Abstract:
:The treatment of renal cell carcinoma (RCC) has changed greatly over the past 15 years. Progress in the surgical management of the primary tumor and increased understanding of the molecular biology and genomics of the disease have led to the development of new therapeutic agents. The management of the primary tumor has changed owing to the realization that clean margins around the primary lesion are sufficient to prevent local recurrence, as well as the development of more sophisticated tools and techniques that increase the safety of partial nephrectomy. The management of advanced disease has altered even more dramatically as a result of new agents that target the tumor vasculature or that attenuate the activation of intracellular oncogenic pathways. This review summarizes data from prospective randomized phase III studies on the surgical management and systemic treatment of RCC, and provides an up to date summary of the histology, genomics, staging, and prognosis of RCC. It describes the management of the primary tumor and offers an overview of systemic agents that form the mainstay of treatment for advanced disease. The review concludes with an introduction to the exciting new class of immunomodulatory agents that are currently in clinical trials and may form the basis of a new therapeutic approach for patients with advanced RCC.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Jonasch E,Gao J,Rathmell WKdoi
10.1136/bmj.g4797subject
Has Abstractpub_date
2014-11-10 00:00:00pages
g4797eissn
0959-8138issn
1756-1833journal_volume
349pub_type
杂志文章,评审abstract:OBJECTIVE:To discover if there is an association between respiratory tract infections and pericoronitis of erupting third molars in young adults. DESIGN:Data from male military conscripts' medical records were collected over five years and the incidence of respiratory tract infection before and after acute pericoronit...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6983.834
更新日期:1995-04-01 00:00:00
abstract:OBJECTIVE:To quantify the association between exposure to higher temperatures and the risk of myocardial infarction at an hourly temporal resolution. DESIGN:Case-crossover study. SETTING:England and Wales Myocardial Ischaemia National Audit Project (MINAP) database. PARTICIPANTS:24,861 hospital admissions for myocar...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e8050
更新日期:2012-12-13 00:00:00
abstract:OBJECTIVE:To test the hypothesis that radiography of the lumbar spine in patients with low back pain is not associated with improved clinical outcomes or satisfaction with care. DESIGN:Randomised unblinded controlled trial. SETTING:73 general practices in Nottingham, north Nottinghamshire, southern Derbyshire, north ...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.322.7283.400
更新日期:2001-02-17 00:00:00
abstract:OBJECTIVES: To estimate differences in annual income of physicians in the United States by race and sex adjusted for characteristics of physicians and practices. DESIGN: Cross sectional survey study. SETTING: Nationally representative samples of US physicians. PARTICIPANTS: The 2000-13 American Community Survey (ACS...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.i2923
更新日期:2016-06-07 00:00:00
abstract:OBJECTIVE:To examine whether total joint arthroplasty of the hip and knee reduces the risk for serious cardiovascular events in patients with moderate-severe osteoarthritis. DESIGN:Propensity score matched landmark analysis. SETTING:Ontario, Canada. PARTICIPANTS:2200 adults with hip or knee osteoarthritis aged 55 or...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f6187
更新日期:2013-10-30 00:00:00
abstract::Objectives To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21st birth weight standard.Design Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14 birth cohorts with gestatio...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.j3677
更新日期:2017-08-17 00:00:00
abstract:OBJECTIVE:To determine the implications of variation in mortality associated with use of weapons in different contexts. DESIGN:Literature review. SETTINGS:Armed conflicts and civilian mass shootings, 1929-96. MAIN OUTCOME MEASURE:Mortality from wounds. RESULTS:During the fighting of war the number of people wounded...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.319.7207.407
更新日期:1999-08-14 00:00:00
abstract::WHO is under pressure from all sides to justify its existence. Donors want to know what they are getting for their money, and health professionals question the relevance of the organisation's work. The pressure to justify itself is perhaps strongest of all in Europe, where most member countries have fully fledged heal...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6976.389
