[The clinical picture of renal cell carcinoma. The place of diagnostic imaging].

Surgery continues to be the only treatment of proven efficiency for renal cell carcinoma. Chemo- and radiotherapy must be regarded as ineffective. Antagonists of the multiple drug-resistance gene, which is responsible for the chemoresistance of renal cell carcinoma as well as immunotherapy, are new experimental approaches in the treatment of renal cell carcinoma. The broad use of ultrasonography as a screening method has led to an increase in the diagnosis of small, asymptomatic renal tumors. At present, almost 65% of the renal tumors referred for surgery at our institution are asymptomatic. We found parenchyma-sparing surgery to be adequate treatment for many of these tumors. Advanced stages of renal cell carcinoma, on the other hand, can be cured by ultra-radical surgery (e.g., tumor thrombectomy or metastasectomy) in a considerable percentage of patients, as long as diffuse distant metastases are absent. Utilization of a broad range of imaging techniques is mandatory to rule out diffuse dissemination when considering such an operation.