In this study, 6,043 patients with metastatic renal cell carcinoma (RCC) had a nephrectomy while 489 did not and were follow-up. Age, stage, presence of metastases and tumour size were assessed. The study showed that there was no survival benefit for patients with stage T4 disease and metastases or older than 76 years of age from having a nephrectomy.
However, the results of this study should be interpreted with caution due to variations in the patient populations in the study, missing/incomplete data and variations in categorising and reporting the data. Detailed information of drug treatments, such as targeted therapy, chemotherapy, and immunotherapy, was also missing or incomplete. Additionally, there were no standard criteria for patients who were recommended for nephrectomy. The results from this study should be used to generate a hypothesis and more work is needed to find the ideal criteria to select RCC patients for nephrectomy. Not all metastatic RCC patients are suitable for nephrectomy and the selection of patients for nephrectomy should always involve a multidisciplinary discussion.