ABSTRACT
Metastatic renal cell carcinoma (RCC) remains an incurable condition and the development of adjuvant treatments that can decrease the risk of patients developing metastasis following nephrectomy remains an important goal. A number of prognostic factors have been described that aim to identify those patients with primary RCC who are at risk of relapse.1-6
The approach of identifying such patients is well illustrated by the successful adjuvant strategies that are now standard of care in many of the commoner tumour types, such as breast7
and colorectal8,9 cancer. The agents used in these adjuvant strategies are those with some proven efficacy in the metastatic setting. Unfortunately in renal cancer, despite the use of chemo-immunotherapy, currently there is no good treatment for stage 4 disease, which has hampered the development of adjuvant therapy in renal cancer. Consequently, while a number of studies have addressed the question of adjuvant therapy, most of these were small and did not demonstrate a significant benefit of treatment. However, with the advent of novel agents that appear to be active in stage 4 disease, adjuvant therapy is again becoming an important area of investigation.
