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Renal Cell Carcinoma: Genetics, Surgical Management, and Systemic Therapy

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: 15 March 2026 | Viewed by 1052

Special Issue Editors


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Guest Editor
Department of Urology, Wake Forest University School of Medicine, Winston Salem, NC 27101, USA
Interests: robotics; renal cell cancer; tumor thrombi

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Guest Editor
Department of Urology, A.C.Camargo Cancer Center, Sao Paulo 01509-001, SP, Brazil
Interests: global health; renal cell carcinoma; open surgery

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Guest Editor Assistant
Department of Urology, Wake Forest Baptist Medical Center, Winston Salem, NC 27101, USA
Interests: disparities; tumor thrombus; renal cell carcinoma; systemic therapy

Special Issue Information

Dear Colleagues,

Renal cell carcinoma is the most common type of kidney cancer and accounts for approximately 2% of all cancer cases worldwide every year. Mortality rates are now estimated at nearly 200,000 people per year. Its management is multidisciplinary, often involving urology, nephrology, and medical oncology, among other specialisms. Further, there are more options now than ever before for treating patients afflicted with this disease. Traditional modalities such as surgery remain the mainstay in many settings; however, less invasive interventional options such as cryotherapy and ablation are also available. Additionally, systemic therapy has revolutionized treatment outcomes for renal cell carcinoma patients, but there is room for further innovation. Lastly, discoveries at the genetic level have provided practitioners with a wealth of information on how the disease can be caused and targeted. For this Special Issue, we invite papers from a variety of backgrounds on topics including, but not limited to, the genetics, surgical outcomes, systemic therapy, and social disparities of the disease.

Dr. Alejandro Remigio Rodríguez
Prof. Dr. Stênio C. Zequi
Guest Editors

Dr. Maxwell Sandberg
Guest Editor Assistant

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Keywords

  • renal cell carcinoma
  • robotics
  • laparoscopy
  • systemic therapy
  • genetics
  • surgery
  • urology
  • disparities
  • tumor thrombus
  • cryotherapy
  • global health

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Published Papers (2 papers)

