Quality statement 6: Uro–oncology multidisciplinary team
Quality statement
Adults with advanced renal cell carcinoma (RCC) have their treatment options discussed by a uro–oncology multidisciplinary team.
Rationale
Improving uptake of systemic anticancer therapy (SACT) is a priority for the care of adults with advanced RCC. Management options for advanced RCC can be very complex because they are based on many factors including the person's performance status, number and location of any metastases, baseline risk group, general health and comorbidities. It is important that treatment opportunities are not delayed or missed, and that treatment risks are well managed through discussion by a uro–oncology multidisciplinary team.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Process
Proportion of adults with advanced RCC who have their treatment options discussed by a uro–oncology multidisciplinary team.
Numerator – the number in the denominator who have their treatment options discussed by a uro–oncology multidisciplinary team.
Denominator – the number of adults with advanced RCC.
Data source: The National Kidney Cancer Audit - National Cancer Audit Collaborating Centre's State of the Nation Report performance indicator dashboard presents data on the percentage of people with a new diagnosis of kidney cancer who had a record of being discussed at a multidisciplinary team meeting.
Outcome
Proportion of adults with advanced RCC who have initial SACT treatment within 12 months of diagnosis.
Numerator – the number in the denominator who have initial SACT treatment within 12 months of diagnosis.
Denominator – the number of adults with advanced RCC.
Data source: National Kidney Cancer Audit - National Cancer Audit Collaborating Centre's State of the Nation Report performance indicator dashboard presents data on the proportion of people with metastatic RCC who receive initial SACT within 12 months of diagnosis. It is not expected that achievement will be 100%. This is because SACT is not suitable for all adults with advanced RCC. Commissioners and services may wish to focus on local uptake of SACT compared with the national average.
What the quality statement means for different audiences
Service providers (such as secondary and tertiary care services) ensure that management pathways and policies are in place for adults with advanced RCC to have their treatment options discussed by a uro–oncology multidisciplinary team.
Healthcare professionals (such as doctors, nurses and specialists) are aware of local protocols for adults with advanced RCC to have their treatment options discussed by a uro–oncology multidisciplinary team.
Commissioners ensure that services that have a uro–oncology multidisciplinary team that discusses treatment options for adults with advanced RCC.
Adults with advanced RCC have their treatment discussed by a team of healthcare professionals who specialise in different areas of treatment. The team make an assessment and discuss all possible treatment options to ensure the person has the treatment and care that will work best for them.
Source guidance
Kidney cancer: diagnosis and management. NICE guideline NG256 (2026), recommendation 1.12.1
Definitions of terms used in this quality statement
Advanced RCC
RCC that is locally advanced and inoperable, or metastatic. Locally advanced RCC has grown into the surrounding tissue or blood vessels. It may have spread to nearby lymph nodes but has not spread to distant parts of the body. Metastatic RCC has spread from the kidney to other parts of the body, such as the lungs, lymph nodes or bones. This is also called stage 4 cancer. [NICE's guideline on kidney cancer, terms used in this guideline]
Uro–oncology multidisciplinary team
A group of healthcare professionals with expertise in managing kidney cancer (for example, a radiologist, pathologist, oncologist and urologist with speciality in kidney cancer surgery). They review clinical information and discuss treatment options, including any potential integration of pharmacological and non-pharmacological treatments, tailored to the person's individual needs. This could include identifying relevant research, including clinical trials, for discussion with the person. [NICE's guideline on kidney cancer, terms used in this guideline, recommendations 1.1.8 and 1.12.1, and the rationale and impact section for recommendations on referring adults with advanced RCC]
Equality and diversity considerations
All adults with advanced RCC should have access to SACT, regardless of their age, disability or where they live. Adults should be made aware that they may be eligible for the NHS healthcare travel costs scheme.