The role of cytoreductive nephrectomy (CN) in treatment of locally advanced or metastatic renal cell carcinoma (mRCC) in the era of targeted therapies (TT) is still not clearly defined. The study population consisted of 730 patients with synchronous mRCC. The RenIS (Renal carcinoma Information System) registry was used as the data source. The CN/TT cohort included patients having CN within 3 months from the mRCC diagnosis and subsequently being treated with TT, while the TT cohort included patients receiving TT upfront. Median progression-free survival from the first intervention was 6.7 months in the TT arm and 9.3 months in the CN/TT patients (p < 0.001). Median overall survival was 14.2 and 27.2 months, respectively (p < 0.001). Liver metastasis, high-grade tumor, absence of CN, non-clear cell histology, and MSKCC (Memorial Sloan-Kettering Cancer Center) poor prognosis status were associated with adverse treatment outcomes. According to the results of this retrospective study, patients who underwent CN and subsequently were treated with TT had better outcomes compared to patients treated with upfront TT. The results of the study support the use of CN in the treatment algorithm for mRCC.

Central European Institute of Technology Masaryk University University Campus Bohunice 625 00 Brno Czech Republic

Department of Comprehensive Cancer Care Faculty of Medicine Masaryk University 625 00 Brno Czech Republic

Department of Comprehensive Cancer Care Masaryk Memorial Cancer Institute 656 53 Brno Czech Republic

Department of Oncology 1st Faculty of Medicine Charles University and General University Hospital 120 00 Prague Czech Republic

Department of Oncology 1st Faculty of Medicine Thomayer Hospital and Charles University 140 59 Prague Czech Republic

Department of Oncology Motol University Hospital and 2nd Faculty of Medicine Charles University 150 06 Prague Czech Republic

Department of Oncology Palacky University Medical School and Teaching Hospital 779 00 Olomouc Czech Republic

Department of Oncology University Hospital 323 00 Pilsen Czech Republic

Department of Surgery University Hospital Bohunice Faculty of Medicine Masaryk University 625 00 Brno Czech Republic

Department of Urologic Oncology Masaryk Memorial Cancer Institute and Masaryk University 656 53 Brno Czech Republic

Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University 625 00 Brno Czech Republic

University Hospital in Hradec Kralove 500 05 Hradec Kralove Czech Republic

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