Moderator: Dr Jonathan Wala

Speakers & Topics:

• Dr Amina K. Habib: Optimizing Kidney Cancer Care
• Dr Patrick Mbuthia: Surgical Aspects of Kidney Cancer Management

Diagnosis and Evaluation

– RCC includes clear cell, papillary, chromophobe, and rare subtypes.
– Classic triad (flank pain, hematuria, mass) is rare and suggests late-stage disease.
– Paraneoplastic syndromes present in ~30% of cases.
– Imaging: Ultrasound (cystic lesions), MRI/CT (staging), and renal function tests.
– Renal biopsy recommended for indeterminate lesions, small masses for surveillance, or metastatic confirmation.

Surgical Management

– Partial nephrectomy preferred in localized RCC for nephron-sparing and better long-term outcomes.
– Thrombectomy improves survival in non-metastatic RCC with IVC involvement.
– Cytoreductive nephrectomy and metastasectomy have roles in selected metastatic cases.

 Upper Tract Urothelial Carcinoma (UTUC)

– Represents 5–10% of urothelial cancers, commonly presents with hematuria.
– Risk factors: smoking, aristolochic acid, arsenic exposure, Lynch syndrome.
– Diagnostic tools: CT/MRI, cystoscopy, urinary cytology, retrograde pyelography, ureteronephroscopy.

Management of UTUC

– Low-risk: Endoscopic ablation + topical chemotherapy.
– High-risk localized: Radical nephroureterectomy + bladder cuff removal, postoperative intravesical chemotherapy.
– Role of lymph node dissection and neoadjuvant chemotherapy is still being defined.