Partial nephrectomy for metastatic renal cell carcinoma: Where do we stand?

Area of Science:

• Urology
• Oncology
• Nephrology

Background:

• Nephron-sparing surgery (NSS) is a standard treatment for localized renal cell carcinoma (RCC), offering oncologic efficacy with reduced risk of chronic kidney disease compared to radical nephrectomy.
• Limited data exist on the safety and efficacy of NSS specifically in the context of metastatic RCC.

Purpose of the Study:

• To systematically review the literature to evaluate the feasibility and impact on cancer-specific survival (CSS) of NSS in patients diagnosed with metastatic RCC.

Main Methods:

• A systematic literature review was conducted to identify studies reporting on NSS in patients with metastatic RCC.
• Data on feasibility, oncologic outcomes, and cancer-specific survival were extracted and analyzed.

Main Results:

• The available evidence indicates that NSS is a feasible surgical option for patients with metastatic RCC.
• Oncologic outcomes, specifically cancer-specific survival (CSS), appear comparable between NSS and radical cytoreductive nephrectomy in this patient population.

Conclusions:

• Nephron-sparing surgery (NSS) is a viable and safe approach for managing metastatic renal cell carcinoma (RCC).
• NSS demonstrates comparable cancer-specific survival (CSS) to radical cytoreductive nephrectomy, suggesting it can be considered in select patients with metastatic disease.