Hyung L. Kim, MD, Medallion Group Chair in Urology, co-medical director of the Urologic Oncology Center, associate director, Surgical Research in the Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center, discusses cytoreductive nephrectomy in patients with metastatic renal cell carcinoma (RCC).

Nephrectomy is done in 2 different settings with 2 different goals, says Kim. In patients with clinically localized disease the goal is cure, but in metastatic disease the goal is to extend disease-free survival by reducing the disease burden through cytoreductive nephrectomy.

Cytoreductive nephrectomy was established as a standard of care in an era where the standard systemic therapy was interferon. However, new treatments have been introduced such as tyrosine kinase inhibitors, antiangiogenic therapy, and immunotherapy, calling the benefit of cytoreductive therapy into question. There are some trials directly addressing this question, says Kim, but results are not currently available.