TABLE 1.

Pros and Cons of Nephrectomy in Metastatic Renal Cell Carcinoma

Pros of Nephrectomy in Metastatic RCC	Cons of Nephrectomy in Metastatic RCC
Control of symptoms from primary tumor	Complications of surgery
Phase III trials showing OS benefit	No benefit proven with targeted therapy No change in response to systemic therapy
Resection of resistant clones	Delay of systemic therapy
Long-term remissions noted with surgical resection of metastatic RCC	Impaired creatinine clearance, increased risk of hypertension
Nephrectomy patients comprise 90% of clinical trial patient population	Unlikely to benefit patients with comorbidities and impaired performance status

Abbreviations: RCC, renal cell carcinoma; OS, overall survival