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Dr Gennady Bratslavsky gave a presentation at a urology symposium in Israel last week discussing the question of whether the primary tumour should be treated in metastatic renal cell carcinoma (RCC).
The outline of his presentation included:
Current guidelines for metastatic RCC
The rational behind cytoreductive nephrectomy (CN)
Historical evidence supporting current guidelines
A discussion about the results from the CARMENA trial, which compared sunitinib alone nephrectomy followed by sunitinib.
Dr Bratslavsky concluded that it is important to remember that the optimal candidates for cytoreductive nephrectomy are those with good performance and minimal disease. The role of cytoreductive nephrectomy is even less clear now in the era of immunotherapy.