Chief Editor: E Jason Abel, MD  more...
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Answer

For stage II and III renal tumors, the National Comprehensive Cancer Network (NCCN) guideline recommends radical nephrectomy. in most cases. Partial nephrectomy may be used if clinically indicated, such as in unilateral tumors, where technically feasible, or the following:

  • Uninephric state
  • Renal insufficiency
  • Bilateral renal masses
  • Familial RCC

The European Society of Medical Oncology (ESMO) guideline recommends laparoscopic radical nephrectomy for T2 tumors (>7 cm). For locally advanced RCC (T3 and T4), open radical nephrectomy is the standard of care, though a laparoscopic approach can be considered. However, systemic adrenalectomy or extensive lymph node dissection is not recommended when there is no evidence of adrenal or lymph node invasion. There is no recommended adjuvant treatment. Adjuvant and neoadjuvant treatment should not be considered outside of clinical trials. [75]


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