Cytoreductive Nephrectomy in 2021: Obsolete but Necessary

Effect of Inferior Vena Cava Tumor Thrombus on Overall Survival in Metastatic Renal Cell Carcinoma Patients Treated with Cytoreductive Nephrectomy

“…Second, selection biases are clearly applicable and cannot be controlled for, like in previous analyses by Abel et al [2] , as well as Lenis et al [3] . Within the current study design, which exclusively investigated surgically treated patients, age was restricted to ≤75 yr at diagnosis to account for a more pronounced and more heterogeneous perioperative risk profile with increasing age, especially above 75 yr. Third, absence of specific information that would have allowed stratification according to the risk criteria, as well as detailed information regarding systemic therapy, including the sequence of systemic therapy, was not available within the current study population [1] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] . Fourth, pT3a-substage patients with tumor features (eg, perinephritic fat invasion) other than vascular invasion were excluded from the initial analyses and were subsequently considered in a secondary analysis without change to the recorded results.…”

Deferred Nephrectomy after a Surprising Response to Immunotherapy in Poor Risk Patients: A Case Report

“…In a recent Open To Debate discussion published on European Urology Open Science, expert opinions were still discordant about the ideal candidate for CN [28,29]. While Meza and colleagues believe that CN should only be considered as a symptomatic treatment in selected cases (gross hematuria, local pain), Méjean and Bex claim that upfront CN can also be proposed to oligometastatic pts whose disease may be surgically radicalised and to pts with a single IMDC risk factor, whereas the presence of a second risk factor should lead to choose an upront systemic treatment with the option of performing a deferred CN if a response at metastatic sites is achieved [28,30].…”

“…Immune-related toxicities and the potential need for corticosteroids may further complicate the surgical procedure. In fact, it was found that nephrectomy following ICIs may be a technically tricky procedure [30].…”