更新日期:1995-02-11 00:00:00
abstract:OBJECTIVE:To examine how the relaxation of the one child policy and policies to reduce caesarean section rates might have affected trends over time in caesarean section rates and perinatal and pregnancy related mortality in China. DESIGN:Observational study. SETTING:China's National Maternal Near Miss Surveillance Sy...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.k817
更新日期:2018-03-05 00:00:00
abstract:OBJECTIVE:To observe the effects of stimulation of the sacral anterior roots on anorectal and low colonic pressures and to programme implanted stimulators to produce defecation. DESIGN:Prospective study of 12 consecutive patients. SETTING:Spinal injuries unit and university gastrointestinal physiology department. PA...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6738.1494
更新日期:1990-06-09 00:00:00
abstract::Lifetime fertility, abortion rates, and the proportion of pregnancies resulting in induced abortion were investigated in 105 district health authorities in England. In 1995, a total of 147,851 abortions occurred among women living in England, compared with 613,257 live births; a ratio of 1:4. This was equivalent to ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.316.7146.1711
更新日期:1998-06-06 00:00:00
abstract:OBJECTIVE:To obtain data on sexual contact between doctors and their patients. DESIGN:Anonymous questionnaire with 17 items sent to all working gynaecologists (n = 595) and all ear, nose, and throat specialists (n = 380) in the Netherlands. RESULTS:Response rate was 74%; a total 64 doctors gave a reason for not compl...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6841.1531
更新日期:1992-06-13 00:00:00
abstract::Many clinicians remain unsure of the relevance of measuring quality of life to their clinical practice. In health economics quality of life measures have become the standard means of assessing the results of health care interventions and, more controversially, the means of prioritising funding; but they have many othe...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.305.6861.1074
更新日期:1992-10-31 00:00:00
abstract::The first call for applications to the NHS research and development programme on the interface between primary and secondary care was advertised in February 1994. A total of 674 outline proposals were submitted and 54 (8%) secured funding. Projects have been commissioned in 16 of the 21 priority areas and around 6m po...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.7012.1080
更新日期:1995-10-21 00:00:00
abstract:OBJECTIVE:To determine whether a decision aid designed for adults with low education and literacy can support informed choice and involvement in decisions about screening for bowel cancer. DESIGN:Randomised controlled trial. SETTING:Areas in New South Wales, Australia identified as socioeconomically disadvantaged (lo...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.c5370
更新日期:2010-10-26 00:00:00
abstract:OBJECTIVE:To assess whether a strategy of endovascular repair (if aortic morphology is suitable, open repair if not) versus open repair reduces early mortality for patients with suspected ruptured abdominal aortic aneurysm. DESIGN:Randomised controlled trial. SETTING:30 vascular centres (29 UK, 1 Canadian), 2009-13. ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.f7661
更新日期:2014-01-13 00:00:00
abstract:OBJECTIVES:To examine the effects of physical work environment on long term sickness absence and to investigate interaction between physical and psychosocial risk factors. DESIGN AND SETTING:Prospective cohort study of long term sickness absence among employees in Denmark. PARTICIPANTS:5357 employees interviewed in 2...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.38731.622975.3A
更新日期:2006-02-25 00:00:00
abstract:OBJECTIVE:To determine the effects on independence in older people needing rehabilitation in a locality based community hospital compared with care on a ward for elderly people in a district general hospital. DESIGN:Randomised controlled trial. SETTING:Care in a community hospital and district general hospital in Bra...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.38498.387569.8F
更新日期:2005-08-06 00:00:00
abstract:OBJECTIVE:To determine whether short-term, oral low dose prednisolone (< or = 15 mg daily) is superior to placebo and non-steroidal anti-inflammatory drugs in patients with rheumatoid arthritis. DESIGN:Meta-analysis of randomised trials of oral corticosteroids compared with placebo or a non-steroidal anti-inflammatory...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.316.7134.811
