Renal cancer in adults
Authors: Benahmed Nadia , Robays Jo , Stordeur Sabine , Gil Thierry , Joniau Steven , Lumen Nicolaas , Renard Laurette , Rorive Sandrine , Schrijvers Dirk , Tombal Bertrand , Van den Eynden Bart , Villeirs Geert , Rottey Sylvie 
Published: January 2025

COMPOSITION OF THE GUIDELINE DEVELOPMENT GROUP 10 -- 1.1. COMPOSITION OF THE GUIDELINE DEVELOPMENT GROUP 10 -- 1.2. COMPOSITION OF THE KCE EXPERT TEAM 10 -- 2. SEARCH STRATEGIES 11 -- 2.1. SEARCH STRATEGY FOR GUIDELINES 11 -- 2.2. SEARCH STRATEGIES FOR OTHER PUBLICATIONS (SYSTEMATIC REVIEWS, METAANALYSES, INDIVIDUAL RCT) 14 -- 2.2.1. Diagnosis, prognosis, prediction of treatment effectiveness and follow-up 14 -- 2.2.2. Treatment of localized, metastatic or advanced renal cancer and palliative treatment 29 -- 2.2.3. Long-term outcomes of partial nephrectomy in comparison with radical nephrectomy 34 -- 3. QUALITY APPRAISAL 40 -- 3.1. QUALITY APPRAISAL TOOL FOR GUIDELINES 40 -- 3.2. GUIDELINES SELECTION AND QUALITY APPRAISAL 41 -- 3.3. QUALITY APPRAISAL TOOL FOR SYSTEMATIC REVIEWS 42 -- 3.4. QUALITY APPRAISAL FOR DIAGNOSTIC STUDIES (QUADAS 2 TOOL) 43 -- 3.5. STUDY SELECTION AND QUALITY APPRAISAL 44 -- 3.5.1. Diagnosis and follow-up 44 -- 3.5.2. Treatments 52 -- 3.5.3. Evaluation of long term outcomes of partial nephrectomy in comparison with radical nephrectomy 56 -- 4. EVIDENCE TABLES 59 -- 4.1. GUIDELINES 59 -- 4.1.1. Diagnosis and follow up 62 -- 4.1.2. Treatment 66 -- 4.2. ADDITIONAL EVIDENCE FOR TREATMENT 85 -- 4.2.1. Treatment of localized renal cancer 85 -- 4.2.2. Adjuvant therapy 95 -- 4.2.3. Treatment of local recurrence/ metastases 109 -- 4.2.4. What is the long term induced morbidity by type of surgery? 130 -- 5. GRADE PROFILES 139 -- 5.1. TREATMENT 139 -- 5.1.1. Primary treatment 139 -- 5.1.2. Adjuvant treatment 146 -- 5.1.3. Treatment of local recurrence/metastasis 147 -- 6. FOREST PLOTS 162 -- 6.1. TREATMENT 162 -- 6.1.1. Combination of immuno(chemo)therapy vs control in metastatic renal cancer 162 -- 6.1.2. Bevacizumab + IFN versus IFN 164 -- 7. ADDITIONAL EVIDENCE 165 -- 7.1. CHEMOTHERAPY IN METASTATIC RENAL CANCER 165 -- 7.1.1. Chemotherapy 165 -- 7.1.2. Chemotherapy as enhancement agents for cytokine therapies 165 -- 7.1.3. Chemotherapy combined with cytokine agents versus other controls 165 -- 7.2. IMMUNOTHERAPY IN METASTATIC RENAL CANCER 165 -- 7.2.1. Interferon- &#945; (IFN- &#945;) 165 -- 7.2.2. Interleukine-2 (IL-2) 166 -- 7.2.3. Interferon- &#947; 166 -- 7.2.4. Combination of immunotherapy or immuno-chemotherapy 166 -- 7.2.5. Adoptive cellular immunotherapy 167 -- 7.3. ADVERSE EVENTS OF TARGETED THERAPY 167 -- 7.3.1. First-line treatment 168 -- 7.3.2. Second-line treatment 190 -- 7.3.3. Third-line treatment 203 -- 7.3.4. Discontinuation rate due to adverse events 207 -- 8. EXTERNAL REVIEW 208 -- 8.1. EVALUATION OF THE RECOMMENDATIONS BY THE GUIDELINE DEVELOPMENT GROUP 208 8.1.1. GDG meeting 1 208 -- 8.1.2. GDG meeting 2 210 -- 8.1.3. GDG meeting 3 213 -- 8.2. EVALUATION OF THE RECOMMENDATIONS BY THE STAKEHOLDERS 216 -- 9. TNM CLASSIFICATION 222 -- 9.1. CTNM CLINICAL CLASSIFICATION 222 -- 9.2. PTNM PATHOLOGICAL CLASSIFICATION 223 -- 9.3. STAGE GROUPING 223 -- 10. REIMBURSEMENT RULE BY HEALTH INSURANCE FOR SYSTEMIC TREATMENT 224 -- 10.1. BEVACIZUMAB + IFN- &#913; 224 -- 10.2. AXITINIB 226