Riccardo Autorino MD, PhD, FEBU, discusses the decline in using cytoreductive nephrectomy (CN) for metastatic renal cell carcinoma (mRCC) due to the shift toward targeted therapy in urological practice. He explains the rationale behind CN, its drawbacks, and individual scenarios in which it could provide a benefit, as opposed to targeted therapy and nephron sparing surgery (NSS). Furthermore, he presents the current therapeutic algorithm for patient selection in these treatment options.

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