American Board of Internal Medicine (ABIM) Certification Practice Exam

What is an accepted treatment for non-metastatic renal cell carcinoma?

1. Active surveillance or ablation

2. Radical or partial nephrectomy

3. Combination chemotherapy

4. Hormonal therapy

The correct answer is: Radical or partial nephrectomy

Radical or partial nephrectomy is a well-established treatment for non-metastatic renal cell carcinoma (RCC). This approach is commonly employed because surgical removal of the tumor is the most effective way to achieve local control and potentially cure the disease in its early stages. Radical nephrectomy involves the complete removal of the affected kidney along with surrounding tissue, whereas partial nephrectomy entails the removal of only the tumor while preserving as much healthy kidney tissue as possible. These options are particularly suitable for patients with localized tumors that have not spread beyond the kidney. In contrast, active surveillance and ablation can be appropriate in specific cases, especially for small, indolent tumors, but are not typically the primary treatment for non-metastatic disease where surgery is feasible. Combination chemotherapy is generally not effective for RCC, as the disease is often resistant to conventional cytotoxic agents. Hormonal therapy does not play a role in the management of RCC, which is primarily treated through surgical means and targeted therapies once a patient has metastatic disease.