收稿日期: 2025-02-16
网络出版日期: 2025-07-18
基金资助
国家自然科学基金资助项目(82260609);云南省基础研究专项(202201AS070085)
The role and research progress of cytoreductive nephrectomy in metastatic renal cell carcinoma
Received date: 2025-02-16
Online published: 2025-07-18
随着靶向疗法和新型免疫检查点抑制剂的出现，转移性肾细胞癌（metastatic renal cell carcinoma， mRCC）的治疗格局在过去20年中迅速发展。其中，减瘤性肾切除术（cytoreductive nephrectomy， CN）是一个悬而未决的问题，与系统治疗（systemic therapy， ST）相比，其生存效益值得怀疑。CN在mRCC系统治疗中的作用和时机尚未明确。此外，CN患者选择上同样缺乏明确的共识。因此，本文简要综述mRCC中CN的现有证据，结合当前最新的肾癌诊疗指南，重点探讨CN在mRCC中的手术时机、获益人群及转移瘤切除术的价值。此外，本文讨论CN在转移性非透明细胞肾癌的作用，并展望CN在mRCC未来的应用前景和不断变化的角色。
郭彩访 , 范宏 , 栾婷 , 詹辉 , 王海峰 , 王剑松 . 减瘤性肾切除术在转移性肾细胞癌治疗中的研究进展[J]. 实用医学杂志, 2025 , 41(13) : 1952 -1957 . DOI: 10.3969/j.issn.1006-5725.2025.13.002
The treatment landscape for metastatic renal cell carcinoma （mRCC） has evolved rapidly over the past two decades with the introduction of targeted therapies and novel immune checkpoint inhibitors. Among these developments， cytoreductive nephrectomy （CN） remains a controversial and unresolved issue， with its survival benefits being questioned compared to systemic therapy （ST）. The role and optimal timing of CN in the context of modern systemic treatment for mRCC remain unclear. Additionally， there is still no well-defined consensus on patient selection for CN. Therefore， this article provides a concise review of current evidence regarding CN in mRCC， incorporating the latest renal cancer management guidelines. We focus particularly on optimal surgical timing， candidate patient selection， and the therapeutic value of metastasectomy. Furthermore， we examine the current role of CN in metastatic non-clear cell renal cell carcinoma and explore its evolving clinical applications and future prospects in mRCC treatment.
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