Cancer outside the confines of the kidney carries a less favorable prognosis than one confined to the kidney. As mentioned previously, the abdominal CT and ultrasound are the main imaging studies. Also needed is a complete blood panel that assesses the hematologic system, liver and kidney function. Because survival depends on surgical removal, as no effective chemo or radiotherapy has been identified against this disease, the evaluation of any patient presenting with RCC should include a history and physical examination with a determination made of the patient's ability to undergo major surgery and tolerate general anesthesia. In general the propensity for metastases increases with larger lesions.
Surgery is the only currently known curative therapeutic modality.
Survival data varies with pathologic stage. For RCC that extends into major veins, adrenal glands, or perinephric tissue, but not beyond Gerota's fascia, the 5-year survival averages 50 percent. The technique is becoming popular for the management of small RCC in that recent data has shown that the results may be equal to the radical nephrectomy in these select cases. This procedure was initially developed for patients who developed RCC in a solitary kidney. Radiation therapy has been applied to RCC as both an adjuvant to surgical therapy and as a treatment for metastatic lesions.