European Association of Urology Guidelines on Renal Cell Carcinoma: The 2019 Update

Research output: Contribution to journalArticle


Context: The European Association of Urology Renal Cell Carcinoma (RCC) Guideline Panel has prepared evidence-based guidelines and recommendations for the management of RCC. Objective: To provide an updated RCC guideline based on standardised methodology including systematic reviews, which is robust, transparent, reproducible, and reliable. Evidence acquisition: For the 2019 update, evidence synthesis was undertaken based on a comprehensive and structured literature assessment for new and relevant data. Where necessary, formal systematic reviews adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were undertaken. Relevant databases (Medline, Cochrane Libraries, trial registries, conference proceedings) were searched until June 2018, including randomised controlled trials (RCTs) and retrospective or controlled studies with a comparator arm, systematic reviews, and meta-analyses. Where relevant, risk of bias (RoB) assessment, and qualitative and quantitative syntheses of the evidence were performed. The remaining sections of the document were updated following a structured literature assessment. Clinical practice recommendations were developed and issued based on the modified GRADE framework. Evidence synthesis: All chapters of the RCC guidelines were updated based on a structured literature assessment, for prioritised topics based on the availability of robust data. For RCTs, RoB was low across studies. For most non-RCTs, clinical and methodological heterogeneity prevented pooling of data. The majority of included studies were retrospective with matched or unmatched cohorts, based on single- or multi-institutional data or national registries. The exception was for the treatment of metastatic RCC, for which there were several large RCTs, resulting in recommendations based on higher levels of evidence. Conclusions: The 2019 RCC guidelines have been updated by the multidisciplinary panel using the highest methodological standards. These guidelines provide the most reliable contemporary evidence base for the management of RCC in 2019. Patient summary: The European Association of Urology Renal Cell Carcinoma Guideline Panel has thoroughly evaluated the available research data on kidney cancer to establish international standards for the care of kidney cancer patients.


  • Börje Ljungberg
  • Laurance Albiges
  • Yasmin Abu-Ghanem
  • Karim Bensalah
  • Saeed Dabestani
  • Sergio Fernández Pello Montes
  • Rachel H. Giles
  • Fabian Hofmann
  • Milan Hora
  • Markus A. Kuczyk
  • Teele Kuusk
  • Thomas B. Lam
  • Lorenzo Marconi
  • Axel S. Merseburger
  • Thomas Powles
  • Michael Staehler
  • Rana Tahbaz
  • Alessandro Volpe
  • Axel Bex
External organisations
  • Umeå University
  • University of Paris-Saclay
  • Sheba Medical Center
  • University Medical Center Utrecht
  • Sunderby Hospital
  • Charles University in Prague
  • Hannover Medical School
  • University of Aberdeen
  • University Hospital of Coimbra
  • University Medical Center Schleswig-Holstein Campus Lubeck
  • Queen Mary University
  • University Medical Center Hamburg-Eppendorf
  • University of Eastern Piedmont
  • Antoni Van Leeuwenhoek Hospital
  • University of Rennes I
  • Skåne University Hospital
  • University Hospital Cabueñes
  • Royal Free Hospital
  • Aberdeen Royal Infirmary
  • Barts Health NHS Trust
  • Ludwig-Maximilian University of Munich
  • University Hospital of Novara
  • Royal Free London NHS Foundation Trust
  • University College London
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Urology and Nephrology
  • Cancer and Oncology


  • Diagnosis, European Association of Urology, Follow-up, Guidelines, Management, Medical, Renal cell cancer, Surgery
Original languageEnglish
Pages (from-to)799-810
Number of pages12
JournalEuropean Urology
Issue number5
Early online date2019 Feb 23
Publication statusPublished - 2019 May
Publication categoryResearch