ASCO 2023 | Individualized approach to cytoreductive nephrectomy in mRCC: factors, considerations, and treatment

Shawn Dason, MD, The Ohio State University Comprehensive Cancer Center, Columbus, OH, discusses individualized decision-making for cytoreductive nephrectomy in metastatic renal cell carcinoma. Factors to consider when individualizing treatment include patient characteristics such as age, performance status, and IMDC risk criteria, as well as disease-related factors such as histology, disease burden, and distribution. While there is no clear and definitive guidance from the literature, certain situations may indicate that upfront cytoreductive nephrectomy is not advisable, such as the presence of multiple negative criteria or urgent systemic disease requiring immediate treatment. In other cases, considering upfront systemic therapy and deferring nephrectomy based on the overall treatment plan and patient preferences may be a reasonable approach. Multidisciplinary discussions and shared decision-making can be valuable in these complex cases where there is limited understanding of the optimal course of action. This interview took place at the American Society of Clinical Oncology (ASCO) 2023 Annual Congress in Chicago, IL.

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