And lastly, we come to the M staging or metastatic staging for kidney cancer.
This figure shows multiple metastatic deposits in the liver.
And here cancer has spread to the lungs in form of multiple nodular deposits.
It may also spread to the peritoneum in form of peritoneal deposits as you can see in the figure.
Metastatic deposits in the adrenal gland without direct extension of the tumor may also be seen.
Sometimes, it may also spread to the brain or bones.
Chemotherapy is the mainstay of treatment for patients with metastatic disease.
Nowadays, a lot of oral medications are available for treatment of kidney cancer.
In a patient with metastatic disease anytime after starting chemotherapy, if the surgeon feels that the disease can be surgically resected, then surgical resection may be was done in metastatic disease also.
And rarely, upfront surgical resection may be done in metastatic disease, with or without chemotherapy later.
But the final decision whether to start chemotherapy or to do surgery is taken by oncologists on an individual patient basis, after assessing the exact conditions of the patient, comorbidities, performance status, along with other factors.
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