- Kidney cancer M:F incidence ratio is 1.75:1 and it is the most lethal of all GU malignancies.
- VHL is the most common familial RCC syndrome; belzutifan (Welireg) is the HIF-2α inhibitor approved for VHL-associated tumours.
- Clear cell RCC is the most common subtype; WHO/ISUP grading is based on nucleolar prominence.
- AJCC T-staging cut-offs: T1a ≤4 cm, T1b >4-7 cm, T2a >7-10 cm, T2b >10 cm confined to kidney.
- IVC tumour thrombus levels: 0 (renal vein), I (≤2 cm into IVC), II (above renal vein, below hepatic veins), III (between hepatic veins and diaphragm), IV (above diaphragm).
- KEYNOTE-564 supports adjuvant pembrolizumab after nephrectomy in high-risk RCC.
- Motzer (MSKCC) and Heng (IMDC) criteria stratify metastatic RCC prognosis; CheckMate 214 supports nivolumab + ipilimumab for intermediate/poor-risk disease.
- For a fat-containing renal mass, a T2-weighted MRI with fat suppression is most likely to identify macroscopic fat and confirm angiomyolipoma (AML).
- Renal sarcoma is less common but more lethal than sarcoma of any other genitourinary site.