更新日期:1998-03-14 00:00:00
abstract:OBJECTIVE:To derive and validate an algorithm to estimate the absolute risk of having ovarian cancer in women with and without symptoms. DESIGN:Cohort study with data from 375 UK QResearch general practices for development and 189 for validation. PARTICIPANTS:Women aged 30-84 without a diagnosis of ovarian cancer at ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.d8009
更新日期:2011-01-04 00:00:00
abstract:OBJECTIVE:To determine the outcome of administration of neuroleptics to patients with senile dementia of Lewy body type confirmed at necropsy. DESIGN:Retrospective analysis of clinical notes blind to neuropathological diagnosis. SETTING:Specialist psychogeriatric assessment units referring cases for necropsy to a tea...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.305.6855.673
更新日期:1992-09-19 00:00:00
abstract:OBJECTIVES:To investigate use of commodes and attitudes of users and carers to them. DESIGN:Interview with semi-structured questionnaire of subjects supplied with commodes from Leeds community appliance centre. SUBJECTS:140 users of a commode and 105 of their carers. RESULTS:Main reasons for being supplied with a co...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6914.1258
更新日期:1993-11-13 00:00:00
abstract:BACKGROUND:Twenty-four hour ambulatory blood pressure thresholds have been defined for the diagnosis of mild hypertension but not for its treatment or for other blood pressure thresholds used in the diagnosis of moderate to severe hypertension. We aimed to derive age and sex related ambulatory blood pressure equivalent...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.c1104
更新日期:2010-04-14 00:00:00
abstract::IgG4 related disease was recognized as a unified disease entity only 15 years ago. Awareness of IgG4 related disease has increased worldwide since then, and specialists are now familiar with most of its clinical manifestations. Involvement of the pancreato-biliary tract, retroperitoneum/aorta, head and neck, and saliv...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.m1067
更新日期:2020-06-16 00:00:00
abstract:OBJECTIVE:To determine whether the author's 20.9 lb (9.5 kg) carbon frame bicycle reduced commuting time compared with his 29.75 lb (13.5 kg) steel frame bicycle. DESIGN:Randomised trial. SETTING:Sheffield and Chesterfield, United Kingdom, between mid-January 2010 and mid-July 2010. PARTICIPANTS:One consultant in an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.c6801
更新日期:2010-12-09 00:00:00
abstract::Some existing laws and some proposed legislation regulating the practice of in vitro fertilization (IVF) limit its availability to infertile couples. Dawson and Singer question whether it is reasonable to so restrict access to IVF, and examine some of the medical and social circumstances in which IVF and the related ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6718.167
更新日期:1990-01-20 00:00:00
abstract:OBJECTIVE:To investigate the relations of maternal diet and smoking during pregnancy to placental and birth weights at term. DESIGN:Prospective cohort study. SETTING:District general hospital in the south of England. PARTICIPANTS:693 pregnant nulliparous white women with singleton pregnancies who were selected from ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.319.7206.339
更新日期:1999-08-07 00:00:00
abstract:OBJECTIVE:To develop and validate a prognostic model for early death in patients with traumatic bleeding. DESIGN:Multivariable logistic regression of a large international cohort of trauma patients. SETTING:274 hospitals in 40 high, medium, and low income countries PARTICIPANTS:Prognostic model development: 20,127 t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e5166
更新日期:2012-08-15 00:00:00
abstract:OBJECTIVE:To estimate the effectiveness of delivering an anthelmintic through a community child health programme on the weight gain of preschool children in Uganda. DESIGN:Cluster randomised controlled trial. SETTING:Eastern Uganda. PARTICIPANTS:48 parishes participating in a new programme for child health: 24 offer...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.38877.393530.7C
更新日期:2006-07-15 00:00:00
abstract:OBJECTIVE:To re-evaluate the causal effect of interpregnancy interval on adverse birth outcomes, on the basis that previous studies relying on between mother comparisons may have inadequately adjusted for confounding by maternal risk factors. DESIGN:Retrospective cohort study using conditional logistic regression (mat...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.g4333
更新日期:2014-07-23 00:00:00