Optimizing renal function and outcome of patients with cT2 renal cell carcinoma

The surgical approach to renal cell carcinoma (RCC) primary tumor and distant metastases has been the focus of a series of studies in the last years. On this scenario, Lebacle et al. (1) evaluated the role of neoadjuvant axitinib in cT2 RCC. They conducted an open-label, non-randomized, multicenter phase II study (AXIPAN) with the main goal of creating the favorable conditions for Partial Nephrectomy (PN) in patients with cT2 clear cell (cc)RCC. From the literature it is well known that radical nephrectomy (RN) is recommended in cases of large (>7 cm) or highly complex tumors (2), while PN is feasible in some T2 tumors (3) and can preserve a better renal function compared to RN and improve the survival rate (4). However, PN is technically challenging and requires expert surgeons.