Klatte T, et al. - Cytoreductive nephrectomy (CN) was hypothesized to improve overall survival (OS) in patients with synchronous metastatic renal cell carcinoma (mRCC) who subsequently received targeted therapies (TT). As shown by inverse probability of treatment weighting (IPTW)-adjusted analysis, CN appeared to improve OS in patients with synchronous mRCC treated with TT. The survival difference was noted after 12 months. An advantage could be gained by specific subgroups from CN.