Smjernice za dijagnosticiranje, liječenje i praćenje bolesnika s rakom bubrega

Tomislav Omrčen, Tihana Boraska Jelavić, Marijan Šitum, Katarina Vilović, Krešimir Dolić, Dag Zahirović, Ira Pavlović Ružić, Kristian Krpina, Marijana Jazvić, Boris Ružić, Monika Ulamec, Marija Gamulin, Milena Gnjidić, Željko Kaštelan, Marijana Ćorić, Ana Marija Alduk, Maja Drežnjak Madunić, Josipa Jović Zlatović, Zvonimir Curić, Eduard Vrdoljak

Svjetlostanični karcinom 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 zbog nekoga drugog razloga. 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, sustavnu terapiju malim molekulama, imunoterapiju, kemoterapiju u odabranih bolesnika te palijativnu radioterapiju. U tekstu koji slijedi predstavljene su kliničke upute radi standardizacije postupaka i kriterija postavljanja dijagnoze, liječenja i praćenja bolesnika s rakom bubrega u Republici Hrvatskoj.

Clear cell cancer is the most common form of kidney cancer. Clinically, it is mostly asymptomatic, and only a small proportion of patients present with hematuria, pain, and palpable abdominal mass. It is most commonly detected incidentally during radiological examinations for other causes. Diagnosis of kidney cancer is confirmed by pathohistological findings after the radiological imaging procedures. The decision on optimal treatment is based on a clinical assessment, stage of the disease and the presence of other risk factors. Depending on this, treatment options include surgical procedure, systemic treatment with small molecules, immunotherapy, chemotherapy in selected patients, and palliative radiotherapy. In the following text clinical guidelines have been presented to standardize procedures and criteria for diagnosing, treating and monitoring kidney cancer patients in the Republic of Croatia.