CANCER RENALDr. Daniel Amaro MedranoMedico Especialista en Medicina InternaAsistente del HRMNBJefe del Departamento de Medicina del HRMNB

CLASIFICACIN DE LA OMS

HIPERNEFROMASinnimos : Carcinoma de clulas claras Adenocarcinoma renal Tumor de grawitz

EPIDEMIOLOGIALos carcinomas del parnquima renal son los ms frecuentes en la edad adulta.

Representan un 2.3% de las neoplasias malignas del adulto.

La incidencia anual en EEUU es aproximadamente de 28.000 nuevos casos ao.

El cncer renal tiene una incidencia levemente superior en la raza blanca.

Ms frecuente en varones con una relacin 3:1 respecto a las mujeres y afecta ms a poblaciones urbanas que a comunidades rurales.

En el 80% de los casos la enfermedad aparecer entre los 50 y 70 aos de edad con un pico mximo de incidencia en la sexta dcada de la vida.

Tiene un crecimiento lento y es casi siempre unilateral (98%)

Incidencia con el tiempoSource Cancer Research UK

Chart1

187511507.06929379323.3662183394

194212427.23807530383.5283013944

210512457.80743821833.5679451718

221813108.2183225043.7055387029

226013908.21500813713.8938365968

234014048.57771364163.9761442305

240514908.70447741084.1036795452

233914528.44891287444.0382550826

248815618.92804213884.2808439063

258116359.19231599814.4651499755

2864166910.06932819384.5586955431

2850179510.03485188594.8170482786

2885181810.00766618994.9682884985

3062187010.50705730215.00127222

3130185910.6360666524.8940271577

3282201211.1606468025.3971705999

3194206110.7937462735.34044503

3307208710.96560574395.5573502015

3533220911.62497604325.8214668154

Males Numbers

Females Numbers

Males DAS(E)

Females DAS(E)

Numbers of new cases

Rate per 100,000

Kidney cancer incidence, numbers of newly diagnosed cases and directly age standardised rates (European) per 100,000 population

Lung

19791980198119821983198419851986198719881989199019911992199319941995199619971979198019811982198319841985198619871988198919901991199219931994199519961997

Males Numbers31128310213133631204309723030531589296682953229363284652798927946280732653926255253392423923876

Females Numbers949999831066011027111741161212515123081301413280131801326213570141731388214126143171415314112

Males DAS(E)113.9005944195112.264201597112.2294646318111.0493248131108.7907773519106.6159006388109.9884573095102.4971966906101.0974977848100.193335070896.194187818693.921330928691.971578860392.263524557285.6304393385.203764259881.269605643677.102843742575.0245292496

Females DAS(E)26.985948595727.957434938729.534598510330.132517055330.330548998231.385234457833.276550341832.394041072134.277062470634.635996643934.108974373334.32878706634.501162071235.619645834834.790022762135.271871160735.361555739435.217431710834.8100080661

Lung

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&A

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Males Numbers

Females Numbers

Males DAS(E)

Females DAS(E)

Number of new cases per year

Rate per 100,000

Incidence of lung cancer, numbers of new cases and directly age standardised (European) rates per 100,000, Great Britain, 1979-1997

Breast

1979198019811982198319841985198619871988198919901991199219931994199519961997

Numbers23715249562501225725256282592528129279452923929743313443215234251351193366034824351573566136841

DAS(E)74.772367428678.511551988578.021076281480.383056606179.059896568379.710049944385.695531474285.587521374888.677210417489.974961666295.047263493398.7345390854105.536881518107.6163311942101.8143269341104.5660265488104.71777776105.6714336081108.8473800322

Breast

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00

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Numbers

DAS(E)

Numbers of newly diagnosed cases

Rate per 100,000 population

Female breast cancer incidence, numbers of newly diagnosed cases and directly age standardised (European) rates per 100,000, Great Britain, 1979-1997

colorectal

19791980198119821983198419851986198719881989199019911992199319941995199619971979198019811982198319841985198619871988198919901991199219931994199519961997

Males Numbers12464127851325313327136841387414400139591453014849152221539615552164911649916432159251697516680

Females Numbers13649139851465114575147341462615103149151536615493156371547615513162211562115740152201629515569

Males DAS(E)46.895156148947.691683722349.050071659948.710371698749.386596323749.858303566450.999014509649.045641154750.793503448651.370453147652.145970537452.468437724451.890748178555.094259226653.964245175553.837723448251.593424557254.625537059252.8559204175

Females DAS(E)35.036964358235.396316113736.808453026236.51437064336.515633039235.648930976336.682848184536.209645925236.649913956536.687514710636.569687059736.233876194736.128146349137.491401034136.254644048736.318107436134.566351825637.247141008135.3624842254

colorectal

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Males Numbers

Females Numbers

Males DAS(E)

