The effectiveness of immunotherapy and targeted therapy has been well established in metastatic renal cell cancer (mRCC). These therapies demonstrated higher overall response rates and led to prolonged survival. In contrast, in localized RCC, conventional treatment is either partial or complete nephrectomy. While surgery is a curative option in early stages, high recurrence rates remain a concern, with survival rates ranging from 53% to 85%, depending on the initial stage at the time of diagnosis. Given favorable outcomes with systemic therapies in the metastatic setting, there has also been an increased interest in utilizing these therapies for the localized stage with the rationale to eradicate the micro-metastatic clone, thereby reducing the recurrence rates. Despite these encouraging developments, challenges regarding the optimal timing, duration, and combination of systemic therapies are still under investigation. Adding to that, balancing the benefits of systemic therapies with potential toxicities is also crucial, especially in patients who might otherwise benefit from surgery alone. This review describes the current landscape, ongoing clinical trials, and future directions of systemic therapy in the management of localized RCC.
免疫疗法与靶向疗法在转移性肾细胞癌（mRCC）治疗中的有效性已得到充分证实。这些疗法展现出更高的总体缓解率，并能显著延长患者生存期。相比之下，局限性肾细胞癌的传统治疗手段主要为部分或根治性肾切除术。虽然手术在早期阶段具有根治潜力，但高复发率仍是临床关注的重点——根据诊断时的初始分期，患者生存率在53%至85%之间波动。鉴于全身性疗法在转移性肾癌治疗中取得的良好疗效，学界对将其应用于局限性阶段的兴趣日益增长，其理论依据在于清除微转移克隆，从而降低复发风险。尽管这些进展令人鼓舞，但关于全身性疗法的最佳应用时机、持续时间和联合方案等挑战仍有待探索。此外，在可能仅通过手术即可获益的患者群体中，权衡全身性疗法的获益与潜在毒性也至关重要。本综述将系统阐述当前局限性肾细胞癌全身性治疗的发展现状、正在进行的临床试验及未来研究方向。
肿瘤(癌症)患者之家