Resection of the primary kidney cancer plus adjuvant cytokine therapy in patients presenting with metastatic disease is the standard of care
In this landmark study 246 patients with metastatic kidney cancer including patient with renal vein or vena cava extension were randomized to either nephrectomy (cytoreductive) plus IFN alpha-2b or IFN alone. The mean age was 59 and follow up was 1 year. There was an overall survival benefit in favor of the surgery group of 11.1 months v 8.1 months for patients only given IFN. Surgery was performed first followed by cytokine therapy 2-4 weeks later when the patient had recovered. Cytoreductive nephrectomy has become the standard of care in patients with metastatic kidney cancer with resectable primary tumors.