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"This book provides a comprehensive look at renal cell carcinoma, exploring its biology as well as current and future molecular targets for renal cancer carcinoma."

"ABSTRAKKarsinoma sel ginjal terhitung sekitar 3% dari kanker pada orang dewasa dan 85% dari semua keganasan primer ginjal. Tumor ini biasanya tidak memberikan gejala hingga penyakit sudah berada pada stadium lanjut. Metastasis pada kelenjar getah bening dan metastasis jauh diketahui merupakan faktor prognostik yang penting pada karsinoma sel ginjal. Parameter klinis diperlukan untuk memprediksi metastasis sebelum operasi. Penelitian ini merupakan penelitian prospektif dengan mengambil data dari rekam medis dari Januari 1995 hingga Desember 2015 di Rumah Sakit Cipto Mangunkusumo. Penelitian ini mengevaluasi faktor prediktif klinis untuk kejadian metastasis pada karsinoma sel ginjal.

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ABSTRACTRenal cell carcinoma (RCC) accounts for about 3% of cancers in adults as well as 85% of all primary malignancies arising from the kidney. RCC is commonly large at presentation and symptoms may not occur until relatively late in the disease. Lymph node and distant metastases were known as the prognostic factor in renal cell carcinoma. Clinical parameters are needed to predict the metastases preoperatively. This is a prospective-analytic using medical record data from January 1995 - December 2015 at Cipto Mangunkusumo Hospital. This study evaluate clinical predictive factors for metastatic renal cell carcinoma incidence;"

"Pendahuluan dan tujuan: Renal cell carcinoma (RCC) adalah tumor paling umum kedua pada sistem urologi. Sampai saat ini, satu-satunya pendekatan kuratif bagi mereka yang memiliki RCC lokal adalah operasi radikal; namun, kejadian rekurensi setelah nefrektomi memadai telah dilaporkan terjadi sebanyak 20 hingga 40% dari pasien dengan RCC lokal. Penelitian ini bertujuan untuk menyelidiki karakteristik dan kesintasan hidup pasien dengan RCC yang menjalani nefrektomi.Metode: Kami menggunakan desain studi retrospektif dengan mengevaluasi rekam medis pasien yang didiagnosis dengan RCC yang menjalani tindakan bedah di Rumah Sakit Cipto Mangunkusumo, Rumah Sakit Kanker Dharmais, Rumah Sakit Medistra, dan Rumah Sakit Metropolitan Medical Centre, Jakarta, Indonesia selama periode Januari 1994 hingga Desember 2016.Hasil: Usia rata-rata pasien saat operasi dilakukan adalah 52,92 ± 14,85, dan 114 (71,7%) subyeknya adalah laki-laki. Lima puluh dua (32,7%) subyek dengan pT2 RCC, dan tiga puluh lima (22%) subyek dengan patologis stadium 2. Seratus empat puluh tujuh (92,4%) subyek memiliki clear cell RCC. Kesintasan hidup rata-rata adalah 8,37 (0,1-143) bulan.Kesimpulan: Angka median kesintasan pasien karsinoma sel ginjal (RRC) yang menjalani nefrektomi adalah 8,37 bulan, yang menunjukkan bahwa perawatan lebih lanjut diperlukan untuk meningkatkan tingkat kelangsungan hidup populasi ini. Namun, penelitian ini dibatasi oleh sifat studi retrospektif dan jumlah subjek yang terbatas. Studi acak, terkontrol, multicenter, yang lebih besar diperlukan untuk mengevaluasi angka kesintasan pasien RCC.

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Introduction and objectives: Renal cell carcinoma (RCC) is the second most common urologic tumour. To this date, the only curative approach for those with localised RCC is radical surgery; yet, the development of disease recurrence after adequately performed nephrectomy has been reported in 20 to 40% of those with localised RCC. The present study aims to investigate the characteristics and survival of those with RCC undergoing nephrectomy.

Methods: We used retrospective study design by evaluating the medical records of patients diagnosed with RCC who were treated surgically at Cipto Mangunkusumo Hospital, Dharmais Cancer Hospital, Medistra Hospital, and Metropolitan Medical Centre Hospitals, Jakarta, Indonesia during the period from January 1994 to December 2016.

Results: The mean age at surgery of the subjects was 52.92 ± 14.85, and 114 (71.7%) subjects were male. Fifty-two (32.7%) subjects had pT2 RCC, and thirty-five (22%) of the subjects had pathologic stage of 2. One hundred and forty-seven (92.4%) subjects had clear cell RCC. The median survival was 8.37 (0.1-143) months.

Conclusion: The median survival of those with renal cell carcinomas (RCCs) who underwent nephrectomy was 8.37 months, which demonstrate that further treatment is required to increase the survival rate of these population. However, this study was limited by its retrospective nature and limited subjects. Larger multicenter controlled randomised studies are required to evaluate the survival of those with RCC."

