Submit to Special Issue Submit Abstract to Special Issue Review for Cancers Propose a Special Issue

Journal Menu

Journal Browser

► Journal Browser

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

Editors
Special Issue Information
Keywords
Benefits of Publishing in a Special Issue
Published Papers

A special issue of Cancers (ISSN 2072-6694).

Deadline for manuscript submissions: 31 August 2026 | Viewed by 6729

Share This Special Issue

Editors

Dr. Alejandro Remigio Rodríguez

E-Mail Website
Guest Editor

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

Prof. Dr. Stênio C. Zequi

E-Mail Website
Guest Editor

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

Dr. Maxwell Sandberg

E-Mail Website
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

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Publisher's Notice

The Special Issue, together with its publications, has been removed from Section Methods and Technologies Development on 15 January 2026. The publications remain available in the regular issues in which they were originally published. The Editorial Office confirms that these articles adhered to MDPI's standard editorial process (https://www.mdpi.com/editorial_process).

Keywords

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

Benefits of Publishing in a Special Issue

Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (6 papers)

Download All Papers

Order results

Result details

Show export options Show export options

Select all

Export citation of selected articles as:

Research

Jump to: Review, Other

14 pages, 790 KB

Open AccessArticle

The Role of Cytoreductive Nephrectomy in Metastatic Non-Clear Cell Carcinoma in the Era of Emerging Systemic Therapy: A Retrospective Cohort Study

by Mohammad Arfat Ganiyani, Hiba Narvel, Arjun Pon Avudaiappan, Mrudula Thiriveedi, Mohamed Javid Raja Iyub, Manas Pustake, Karan Jatwani, Murugesan Manoharan and Rohan Garje

Cancers 2026, 18(13), 2114; https://doi.org/10.3390/cancers18132114 - 29 Jun 2026

Viewed by 422

Abstract

Background: Renal cell carcinoma accounts for nearly 15,000 deaths annually in the US, and approximately 30–40% of patients present with metastatic disease (mRCC). The advent of immune checkpoint inhibitors (IO) and tyrosine kinase inhibitors (TKI) has revolutionized the treatment paradigm of patients with mRCC. However, the role of cytoreductive nephrectomy (CN) in the IO-TKI era, particularly for rare and understudied histologies such as non-clear-cell RCC, remains poorly understood. Methods: We conducted a retrospective cohort study of patients with metastatic non-clear-cell RCC. Patients were stratified by receipt of CN. Baseline demographic, clinical, histologic, and metastatic site variables were collected. Overall survival was analyzed using Kaplan–Meier methods and compared with the log-rank test. Cox proportional hazards regression was performed to identify independent predictors of survival, including CN, systemic therapy, year of diagnosis, histology, and metastatic sites. Results: Among 2753 patients with metastatic nccRCC, 1654 (60.1%) underwent CN and 1099 (39.9%) did not undergo CN. The 2-year and 5-year OS rates were 35.52% and 19.22% in the CN group versus 18.53% and 7.47% in the non-CN group (p < 0.001). In the doubly robust IPTW-weighted multivariable Cox regression analysis, CN was associated with improved overall survival, corresponding to a 40% lower risk of death compared with no CN (HR 0.60, 95% CI 0.54–0.66; p < 0.001). Additionally, more recent treatment eras were associated with progressively improved overall survival, with patients diagnosed between 2015 and 2017 and 2018 onward demonstrating significantly improved OS compared with those diagnosed between 2004 and 2014. Conclusions: Our study demonstrates that CN was associated with improved OS in patients with non-clear-cell mRCC by reducing the risk of death by 40% after adjusting for baseline characteristics. These findings emphasize the role of CN even in the IO-TKI era for the management of patients with non-clear-cell mRCC. However, these findings should be interpreted in the context of the retrospective study design, potential selection bias, and lack of granular systemic therapy data within the NCDB. Full article

(This article belongs to the Special Issue Renal Cell Carcinoma: Genetics, Surgical Management, and Systemic Therapy)

► Show Figures

Figure 1

11 pages, 512 KB

Open AccessArticle

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. Rodriguez Show full author list Hide full author list