Females DAS(E)

Numbers of new cases

Rate per 100,000

Colorectal cancer incidence, numbers of newly diagnosed cases and directly age standardised rates (European) per 100,000 population

prostate

1979198019811982198319841985198619871988198919901991199219931994199519961997

Numbers935398441029210669111451143112325125681308313799140681469115645171291892721186210982214221303

DAS(E)39.00598544940.266788550741.266285229842.223806645243.444564890544.065975666946.614418648746.632827363848.072620414350.248876948350.550019198352.195197854654.727742078359.279869664165.033515236672.178875061371.303127134274.143699424370.7364811277

prostate

00

00

00

00

00

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00

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00

Numbers

DAS(E)

Numbers of newly diagnosed cases

Rate per 100,000 population

Prostate cancer incidence, numbers of newly diagnosed cases and directly age standardised (European) rates per 100,000 males, Great Britain, 1979-1997

bladder

19791980198119821983198419851986198719881989199019911992199319941995199619971979198019811982198319841985198619871988198919901991199219931994199519961997

Males Numbers7231742777237742802582528622845587859179897092119185947795019506953792138721

Females Numbers2759281430442995311831703374347234913695376436063660388038443707387636753718

Males DAS(E)29.638807521829.894928080431.009260176530.784013160231.553974425632.167908757333.275863125432.363117498933.352662592334.691099307133.587727575834.229614705333.627131640734.164200397934.047487007733.72712517933.430728554631.880136022129.8109405808

Females DAS(E)7.14376984887.21901524927.79653025777.63445160397.89175365147.92550031238.32795771228.53411921898.3982640988.88099272669.08208756798.3680778568.5110154978.88917233498.95778835978.27776601548.73347352688.22653287578.2231054808

bladder

0000

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0000

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0000

0000

0000

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0000

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Males Numbers

Females Numbers

Males DAS(E)

Females DAS(E)

Numbers of new cases

Rate per 100,000

Bladder cancer incidence, numbers of newly diagnosed cases and directly age standardised rates (European) per 100,000 population

Stomach

19791980198119821983198419851986198719881989199019911992199319941995199619971979198019811982198319841985198619871988198919901991199219931994199519961997

Males Numbers7812818780867963807177077970782574587648737070666870701765566733648162946349

Females Numbers5470534255625364529252075282486050864784475444124442433740394021394937253846

Males DAS(E)29.070969411630.150837727929.377911580628.655158947928.681839675627.365455272628.005862854327.197075212425.825193923426.069343528925.055653870523.746612582322.639439474623.172771646121.033142558821.759179913920.796603430319.876467992119.9970237386

Females DAS(E)13.24823778512.767805550313.113207228512.485229183712.194019834511.971507285611.805541921110.806906909311.39204986610.407614402510.20971728499.46196138749.43691046389.11678059868.51022229718.54637146888.29215005827.86335961018.1011058556

Stomach

0000

0000

0000

0000

0000

0000

0000

0000

0000

0000

0000

0000

0000

0000

0000

0000

0000

0000

0000

Males Numbers

Females Numbers

Males DAS(E)

Females DAS(E)

Numbers of new cases

Rate per 100,000

Stomach cancer incidence, numbers of newly diagnosed cases and directly age standardised rates (European) per 100,000 population

NHL

19791980198119821983198419851986198719881989199019911992199319941995199619971979198019811982198319841985198619871988198919901991199219931994199519961997

Males Numbers2059215022042316246626512866297933083469354137833884406741154261406841494205

Females Numbers1750193820522093224623712663267928663221327331783454354036523751356836263739

Males DAS(E)7.72063690818.06408324888.28974091048.59336744069.15173737349.722071344210.398915273110.765055078411.945573120312.452373001812.458652028513.325277948813.395473622514.051750961614.050216023814.57893158713.672602431213.865527126613.8853000719

Females DAS(E)5.11414429085.53373519365.86758942785.93806404556.40836538526.64423383557.39809260027.41096380357.88312561688.74785341728.81358106868.66118356539.26414691429.49780199849.660728863310.07306896639.4104696769.52051597819.7469654367

NHL

0000

0000

0000

0000

0000

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0000

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0000

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Males Numbers

Females Numbers

Males DAS(E)

Females DAS(E)

Numbers of new cases

Rate per 100,000

Non-Hodgkin's Lymphoma incidence, numbers of newly diagnosed cases and directly age standardised rates (European) per 100,000 population

oesophagus

19791980198119821983198419851986198719881989199019911992199319941995199619971979198019811982198319841985198619871988198919901991199219931994199519961997

Males Numbers2279246325862673262527552919301032013324331434773519372638503979394940114142

Females Numbers1889193120842105209121882216216223572390248225032561269326812777272426902710

