Debulking nephrectomy in metastatic renal cancer Review uri icon


MeSH Major

  • Carcinoma, Renal Cell
  • Kidney Neoplasms


  • Up to one third of patients with renal cell carcinoma will present with metastatic disease, and 20 to 40% of those with clinically localized disease will eventually be found to have metastatic involvement. Prognosis continues to be guarded for this population, with a 2-year survival of only 10 to 30%. Although advances are being made in the medical management of renal cell carcinoma, the role of surgery in the treatment algorithm is also being additionally refined. Palliative surgery either via nephrectomy or metastasectomy has a role in certain well-selected patients. There are also data to support total metastasectomy at the time of either nephrectomy or recurrence in a small subset of patients with minimal, resectable metastases. More controversial is the idea of cytoreductive nephrectomy as an adjunct to immunotherapy. Recent phase III trials indicate that nephrectomy may play an important role in management of metastatic renal cell carcinoma in conjunction with cytokine-based immunotherapy. Nephrectomy is also an essential component of tumor-based vaccine and adoptive immunotherapy protocols and may play a role in other novel therapies.

publication date

  • September 15, 2004



  • Review



  • eng

Digital Object Identifier (DOI)

  • 10.1158/1078-0432.CCR-sup-040026

PubMed ID

  • 15448027

Additional Document Info

start page

  • 6335S

end page

  • 41S


  • 10


  • 18 II