CML – Kidney Cancer 2009;1(2):33–41.
There were an estimated 54 390 new renal tumors and 13 010 deaths from renal cancer in the US in 2008 [1]. Approximately 30–40% of patients with malignant renal cortical tumors will either present with or later develop metastatic disease [2–11]. In metastatic renal cell carcinoma (mRCC), surgical intervention may be performed alone to resect the primary tumor and isolated or limited metastatic disease (metastasectomy), or as a cytoreductive nephrectomy (CRN) in the face of unresectable metastatic disease prior to the initiation of systemic therapy. The vast majority of mRCC patients have large, locally advanced tumors, often with regional nodal, renal vein, and/or inferior vena caval extension. Approximately 90% of mRCC patients have the conventional clear cell histological subtype [10].