Abstract
This chapter deals with the treatment of patients with generalized RCC in the sense of integration surgical and oncological approach. First, it compared the effect of cytoreductive nephrectomy in time of immunotherapy and during the era of biological therapy, subsequently addressed the possibility of metastases resection and treatment of individual types of metastasis.
Sub-chapters talk about the position of adrenalectomy and lymphadenectomy in the surgical solution of renal cell cancers. It is also discusses the prognostic factors of a generalized renal cell carcinoma, the optimal systemic treatment and timing of surgical intervention in relation to multimodal treatment.