This is Episode 24: Renal Cell Carcinoma Localized Disease, Surgery, Ablation, and Primary SBRT. Here is the modern frame. Localized RCC is still primarily a surgical disease. Conventional fractionation never established a curative or adjuvant role in this setting. But stereotactic ablative body radiotherapy has changed the conversation for selected patients who are medically inoperable, technically high risk for surgery, or who decline surgery.