Males DAS(E)8.5424451089.1597424279.4281323219.69848240379.50539702299.864462246510.327828446610.629220498711.243440024811.617492348511.420796745711.913951258911.847223562712.575158272112.70184232413.216132856612.93559082613.05810973413.2838918019

Females DAS(E)4.73789457024.78194943415.12527874265.12747846285.03104359025.23289823185.14296331785.03406898985.38955013865.42862210865.68618634295.56507736115.67698360055.96634113895.87588651456.1011216115.92000860545.79340659875.8259731385

oesophagus

0000

0000

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0000

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0000

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Males Numbers

Females Numbers

Males DAS(E)

Females DAS(E)

Numbers of new cases

Rate per 100,000

Oesophageal cancer incidence, numbers of newly diagnosed cases and directly age standardised rates (European) per 100,000 population

Ovary

1979198019811982198319841985198619871988198919901991199219931994199519961997

Numbers4795502050725123535753555580549757735736573657045922594458775941625764086674

DAS(E)14.959462371715.745133541515.811893987315.874799987516.413197067316.372298079116.91988574816.677851247317.43961610617.237259925217.128003699116.833955728217.632260187117.553778732117.065605724117.150533369317.984992009118.373685394119.0168817553

Ovary

00

00

00

00

00

00

00

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00

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00

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Numbers

DAS(E)

Numbers of newly diagnosed cases

Rate per 100,000 population

Ovarian cancer incidence, numbers of newly diagnosed cases and directly age standardised (European) rates per 100,000, Great Britain, 1979-1997

Pancreas

19791980198119821983198419851986198719881989199019911992199319941995199619971979198019811982198319841985198619871988198919901991199219931994199519961997

Males Numbers3412332033413319335633593405329732773353325833583347334432403116313631913174

Females Numbers3147315131843310325732623509341734763474359535073542355234773502343434613379

Males DAS(E)12.96511536412.304008776112.252722844912.054275180512.065113866112.069302104711.951996173211.588696747411.412454639811.601075519211.087735225111.408185588911.122195663411.195708468510.579575278710.25051195410.274615871410.349498000910.0747905433

Females DAS(E)7.88941159397.83451745047.71991670358.0015458537.85666974727.75952166778.2069071117.95430015618.15901154647.96922485248.32330184198.03566363017.98716739827.92728732587.84691506537.78768906367.66769597877.66714094947.4424623919

Pancreas

0000

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Males Numbers

Females Numbers

Males DAS(E)

Females DAS(E)

Numbers of new cases

Rate per 100,000

Pancreatic cancer incidence, numbers of newly diagnosed cases and directly age standardised rates (European) per 100,000 population

leukaemia

19791980198119821983198419851986198719881989199019911992199319941995199619971979198019811982198319841985198619871988198919901991199219931994199519961997

Males Numbers2580256026802788278628413080277829643197312331703308322033343392360233463371

Females Numbers2064213122622300245224532615239026142717268926152592267527672845287727712765

Males DAS(E)9.89375825099.662721090510.054925009910.357223722610.267604095510.388710866811.17521888459.972182852710.566680311311.294693032111.016214451211.021162113311.280412759110.937800862511.070008081111.367268260611.948853088410.998719035611.0586130125

Females DAS(E)5.92901331945.9587303276.19652212026.31621996.75774901546.70203245996.99975136596.40467513696.96863901077.08603913217.04545208396.887683296.69402040226.88058328457.07458290777.33132868937.35473983767.10564782377.0433296165

leukaemia

0000

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Males Numbers

Females Numbers

Males DAS(E)

Females DAS(E)

Numbers of new cases

Rate per 100,000

Leukaemia incidence, numbers of newly diagnosed cases and directly age standardised rates (European) per 100,000 population

Kidney

19791980198119821983198419851986198719881989199019911992199319941995199619971979198019811982198319841985198619871988198919901991199219931994199519961997

Males Numbers1875194221052218226023402405233924882581286428502885306231303282319433073533

Females Numbers1150124212451310139014041490145215611635166917951818187018592012206120872209

Males DAS(E)7.06929379327.23807530387.80743821838.2183225048.21500813718.57771364168.70447741088.44891287448.92804213889.192315998110.069328193810.034851885910.007666189910.507057302110.63606665211.16064680210.79374627310.965605743911.6249760432

Females DAS(E)3.36621833943.52830139443.56794517183.70553870293.89383659683.97614423054.10367954524.03825508264.28084390634.46514997554.55869554314.81704827864.96828849855.001272224.89402715775.39717059995.340445035.55735020155.8214668154

Kidney

Males Numbers

Females Numbers

Males DAS(E)

Females DAS(E)

