Journal
UROLOGIC CLINICS OF NORTH AMERICA
Volume 39, Issue 2, Pages 211-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.ucl.2012.01.005
Keywords
Renal cell carcinoma; Adjuvant therapy; Neoadjuvant therapy; Cytoreductive nephrectomy; Immunotherapy; Targeted therapy; Angiogenesis inhibitor; Tyrosine kinase inhibitor
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Proper integration of surgery and systemic therapy is essential for improving outcomes in renal cell carcinoma (RCC). There is no current role for adjuvant therapy after nephrectomy for clinically localized disease. The potential benefits of neoadjuvant therapy for locally advanced nonmetastatic disease are in need of further study. In metastatic disease, the proper integration of cytoreductive surgery and systemic therapy remains to be elucidated. Presurgical targeted therapy is feasible and may be beneficial. Pending the results of randomized controlled trials, upfront cytoreductive nephrectomy in appropriate patients will likely continue as the paradigm of choice in metastatic RCC.
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