Last week, Dr Marston W. Linehan’s team at the Urology Oncology Branch of the National Cancer Institute/ National Institutes of Health, in Bethesda, MD, published surveillance and treatment recommendations to treat patients with BHD-associated renal cell carcinoma.
Stamatakis et al., 2013 recommend abdominal screening – preferably by MRI – every 36 months upon diagnosis if no kidney lesions are present. Once kidney tumours are identified, regular abdominal screening should be initiated, with the screening interval being determined by the number, location and growth rate of the tumours and general health of the patient. Once the largest tumour reaches 3 cm in size, nephron sparing surgery should be performed.
In the authors’ experience, only in the rarest cases, usually when the renal tumours are of clear-cell histology, do renal tumours metastasize and require multiple treatments. In the majority of cases, patients will achieve a curative outcome and will only require one surgical intervention in their lifetime with this approach.