ABSTRACT

Patients with metastatik renal cell carcinoma (RCC) have a poor prognosis. The disease can spread nearly every location in the human body. Surgery in disseminated disease is the most effective therapeutic choice as it is in localized disease. Metastasectomy provides long term survival and palliation. The knowledge of the biology of RCC subtypes has evolved in years and paves the way for targeted molecular therapies (TMT) alternative to cytokine/ immunotherapy in mRCC. Prospective studies in immunotherapy era and the retrospective ones in the TMT era showed that the surgical cytoreduction and metastasectomy have protected their value. The efforts for prolonging the survival are more successful in patients with low tumor burden, limited dissemination of disease, favorable performance status, and longer time from nephrectomy to diagnosis of metastasis. Surgery provides better outcome in means of survival and quality of life especially in lung and bone metastasis.