Numbers of new cases

Rate per 100,000

Kidney cancer incidence, numbers of newly diagnosed cases and directly age standardised rates (European) per 100,000 population

Melanoma

19791980198119821983198419851986198719881989199019911992199319941995199619971979198019811982198319841985198619871988198919901991199219931994199519961997

Males Numbers7567988628759749591267128714691767161517011679185921222130217122132366

Females Numbers1444154116251746189919042313234625852829269625062560282531663191326931713243

Males DAS(E)2.92005424293.08708590233.30554078623.37141877453.66736886013.62128615694.76322706034.80545349445.42942014786.46505846415.90887603716.1535837886.00290553386.5916959017.46646836657.46039327147.44790459347.52963560417.9962222477

Females DAS(E)4.88002613915.1430062755.44179243945.79880231446.27338031376.26730344747.77879605067.64490696728.40312367499.11669792158.55156150267.82106252077.87962902848.60114345169.69895594599.67284593179.92105898149.55111380779.6881764842

Melanoma

0000

0000

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0000

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0000

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0000

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0000

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0000

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Males Numbers

Females Numbers

Males DAS(E)

Females DAS(E)

Numbers of new cases

Rate per 100,000

Melanoma skin cancer incidence, numbers of newly diagnosed cases and directly age standardised rates (European) per 100,000 population

Uterus

1979198019811982198319841985198619871988198919901991199219931994199519961997

Numbers4237433043874372438544354490436143794535450244994544467646414760451346044748

DAS(E)12.770291588613.032447876813.094473523813.027257341213.118763232313.23800064513.337776022512.907037838512.845411373213.288093091213.211640285313.110438266313.114384984313.509591009913.3295009613.52119114412.850414424713.049180677313.5326893151

Uterus

00

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Numbers

DAS(E)

Numbers of newly diagnosed cases

Rate per 100,000 population

Cancer of the uterus incidence, numbers of newly diagnosed cases and directly age standardised (European) rates per 100,000, Great Britain, 1979-1997

Lip and mouth

19791980198119821983198419851986198719881989199019911992199319941995199619971979198019811982198319841985198619871988198919901991199219931994199519961997

Males Numbers2166211321352283227022292288226323002420230723922556262925882728273528282810

Females Numbers1453136614641437151814871503140415041508149315721562163315901670168517081860

Males DAS(E)8.34541574438.03101210748.05730072758.55845587668.43722363728.27312366688.43698444258.26190701518.38542416468.79112404718.34320950358.61311275539.02591544049.28184423799.0129074349.53600049469.49727007919.77489354979.56021405

Females DAS(E)4.16965335643.8228707034.16591482024.09749067384.2203517054.20311793954.24664643383.89711113044.19042643084.24024306384.15238787334.39187611134.33644630564.5743668224.46315193464.59660204574.7526520264.80105232565.2134579675

Lip and mouth

0000

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0000

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Males Numbers

Females Numbers

Males DAS(E)

Females DAS(E)

Numbers of new cases

Rate per 100,000

Lip and mouth skin cancer incidence, numbers of newly diagnosed cases and directly age standardised rates (European) per 100,000 population

Brain

19791980198119821983198419851986198719881989199019911992199319941995199619971979198019811982198319841985198619871988198919901991199219931994199519961997

Males Numbers1529153616061559162417031765170318471867192119081971210520482071197019102050

Females Numbers1144119912131170125413221348128813331486150014351473163616181617156015901490

Males DAS(E)5.81798125065.8078421026.08049852845.86616080416.09195204666.43354214046.60187528356.38646742516.87800120016.85541660617.03657884226.994472537.09482458747.56182740867.23449224627.27560463226.8410615466.63426832717.0188421969

Females DAS(E)3.94108646844.00609251624.07875222973.98287910724.24414802654.42951936124.44619623134.25759592224.39872396284.88834004254.86844291174.71699132544.82213251635.14555683355.08956013394.97511328494.82968860094.84313124554.5623232127

Brain

0000

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Males Numbers

Females Numbers

Males DAS(E)

Females DAS(E)

Numbers of new cases

Rate per 100,000

Brain cancer incidence, numbers of newly diagnosed cases and directly age standardised rates (European) per 100,000 population

cervix

1979198019811982198319841985198619871988198919901991199219931994199519961997

Numbers4293446445434349441145704840480047704940456547354095380036903536337233193146

DAS(E)14.689801974415.211246827615.514725134714.751841627814.946527508915.514551319316.444160310116.216002577915.966279435816.59255714414.991639349315.661876729113.322735101812.101861290611.756194592911.124035821110.472231939310.28650331789.7735896863

cervix

00

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00

00

00

00

00

Numbers

DAS(E)

