肾细胞癌（RCC）在肿瘤学预后和临床行为上显示出广泛的光谱，并以转移性环境下通常不佳的结果而闻名。然而，在细胞因子时代后引入免疫治疗之后，转移性RCC的治疗格局发生了变化，胜过以前的靶向治疗，为晚期疾病患者带来了新的希望。细胞创伤性肾切除（CN）一直备受争议，与系统治疗相比，存活益处有待质疑。尽管来自CARMENA和SURTIME两项随机临床试验的结果令人沮丧，但人们对CN的作用正重新激起兴趣，当代的现实研究提供了支持性证据，暗示CN在经免疫治疗或即将接受免疫治疗的选择性患者中仍可能发挥作用，不仅能够用于症状控制，也有助于肿瘤治疗。在本综述文章中，我们试图在当代医学中对转移性RCC的CN作用进行综述，重点关注采用免疫检查点抑制剂联合免疫治疗的治疗方法。©韩国泌尿外科协会。

Renal cell carcinoma (RCC) displays a wide spectrum of oncological prognosis and clinical behavior, and is noted for its generally poor outcome in metastatic settings. However, the introduction of immunotherapy after the cytokine era has changed the landscape of treatment for metastatic RCC, outperforming previous targeted therapy and providing new hope for patients with advanced disease. Cytoreductive nephrectomy (CN) has been the center of controversy, with questionable survival benefit when compared to systemic therapy. Despite discouraging results from the two randomized clinical trials (CARMENA & SURTIME), interest into the role of CN is being rekindled, and contemporary real-world studies provide supporting evidence to suggest that CN may still have a role in well-selected patients treated or expecting treatment with immunotherapy, not only for symptomatic control but also for oncological benefit. In this review article, we attempt to review the modern insight into the role of CN for metastatic RCC in contemporary medicine, with a focus on treatment with immune checkpoint inhibitor combination-based immunotherapy.© The Korean Urological Association.