When is palliative nephrectomy considered in the treatment of renal cell carcinoma (RCC)?

Updated: May 21, 2019
  • Author: Kush Sachdeva, MD; Chief Editor: E Jason Abel, MD  more...
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Answer

Palliative nephrectomy should be considered in patients with metastatic disease for alleviation of symptoms such as pain, hemorrhage, malaise, hypercalcemia, erythrocytosis, or hypertension. Several randomized studies have shown improved overall survival in patients presenting with metastatic kidney cancer who have nephrectomy, followed by either interferon or interleukin-2 therapy. If the patient has good physiologic status, then nephrectomy should be performed before immunotherapy.

Reports have documented regression of metastatic renal cell carcinoma after removal of the primary tumor. Adjuvant nephrectomy is not recommended for inducing spontaneous regression; rather, it is performed to decrease symptoms or to decrease tumor burden for subsequent therapy in carefully controlled environments.


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