Overview of Clear Cell Renal Cell Carcinoma
Panelists discuss how clear cell renal cell carcinoma (RCC) represents the most common kidney cancer subtype, typically affecting men in their 50s and 60s who often present incidentally with metastatic disease, and has limited identifiable risk factors beyond smoking, hypertension, and obesity.
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Clear cell RCC represents the most common subtype of kidney cancer, ranking as the 8th most prevalent cancer in the United States. Brian Rini, MD, leads this comprehensive discussion with kidney cancer specialists Arpita Desai, MD; Sundhar Ramalingam, MD; and Scott Tykodi, MD, PhD. Clear cell RCC derives its name from the clear appearance of cancer cells under microscopic examination, distinguishing it from other histological subtypes such as papillary and chromophobe variants.
The typical profile of a patient with clear cell RCC includes men more frequently than women, usually presenting in their 50s and 60s. Modern diagnosis often occurs incidentally through emergency department CT scans performed for unrelated symptoms, with approximately one-third of patients presenting with metastatic disease at diagnosis. Classic symptoms include hematuria (blood in urine), flank pain, and rarely palpable masses, though the complete triad is uncommon in contemporary practice.
Risk factor identification remains challenging for most patients, with smoking representing a relatively weak but established risk factor compared with its association with lung cancer. Hypertension and obesity show correlations with kidney cancer development, though causation remains unproven and may reflect demographic overlap. Chemical exposures demonstrate weak associations, and inherited syndromes such as von Hippel-Lindau disease account for less than 5% of cases. This foundation sets the stage for discussing modern immunotherapy-based treatment approaches that have revolutionized first-line clear cell RCC management over the past decade.
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