The role and timing of debulking nephrectomy in mRCC has been evolving over the last several years. This is in part due to CARMENA, which in my opinion reinforced that patient selection is critical, and in part due to increased activity of systemic therapy. I think patients with limited IMDC risk fa...

This is an evolving question in the treatment of RCC. CARMENA trial was conducted in sunitinib era, and we have different treatment options currently, such as IO/IO or IO/VEGF. The role of cytoreductive nephrectomy should be answered by using those newer agents, and there are ongoing trials such as ...

The role of cytoreductive nephrectomy is not clear in metastatic RCC in the setting of immune therapy. The SWOG trial, S1931/PROBE is addressing that question. Certainly upfront, nephrectomy cannot be recommended with the increasing efficacy of systemic therapy which is the backbone of therapy. The ...