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🌱 來自：Treatment principles-of-renal-cell-carcinoma

cytoreductive nephrectomy in metastatic rcc

• Benefit depends on pt selection. 2 phase III trials reported in 2001 showed ↑ OS w/ nephrectomy + IFNα vs. IFNα alone (NEJM 2001;345:1655; Lancet 2001;358:9286).
• However, the CARMENA trial showed ↑ OS w/ sunitinib alone vs. nephrectomy + sunitinib (NEJM 2018;379:417).
• Best candidates for nephrectomy are intermediate-risk pts w/ limited metastatic burden & low perioperative risk; avoid up-front surgery in pts w/ urgent need for systemic dz shrinkage or where operative complications could delay systemic therapy