Objective. To increase the effectiveness of drug treatment via systemic therapy (ST) in combination with incomplete cytoreductive interventions – incomplete metastasectomy (iME). Materials and methods. Three centers took part in the study. All 147 patients with mRCC received anticancer drug therapy. Part of them (n = 47) underwent surgery (iME) before or together with anticancer treatment, where iME meant complete metastasis excision within one organ with residual tissue in other organs (research group). Control group (n = 100) included patients who received only systemic antitumor treatment. Primary control point was overall survival (OS), secondary – time to progression. Results. Median OS in combined treatment group was 32 months, while in control group – 29 months (p = 0.21). When analyzing surgical stage in combined treatment, OS was statistically more significant in patients with iME before ST (n = 20) than in patients with two parallel treatment schemes: 46 and 31 months, respectively (p = 0.007). When analyzing metastases localization, it was found that iME is effective for metastases to distant lymph nodes and adrenal gland. Adrenalectomy (p = 0.03) and lymphadenectomy (p = 0.04) showed higher results than ST: 17 and 15 months versus 6 month, respectively. IME in patients with poor prognosis did not reveal any advantages: median OS reached 7 months, which was significantly inferior to the favorable prognosis group, where median OS was 25 months (p = 0.03). Conclusion. IME can be used as a part of combined treatment in mRCC patients. It should be considered as the first treatment stage with subsequent ST.