Key Points Question Is cytoreductive nephrectomy associated with improved overall survival for patients with metastatic clear cell renal cell carcinoma? Findings In this cohort study of 12 766 patients, receipt of… Click to show full abstract
Key Points Question Is cytoreductive nephrectomy associated with improved overall survival for patients with metastatic clear cell renal cell carcinoma? Findings In this cohort study of 12 766 patients, receipt of a cytoreductive nephrectomy was not associated with improved overall survival using instrumental variable analysis to adjust for bias due to unmeasured confounding. Methods that do not adjust for this bias would have suggested a substantial overall survival benefit. Meaning Consistent with contemporary Level I evidence, instrumental variable analysis demonstrated that cytoreductive nephrectomy was not associated with improved overall survival for patients with metastatic clear cell renal cell carcinoma.
               
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