Approche multidisciplinaire dans le traitement du cancer du rein métastatique Approche multidisciplinaire dans le traitement du cancer du rein métastatique Pierre I. Karakiewicz, MD, MPH Urologic Oncologist, Associate Professor and Senior Research Scientist, Director, Cancer Prognostics and Health Outcomes Unit University of Montreal Health Center (CHUM) Pierre I. Karakiewicz, MD, MPH Urologic Oncologist, Associate Professor and Senior Research Scientist, Director, Cancer Prognostics and Health Outcomes Unit University of Montreal Health Center (CHUM)
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Approche multidisciplinaire dans le traitement du cancer
du rein métastatique
Approche multidisciplinaire dans le traitement du cancer
du rein métastatique
Pierre I. Karakiewicz, MD, MPHUrologic Oncologist,
Associate Professor andSenior Research Scientist,
Director, Cancer Prognostics and Health Outcomes UnitUniversity of Montreal Health Center (CHUM)
Pierre I. Karakiewicz, MD, MPHUrologic Oncologist,
Associate Professor andSenior Research Scientist,
Director, Cancer Prognostics and Health Outcomes UnitUniversity of Montreal Health Center (CHUM)
Canadian cancer facts and figures 2007
Canadian cancer facts and figures 2007
Cancer incidence and mortality 2007 Cancer incidence and mortality 2007
Incidence
Mortality
6th
10th
Five year cancer survivalFive year cancer survival
RCC Stage vs. prognosisRCC Stage vs. prognosis
Cohen HT, McGovern FJ. N Engl J Med. 2005;353:2477-2490.
Stage I
Tumor < 7 cm in greatest dimension and limited to kidney; 5-year survival, 95%
Stage II
Tumor > 7 cm in greatest dimension and limited to kidney; 5-year survival, 88%
Stage III
Tumor in major veins or adrenal gland, tumor within Gerota’s fascia, or 1 regional lymph node involved; 5-year survival, 59%
Stage IV
Tumor beyond Gerota’s fascia or > 1 regional lymph node involved; 5-year survival, 20%
Histology Type % Prognosis Gene
Clear cell 85 Poor VHL
Papillary Type I Papillary Type 2
55
Good Poor
MET, FH, TFE3
Chromophobe 3 Good BHD
Oncocytoma 4 Good BHD
Collecting duct < 1 Poor None known
Sarcomatoid / Other 1–2 Poor None known
Tumor histology vs. prognosisTumor histology vs. prognosis