1. INTRODUCTION
1.1. Aims and scope
The European Association of Urology (EAU) Renal Cell Cancer (RCC) Guidelines Panel has compiled these clinical guidelines to provide urologists with evidence-based information and recommendations for the management of RCC.
It must be emphasised that clinical guidelines present the best evidence available to the experts, but following guideline recommendations will not necessarily result in the best outcome. Guidelines can never replace clinical expertise when making treatment decisions for individual patients, but rather help to focus decisions - also taking personal values and references/individual circumstances of patients into account. Guidelines are not mandates and do not purport to be a legal standard of care.
1.2. Panel composition
The EAU Guidelines Panel on RCC consists of an international multidisciplinary group of clinicians, including urological surgeons, oncologists, methodologists, a pathologist and a radiologist, with particular expertise in the field of renal cancer care. Since 2015, the Panel has incorporated two patient advocates to provide a consumer perspective for its guidelines. All experts involved in the production of this document have submitted potential conflict of interest statements, which can be viewed on the EAU website Uroweb: https://uroweb.org/guidelines/renal-cell-carcinoma.
1.3. Available publications
A quick reference document (Pocket Guidelines) is available presenting the main findings of the RCC Guidelines. This is an abridged version which may require consultation together with the full text version. All documents can be accessed on the EAU website: https://uroweb.org/guidelines/renal-cell-carcinoma
1.4. Publication history and summary of changes
1.4.1. Publication history
The EAU RCC Guidelines were first published in 2000. This 2024 RCC Guidelines document presents a limited update of the 2023 publication.
1.4.2. Summary of changes
All chapters of the 2024 RCC Guidelines have been updated, based on the 2023 version of the Guidelines. References have been added throughout the document. Other key changes incorporated in this publication includes:
- A new section 5.2.3 on other investigations and emerging technologies;
- An update of Table 5.1: Bosniak classification of renal cysts;
- New summary of evidence (SOE) and recommendations for prognostic factors using the Leibovich and VENUSS scoring models;
- A new section 7.1.3.2.8 on off-clamp vs on clamp partial nephrectomy as well as accompanying new SOE and recommendations in section 7.1.3.4;
- A new update in section 7.1.4.3.6 on stereotactic ablative radiotherapy;
- New SOE and recommendations for neoadjuvant therapy in section 7.2.5.5;
- A new section 7.4.2.4 on small molecule inhibitors, as well as new accompanying SOE and recommendation is section 7.4.2.5;
- Updates on the SOE and recommendations in section 7.4.4.1.2;
- Updates to both figure 7.1 and figure 7.2;
- New SOE in section 7.4.4.2.2 as well as in both SOE and recommendation table 7.4.4.2.1;
- A new section 7.4.4.2 on other rare tumours;
- New SOE and recommendation in section 8.3;
- A new section 8.4 on patient involvement including a recommendation table.