Review ArticlesCytoreductive Nephrectomy in Patients Presenting With Advanced Disease Have We Finally Answered the Question?Shapiro, Daniel D. MD; Westerman, Mary E. MD; Karam, Jose A. MD; Wood, Christopher G. MDAuthor Information From the Department of Urology, University of Texas, MD Anderson Cancer Center, Houston, TX. The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Reprints: Christopher G. Wood, MD, Department of Urology, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe, Unit 1373, Houston, TX 77030. E-mail: [email protected]. The Cancer Journal: 9/10 2020 - Volume 26 - Issue 5 - p 382-389 doi: 10.1097/PPO.0000000000000470 Buy Metrics Abstract Determining the appropriate patients for cytoreductive nephrectomy (CN) has evolved with the integration of more effective systemic therapies for patients with metastatic renal cell carcinoma (mRCC). While previously considered to be first-line therapy for mRCC, CN has not demonstrated a significant survival advantage over systemic therapy in more recent randomized trials when compared with targeted therapy. Conversely, multiple observational studies demonstrate a therapeutic benefit for CN. This review synthesizes the current literature regarding patient selection for CN and further evaluates the role of CN in the current era of immune checkpoint inhibitor therapy. With careful patient selection, CN maintains an important role in the management of mRCC patients. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.