From the Department of Urology, University of Texas, MD Anderson Cancer Center, Houston, TX.
Cancer J. 2020 Sep/Oct;26(5):382-389. doi: 10.1097/PPO.0000000000000470.
Determining the appropriate patients for cytoreductive nephrectomy (CN) has evolved with the integration of more effective systemic therapies for patients with metastatic renal cell carcinoma (mRCC). While previously considered to be first-line therapy for mRCC, CN has not demonstrated a significant survival advantage over systemic therapy in more recent randomized trials when compared with targeted therapy. Conversely, multiple observational studies demonstrate a therapeutic benefit for CN. This review synthesizes the current literature regarding patient selection for CN and further evaluates the role of CN in the current era of immune checkpoint inhibitor therapy. With careful patient selection, CN maintains an important role in the management of mRCC patients.
确定接受细胞减灭性肾切除术 (CN) 的合适患者已随着转移性肾细胞癌 (mRCC) 患者更有效系统治疗的整合而发展。虽然之前被认为是 mRCC 的一线治疗，但与靶向治疗相比，最近的随机试验并未显示 CN 在生存率方面具有明显优势。相反，多项观察性研究表明 CN 具有治疗益处。本综述综合了目前关于 CN 患者选择的文献，并进一步评估了 CN 在当前免疫检查点抑制剂治疗时代的作用。通过仔细的患者选择，CN 在 mRCC 患者的治疗中仍然发挥着重要作用。
