Recommendations for research
The guideline committee has made the following recommendations for research.
Key recommendations for research
1 Combinations and sequences of diagnostic approaches to differentiate between benign and malignant renal lesions
What are the most accurate and cost-effective combinations and sequences of diagnostic approaches (imaging and biopsy) for differentiating between benign and malignant renal lesions in people with suspected renal cell carcinoma (RCC)?
For a short explanation of why the committee made this recommendation for research, see the rationale section on imaging.
Full details of the evidence and the committee's discussion are in evidence review I1: CT and MRI for diagnosing renal lesions in adults with suspected renal cell carcinoma and evidence review I2: additional imaging tests for differentiating types of renal lesions.
2 Risk prediction tools for people with localised RCC undergoing active surveillance
Which risk prediction tools, biomarkers or factors can most accurately predict the risk of progression, metastasis, or both of localised RCC in people who are undergoing active surveillance across a broad population with different characteristics (for example, ethnicity and sex), including all subtypes of RCC?
For a short explanation of why the committee made this recommendation for research, see the rationale section on risk prediction tools for localised and locally advanced RCC.
Full details of the evidence and the committee's discussion are in evidence review K: risk prediction tools for localised and locally advanced renal cell carcinoma.
3 Stereotactic ablative radiotherapy for treating localised RCC
What is the clinical and cost effectiveness of stereotactic ablative radiotherapy (SABR), compared with surgical interventions, thermal ablation and active surveillance, for localised RCC?
For a short explanation of why the committee made this recommendation for research, see the rationale section on surgery, thermal ablation, active surveillance or SABR.
Full details of the evidence and the committee's discussion are in evidence review B: management of localised renal cell carcinoma using non-surgical interventions or active surveillance.
4 Active surveillance approaches for early detection of disease progression
For people with small renal lesions (whether benign, malignant or unknown) that have not been treated, what are the most clinically and cost-effective approaches to active surveillance (including method, duration, appropriate frequency of imaging and when to discharge), for the early detection of disease progression in people with localised RCC?
For a short explanation of why the committee made this recommendation for research, see the rationale section on active surveillance information, imaging types and scheduling.
Full details of the evidence and the committee's discussion are in evidence review E: monitoring of untreated renal lesions using active surveillance.
5 Follow-up strategies for localised and locally advanced RCC
For people who have had treatment for localised or locally advanced RCC, what are the most clinically and cost-effective risk of recurrence stratified follow-up strategies (based on method, duration and frequency)?
For a short explanation of why the committee made this recommendation for research, see the rationale section on follow-up for localised and locally advanced RCC.
Full details of the evidence and the committee's discussion are in evidence review F: follow-up of previously treated renal cell carcinoma.
Other recommendations for research
6 Risk prediction tools for people with localised RCC having thermal ablation or SABR
Which risk prediction tools, biomarkers or clinical factors can most accurately predict the risk of recurrence in people with localised RCC who are having thermal ablation or SABR, and have not had surgery?
For a short explanation of why the committee made this recommendation for research, see the rationale section on risk prediction tools for localised and locally advanced RCC.
Full details of the evidence and the committee's discussion are in evidence review K: risk prediction tools for localised and locally advanced renal cell carcinoma.
7 Risk prediction tools for people with localised or locally advanced chromophobe RCC
Which risk prediction tools, biomarkers or clinical factors can most accurately predict the risk of recurrence in people with localised or locally advanced chromophobe RCC across a broad population with different characteristics (for example, ethnicity and sex)?
For a short explanation of why the committee made this recommendation for research, see the rationale section on risk prediction tools for localised and locally advanced RCC.
Full details of the evidence and the committee's discussion are in evidence review K: risk prediction tools for localised and locally advanced renal cell carcinoma.
8 Risk prediction tools for metastatic RCC
Which risk prediction tools, biomarkers or clinical factors can most accurately predict survival, risk of disease progression, or response to treatment across a broad population with different characteristics (for example, ethnicity and sex) who have metastatic RCC?
For a short explanation of why the committee made this recommendation for research, see the rationale section on risk prediction tools for metastatic RCC.
Full details of the evidence and the committee's discussion are in evidence review L: risk prediction tools for metastatic renal cell carcinoma.
9 Metastasectomy for metastatic RCC
What is the clinical and cost effectiveness of metastasectomy before systemic anticancer therapy (SACT) or after SACT has been started compared with SACT alone for people with metastatic RCC who have had their primary mass removed?
For a short explanation of why the committee made this recommendation for research, see the rationale section on non-pharmacological management of metastatic RCC.
Full details of the evidence and the committee's discussion are in evidence review H: management of advanced renal cell carcinoma using non-pharmacological interventions.
10 Thermal ablation after SACT has been started for managing metastatic RCC
What is the clinical and cost effectiveness of thermal ablation after SACT has been started compared with SACT alone for treating metastases in people with metastatic RCC?
For a short explanation of why the committee made this recommendation for research, see the rationale section on non-pharmacological management of metastatic RCC.
Full details of the evidence and the committee's discussion are in evidence review H: management of advanced renal cell carcinoma using non-pharmacological interventions.
11 Different types of minimally invasive radical nephrectomy techniques compared to each other
What is the clinical effectiveness, cost effectiveness and impact on quality of life of different types of minimally invasive radical nephrectomy techniques compared to each other in people with locally advanced RCC?
For a short explanation of why the committee made this recommendation for research, see the rationale section on surgery for suspected or confirmed locally advanced RCC.
Full details of the evidence and the committee's discussion are in evidence review C: management of locally advanced renal cell carcinoma using nephrectomy or stereotactic ablative radiotherapy.
12 SABR for treating the primary mass in locally advanced inoperable RCC
What is the clinical and cost effectiveness of SABR for treating the primary mass after SACT has been started in people with locally advanced inoperable RCC?
For a short explanation of why the committee made this recommendation for research, see the rationale section on non-pharmacological management of metastatic RCC.
Full details of the evidence and the committee's discussion are in evidence review H: management of advanced renal cell carcinoma using non-pharmacological interventions.