Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden.
Department of Urology, University of Rennes, Rennes, France.
Eur Urol. 2015 May;67(5):913-24. doi: 10.1016/j.eururo.2015.01.005. Epub 2015 Jan 21.
The European Association of Urology Guideline Panel for Renal Cell Carcinoma (RCC) has prepared evidence-based guidelines and recommendations for RCC management.
To provide an update of the 2010 RCC guideline based on a standardised methodology that is robust, transparent, reproducible, and reliable.
For the 2014 update, the panel prioritised the following topics: percutaneous biopsy of renal masses, treatment of localised RCC (including surgical and nonsurgical management), lymph node dissection, management of venous thrombus, systemic therapy, and local treatment of metastases, for which evidence synthesis was undertaken based on systematic reviews adhering to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Relevant databases (Medline, Cochrane Library, trial registries, conference proceedings) were searched (January 2000 to November 2013) including randomised controlled trials (RCTs) and retrospective or controlled studies with a comparator arm. Risk of bias (RoB) assessment and qualitative and quantitative synthesis of the evidence were performed. The remaining sections of the document were updated following a structured literature assessment.
All chapters of the RCC guideline were updated. For the various systematic reviews, the search identified a total of 10,862 articles. A total of 151 studies reporting on 78,792 patients were eligible for inclusion; where applicable, data from RCTs were included and meta-analyses were performed. For RCTs, there was low RoB across studies; however, clinical and methodological heterogeneity prevented data pooling for most studies. The majority of studies included were retrospective with matched or unmatched cohorts based on single or multi-institutional data or national registries. The exception was for systemic treatment of metastatic RCC, in which several RCTs have been performed, resulting in recommendations based on higher levels of evidence.
The 2014 guideline has been updated by a multidisciplinary panel using the highest methodological standards, and provides the best and most reliable contemporary evidence base for RCC management.
The European Association of Urology Guideline Panel for Renal Cell Carcinoma has thoroughly evaluated available research data on kidney cancer to establish international standards for the care of kidney cancer patients.
欧洲泌尿外科学会（EAU）肾癌指南小组为肾癌（RCC）的管理制定了基于循证的指南和建议。
基于稳健、透明、可重现和可靠的标准化方法，对 2010 年 RCC 指南进行更新。
对于 2014 年的更新，小组确定了以下优先事项：肾肿块的经皮活检、局限性 RCC 的治疗（包括手术和非手术管理）、淋巴结清扫术、静脉血栓形成的处理、系统治疗以及转移灶的局部治疗，对于这些主题，基于符合系统评价和荟萃分析（PRISMA）指南的系统评价，进行了证据综合。检索了相关数据库（Medline、Cochrane 图书馆、试验注册处、会议录）（2000 年 1 月至 2013 年 11 月），包括随机对照试验（RCT）和具有对照臂的回顾性或对照研究。对风险偏倚（RoB）进行评估，并对证据进行定性和定量综合。根据结构化文献评估，对文件的其余部分进行了更新。
RCC 指南的所有章节均已更新。对于各种系统评价，共检索到 10862 篇文章。共有 151 项研究报告了 78792 例患者，符合纳入标准；在适用的情况下，纳入了 RCT 的数据并进行了荟萃分析。对于 RCT，研究之间的 RoB 较低；然而，由于大多数研究存在临床和方法学异质性，因此无法进行数据汇总。大多数研究为回顾性研究，基于单中心或多中心数据或国家登记处，使用匹配或不匹配的队列。转移性 RCC 的系统治疗是个例外，因为已经进行了几项 RCT，从而根据更高水平的证据提出了建议。
多学科小组使用最高的方法学标准对 2014 年指南进行了更新，为 RCC 管理提供了最佳和最可靠的当代循证基础。
欧洲泌尿外科学会肾癌指南小组彻底评估了肾脏癌症的现有研究数据，为肾癌患者的护理制定了国际标准。
