Renal cell carcinoma: changes in natural history and treatment of metastatic disease
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The current dissertation treats different aspects of renal cell carcinoma management: changes in diagnostics and surgical treatment, prognostic factors of immunotherapy and a phase II study of combination therapy with interferon-alfa2A and capecitabine in metastatic disease with analysis of thymidine phosphorylase expression in tumor tissue. The increase in the survival of Estonian patients has been due to the larger number of cases with early disease stage, which is associated with the application of ultrasonography and computed tomography. Another factor for better survival was the higher operation rate among patients with stage IV disease. Capecitabine and interferon-alfa2A combination has clinical activity and a relatively acceptable toxicity profile in the treatment of patients with metastatic renal cell carcinoma.