How would you treat a patient with poorly differentiated carcinoma with squamous differentiation of the kidney following nephrectomy with metastatic retroperitoneal adenopathy?

Depending on the patient’s age and performance status I would determine if retroperitoneal dissection is an option (assuming that’s the only site of metastatic disease)

If possible, send the pathology specimens out for a second or third opinion.

I would also consider next-generation sequencing, as ...

Unfortunately outcomes for patients with pure squamous cell carcinoma of urothelium do poorly with approaches that target urothelial type histologies. If surgical resection can render pt disease free with reasonable morbidity than may make sense. I agree with sequencing the tumor to identify perhaps...