ArticleThe oncologist2025
Clinical and pathological outcomes of deferred nephrectomy in patients with metastatic and locally advanced RCC after immune checkpoint inhibitors.
Article in The oncologist, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- A 73-Year-Old Man With a Late Isolated Brain Metastasis of Clear Cell Renal Cell Carcinoma Following a Durable Complete Response to Lenvatinib-Pembrolizumab, Resulting in Deferred Cytoreductive Nephrectomy.The American journal of case reports · 2026Article
- Review
- CT-based renal artery caliber change as a potential imaging marker of treatment response in renal cell carcinoma; an exploratory imaging study.Cancer imaging : the official publication of the International Cancer Imaging Society · 2026Article
- Deciphering the mechanistic landscape of immune checkpoint blockade in ccRCC: from molecular drivers to therapeutic responses.Frontiers in immunology · 2026Review
- Integrative multi-omics analysis identifies a PTM-related immune signature and IRF9 as a driver in ccRCC.Frontiers in immunology · 2025Article
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Authors and funding
12 authors.
Funding
Abstract
BACKGROUND AND
objectiveCytoreductive nephrectomy following immune checkpoint blockade (ICB) in metastatic renal cell carcinoma remains controversial, with limited data on its clinical and pathological outcomes. This study evaluated the outcomes of patients undergoing deferred cytoreductive nephrectomy (dCN) after ICB-based treatment, focusing on the radiologic and pathological responses, and postoperative clinical outcomes.
methodsWe retrospectively reviewed 24 patients with metastatic or locally advanced RCC who underwent dCN after ICB at a single institution between April 2018 and May 2024. We assessed the radiological response to ICB, pathological findings (presence and extent of necrosis) in resected primary tumors, and postoperative clinical outcomes, including the rate of patients without measurable disease and those who discontinued systemic therapy.
resultsMedian ICB exposure prior to surgery was 11.3 months. Radiologically, 67% of patients had partial response, 29% had stable disease, and 4% had a complete response. Pathology showed 96% of specimens with necrosis, 21% of specimens showing no residual disease (pT0), and 21% exhibiting ≥95% necrosis. Postoperatively, 50% of patients had nonmeasurable disease of first follow-up scans, and 54% discontinued systemic therapy, with 9 patients remaining on surveillance at last follow-up. Limitations include the small sample size and retrospective design.
conclusionDeferred CN following ICB therapy is feasible. Extensive necrosis in the resected surgical specimen after ICB-based therapy requires further investigation as a prognostic marker for durable responses off systemic therapy.
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