James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, 600 N. Wolfe Street / Marburg 144, Baltimore, MD 21287, USA.
James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, 600 N. Wolfe Street / Marburg 144, Baltimore, MD 21287, USA.
Urol Clin North Am. 2020 Aug;47(3):359-370. doi: 10.1016/j.ucl.2020.04.009. Epub 2020 Jun 11.
The role for cytoreductive nephrectomy (CN) in the treatment of metastatic renal cell carcinoma (mRCC) has evolved with advancements in systemic therapy. During the cytokine-based immunotherapy era, CN provided a clear survival benefit and was considered standard of care in management of mRCC. The development of targeted systemic therapy directed at the vascular endothelial growth factor pathway altered the treatment paradigm and accentuated the importance of risk stratification in treatment selection. This article reviews the literature evaluating the benefit of CN during the evolution of systemic therapy and provides clinical recommendations for current utilization of CN in patients with mRCC.
细胞减灭性肾切除术 (CN) 在转移性肾细胞癌 (mRCC) 治疗中的作用随着系统治疗的进展而发展。在细胞因子为基础的免疫治疗时代，CN 提供了明确的生存获益，并被认为是 mRCC 管理的标准治疗方法。针对血管内皮生长因子途径的靶向系统治疗的发展改变了治疗模式，并强调了在治疗选择中进行风险分层的重要性。本文回顾了评估系统治疗演变过程中 CN 获益的文献，并为当前 mRCC 患者中 CN 的应用提供了临床建议。
