Roser Vives Dilme1, Juan Gómez Rivas2, Riccardo Campi3,4,5, Javier Puente6, Tamara Jerez2, Dmitry Enikeev7, Francesco Esperto8, Jesús Moreno Sierra2. 1. Department of Urology, Hospital Clínico San Carlos, Complutense University of Madrid, Profesor Martín Lagos s/n, 28040, Madrid, Spain. rvivesdilme@gmail.com. 2. Department of Urology, Hospital Clínico San Carlos, Complutense University of Madrid, Profesor Martín Lagos s/n, 28040, Madrid, Spain. 3. Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy. 4. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy. 5. European Association of Urology (EAU) Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, Netherlands. 6. Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), CIBERONC, Madrid, Spain. 7. Institute of Urology and Reproductive Health, Sechenov University, Moscow, Russian Federation. 8. Department of Urology, University of Rome, Campus Biomedico, Rome, Italy.
Abstract
PURPOSE OF REVIEW: The aim of this review was to summarize the evidence on the current role of cytoreductive nephrectomy (CN) in patients with metastatic renal cell carcinoma (mRCC). RECENT FINDINGS: Since the advent of systemic targeted therapies for mRCC treatment, the role of CN has been questioned. Several retrospective observational studies demonstrated a therapeutic benefit for CN, while recent prospective randomized trials have challenged this evidence. As such, patient selection has become of paramount importance in this setting. The role of CN on mRCC treatment is still object of debate. In carefully selected patients, CN remains an important option as a component of a multimodal therapeutic approach. As systemic therapies for mRCC continue to evolve, future trials are needed to evaluate the benefits and limits of CN in the immunotherapy era, tailoring the treatment sequence and selecting the patients who are most likely to benefit from surgical interventions.
PURPOSE OF REVIEW: The aim of this review was to summarize the evidence on the current role of cytoreductive nephrectomy (CN) in patients with metastatic renal cell carcinoma (mRCC). RECENT FINDINGS: Since the advent of systemic targeted therapies for mRCC treatment, the role of CN has been questioned. Several retrospective observational studies demonstrated a therapeutic benefit for CN, while recent prospective randomized trials have challenged this evidence. As such, patient selection has become of paramount importance in this setting. The role of CN on mRCC treatment is still object of debate. In carefully selected patients, CN remains an important option as a component of a multimodal therapeutic approach. As systemic therapies for mRCC continue to evolve, future trials are needed to evaluate the benefits and limits of CN in the immunotherapy era, tailoring the treatment sequence and selecting the patients who are most likely to benefit from surgical interventions.
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