Renal Cell Carcinoma (Hypernephroma): Complications

The following are the most important diseases or complications that can be caused by hypernephroma (renal cell carcinoma):

Neoplasms – Tumor Diseases (C00-D48).

• Malignant melanoma (primary melanoma) (3.19 times the standardized incidence rate as the ratio of observed to expected tumor incidence)

Metastases (daughter tumors).

• Brain
• Bone
• Liver
• Lung (first filter station) (60-70%) Note: Primary non-small cell lung cancer (NSCLC) can be easily missed or misinterpreted as metastatic in patients with metastatic renal cell carcinoma.
• Lymph nodes (60-65%)

Other notes

• Approximately one quarter of patients already have hematogenous (“in the bloodstream”) distant metastases at the time of diagnosis.
• The likelihood of metastases depends on the tumor size
  • Tumor size < 1 cm: no metastases.
  • Tumor sizes 1.1-2 cm: 1.1 %.
  • Tumor sizes 2.1-3 cm: 3.3 %
  • Tumor sizes 3.1-4 cm: 6.0 %

Prognostic factors

• Obesity paradox: On the one hand, obesity favors the development of this tumor; on the other hand, the more obese the patient, the better the chances of survival, apparently. Obese patients (grade 1) (BMI 30.0-34.9) and obese patients (grade 2) (BMI ≥ 35) showed a significantly lower risk of dying (HR 0.50, 95% CI 0.31-0.81 and HR 0.24, 95% CI 0.09-0.60, respectively):Discussion:It is possible that renal cell carcinoma in obese individuals is a special biological subgroup that explains the lower average tumor stage and more favorable grading.
• Low preoperative cholesterol levels are associated with increased mortality risk (risk of death); for every 10 mg/dl increase in cholesterol, cancer-specific mortality (death rate) decreased by 13
• Increased expression of colony-stimulating factor 1 (CSF-1) is associated with poor prognosis (poor survival and early recurrence/recurrence of disease) in patients with clear cell renal cell carcinoma (ccRCC) following surgery
• Performance status, the occurrence of metastases depending on the timing and location, symptoms, hematologic parameters (Hb level, platelet count, neutrophil count), LDH are clinical prognostic factors.Other laboratory parameters: Calcium i. Serum; alkaline phosphatase.

Prognostic model of the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC):

• Performancestatus <80
• Interval from diagnosis to system therapy <1 year.
• Hemoglobin (blood pigment) below normal value.
• Hypercalcemia / calcium excess (corrected serum calcium).
• Neutrophils (count as white blood cells) above the normal value.
• Platelets (blood platelets) above the normal value.

Prognosis by risk group in first-line therapy.