Renal cell cancer--a multimodal approach to preserving renal function and improving survival

Renal cancer comprises ~3% of all malignancies and in the past decade, the incidence has grown from 2.3 to 4.3% per year [1]. In Germany, the estimated number of newly diagnosed cases of renal cell cancer is 21.3 per 100 000 for men and 10 per 100 000 for women [2]. Renal cell cancer accounts for the top 10 cancer-associated mortalities in the Western world [3]. The size of renal cancer tumours has decreased in the past decade mainly due to the widespread use of ultrasonography [4, 5]. Within the past 10 years, tumour size at initial diagnosis has decreased from 4.1 cm in 1998 to 3.1 cm in 2008. In addition, the majority of patients diagnosed with renal cell cancer are in the 701 to 85 age group, with considerable comorbidity [3]. Despite early diagnosis and a smaller tumor size, the overall survival in patients with renal cell cancer has not improved significantly in the past years. In contrast to other parenchymal malignancies, reduction of organ mass in renal cell cancer and the partial loss of renal function influence the survival of patients with kidney-associated malignancy considerably [6].