CLINICAL RECOMMENDATIONS FOR TREATING AND MONITORING PATIENTS WITH RENAL CANCER
Autori:
Marija Petković, Eduard Vrdoljak, Ira Pavlović Ružić, Borislav Belev, Tomislav Omrčen, Dubravka Ledina, Rudolf Tomek, Boris Ružić, Marijan Šitum, Ante Buća, Valdi Pešutić Pisac
Sažetak
Svjetlostanični tip karcinoma bubrežnih stanica najčešći je oblik raka bubrega. Klinički je uglavnom asimptomatski, a samo se kod manjeg postotka bolesnika očituje hematurijom, tupom boli i palpabilnom masom u trbuhu. Najčešće se otkrije slučajno tijekom radioloških pregleda. Dijagnoza raka bubrega potvrđuje se patohistološkim nalazom nakon provedene dijagnostičke obrade. Odluka o liječenju donosi se temeljem kliničke procjene stadija bolesti i drugih čimbenika rizika. Ovisno o tome, mogućnosti liječenja uključuju kirurški zahvat te s obzirom na visoku rezistenciju raka bubrega na kemoterapiju i hormonsku terapiju, primjenu ciljane terapije (imunoterapija, inhibicija aktivnosti receptora tirozin kinaze) te palijativnu radioterapiju. U tekstu koji slijedi predstavljene su kliničke upute s ciljem standardizacije postupaka i kriterija postavljanja dijagnoze, upravljanja i liječenja te praćenja bolesnika s rakom bubrega u Republici Hrvatskoj.
Summary
Clear cell renal carcinoma is the most common kidney cancer. It is generally asymptomatic. A small percentage of patients present with hematuria, flank pain and abdominal mass. It is usually detected accidentally during radiologic examination. The diagnosis of kidney cancer is confirmed by pathohistological findings after completion of the diagnostic process. The decision about treatment is made based on clinical assessment of disease stage and other risk factors. Depending on that, treatment options include surgery, and considering high resistance of kidney cancer on chemotherapy and hormone therapy, use of targeted therapies (immunotherapy, tyrosine kinase inhibitors) and palliative radiotherapy. The following text presents the clinical guidelines in order to standardize procedures and criteria for the diagnosis, management, treatment and monitoring of patients with kidney cancer in the Republic of Croatia.
