Determining the appropriate patients for cytoreductive nephrectomy (CN) has evolved with the integration of more effective systemic therapies for patients with metastatic renal cell carcinoma (mRCC). While previously considered to be first-line therapy for mRCC, CN has not demonstrated a significant survival advantage over systemic therapy in more recent randomized trials when compared with targeted therapy. Conversely, multiple observational studies demonstrate a therapeutic benefit for CN. This review synthesizes the current literature regarding patient selection for CN and further evaluates the role of CN in the current era of immune checkpoint inhibitor therapy. With careful patient selection, CN maintains an important role in the management of mRCC patients.

随着对转移性肾细胞癌(mRCC)患者更有效的全身治疗的整合，确定适合进行细胞减灭性肾切除术(CN) 的患者已经发展。虽然以前被认为是 mRCC 的一线治疗，但在最近的随机试验中，与靶向治疗相比，CN 并未表现出优于全身治疗的显着生存优势。相反，多项观察性研究表明 CN 具有治疗益处。本综述综合了当前关于 CN 患者选择的文献，并进一步评估了 CN 在当前免疫检查点抑制剂治疗时代的作用。通过仔细选择患者，CN 在 mRCC 患者的管理中保持重要作用。