Page 1 - Kidney Cancer Research Network of Canada (KCRNC) consensus statement on the role of cytoreductive nephrectomy for patients with metastatic renal cell carcinoma

CUAJ – Consensus Statement Mason et al
KCRNC consensus: Cytoreductive nephrectomy for mRCC

Kidney Cancer Research Network of Canada (KCRNC) consensus statement on the
role of cytoreductive nephrectomy for patients with metastatic renal cell carcinoma

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Ross J. Mason ; Lori Wood ; Anil Kapoor ; Naveen Basappa ; George Bjarnason ;
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Stephen A. Boorjian ; Rodney H. Breau ; Ilias Cagiannos ; Michael A.S. Jewett ; Pierre
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I. Karakiewicz ; Wassim Kassouf ; Christian Kollmannsberger ; Aly-Khan A. Lalani ;
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Jean-Baptiste Lattouf ; Luke T. Lavallée ; Stephen Pautler ; Nicholas Power ; Patrick
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Richard ; Alan So ; Simon Tanguay ; Ricardo A. Rendon 1
1 Department of Urology, Dalhousie University, Halifax, NS, Canada; Division of Medical Oncology,
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Dalhousie University, Halifax, NS, Canada; Division of Urology, McMaster University, Hamilton, ON,
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Canada; Division of Medical Oncology, University of Alberta, Edmonton, AB, Canada; Division of
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Medical Oncology, University of Toronto, Toronto, ON, Canada; Department of Urology, Mayo Clinic,
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Toronto, ON, Canada; Division of Urology, University of Ottawa, Ottawa, ON, Canada; Division of
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Urology, University of Toronto, Toronto, ON, Canada; Département de Chirurgie (Urologie), Université
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de Montréal, Montreal, QC, Canada; Division of Urology, McGill University, Montreal, QC, Canada;
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11 Division of Medical Oncology, University of British Colombia, Vancouver, BC, Canada; Department of
Oncology, McMaster University, Hamilton, ON, Canada; Division of Urology, Western University,
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London, ON, Canada; Division of Urology, Université de Sherbrooke, Sherbrooke, QC, Canada;
15 Department of Urologic Sciences, University of British Colombia, Vancouver, BC, Canada

Acknowledgements: The authors would like to acknowledge Larry Prokop from Mayo Clinic libraries
(Rochester, MN) for performing the comprehensive literature search utilized in the development of this
document.

Cite as: Can Urol Assoc J 2018 December 21; Epub ahead of print.
http://dx.doi.org/10.5489/cuaj.5787

Published online December 21, 2018

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Introduction
In recent decades, there have been significant advances in the systemic treatment options
for patients with metastatic renal cell carcinoma (mRCC) with the introduction of
targeted therapies and, more recently, immune checkpoint inhibition. Prior to the
introduction of these contemporary therapies for mRCC, two randomized controlled trials
identified a survival advantage to performing cytoreductive nephrectomy (CN) followed
by interferon alpha-2b versus interferon alpha-2b alone [1, 2]. However, whether CN,
defined as nephrectomy in the setting of metastatic disease, provides a similar survival
advantage for patients receiving modern systemic therapy has remained controversial
with two recent randomized trials calling into question the value of CN[3, 4]. In addition,