Numbers of newly diagnosed cases

Rate per 100,000 population

Cervical cancer incidence, numbers of newly diagnosed cases and directly age standardised (European) rates per 100,000, Great Britain, 1979-1997

males

19791980198119821983198419851986198719881989199019911992199319941995199619971979198019811982198319841985198619871988198919901991199219931994199519961997

Lung31128310213133631204309723030531589296682953229363284652798927946280732653926255253392423923876

Colorectal12464127851325313327136841387414400139591453014849152221539615552164911649916432159251697516680

Prostate935398441029210669111451143112325125681308313799140681469115645171291892721186210982214221303

Stomach7812818780867963807177077970782574587648737070666870701765566733648162946349

Bladder7231742777237742802582528622845587859179897092119185947795019506953792138721

Pancreas3412332033413319335633593405329732773353325833583347334432403116313631913174

Leukaemia2580256026802788278628413080277829643197312331703308322033343392360233463371

Oesophagus2279246325862673262527552919301032013324331434773519372638503979394940114142

Lip and mouth2166211321352283227014872288226323002420230723922556262925882728273528282810

NHL2059215022042316246626512866297933083469354137833884406741154261406841494205

Kidney1875194221052218226023402405233924882581286428502885306231303282319433073533

Brain and CNS1529153616061559162417031765170318471867192119081971210520482071197019102050

Melanoma7567988628759749591267128714691767161517011679185921222130217122132366

19791980198119821983198419851986198719881989199019911992199319941995199619971979198019811982198319841985198619871988198919901991199219931994199519961997

Lung113.9005944195112.264201597112.2294646318111.0493248131108.7907773519106.6159006388109.9884573095102.4971966906101.0974977848100.193335070896.194187818693.921330928691.971578860392.263524557285.6304393385.203764259881.269605643677.102843742575.0245292496

Colorectal46.895156148947.691683722349.050071659948.710371698749.386596323749.858303566450.999014509649.045641154750.793503448651.370453147652.145970537452.468437724451.890748178555.094259226653.964245175553.837723448251.593424557254.625537059252.8559204175

Prostate39.00598544940.266788550741.266285229842.223806645243.444564890544.065975666946.614418648746.632827363848.072620414350.248876948350.550019198352.195197854654.727742078359.279869664165.033515236672.178875061371.303127134274.143699424370.7364811277

Stomach29.070969411630.150837727929.377911580628.655158947928.681839675627.365455272628.005862854327.197075212425.825193923426.069343528925.055653870523.746612582322.639439474623.172771646121.033142558821.759179913920.796603430319.876467992119.9970237386

Bladder29.638807521829.894928080431.009260176530.784013160231.553974425632.167908757333.275863125432.363117498933.352662592334.691099307133.587727575834.229614705333.627131640734.164200397934.047487007733.72712517933.430728554631.880136022129.8109405808

Pancreas12.96511536412.304008776112.252722844912.054275180512.065113866112.069302104711.951996173211.588696747411.412454639811.601075519211.087735225111.408185588911.122195663411.195708468510.579575278710.25051195410.274615871410.349498000910.0747905433

Leukaemia9.89375825099.662721090510.054925009910.357223722610.267604095510.388710866811.17521888459.972182852710.566680311311.294693032111.016214451211.021162113311.280412759110.937800862511.070008081111.367268260611.948853088410.998719035611.0586130125

Oesophagus8.5424451089.1597424279.4281323219.69848240379.50539702299.864462246510.327828446610.629220498711.243440024811.617492348511.420796745711.913951258911.847223562712.575158272112.70184232413.216132856612.93559082613.05810973413.2838918019

Lip and mouth8.34541574438.03101210748.05730072758.55845587668.43722363728.27312366688.43698444258.26190701518.38542416468.79112404718.34320950358.61311275539.02591544049.28184423799.0129074349.53600049469.49727007919.77489354979.56021405

NHL7.72063690818.06408324888.28974091048.59336744069.15173737349.722071344210.398915273110.765055078411.945573120312.452373001812.458652028513.325277948813.395473622514.051750961614.050216023814.57893158713.672602431213.865527126613.8853000719

Kidney7.06929379327.23807530387.80743821838.2183225048.21500813718.57771364168.70447741088.44891287448.92804213889.192315998110.069328193810.034851885910.007666189910.507057302110.63606665211.16064680210.79374627310.965605743911.6249760432

Brain and CNS5.81798125065.8078421026.08049852845.86616080416.09195204666.43354214046.60187528356.38646742516.87800120016.85541660617.03657884226.994472537.09482458747.56182740867.23449224627.27560463226.8410615466.63426832717.0188421969

Melanoma2.92005424293.08708590233.30554078623.37141877453.66736886013.62128615694.76322706034.80545349445.42942014786.46505846415.90887603716.1535837886.00290553386.5916959017.46646836657.46039327147.44790459347.52963560417.9962222477

