This meta-analysis pooled 15 studies (n = 2,912) evaluating deferred systemic therapy for metastatic renal cell carcinoma. Systemic therapy–free survival was 74% at 1 year, 54% at 2 years, and 37% at 5 years. Overall survival was excellent: 96% at 1 year, 89% at 2 years, and 69% at 5 years. As expected, subgroup analyses demonstrated even more favorable outcomes among favorable-risk patients with few to no adverse features and limited metastatic sites. While not everyone here received ablative radiation, it featured prominently as a component of “active surveillance” (emphasis on active) in several cohorts, reinforcing its role as a tool for disease control and systemic therapy deferral in oligometastatic RCC. | Tsuboi, Urol Oncol 2025
