患者男，65岁。无痛性肉眼血尿，肾脏彩超示:左肾实质性占位，腹部CT示:左肾近皮质缘有一2cm*3cm大小低密度灶，强化不明显，向肾外突出，腹主动脉旁见一个软组织密度结节影。该患者下一步的首选治疗策略是

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