Against: The case for cytoreductive nephrectomy for the management of metastatic renal cell carcinoma.

摘要

The American Cancer Society estimates that in 2009 approximately 57,760 cases of kidney cancer will be diagnosed and 12,980 patients will die of the disease. Despite the stage migration of renal cell carcinoma attributed to incidental detection of localized disease, as many as 30% of patients will have metastatic disease at initial presentation. Traditionally, patients with metastatic RCC have been treated with cytokine based immunotherapy with response rates of approximately 15%.