The 2021 EAU Guidelines on Renal Cell Carcinoma: What’s going on?

By Umberto Capitanio and Börje Ljungberg, on behalf of the EAU RCC Guidelines Panel

Unfortunately, 2020 was a difficult year due to COVID-19 pandemic, which affected people all around the world. Urological patients, too, suffered and died due to the infection. Worldwide, health care professionals and providers have been working hard to solve this international crisis.

Nonetheless, scientific societies have tried to proceed with their aims to provide and share new research data and findings to improve patient care. In order to update the EAU Guidelines on Renal Cell Carcinoma (RCC), Guideline Panel members worked remotely during the past 7 months to be able to revise and deliver the recommendations for this new year. Novel and relevant evidences have been identified, collated and appraised through a structured assessment of the literature. A broad and comprehensive scoping search was performed, limited to studies representing a high certainty of evidence. Databases covered included Medline, EMBASE and the Cochrane Libraries. After deduplication, a total of 1,973 innovative papers were identified, obtained and screened for relevance. For each recommendation within the guidelines, a modified GRADE rating form was included as well. Specific chapters were updated by way of systematic reviews, commissioned and undertaken by the EAU RCC Guidelines Panel based on prioritised topics or questions.

These reviews were performed using the standard Cochrane systematic review methodology. The chapters most extensively modified as compared to the 2020 EAU Guidelines on Renal Cell Carcinoma are:

• Diagnostic evaluation (Chapter 5), including new recommendations regarding imaging tests
• Prognosis (Chapter 6), which now incorporates externally validated prognostic and predictive risk-classification tools for organ-confined, locally advanced and metastatic RCC patients
• Treatment (Chapter 7), embracing novel data on cancer control with minimally invasive procedures and dual checkpoint inhibition therapies
• Follow-up (Chapter 8), incorporating data from the RECUR consortium

Finally, research priorities and clinical gaps were set to monitor for the future. During the next months, the Guidelines will be peer-reviewed prior to final publication in early 2021.

Hoping to meet you in person again in 2021, the EAU RCC Guidelines Panel wishes all of you a safe and happy end of the year and a quick return to normality.

EAU RCC Guidelines Panel members: B. Ljungberg (Chair), A. Bex (Vice-chair), L. Albiges, J. Bedke, U. Capitanio, M. Hora, T. Klatte, T. Lam, L. Marconi, T. Powles, A. Volpe

EAU Guidelines on Renal Cell Carcinoma Associates: Y. Abu-Ghanem, S. Dabestani, S. Fernández-Pello Montes, F. Hofmann, T. Kuusk, R. Tahbaz

Patient Advocate: R.H. Giles

Related article:

• Updated European Association of Urology guidelines on renal cell carcinoma: Nivolumab plus cabozantinib joins immune checkpoint inhibition combination therapies for treatment-naïve metastatic clear-cell renal cell carcinoma
• Jens Bedke et al.