Cytoreductive nephrectomy following treatment with anti-vascular endothelial growth factor-targeted agents: is it surgically safe?

In the era of cytokine therapy, 2 prospective randomized clinical trials (RCTs) demonstrated significantly more superior overall survival (OS) of metastatic renal cell carcinoma (mRCC) patients receiving cytoreductive nephrectomy followed by interferon-α (IFN-α) than of those treated with IFN-α alone (1,2); therefore, it has been recognized as a standard therapeutic approach for mRCC patients to perform cytoreductive nephrectomy prior to the introduction of systemic therapy.