Cancers 2025, 17(21), 3490; https://doi.org/10.3390/cancers17213490 - 30 Oct 2025

Cited by 4 | Viewed by 1155

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 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

(This article belongs to the Special Issue Renal Cell Carcinoma: Genetics, Surgical Management, and Systemic Therapy)

► Show Figures

Figure 1

13 pages, 847 KB

Open AccessArticle

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

Cited by 1 | Viewed by 1164

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. 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

(This article belongs to the Special Issue Renal Cell Carcinoma: Genetics, Surgical Management, and Systemic Therapy)

► Show Figures

Figure 1

Review

Jump to: Research, Other

37 pages, 3866 KB

Open AccessReview

Open Surgical Management of Renal Cell Carcinoma with Infradiaphragmatic Venous Tumor Thrombus (Mayo Levels 0–III): The Epitome of Surgical Self-Reliance in Urology

by Dorin Novacescu, Adelina Baloi, Silviu Latcu, Flavia Zara, Dorel Sandesc, Cristina-Stefania Dumitru, Cristian Condoiu, Razvan Bardan, Vlad Dema, Radu Caprariu, Talida Georgiana Cut and Alin Cumpanas

Cancers 2026, 18(7), 1080; https://doi.org/10.3390/cancers18071080 - 26 Mar 2026

Cited by 1 | Viewed by 2540

Abstract

Background/Objectives: Renal cell carcinoma (RCC) with venous tumor thrombus (VTT) extending into the inferior vena cava (IVC) occurs in 4–10% of patients and represents one of the most technically demanding scenarios in urologic surgery. Open radical nephrectomy with en bloc thrombectomy remains the gold standard for infradiaphragmatic disease (Mayo Levels 0–III), offering the only realistic prospect for long-term cure. This narrative review provides a technically oriented, evidence-based guide for surgical urologists managing these complex cases. Methods: PubMed/MEDLINE, Scopus, and Web of Science were searched (1970–March 2025) using terms related to RCC, venous tumor thrombus, IVC thrombectomy, and perioperative management. Priority was given to prospective studies, systematic reviews, large retrospective cohorts, and current guidelines (EAU 2025, NCCN v2.2024). Original intraoperative photographs supplement procedural descriptions. Results: We detail the complete perioperative pathway: VTT classification (Mayo/AJCC), multimodal imaging, patient optimization, and level-specific open surgical techniques—ranging from Satinsky clamping for Level 0–I thrombi to full piggyback liver mobilization with hepatic vascular exclusion for Level III disease. Contemporary perioperative mortality is <2% at high-volume centers (reported in single and multicenter retrospective series from high-volume institutions), with 5-year cancer-specific survival of approximately 50–60% in non-metastatic cases. Adjuvant pembrolizumab is now a standard of care following the KEYNOTE-564 trial. Neoadjuvant immune checkpoint inhibitor plus tyrosine kinase inhibitor combinations show promising VTT downstaging rates (44–100%), though their role remains investigational. Robotic-assisted thrombectomy demonstrates favorable perioperative outcomes for Level I–II thrombi at experienced centers. Conclusions: Open surgery remains the cornerstone of curative treatment for RCC with infradiaphragmatic VTT, requiring meticulous preoperative planning and multidisciplinary collaboration at high-volume centers. Integration of perioperative systemic therapies and robotic-assisted approaches holds promise for further improving outcomes in this challenging patient population. Full article

(This article belongs to the Special Issue Renal Cell Carcinoma: Genetics, Surgical Management, and Systemic Therapy)

► Show Figures

Figure 1

Other

Jump to: Research, Review

14 pages, 1126 KB

Open AccessSystematic Review

Robot-Assisted Versus Open Nephrectomy with Inferior Vena Cava Thrombectomy in Renal Cell Carcinoma: Current Evidence and Surgical Trends

by Zuzanna Korbecka, Beata Jabłońska and Robert Król

Cancers 2026, 18(14), 2251; https://doi.org/10.3390/cancers18142251 - 14 Jul 2026

