(UroToday.com) An ongoing debate in the field of advanced renal cell carcinoma is the benefit and patient selection for cytoreductive nephrectomy. In an analysis presented last year at the 2020 GU ASCO symposium, Dr. Ashanda Esdaille and colleagues presented data on overall survival in 1100+ patients who underwent upfront cytoreductive nephrectomy at 5 tertiary care centers after being diagnosed with synchronous metastatic RCC. In that study, the median overall survival of patients was higher than expected from prior studies, raising the question of observational bias from careful patient selection by care teams for nephrectomy.