Re: Comparison of immediate vs . deferred cytoreductive nephrectomy in patients with synchronous metastatic renal cell carcinoma receiving sunitinib: the SURTIME randomized clinical trial

Renal cell carcinoma (RCC) accounts for 3% of adult solid malignant tumors worldwide and is the third leading cause of mortality amongst urologic malignancies (1). Nearly 20% of patients diagnosed with RCC suffer from metastatic disease by the time of diagnosis and up to 40% of patients treated with radical nephrectomy for localized RCC will develop a metastatic disease (2). The last decade has been characterized by a profound evolution in the treatment of RCC due to the improvement of the understanding of biomarkers driving cancer growth. In this context, the role of cytoreductive nephrectomy (CN) has been extensively discussed in the light of the new evidence on systemic treatment.