Urologic Oncology, Department of Urology, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1373, Houston, TX 77030, USA.
Urol Clin North Am. 2012 May;39(2):211-31, vii. doi: 10.1016/j.ucl.2012.01.005.
Proper integration of surgery and systemic therapy is essential for improving outcomes in renal cell carcinoma (RCC). There is no current role for adjuvant therapy after nephrectomy for clinically localized disease. The potential benefits of neoadjuvant therapy for locally advanced nonmetastatic disease are in need of further study. In metastatic disease, the proper integration of cytoreductive surgery and systemic therapy remains to be elucidated. Presurgical targeted therapy is feasible and may be beneficial. Pending the results of randomized controlled trials, upfront cytoreductive nephrectomy in appropriate patients will likely continue as the paradigm of choice in metastatic RCC.
手术与全身治疗的恰当结合对于改善肾细胞癌（RCC）的预后至关重要。对于临床局限性疾病，肾切除术后目前尚无辅助治疗的作用。新辅助治疗局部晚期非转移性疾病的潜在益处仍需要进一步研究。在转移性疾病中，适当的细胞减灭手术与全身治疗的结合仍有待阐明。术前靶向治疗是可行的，可能有益。在随机对照试验结果出来之前，在适当的患者中进行初始细胞减灭性肾切除术可能仍将作为转移性 RCC 的首选方案。