Numbers and rates for the major cancer sites in men (Great Britain)

197919891997

siteNumberDAS(E)siteNumberDAS(E)rank in 1979siteNumberDAS(E)rank in 1979

1Lung31128113.90Lung2846596.191Lung2387675.021

2Colorectal1246446.90Colorectal1522252.152Prostate2130370.743

3Prostate935339.01Prostate1406850.553Colorectal1668052.862

4Stomach781229.07Bladder897033.595Bladder872129.815

5Bladder723129.64Stomach737025.064Stomach634920.004

6Pancreas341212.97NHL354112.4610NHL420513.8910

7Leukaemia25809.89Oesophagus331411.428Oesophagus414213.288

8Oesophagus22798.54Pancreas325811.096Kidney353311.6211

9Lip and mouth21668.35Leukaemia312311.027Leukaemia337111.067

10NHL20597.72Kidney286410.0711Pancreas317410.076

11Kidney18757.07Lip and mouth23078.349Lip and mouth28109.569

12Brain and CNS15295.82Brain and CNS19217.0412Melanoma23668.0013

13Melanoma7562.92Melanoma16155.9113Brain and CNS20507.0212

males

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

Lung

Colorectal

Prostate

Stomach

Bladder

Pancreas

Leukaemia

Oesophagus

Lip and mouth

NHL

Kidney

Brain and CNS

Melanoma

Number of new cases reported

Incidence trends (numbers) in major cancer sites for males, 1979-1997

females

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

0000000000000

Lung

Colorectal

Prostate

Stomach

Bladder

Pancreas

Leukaemia

Oesophagus

Lip and mouth

NHL

Kidney

Brain and CNS

Melanoma

Rate per 100,000

Directly age standardised incidence rates (European) for the major sites, men in Great Britain 1979-1997

19791980198119821983198419851986198719881989199019911992199319941995199619971979198019811982198319841985198619871988198919901991199219931994199519961997

Breast23715249562501225725256282592528129279452923929743313443215234251351193366034824351573566136841

Colorectal13649139851465114575147341462615103149151536615493156371547615513162211562115740152201629515569

Lung949999831066011027111741161212515123081301413280131801326213570141731388214126143171415314112

Ovary4795502050725123535753555580549757735736573657045922594458775941625764086674

Uterus4237433043874372438544354490436143794535450244994544467646414760451346044748

Stomach5470534255625364529252075282486050864784475444124442433740394021394937253846

NHL1750193820522093224623712663267928663221327331783454354036523751356836263739

Bladder2759281430442995311831703374347234913695376436063660388038443707387636753718

Pancreas3147315131843310325732623509341734763474359535073542355234773502343434613379

Melanoma1444154116251746189919042313234625852829269625062560282531663191326931713243

Cervix4293446445434349441145704840480047704940456547354095380036903536337233193146

Leukaemia2064213122622300245224532615239026142717268926152592267527672845287727712765

Oesophagus1889193120842105209121882216216223572390248225032561269326812777272426902710

Kidney1150124212451310139014041490145215611635166917951818187018592012206120872209

Lip and mouth1453136614641437151814871503140415041508149315721562163315901670168517081860

Brain and CNS1144119912131170125413221348128813331486150014351473163616181617156015901490

19791980198119821983198419851986198719881989199019911992199319941995199619971979198019811982198319841985198619871988198919901991199219931994199519961997

Breast74.772367428678.511551988578.021076281480.383056606179.059896568379.710049944385.695531474285.587521374888.677210417489.974961666295.047263493398.7345390854105.536881518107.6163311942101.8143269341104.5660265488104.71777776105.6714336081108.8473800322

Colorectal35.036964358235.396316113736.808453026236.51437064336.515633039235.648930976336.682848184536.209645925236.649913956536.687514710636.569687059736.233876194736.128146349137.491401034136.254644048736.318107436134.566351825637.247141008135.3624842254

Lung26.985948595727.957434938729.534598510330.132517055330.330548998231.385234457833.276550341832.394041072134.277062470634.635996643934.108974373334.32878706634.501162071235.619645834834.790022762135.271871160735.361555739435.217431710834.8100080661

Ovary14.959462371715.745133541515.811893987315.874799987516.413197067316.372298079116.91988574816.677851247317.43961610617.237259925217.128003699116.833955728217.632260187117.553778732117.065605724117.150533369317.984992009118.373685394119.0168817553

Cervix14.689801974415.211246827615.514725134714.751841627814.946527508915.514551319316.444160310116.216002577915.966279435816.59255714414.991639349315.661876729113.322735101812.101861290611.756194592911.124035821110.472231939310.28650331789.7735896863

