Indian Journal of Urology
REVIEW ARTICLE
Year
: 2021  |  Volume : 37  |  Issue : 1  |  Page : 13--19

The current role of cytoreductive nephrectomy for metastatic renal cell carcinoma


Eric C Umbreit, Andrew G McIntosh, Chalairat Suk-Ouichai, Jose A Karam, Christopher G Wood 
 Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

Correspondence Address:
Christopher G Wood
Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas
USA

The management of metastatic renal cell carcinoma (mRCC) continues to be a therapeutic challenge; however, the options for systemic therapy in this setting have exploded over the past 20 years. From the advent of toxic cytokine therapy to the subsequent discovery of targeted therapy (TT) and immune checkpoint inhibitors, the landscape of viable treatment options continues to progress. With the arrival of cytokine therapy, two randomized trials demonstrated a survival benefit for upfront cytoreductive nephrectomy (CN) plus interferon therapy and this approach became the standard for surgical candidates. However, it was difficult to establish the role and the timing of CN with the subsequent advent of TT, just a few years later. More recently, two randomized phase III studies completed in the TT era questioned the use of CN and brought to light the role of risk stratification while selecting patients for CN. Careful identification of the mRCC patients who are likely to have a rapid progression of the disease is essential, as these patients need prompt systemic therapy. With the continued advancement of systemic therapy using the immune checkpoint inhibitors as a first line therapy, the role of CN will continue to evolve.


How to cite this article:
Umbreit EC, McIntosh AG, Suk-Ouichai C, Karam JA, Wood CG. The current role of cytoreductive nephrectomy for metastatic renal cell carcinoma.Indian J Urol 2021;37:13-19


How to cite this URL:
Umbreit EC, McIntosh AG, Suk-Ouichai C, Karam JA, Wood CG. The current role of cytoreductive nephrectomy for metastatic renal cell carcinoma. Indian J Urol [serial online] 2021 [cited 2021 Oct 21 ];37:13-19
Available from: https://www.indianjurol.com/article.asp?issn=0970-1591;year=2021;volume=37;issue=1;spage=13;epage=19;aulast=Umbreit;type=0