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This discussion with Dr Paul Russo presents a case for cytoreductive nephrectomy, despite the results from the CARMENA trial, which did not show an overall survival advantage.
The report concludes that careful selection of patients with intermediate-risk (not poor-risk) metastatic renal cell carcinoma (RCC) and cytoreductive nephrectomy performed by experienced surgeons, followed by treatment with the new generation of drugs either alone or in combination and often sequentially, can extend median overall survival to 40 months. Under these conditions, cytoreductive nephrectomy continues to play a central role in the treatment of metastatic RCC and will continue to do so in the future as more effective drugs are developed.