Stomach13.24823778512.767805550313.113207228512.485229183712.194019834511.971507285611.805541921110.806906909311.39204986610.407614402510.20971728499.46196138749.43691046389.11678059868.51022229718.54637146888.29215005827.86335961018.1011058556

Uterus12.770291588613.032447876813.094473523813.027257341213.118763232313.23800064513.337776022512.907037838512.845411373213.288093091213.211640285313.110438266313.114384984313.509591009913.3295009613.52119114412.850414424713.049180677313.5326893151

Pancreas7.88941159397.83451745047.71991670358.0015458537.85666974727.75952166778.2069071117.95430015618.15901154647.96922485248.32330184198.03566363017.98716739827.92728732587.84691506537.78768906367.66769597877.66714094947.4424623919

Bladder7.14376984887.21901524927.79653025777.63445160397.89175365147.92550031238.32795771228.53411921898.3982640988.88099272669.08208756798.3680778568.5110154978.88917233498.95778835978.27776601548.73347352688.22653287578.2231054808

Leukaemia5.92901331945.9587303276.19652212026.31621996.75774901546.70203245996.99975136596.40467513696.96863901077.08603913217.04545208396.887683296.69402040226.88058328457.07458290777.33132868937.35473983767.10564782377.0433296165

NHL5.11414429085.53373519365.86758942785.93806404556.40836538526.64423383557.39809260027.41096380357.88312561688.74785341728.81358106868.66118356539.26414691429.49780199849.660728863310.07306896639.4104696769.52051597819.7469654367

Melanoma4.88002613915.1430062755.44179243945.79880231446.27338031376.26730344747.77879605067.64490696728.40312367499.11669792158.55156150267.82106252077.87962902848.60114345169.69895594599.67284593179.92105898149.55111380779.6881764842

Oesophagus4.73789457024.78194943415.12527874265.12747846285.03104359025.23289823185.14296331785.03406898985.38955013865.42862210865.68618634295.56507736115.67698360055.96634113895.87588651456.1011216115.92000860545.79340659875.8259731385

Lip and Mouth4.16965335643.8228707034.16591482024.09749067384.2203517054.20311793954.24664643383.89711113044.19042643084.24024306384.15238787334.39187611134.33644630564.5743668224.46315193464.59660204574.7526520264.80105232565.2134579675

Brain and CNS3.94108646844.00609251624.07875222973.98287910724.24414802654.42951936124.44619623134.25759592224.39872396284.88834004254.86844291174.71699132544.82213251635.14555683355.08956013394.97511328494.82968860094.84313124554.5623232127

Kidney3.36621833943.52830139443.56794517183.70553870293.89383659683.97614423054.10367954524.03825508264.28084390634.46514997554.55869554314.81704827864.96828849855.001272224.89402715775.39717059995.340445035.55735020155.8214668154

197919891997

Rank 1979siteNumberDAS(E)siteNumberDAS(E)rank in 1979siteNumberDAS(E)rank in 1979

1Breast2371574.7723674286Breast3134495.04726349331Breast36841108.84738003221

2Colorectal1364935.0369643582Colorectal1563736.56968705972Colorectal1556935.36248422542

3Lung949926.9859485957Lung1318034.10897437333Lung1411234.81000806613

4Stomach547013.248237785Ovary573617.12800369915Ovary667419.01688175535

5Ovary479514.9594623717Stomach475410.20971728494Uterus474813.53268931517

6Cervix429314.6898019744Cervix456514.99163934936Stomach38468.10110585564

7Uterus423712.7702915886Uterus450213.21164028537NHL37399.746965436712

8Pancreas31477.8894115939Bladder37649.08208756799Bladder37188.22310548089

9Bladder27597.1437698488Pancreas35958.32330184198Pancreas33797.44246239198

10Leukaemia20645.9290133194NHL32738.813581068612Melanoma32439.688176484214

11Oesophagus18894.7378945702Melanoma26968.551561502614Cervix31469.77358968636

12NHL17505.1141442908Leukaemia26897.045452083910Leukaemia27657.043329616510

13Lip and mouth14534.1696533564Oesophagus24825.686186342911Oesophagus27105.825973138511

14Melanoma14444.8800261391Kidney16694.558695543115Kidney22095.821466815415

15Kidney11503.3662183394Brain and CNS15004.868442911716Lip and mouth18605.213457967513

16Brain and CNS11443.9410864684Lip and mouth14934.152387873313Brain and CNS14904.562323212716

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Breast

Colorectal

Lung

Ovary

Uterus

Stomach

NHL

Bladder

Pancreas

Melanoma

Cervix

Leukaemia

Oesophagus

Kidney

Lip and mouth

Brain and CNS

Number of new cases reported

Incidence trends (numbers) in the major cancer sites for females, 1979-1997, Great Britain

