Ces Urol 2022, 26(1):13-28 | DOI: 10.48095/cccu2022007

Cytoreductive nephrectomy: identifying an ideal candidate based on preoperative predictive factors

Vladimír Študent ml.¹, Hana Študentová²

¹ Urologická klinika FN a LF UP Olomouc

² Onkologická klinika FN a LF UP Olomouc

Študent V ml., Študentová H. Cytoreductive nephrectomy: identifying an ideal candidate based on preoperative predictive factors. Treatment of metastatic renal cell carcinoma (mRCC) has changed dramatically in recent years. Targeted therapy (TT) and, more recently, immunotherapy in the form of immune checkpoint inhibitors (ICIs) have brought about a dramatic prolongation of the overall survival (OS) of patients. The urologist's role in mRCC is associated with cytoreductive nephrectomy (CN), which aims to alleviate symptoms or prolong OS. The oncological benefits of CN have recently been questioned through two prospective randomized studies, CARMENA and SURTIME. The situation is less clear today because all retrospective studies have confirmed the oncological importance of CN in the treatment of TT, but a new systemic treatment for mRCC is being used (ICIs). The main problem remains the correct selection of patients suitable for CN. At the time of TT, it was already clear that CN is not beneficial for all patients with mRCC. This article aims to present individual preoperative factors that could help in the correct selection of CN and discuss the surgical aspects of CN execution.

Keywords: Metastatic renal cell carcinoma, cytoreductive nephrectomy, predictive factors.

Received: January 7, 2022; Revised: February 21, 2022; Accepted: February 28, 2022; Prepublished online: March 1, 2022; Published: March 30, 2022