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KMID : 1001020220200030151
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Journal of Urologic Oncology
2022 Volume.20 No. 3 p.151 ~ p.162
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2021 Consensus Statements on the Cytoreductive Nephrectomy for Metastatic Renal Cell Carcinoma From the Korean Renal Cancer Study Group (KRoCS)
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Lee Chan-Ho
Kang Min-Yong
Kwak Cheol
Kim Sung-Han
Kim Jung-Kwon
Park Jae-Young
Seo Seong-Il
Seo Ill-Young
Suh Jun-Gyo
Song Wan
Song Che-Ryn
Yuk Hyeong-Dong
Lee Sang-Chul
Lee Hyung-Ho
Chung Jin-Soo
Jeong Chang-Wook
Jo Jung-Ki
Choi Chang-Il
Choo Seol-Ho
Han Jun-Hyun
Hwang Eu-Chang
Kim Mi-So
Kim Chan
Choi Seock-Hwan
Hong Sung-Hoo
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Abstract
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Purpose: The Korean Renal Cancer Study Group (KRoCS) provides consensus recommendations on the role of cytoreductive nephrectomy (CRN) in patients with metastatic renal cell carcinoma (mRCC).
Materials and Methods: A group of mRCC experts from the Korean Urological Oncology Society convened at the 2021 KRoCS meeting on CRN for mRCC.
Results: The consensus document was developed to address 4 questions related that were judged to be the most relevant to patient care: (1) Is there a role for CRN in patients planning targeted therapy? (2) Is there a role for CRN in patients planning immuno-oncology agents? (3) When is the optimal time of CRN in patients planning systemic treatment? (4) What is the ideal patient selection for CRN? The panelists have come up with following consensus. For mRCC patients, CRN should be considered only in those with IMDC (International Metastatic Renal Cell Carcinoma Database Consortium) favorable and intermediate risk disease, regardless of the systemic treatment plans. Timing of CRN should consider the risk group as well as the number of risk factors, but is generally recommended for after assessing the degree of response to initial systemic treatment. Patients with good performance status, limited metastatic burden on top of resectable primary tumor are candidates recommended for CRN with or without metastasectomy with priority.
Conclusions: In conclusion, there is still a role for CRN in the multimodality treatment of mRCC. Careful patient selection is of paramount importance. As the treatment landscape of mRCC continues to change, the role of CRN in the current immuno-oncology era will require more exploration.
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KEYWORD
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Cytoreductive surgical procedures, Nephrectomy, Renal cell carcinoma, Immunotherapy, Targeted therapy
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