Kidney cancer accounts for about 3% of all cancers and has an incidence in males that is nearly double that in females.
There are several histological variants of renal tumors, the most common being clear cell carcinoma, papillary renal carcinoma, and chromophobe carcinoma. The most common kidney cancer in pediatric age is Wilms’ tumor.

WHAT ARE THE RISK FACTORS?

Among the main risk factors are:

• Smoking: About 50% of patients with kidney cancer are or have been smokers. The number of years spent smoking is directly proportional to the risk of developing kidney cancer.
• Obesity and metabolic syndrome
• Hypertension
• Genetics: About 8% of renal tumors are hereditary. Renal carcinoma can be observed in various syndromes, such as Von Hippel-Lindau syndrome, tuberous sclerosis, and Birt-Hogg-Dubé syndrome.

DIAGNOSIS

Renal carcinoma in its early stages does not present specific symptoms, which often makes the diagnosis incidental: about 60% of renal tumors are diagnosed incidentally, often during an abdominal ultrasound performed for other issues. When present, the most common symptoms are:

• A palpable mass in the abdomen
• Blood in the urine (hematuria)
• Localized pain in the lumbar region
• Systemic symptoms: these may include weight loss, severe fatigue, low-grade fever, anemia, hypertension, and hypercalcemia.

Imaging diagnostics represent the cornerstone of kidney cancer diagnosis: abdominal ultrasound allows us to distinguish a solid mass from a liquid one. CT and MRI provide further information about the nature of the renal formation and its extent.

TREATMENT

For localized kidney cancer, the treatment is surgical. Radical nephrectomy involves the total removal of the kidney. However, in cases of small neoplasms, a conservative approach may be taken, which involves the exclusive removal of the tumor while preserving the rest of the organ. In particular situations, such as small tumors, bilateral disease, or neoplasms that are difficult to treat surgically, focal therapy may be considered, which involves ablating the mass through cryoablation or thermoablation.
Metastatic kidney tumors, on the other hand, are treated with a combination of an immunotherapy drug and a biologic drug targeting molecular pathways.

To date, there are no specific tumor markers for the diagnosis and screening of kidney cancer, and the only form of prevention starts with a healthy lifestyle, avoiding risk factors such as cigarette smoking and a sedentary lifestyle.

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