肾癌不是一种疾病。它由几种不同类型的癌症组成，每种癌症具有不同的组织学，不同的临床过程，对治疗和由不同基因引起的反应不同。完成本课程后，与会者能够描述不同类型的肾癌和导致每种肾癌的基因。他们将学习如何识别肾癌的不同类型的遗传性与零星形式。它们将区分惰性和缓慢生长的肿瘤，例如清晰的细胞肾细胞癌（RCC），1型乳头状RCC和铬虫RCC以及更具侵略性的肿瘤，例如2型乳头状RCC和TFE3 RCC，可以浸润到肾脏全吻中并在肿瘤很小时具有扩散的倾向。与会者将应用此知识来决定主动监测和手术干预措施，以及何时利用肾脏肿瘤活检。与会者将整合肿瘤生物学的知识，以在微创手术的摘除剂技术之间进行选择，以易变癌和开放式手术方法，并具有宽阔的RCC形式的宽阔边缘。与会者将学习如何进行开放和微创的部分肾切除术。将审查腹腔镜和机器人端口放置，以及腹膜后手术在后肾脏肿瘤治疗中的作用。 Critical surgical techniques such as hilar exposure and recommendations about when and how to clamp the hilum, appropriate warm and cold ischemia guidelines and the use kidney cooling will be reviewed. The critical role of intraoperative ultrasound in patients undergoing open as well as minimally invasive partial nephrectomy will be discussed. New surgical techniques for stopping bleeding and safely closing the renal cortex after removal of multiple renal tumors will be discussed. Surgical approaches for reoperative surgery in patients with recurrent, multiple renal tumors will be reviewed. The critical role of intraoperative resuscitation of patients who have undergone significant blood loss will also be discussed. Attendees will learn approaches for management of patients with large renal tumors involving the renal vein and vena cava, how to safely get exposure and management of vascular structures, and when to involve vascular surgery and potentially cardiopulmonary bypass in tumors that extend above the portal vein. Discussion of when to perform lymph node removal and the surgical techniques for ipsilateral, aorto-caval and contralateral nodal dissection will be conducted. There have been significant advances in the systemic therapeutic approaches with targeted therapies and immunotherapies for patients with locally advanced and advanced forms of renal cell carcinoma. The most recent immunotherapy and targeted therapies will be discussed for patients with both clear and non-clear cell RCC, including agents such as nivolumab, ipilimumab, cabozantinib and pazopanib in combination and as single agents. The role of surgery in patients with advanced RCC with the primary kidney tumor in place will be discussed, i.e., when to recommend cytoreductive nephrectomy and when to recommend immediate systemic therapy. Recent findings in the role of adjuvant or neo-adjuvant therapy in patients with locally advanced RCC will be discussed.

致谢

独立教育赠款提供的支持：

阿斯利康
Bristol Myers Squibb
默克公司
辉瑞公司