Abstract
Surgery is the oldest modality of kidney cancer therapy and is usually the first step in the treatment process. To improve surgical outcomes, adjuvant therapy is frequently administered to eliminate residual tumors and reduce the risk of recurrence and metastasis. However, not all patients require adjuvant treatment. The decision regarding whether to treat or not to treat renal cell carcinoma patients depends on the risk of recurrence, including tumor stage and histology, and clinical, biological, and personal risk factors. This article will address the challenges of treating renal cell carcinoma patients with adjuvant therapy and review the current evidence and ongoing clinical trials.