Viewed by 313

Abstract

Background/Objectives: Renal cell carcinoma (RCC) with inferior vena cava tumor thrombus (IVCTT) is a rare and surgically complex condition traditionally managed with open nephrectomy and thrombectomy. Robot-assisted approaches are increasingly used in selected patients, but their comparative perioperative and oncological value remains uncertain. This systematic review aimed to summarize current evidence comparing robot-assisted and open nephrectomy with IVC thrombectomy in RCC. Methods: A systematic search of PubMed, Scopus, Web of Science, and Cochrane Library was performed according to PRISMA guidelines. Original clinical studies reporting perioperative or oncological outcomes of nephrectomy with IVC thrombectomy were included. Owing to substantial heterogeneity, a qualitative synthesis was performed. Results: Thirteen studies were included. Robot-assisted surgery was associated with lower estimated blood loss, reduced transfusion rates, and shorter hospital stay, although operative time was generally longer. Complication rates and oncological outcomes were broadly comparable between approaches. Robotic cohorts were typically highly selected and included mainly patients with lower-level thrombi, limited tumor burden, and procedures performed in high-volume centers. Conclusions: Robot-assisted nephrectomy with IVC thrombectomy appears feasible and safe in carefully selected patients and may improve perioperative outcomes without compromising oncological efficacy. However, open surgery remains essential for complex high-level thrombi. Tumor thrombus level, tumor burden, and institutional expertise should guide surgical approach selection. Full article

(This article belongs to the Special Issue Renal Cell Carcinoma: Genetics, Surgical Management, and Systemic Therapy)

► Show Figures

Figure 1

14 pages, 692 KB

Open AccessSystematic Review

The Prognostic Value of Clinical and Pathological Response to Neoadjuvant Therapy in Metastatic Renal Cell Carcinoma Undergoing Cytoreductive Nephrectomy: A Systematic Review and Clinical Implications

by Daria Chernysheva, Pedro Hernandez-Peñalver, Pablo Maroto, Joan Palou, Alberto Breda and Oscar Rodriguez-Faba

Cancers 2026, 18(11), 1829; https://doi.org/10.3390/cancers18111829 - 2 Jun 2026

Viewed by 413

Abstract

Background: In the immunotherapy era, cytoreductive nephrectomy (CN) for metastatic renal cell carcinoma (mRCC) is increasingly performed after neoadjuvant immune checkpoint inhibitor (ICI)-based therapy. Examination of the nephrectomy specimen may capture the depth of treatment-induced tumor clearance more accurately than size-based radiological criteria alone. However, pathological reporting is highly heterogeneous across studies: residual viable tumor (RVT), necrosis, pT stage, and binary downstaging have all been used, limiting reproducible cross-study comparison. We aimed to characterize this heterogeneity, assess its implications for evidence synthesis, and propose a pragmatic framework for qualitative interpretation. Methods: PRISMA-compliant systematic review of studies reporting pathological response and oncological outcomes in mRCC patients undergoing CN after neoadjuvant systemic therapy (PROSPERO CRD420251154068). A qualitative synthesis was performed. A three-category Pathological Response Category (PRC) framework is proposed to harmonize heterogeneous metrics. Results: Seven retrospective studies (n = 408) were included. Pathological reporting metrics were inconsistent across all studies, preventing formal meta-analysis. Nevertheless, across cohorts reporting survival outcomes, deeper pathological response was directionally associated with more favorable oncologic outcomes. A discordance between radiological and pathological response was observed, including near-complete tumor clearance in patients classified as radiologically stable, reflecting the non-size-based mechanisms of ICI-induced tumor killing. Conclusions: The central finding of this review is not that pathological response predicts survival—which is expected—but that current pathological reporting in the mRCC surgical setting is too heterogeneous to quantify the frequency, depth, or prognostic significance of that response in a reproducible way. Prospective adoption of standardized pathological reporting protocols is the most critical next step for this field. Full article

(This article belongs to the Special Issue Renal Cell Carcinoma: Genetics, Surgical Management, and Systemic Therapy)

► Show Figures

Journal Menu

Journal Browser

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

Share This Special Issue

Editors

Special Issue Information

Publisher's Notice

Keywords

Benefits of Publishing in a Special Issue

Published Papers (6 papers)

Research

Review

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI