Renal Mass and Localized Renal Cancer: AUA Guideline

作者：Steven C. Campbell, Robert G. Uzzo, Mohamad E. Allaf, Eric B Bass, Jeffrey A. Cadeddu, Anthony Chang, Peter E. Clark, Brian J. Davis, Ithaar Derweesh, Leo Giambarresi, Debra A. Gervais, Susie L. Hu, Brian R. Lane, Bradley C. Leibovich, Philip M. Pierorazio · 发表于：The Journal of Urology · 年份：2017 · DOI：10.1016/j.juro.2017.04.100 · 被引用次数：1257 · 研究领域：Renal cell carcinoma treatment、Renal and related cancers、Genetic and Kidney Cyst Diseases

PURPOSE: This AUA Guideline focuses on evaluation/counseling and management of adult patients with clinically localized renal masses suspicious for cancer, including solid-enhancing tumors and Bosniak 3/4 complex-cystic lesions. MATERIALS AND METHODS: Systematic review utilized research from the Agency for Healthcare Research and Quality and additional supplementation by the authors and consultant methodologists. Evidence-based statements were based on body of evidence strength Grade A/B/C (Strong/Moderate/Conditional Recommendations, respectively) with additional statements presented as Clinical Principles or Expert Opinions. RESULTS: Great progress has been made since the previous guidelines on management of localized renal masses were released (2009). The current guidelines provide updated, evidence-based recommendations regarding evaluation/counseling of patients with clinically localized renal masses, including the evolving role of renal mass biopsy. Given great variability of clinical, oncologic and functional characteristics, index patients are not utilized and the panel advocates individualized counseling/management. Management options (partial nephrectomy/radical nephrectomy/thermal ablation/active surveillance) are reviewed including recent data about comparative effectiveness and potential morbidities. Oncologic issues are prioritized while recognizing that functional outcomes are of great importance for survivorship for most patients with localized kidney cancer. ...