0000000000000

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Ovary

Uterus

Stomach

NHL

Bladder

Pancreas

Melanoma

Cervix

Leukaemia

Oesophagus

Kidney

Lip and mouth

Brain and CNS

Number of new cases reported

Incidence trends (numbers) in the major cancer sites for females, 1979-1997, Great Britain

0000000000000000

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Breast

Colorectal

Lung

Ovary

Cervix

Stomach

Uterus

Pancreas

Bladder

Leukaemia

NHL

Melanoma

Oesophagus

Lip and Mouth

Brain and CNS

Kidney

Rate per 100,000 population

Directly age standardised incidence rates (European) for the major sites, women in Great Britain, 1979-1997

Ovary

Cervix

Stomach

Uterus

Pancreas

Bladder

Leukaemia

NHL

Melanoma

Oesophagus

Lip and Mouth

Brain and CNS

Kidney

Rate per 100,000 population

Directly age standardised incidence rates (European) for the major sites, women in Great Britain, 1979-1997

DISTRIBUCION POR EDADESSource BAUS 2001

Distribution of cases

67.16443.461

222.33697.458

458.568238.377

715.644396.417

662.376383.247

189.912159.357

Male

Female

Number of cases

Sheet1

MaleFemaleMaleFemale

/= 808.212.123161317189.912159.357

Sheet2

Sheet3

FACTORES DE RIESGOCarcter familiar/genticoVon Hippel-Lindau 3p25Tabaquismo ObesidadHipertensin arterialTxicos ambientalesDilisisRadiacinFenacetinaExposicin a sustancias qumicas industriales

MANIFESTACIONES CLINICASTrada clsica

HEMATURIA (60%) DOLOR (45%) MASA PALPABLE (35%)

MANIFESTACIONES CLINICAS

Gran simuladorTUMOR DEL INTERNISTAOTRAS PRESENTACIONES Fiebre Perdida de peso Sntomas digestivos Anorexia, Anemia Neuropatas perifricas Hipertensin arterial Hipercalcemia Hipoglucemia Sndrome de Cushing Sindromes paraneoplasicosDisfuncin heptica

ANATOMIA PATOLOGICAOrigen en las clulas epiteliales del tbulo contorneado proximal

Inicio seudocpsula fibrosa capsula renal> crecimiento invade grasa perineal metastatiza a ganglios regionales

pulmn > fciaMetstasis a distancia hgado esqueleto cerebro

La angiognesis es un factor indispensable en el desarrollo y metstasis del cncer renal, ya que el tratamiento actual del cncer renal metasttico est dirigido hacia la inhibicin de este proceso biolgicoEste tumor depende de la angiognesis para su progresin

DIAGNOSTICOSospecha clnicaEcografa Alta sensibilidad TAC EstadificacinRNMLa arteriografa En desuso Solo en duda acerca de si el tumor es renal o metastsico.Biopsia

TRATAMIENTOQUIRRGICONefrectoma radicalNefrectoma parcial

RADIOTERAPIA Poco efectiva

QUIMIOTERAPIA Resistente a frmacos citotxicos

INMUNOTERAPIAInterferon, interleukina

Inhibidores de kinasasSorafenidSunitinid

TRATAMIENTOAnti-angiogenesisBAY 43-9006 (Sorafenib)RapamycinBevacizumab (Avastin)SU011248

NEFROBLASTOMATumor de WilmsTumor de origen embrionarioGrado de curacin del 85%INCIDENCIA7.8/milln de nios < 15Tumor solid abdominal mas fcte5ta lesin maligna de la infanciaForma hereditaria 15 a 20% bilateralPromedio de edad 2.5 aosNias ligeramente mas afectadasAsociaciones con aniridia, hemihipertrofia, disgenesia gonadal y retraso mental.

ANATOMIA PATOLOGICATamao variable10% son multicentricosPresentaHemorragia intratumoralNecrosisConstituido por clulas epiteliales forman tbulo o glomrulos embrionarios rodeados de un estroma de clulas fusiformes.

PulmonMetstasis higado ganglios linfanticosVena renal trombos

MANIFESTACIONES CLINICASMasa abdominal palpable (90%)Hematuria (25%)Fiebre (18%)Dolor abdominalHipertensin

DIAGNOSTICORadiografia simpleUrografiaEcografiaTACDIAGNOSTICO DIFERENCIAL

QuistesTumor de Bolande

ESTADIAJE

Estadio ITumor limitado a rinEstadio IISe extiende ms all de rin pero es resecadoEstadio IIITumor residual en abdomen (ganglios +, afectacin peritoneal, margen + o irresecableEstadio IVMetstasis a distanciaEstadio VBilateral

TRATAMIENTODepender del estadio en que se encuentre.CombinaExresis del tumorRadioterapiaQuimioterapia

GRACIAS