Seeking the solution to the problem of metastatic renal carcinoma
It is estimated there will be 31,900 new cases and 11,900 deaths from renal carcinoma in the U.S. in 2003. Since 1950 there has been a 126% increase report in the incidence of renal carcinoma and a 36.5% increase in annual mortality. In the last 20 years, our understanding of tumors arising from the renal cortex has dramatically expanded because of advances in cytogenetics and histopathologic reclassification, improved abdominal imaging technology leading to a tumor stage migration, and changing surgical strategies. Despite these advances, our efforts to treat metastatic renal carcinoma either with systemic therapies or surgical intervention have been frustrated. In the article by Pantuck et al. in the issue of Cancer, the authors identify the adverse prognostic impact of metastatic regional lymph nodes in patients with metastatic disease when compared with patients with metastatic disease alone.