For the 2026 RCC Guidelines, new and relevant evidence was identified, collated and appraised through a structured assessment of the literature for all sections of the Guidelines. Key changes 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.