Personalizing preoperative risk stratification and refining patient selection for cytoreductive nephrectomy in metastatic renal cell carcinoma

The decision to proceed with cytoreductive nephrectomy should be undertaken after a careful assessment of competing threats and in the context of thoughtful shared decision making that accounts for patient priorities. Future prospective work should build on insights gained by retrospective analyses to determine how multidimensional characterization of patients' function and vulnerabilities can further inform patient selection for cytoreductive nephrectomy by using validated, objective assessments.