Combination of surgery and immunotherapy in metastatic renal cell carcinoma

World J Urol. 2005 Jul;23(3):191-5. doi: 10.1007/s00345-004-0468-y. Epub 2005 Mar 25.

Abstract

The treatment of choice for non-disseminated renal cell cancer (RCC) is surgery. However, the 5-year survival rates for all stages do not exceed 60%, even in contemporary series. Further improvement will most likely have to await the development of a more effective systemic therapy and the application of combined treatment modalities to counter the relatively high number of patients presenting with advanced stages. Whereas textbook belief up to the 1990s suggested refraining from surgical antitumor-therapy in the case of metastatic RCC, current strategies clearly advocate debulking tumor nephrectomy in the context of modern immunotherapies. This dramatic change of attitude stemmed from two randomized phase III trials conducted by EORTC and SWOG, including a combined analysis of both studies, in which cytoreductive tumor nephrectomy conveyed a significant survival benefit over immunotherapy alone. Concepts and progress in this field appear to be of major interest for modern oncologic urologists following the advent of immunotherapeutic strategies that require surgical intervention at some stage of the treatment cascade.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Carcinoma, Renal Cell / drug therapy*
  • Carcinoma, Renal Cell / surgery*
  • Combined Modality Therapy
  • Humans
  • Immunotherapy*
  • Kidney Neoplasms / drug therapy*
  • Kidney Neoplasms / surgery*
  • Nephrectomy

Substances

  • Antineoplastic Agents