Which statement about renal cell carcinoma is true?

• A. It Is Often Resistant to Chemotherapy and Radiation
• B. It Is Commonly Diagnosed Via Ultrasound as the First Test
• C. It Presents with a Classic Triad Early in Disease
• D. It Rarely Metastasizes to the Liver

Answer: (A)

Renal cell carcinoma tends to resist traditional cytotoxic chemotherapy and conventional radiotherapy, which shapes how we treat it. This tumor’s biology makes it poorly responsive to many standard chemotherapies and to radiation, so surgery to remove the tumor or the kidney is the mainstay for localized disease, and systemic therapy for advanced disease centers on targeted agents (like VEGF inhibitors) or immune checkpoint inhibitors rather than standard chemo. Imaging for diagnosis and staging typically relies on CT or MRI rather than ultrasound as the first and defining test. The classic triad of flank pain, hematuria, and a palpable mass is not an early or common presentation. In fact, RCC often spreads hematogenously, and liver metastases are relatively common, so the statement that it rarely metastasizes to the liver is inaccurate. This combination of poor chemo/radiation responsiveness and reliance on surgical or targeted/systemic therapies makes the true statement the one noting its resistance to chemotherapy and radiation.