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中华腔镜泌尿外科杂志(电子版) ›› 2024, Vol. 18 ›› Issue (03) : 208 -213. doi: 10.3877/cma.j.issn.1674-3253.2024.03.002

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靶向免疫治疗时代下减瘤性肾切除术在转移性肾细胞癌治疗中的价值
黄兴1, 王蕾2, 夏丹1,†()   
  1. 1. 310003　杭州，浙江大学医学院附属第一医院泌尿外科
    2. 310003　杭州，浙江大学医学院附属第一医院肿瘤放疗科
  • 收稿日期:2023-04-24 出版日期:2024-06-01
  • 通信作者: 夏丹
  • 基金资助:
    国家重点研发计划(2022YFC2407305)

The role of cytoreductive nephrectomy in metastatic renal cell carcinoma in the targeted therapy and immunotherapy era

Xing Huang1, Lei Wang2, Dan Xia1,†()   

  1. 1. Department of Urology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
    2. Department of Radiation Oncology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
  • Received:2023-04-24 Published:2024-06-01
  • Corresponding author: Dan Xia
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黄兴, 王蕾, 夏丹. 靶向免疫治疗时代下减瘤性肾切除术在转移性肾细胞癌治疗中的价值[J]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(03): 208-213.

Xing Huang, Lei Wang, Dan Xia. The role of cytoreductive nephrectomy in metastatic renal cell carcinoma in the targeted therapy and immunotherapy era[J]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(03): 208-213.

肾细胞癌（RCC）是泌尿系统最常见的恶性肿瘤之一，发病率逐年上升。转移性肾细胞癌（mRCC）占原发RCC的13%，但预后较差。减瘤性肾切除术（CN）是指切除mRCC患者的原发灶，在细胞因子治疗时代具有重要的价值。但是，随着靶向治疗和免疫治疗的快速发展，mRCC的治疗前景令人鼓舞，二者已成为mRCC的一线治疗方案。因此，在靶向免疫治疗时代下mRCC患者能否从CN中获益目前仍然存在争议。本文将试述CN在mRCC治疗模式中的发展历程，特别是在靶向免疫治疗时代下的新进展，以及CN患者的选择和手术时机，为国内泌尿外科工作者提供参考。

关键词: 转移性肾细胞癌, 减瘤手术, 靶向治疗, 免疫治疗

Renal cell carcinoma (RCC) is one of the most common malignant tumors in the urinary systems, and the incidence of RCC has gradually increased. Metastatic RCC (mRCC) accounts for 13% of primary RCC, however, the prognosis of mRCC is extremely poor. Cytoreductive nephrectomy (CN) is the removal of primary tumor in patients with mRCC, and it has been the standard for patients receiving systemic cytokine therapy. With the development of targeted therapies and immunotherapies, the treatment outcome of mRCC has been significantly improved, and targeted therapies and immunotherapies have become frontline treatments for mRCC. Therefore, the role of CN in the management of patients with mRCC came into question in the targeted therapy and immunotherapy era. This article will try to describe the development process of CN in the treatment paradigm of mRCC, especially the latest progress in the targeted-immunotherapy era, as well as patient selection and timing of CN.

Key words: Metastatic renal cell carcinoma, Cytoreductive nephrectomy, Targeted therapy, Immunotherapy
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