"Latar Belakang. Di Indonesia, insiden tumor ginjal menempati urutan ketiga keganasan saluran urogenital pada laki-laki. Penelitian ini bertujuan untuk mengetahui karakteristik demografi, tampilan klinis, laboratorium, staging dan penatalaksanaan yang dilakukan di Di RSUP Dr. Sardjito. Metode. Sebuah studi prospektif pada subyek 105 pasien yang didiagnosis tumor ginjal antara tahun 2009 sampai 2013. Pasien dibagi menjadi 2 grup berdasarkan usia : (1) anak, dan (2) dewasa. Hasil. Selama 5 tahun, ditemukan 105 pasien tumor ginjal, anak 41 orang dan dewasa 57 orang. Rata-rata usia pasien tumor ginjal anak adalah 3,76 ± 2,54 tahun, dan rasio laki-laki : perempuan 1,56 : 1. Rata-rata usia pasien tumor ginjal dewasa adalah 49.51±14.08 tahun. Rasio laki-laki : perempuan adalah 1,48 : 1. Tumor paling sering pada anak adalah nefroblastoma 39 kasus (95,1%) dengan keluhan tersering adalah massa (100%). Tumor paling sering pada dewasa adalah RCC, 26 kasus (46,6%), dengan keluhan terbanyak nyeri pinggang 22 kasus (84,6%), keluhan massa 21 kasus (80,8%), hematuria 14 kasus (53,8%). Kesimpulan. Terjadi penurunan kasus nefroblastoma dan peningkatan kasus RCC di RSUP Dr. Sardjito dalam 5 tahun terakhir. Mayoritas pasien RCC pada dekade 4-5 dan nefroblastoma pada usia 3 tahun, dengan rasio laki-laki:perempuan masing-masing 1,56:1 dan 1,48:1.

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Background. In Indonesia, the incidence of kidney tumor was in the 3rd rank after prostate and bladder cancer among the urogenital cancer in men. The objective of this study is to describe demographic characteristic, clinical feature, and treatment of kidney tumor in Dr. Sardjito Hospital Yogyakarta.

Methods. A prospective study of 105 subjects whom were diagnosed as kidney tumor between year 2009 to 2013. The subjects were cathegorized into two groups according their age: (1) children, and (2) adults.

Results. There were 105 cases of kidney tumor found over the past 5 years, 41 children cases and 57 adult cases. Mean age of the children was 3,76 ±2,54 years old, and male:female ratio 1,56:1. Mean age of adults were 49,51±14,08 years old. Male:female ratio 1,48:1. Majority of tumor in children were nephroblastoma about 39 cases (95,1%) with symptoms most profound were abdominal mass (100%). Majority of kidney tumor found in adults were RCC (26 cases [46,6%]), with symptoms flank pain (22 cases [84,6%]), palpable mass (21 cases [80,8%]), hematuria (14 cases [53,8%]).

Conclusion. The number of nephroblastoma cases were decreased, meanwhile there was an increase in RCC case number in Dr. Sardjito Hospital for the past 5 years. Majority of RCC patients were in decade 5-6, while in nephroblastoma patients, the majority were 3 years old, with the ratio of male:female 1,56:1 and 1,48:1 respectively."

"ABSTRAKIn the past 10 years, recent development of targeted therapy in metastatic renal cell carcinoma (mRCC) has provided a new hope and significantly enhanced the prognosis of the disease. Three class of targeted therapy were developed, including multi-targeted tyrosine kinase inhibitors (TKI), the mammalian target of rapamycin (mTOR) complex-1 kinase inhibitors, and the humanized antivascular endothelial growth factor (VEGF) monoclonal antibody. Hence, the objective of this article was to critically examine the current evidence of targeted therapy treatment for patients with mRCC. In the majority of trials evaluating targeted therapy, patients were stratified according to Memorial Sloan Kattering Cancer Center (MSKCC) risk model and the recommendation of targeted treatment based on risk features. In first-line setting (no previous treatment), sunitinib, pazopanib, or bevacizumab plus IFN-α were recommended as treatment options for patient with favorable- or intermediate- risk features and clear cell histology. Patients who progressed after previous cytokine therapy would have sorafenib or axitinib as treatment options. Clear-cell mRCC with favorable- or intermediate- risk features and failure with first-line TKI therapy might be treated with sorafenib, everolimus, temsirolimus or axitinib. However, the current evidence did not show the best treatment sequencing after first-line TKI failure. In patients with poor-risk clear-cell and non-clear cell mRCC, temsirolimus was the treatment option supported by phase III clinical trial. In addition, several new drugs, nowadays, are still being investigated and waiting for the result of phase II or III clinical trial, and this might change the standard therapy for mRCC in the future."