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Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,536
Online ISSN 1827-1758
ADVANCES IN UROLOGY - PART II
Pignot G., Drai J., Patard J.-J.
Department of Urology, Bicetre Hospital AP-HP, Paris XI University Le Kremlin Bicêtre, Paris, France
Surgery remains the treatment of choice for locally advanced or metastatic renal cell carcinoma. However, the contribution of targeted therapies has recently significantly impacted recurrence-free survival in metastatic patients, challenging in some cases the real interest of nephrectomy. Waiting for the results of CARMENA trial, assessing the impact of cytoreductive nephrectomy on survival, neoadjuvant and adjuvant strategies are emerging. In locally advanced disease, adjuvant therapy should be considered if the patient is considered at high risk of progression, and therefore require its inclusion in a prospective randomized trial. Neo-adjuvant anti-angiogenic strategies show a quite modest improvement in resectability of primary tumor, while allowing performing translational research. However, many questions remain on hold in terms of precise indications, choice of drugs, toxicity and optimal dosing schedule. All these questions explain the current development of phase III trials.