The changing natural history of renal cell carcinoma

Purpose: Our understanding of the natural history of renal cell carcinoma, the role of nephrectomy, the benefits of immunotherapy and the possibilitie s of new technologies are evolving and being integrated with advances in cl assification and staging. We reviewed the relevant literature to clarify th ese pertinent questions and provide a current review of the changes in the epidemiology, treatment and prognosis of patients with renal cell carcinoma . Materials and Methods: We comprehensively reviewed the peer reviewed litera ture on the current management of and results of treatment for renal cell c arcinoma. Results: The incidence of and mortality from renal cell carcinoma have cont inuously increased during the last 50 years. Despite this increase in the n umber of new patients and consequently the number of deaths yearly the perc ent of those surviving for 5 years has notably improved. Factors related to improved survival include advances in renal imaging, earlier diagnosis, im proved staging, better understanding of prognostic indicators, refinement i n surgical technique and the introduction of immunotherapy approaches for a dvanced disease. Conclusions: Currently patients with localized and metastatic renal cell ca rcinoma have had improvements in outlook and the therapeutic options availa ble have expanded.