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Cytoreductive nephrectomy refers to removal of the kidney and cancerous tumor in the setting of cancer spread around the body. In metastatic kidney cancer, cytoreductive nephrectomy is not often curative but can prolong survival in suitable patients.
Metastatectomy refers to removal of metastatic sites of kidney cancer. As there are no curative treatments for metastatic kidney cancer, patients with limited sites of metastatic disease may be eligible for surgical removal at the time of nephrectomy or after. Possible sites include the adrenal glands, pancreas, liver, lung and bone. These surgeries are often done in conjunction with other surgical teams including general surgical oncologist, thoracic surgeons or orthopedic surgeons.
Systemic therapies are most often prescribed by a medical oncologist and the major types of systemic therapy are discussed below:
Therapies can be given before or after surgery. Patients with advanced kidney cancer should be familiar with the following terms regarding the timing of systemic therapies.