The role of metastasectomy in the treatment of metastatic renal cell carcinoma

The role of metastasectomy in metastatic renal cell carcinoma (mRCC) has been widely debated. Most clinical information regarding metastasectomy has been obtained from small retrospective studies that include heterogenous patient populations. It is unclear in what setting patients may confer the most clinical benefit. Moreover, a significant portion of clinical evidence suggesting additional benefit of metastasectomy is derived from a non-contemporary era, when interleukin-2, interferon-alpha, and limited number of tyrosine kinase inhibitors were the only available treatment options in addition to surgery. In efforts to answer these questions, we peruse the current literature of metastasectomy in mRCC by specific anatomical location, analyze the clinicopathological factors associated with metastasectomy outcomes, and discuss the potential role of metastasectomy as an adjunct to targeted therapy and immunotherapy.