Would you offer cytoreductive nephrectomy to a young, healthy patient with widely metastatic renal medullary carcinoma with partial response to cisplatin based chemotherapy?  

This is a challenging situation due to the rapid growth of medullary renal cell carcinoma and the overarching need for systemic disease control with systemic therapy before considering any surgical intervention. We would want to see a deep response with chemotherapy, and some evidence of durability ...

In the setting of widespread metastatic disease with an aggressive tumor such as medullary renal cell carcinoma, partial surgical consolidation after cisplatin-based chemotherapy is unlikely to offer a substantial durable survival benefit, unfortunately. In a patient with partial response to a point...