ABSTRACT
This practice is based on the results of two randomized trials which showed a statistically significant survival advantage for nephrectomy in those who received interferon for their metastatic disease.3,4 Nephrectomy should be offered to every patient with a good European Cooperative Oncology Group (ECOG) performance status who is to receive immunotherapy. However, some have reported that nephrectomy should not be offered if the metastatic tumour burden is high while that of the primary tumour is relatively low. This suggestion is based on the observation that some patients with their primary tumour in situ can have a good outcome when treated with high-dose interleukin 2 (IL-2).5 Furthermore, the role of cytoreductive surgery in the context of the new targeted therapies needs to be formally assessed.
