What are the ESMO clinical practice guidelines for the diagnosis and staging of renal cell carcinoma (RCC)?

Updated: May 21, 2019
  • Author: Kush Sachdeva, MD; Chief Editor: E Jason Abel, MD  more...
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Answer

The ESMO 2016 updated clinical practice guidelines included the following recommendations for the diagnosis and staging of RCC [75] :

  • Diagnosis is usually suggested by ultrasound and further investigated by CT scan. Magnetic resonance imaging (MRI) may provide additional information in investigating local advancement and venous involvement by tumour thrombus.

  • Contrast-enhanced chest, abdominal, and pelvic CT is mandatory for staging; In case of an allergy to CT contrast medium,  a high-resolution CT scan of the chest without contrast medium, together with an abdominal MRI may be used.

  • Unless clinically indicated, the use of bone scan or CT (or MRI) of the brain is not recommended for routine clinical practice

  • Positron emission tomography is not a standard investigation in the diagnosis and staging of RCC

  • A diagnostic biopsy is required before treatment with ablative therapies; it is also indicated in patients with metastatic disease before initiating systemic treatment.

  • The final histopathologic diagnosis, classification, grading, and evaluation of prognostic factors should be based on the nephrectomy specimen when available


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