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

Updated: Feb 19, 2021
  • Author: Kush Sachdeva, MD; Chief Editor: E Jason Abel, MD  more...
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The ESMO 2019 updated clinical practice guidelines include the following recommendations for the diagnosis and staging of RCC. [75]

Diagnosis is usually suggested by ultrasound and further investigated by CT scan. If RCC is suspected, the following laboratory examinations should be performed:

  • Serum creatinine
  • Hemoglobin
  • Leukocyte and platelet counts
  • Lymphocyte-to-neutrophil ratio
  • Lactate dehydrogenase
  • C-reactive protein (CRP)
  • Serum-corrected calcium

Contrast-enhanced chest, abdominal, and pelvic CT is mandatory for accurate RCC staging. Bone scan or brain CT (or magnetic resonance imaging) is not recommended for routine clinical practice unless indicated by clinical or laboratory signs or symptoms.

Renal tumor core biopsy has high sensitivity and specificity for histopathologic confirmation of malignancy. It is especially recommended before ablative therapy and in patients with metastatic disease before systemic treatment is started.

The Union for International Cancer Control tumor, node, and metastasis staging system should be used for staging and risk assessment.

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