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Research

11 pages, 512 KB  
Article
Comparing Cytoreductive Nephrectomy with Tumor Thrombectomy Between Open, Laparoscopic, and Robotic Approaches
by Maxwell Sandberg, Gregory Russell, Phillip Krol, Mitchell Hayes, Randall Bissette, Reuben Ben David, Kartik Patel, Brejjette Aljabi, Seok-Soon Byun, Oscar Rodriguez Faba, Patricio Garcia Marchinena, Thiago Mourao, Gaetano Ciancio, Charles C. Peyton, Rafael Zanotti, Philippe E. Spiess, Reza Mehrazin, Soroush Rais-Bahrami, Diego Abreu, Stenio de Cassio Zequi and Alejandro R. Rodriguezadd Show full author list remove Hide full author list
Cancers 2025, 17(21), 3490; https://doi.org/10.3390/cancers17213490 - 30 Oct 2025
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Abstract
Background/Objectives: For surgical candidates with metastatic renal cell carcinoma with a tumor thrombus (mRCC-TT), surgery is cytoreductive nephrectomy with tumor thrombectomy (CN-TT). This is carried out through an open (OCN-TT), laparoscopic (LCN-TT), or robotic (RCN-TT) approach. The purpose of this study was to [...] Read more.
Background/Objectives: For surgical candidates with metastatic renal cell carcinoma with a tumor thrombus (mRCC-TT), surgery is cytoreductive nephrectomy with tumor thrombectomy (CN-TT). This is carried out through an open (OCN-TT), laparoscopic (LCN-TT), or robotic (RCN-TT) approach. The purpose of this study was to compare survival outcomes to CN-TT by operative approach. Methods: This was a retrospective analysis of all patients with a diagnosis of mRCC-TT, who underwent CN-TT from a multi-institutional database from 1999–2024. Metastatic locations were qualified as either lung, bone, brain, liver, retroperitoneum, adrenal, paraaortic nodes, or other nodes. Progression was defined as radiographic evidence of recurrence or metastasis not seen on imaging prior to CN-TT. Progression locations were all metastatic locales previously noted plus the nephrectomy bed. Overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS) were calculated. Comparisons were performed between OCN-TT, LCN-TT, and RCN-TT. Results: A total of 131 patients were included in the analysis (97 OCN-TT, 25 LCN-TT, and 9 RCN-TT). The TT level was not different (p-value > 0.05) by approach (p-value > 0.05). Preoperative tumor size, final pathologic tumor subtype, and postoperative tumor size were equivalent between the three surgical approaches (p-value > 0.05). Rates of progression were equivalent as were all locations of disease progression in the study (p-value > 0.05). Median OS was 1.6 years in OCN-TT, 1.5 years in LCN-TT, and 2.5 years in RCN-TT (p-value = 0.42). Median CSS was 2.1 years in OCN-TT, 3 years in LCN-TT, and 2.5 years in RCN-TT (p-value = 0.86). PFS was 0.8 years in OCN-TT, 1.2 years in LCN-TT, and 1.2 years in RNC-TT (p-value = 0.76). Conclusions: The operative approach does not affect survival outcomes for CN-TT. Surgeon comfort and patient preference should weigh heavily in operative decision making. Full article
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13 pages, 847 KB  
Article
Propensity Score-Matched Analysis of Neoadjuvant vs. Adjuvant Therapy in Renal Cell Carcinoma
by Cesare Saitta, Giacomo Musso, Giuseppe Garofano, Hajime Tanaka, Dattatraya Patil, Margaret F. Meagher, Srinivas Vourganti, Edward Cherullo, Michael Liss, Marco Paciotti, Giovanni Lughezzani, Nicolò M. Buffi, Viraj Master, Yasuhisa Fujii, Rana R. McKay and Ithaar H. Derweesh
Cancers 2025, 17(21), 3481; https://doi.org/10.3390/cancers17213481 - 29 Oct 2025
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Abstract
Objective: The aim was to compare outcomes in high-risk localized RCC (HRL-RCC) patients treated with adjuvant (AT) and neoadjuvant therapy (NT) utilizing a propensity score-matched model (PSM). Methods: We conducted a multicenter analysis (USA and Japan) for patients who underwent AT or NT. [...] Read more.
Objective: The aim was to compare outcomes in high-risk localized RCC (HRL-RCC) patients treated with adjuvant (AT) and neoadjuvant therapy (NT) utilizing a propensity score-matched model (PSM). Methods: We conducted a multicenter analysis (USA and Japan) for patients who underwent AT or NT. AT was defined as systemic therapy given postoperatively in the absence of metastases; NT was presurgical therapy in the setting of localized disease. AT and NT utilized included target molecular therapy (TMT) or immunotherapy (IO). The PSM model was generated using a nearest neighbor matching algorithm in a 1:2 ratio. The primary outcome was All-Cause Mortality (ACM); the secondary outcomes were Cancer-Specific Mortality (CSM) and recurrence. Cox regression multivariable analysis (MVA) was utilized to elucidate predictors of outcomes. Results: After PSM modeling, 311 patients were analyzed [adjuvant n = 221, 127 TMT vs. 94 IO; neoadjuvant n = 90, 61 TMT vs. 29 IO]; the median follow-up was 44 (IQR 20–74) months. MVA revealed AT as associated with increased ACM (HR = 1.97, p = 0.007), CSM (HR = 2.37, p = 0.007) and recurrence (HR 1.64, p = 0.02). Sub-analysis of the AT cohort revealed IO to be associated with decreased ACM (HR 0.59, p = 0.015). In the neoadjuvant cohort, TMT and IO were associated with decreased ACM (HR 0.49; p = 0.016; HR 0.32, p = 0.016, respectively) and CSM risk (HR 0.47, p = 0.036; HR 0.18, p = 0.017). Conclusions: Our findings suggest a potential advantage of NT in HRL-RCC. Adjuvant immunotherapy was associated with decreased risk of ACM, while in the neoadjuvant group, TMT and IO therapy had similar outcomes. Our findings call for the consideration of a clinical trial to compare the outcomes of AT vs. NT. Full article
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