Description Surgical Kidney Ureter and Major Bladder Procedures for Neoplasm

K idney cancer is rare, accounting for about 3% of all adult cancers. Kidney cancers are classified by cell type. The three most commonly seen in the adult are renal cell carcinoma, transitional cell carcinoma, and sarcoma. Renal cell carcinoma arises in the renal tubules and accounts for more than 90% of kidney cancers. The other types of kidney cancer, transitional cell carcinoma and sarcomas, make up the remaining 10%. Most kidney cancers occur in one kidney only (unilateral) and are large and nodular. Renal metastases from other sites are unusual.

Renal cell tumors usually grow as a single mass; however, several tumors can form in one kidney. Because even large tumors may not cause pain, often the tumor is found only after it has become significant in size. Most are found before metastasis occurs. There are five main types of renal cell carcinoma, all diagnosed by microscopic examination: clear cell, pupillary, chromo-phobe, collecting duct, and unclassified. Renal cell cancer is also graded on a scale of 1 (have a cell nuclei that is very similar to a normal kidney cell nuclei) to 4 (have a cell nuclei that looks very different from a normal kidney cell nuclei). Staging is a far better predictor of prognosis than grading.

The American Cancer Society estimates that there will be 36,160 new cases of kidney cancer this year (not including Wilms' tumor in children) and approximately 12,660 people will die from this disease. The 5-year survival rate is as high as 90% if the cancer is confined to the kidneys, and as low as 9% if metastasis has occurred. Complications from kidney cancer include renal hemorrhage and metastases to the lungs, central nervous system, and gastrointestinal tract. If it is left untreated, kidney cancer causes death.

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