Nephrectomy in metastatic renal cell carcinoma.

Progress in the treatment of metastatic renal cell carcinoma in recent decades might be characterized as promising by the optimist, nonexistent by the pessimist, and somewhere between by the realist. Regardless of one's point of view, the dilemma of what to do with the primary tumor persists. With notable exceptions, the duration and quality of survival are not influenced favorably by nephrectomy.