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 into account personal values and preferences/individual circumstances of patients. 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 included patient advocates to provide a patient-centred 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:
http://uroweb.org/guideline/renalcellcarcinoma/.
1.3. Available publications
A quick reference document, the Pocket Guidelines, is available in print. This is an abridged version which may require consultation together with the full text version. Several scientific publications are available, and all documents are accessible through the EAU website Uroweb: http://uroweb.org/guideline/renal-cell-carcinoma/. An EAU Guidelines-based chatbot is available on the EAU website, offering Guideline-derived information that should not replace clinical expertise or individual judgement.
An EAU Guidelines app for iOS and Android devices is also available containing the Pocket Guidelines, interactive algorithms and calculators, clinical decision support tools, Guidelines cheat sheets and links to the extended guidelines.
1.4. Publication history and summary of changes
1.4.1. Publication history
The EAU RCC Guidelines were first published in 2000. This 2026 RCC Guidelines document presents a limited update of the 2025 publication.
1.4.2. Summary of changes
All chapters of the 2026 RCC Guidelines have been updated, based on the 2025 version of the Guidelines. References have been added throughout the document. Other key changes incorporated in this publication include:
- Update throughout Chapter 3, ‘Epidemiology, aetiology and pathology,’ as well as in Table 3.2.
- Update throughout Chapter 4 on anatomic classification systems.
- New subchapter on frailty and comprehensive geriatric assessment in Chapter 6, as well as a new flowchart and updated Section 6.4.2 on nephrological assessment.
- New summary of evidence (SoE) and recommendations in Section 6.7.
- Update in Section 7.1 regarding patient involvement in kidney cancer provided by the panel patient representatives.
- Inclusion of new text throughout Section 7.2.3.a on radical nephrectomy and Section 7.2.3.b on partial nephrectomy techniques, as well as inclusion of new SOE and recommendations in Section 7.2.3.d.
- New Figure 7.2.4.d.7.a on alternatives to surgery, as well as new recommendations in Figure 7.2.4.d.8 on the therapeutic approaches as alternative to surgery.
- Updated text on the therapy of oligometastatic disease in Section 7.4.2.
- Update of the text, SoE and recommendations in Chapter 9, ‘Follow-up in RCC.