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Clinical Management of Renal Tumors pp 335–353Cite as

Nephrectomy in Patients with Metastatic Renal Cell Carcinoma: Clinical and Biologic Effects

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Abstract

Up to one third of patients with renal cell carcinoma present with metastatic disease, and 20% to 40% of those with clinically localized disease eventually are found to have metastatic involvement. Prognosis continues to be poor for this population with a 2-year survival of only 10% to 30%; however, progress is being made. The role of surgery in those patients with advanced disease is currently being defined. There is a growing body of literature documenting the clinical effects of cytoreductive nephrectomy on patient outcomes. In addition, recent phase III trials have shown that nephrectomy prior to initiation of immunotherapy significantly improves survival in certain well-selected patients with metastatic renal call carcinoma (MRCC). Advances in our understanding of tumor-induced immune dysfunction have allowed greater insight into the biologic effects of nephrectomy on these patients, as well. Fortunately, there are new treatments for MRCC on the horizon, and nephrectomy will likely continue to play a role in these therapies as well.

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  1. Department of Urology, Loyola University Medical Center, Maywood, IL

    Bradley G. Orris MD & Robert C. Flanigan MD

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  1. Bradley G. Orris MD
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  1. Taussig Cancer Center, Cleveland Clinic Foundation, Cleveland, OH

    Ronald M. Bukowski MD

  2. Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH

    Andrew C. Novick MD

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Orris, B.G., Flanigan, R.C. (2008). Nephrectomy in Patients with Metastatic Renal Cell Carcinoma: Clinical and Biologic Effects . In: Bukowski, R.M., Novick, A.C. (eds) Clinical Management of Renal Tumors. Humana Press. https://doi.org/10.1007/978-1-60327-149-3_21

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