Local oncologist recommended Keytruda every 6 weeks for a year. Second opinion oncologist at Duke Cancer Institute said Keytruda was not warranted with G1 tumor grade. He requested my pathology slides so he could have his pathologist evaluate them. The new pathology report lists my tumor as G2 (instead of G1), notes the tumor was necrotic (instead of that not being noted by the original pathologist), and the tumor extends into the pelvicalyceal (instead of perinephric tissue/renal sinus only). I don't know if that will change his recommendation. If it doesn't, I will have to decide which route to take, or to get a third opinion. If he changes his mind and also recommends Keytruda, it's a no-brainer to go that way.

@quiltlady56 I was diagnosed in 2020 had radical nephrectomy told stage 1 6.8cm tumor. Then I have been very sick this last year and was diagnosed stage 4 metastatic ccRCC with two tumors in my liver and one in remaining kidney with stage 4 CKD. That was in March. I just had liver surgery last month to take out the two tumors. Pathology report he did not get all the cancer and they won’t touch the one in my liver afraid I would have to go on dialysis. I still am not on the Keytruda and input they say they are going to start me on. I am now 66. I vomit severely often and have lost 55 pounds in 8 months because I just can eat. I don’t know why they haven’t started the meds yet and nothing in the surgery went as planned. Not sure where to turn at this point.
Praying and wishing good luck to everyone.