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What causes kidney cancer?
Last reviewed: 23.04.2024
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[Pathogenesis of kidney cancer
Kidney cancer is prone to local-destruiruyuschey growth with the invasion of venous vessels and the formation of tumor thrombosis of the renal, inferior vena cava and right heart chambers (10% of observations). Dissemination of the tumor process occurs by lymphogenous and hematogenous pathways. Most often, the lungs are affected (32%). Bones (25%), regional (retroperitoneal) lymph nodes (20%) and liver (7.5%). It is also possible metastasis to the non-regional groups of lymph nodes, adrenal glands, contralateral kidney, brain, soft tissues.
Classification of kidney cancer
Classification of TNM Union International Contre le Cancer (UICC), 2002.
Category T.
- Tx - the primary tumor can not be evaluated.
- T0 is an undiagnosed primary tumor.
- T1 - a tumor with a diameter of less than 7 cm in the largest dimension, bounded by the kidney.
- T1a is a tumor with a diameter less than or equal to 4 cm in the largest dimension, bounded by the kidney.
- T1b - tumor more than 4 cm and less than 7 cm in the largest dimension, limited to the kidney.
- T2 - a tumor with a diameter of more than or equal to 7 cm in the largest measurement, bounded by the kidney.
- T3 is a locally advanced process with invasion of large venous vessels, ipsilateral adrenal gland or paranephric fiber, without germination of the Gerota fascia.
- Т3а - the tumor grows into the tissue of the ipsilateral adrenal gland or paranephric fiber (including peripelvic fiber), without infestation of the Gerota fascia.
- T3b tumor thrombosis of the ipsilateral renal vein, its branches (including muscle branches), or the inferior vena cava, not reaching the diaphragm level.
- T3c - tumor thrombosis of the inferior vena cava with possible invasion into its wall above the level of the diaphragm.
- T4 - the tumor germinates fascia Gerota.
Category N - Regional lymph nodes.
- Nx - regional lymph nodes can not be evaluated.
- N0 - unaffected regional lymph nodes (the basis is considered the absence of signs of malignant growth in more than 8 distant lymph nodes, with the removal of a smaller number of collectors, the crucial role is played by the presence of tumor cells in the remote drug).
- N1 - solitary metastasis in the regional lymph node.
- N2 - metastatic lesion of more than one regional lymph node.
Category M.
- Mx - the fact of having distant metastases can not be estimated.
- M0 is the absence of distant metastases.
- Ml - the presence of distant metastases.
Morphological classification of kidney cancer
There are 5 types of kidney cancer:
- light-celled (60-85%);
- chromophilic, or papillary (7-14%);
- chromophobic (4-10%);
- oncocyte (2-5%);
- cancer of the collecting ducts (1-2%).
Histological types of kidney cancer have a different clinical course and are characterized by a different response to systemic therapy.