Cytoreductive Nephrectomy for Kidney Cancer With Sarcomatoid Histology-Is Up-Front Resection Indicated and, if Not, is it Avoidable?

Patients with sarcomatoid histology undergoing cytoreductive nephrectomy have a dire prognosis despite aggressive surgery and postoperative therapy. The variability in the sarcomatoid component and the lack of specific clinical features make preoperative identification challenging. Research should focus on identifying biomarkers for this subset of tumors that may allow up-front systemic therapy with surgery reserved for responding patients.