The multispeciality approach to the management of localised kidney cancer

Grant D Stewart; Tobias Klatte; Laura Cosmai; Axel Bex; Benjamin W Lamb; Holger Moch; Evis Sala; Shankar Siva; Camillo Porta; Maurizio Gallieni

doi:10.1016/S0140-6736(22)01059-5

The multispeciality approach to the management of localised kidney cancer

Lancet. 2022 Aug 13;400(10351):523-534. doi: 10.1016/S0140-6736(22)01059-5. Epub 2022 Jul 19.

Authors

Grant D Stewart¹, Tobias Klatte², Laura Cosmai³, Axel Bex⁴, Benjamin W Lamb⁵, Holger Moch⁶, Evis Sala⁷, Shankar Siva⁸, Camillo Porta⁹, Maurizio Gallieni¹⁰

Affiliations

¹ Department of Surgery, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK; CRUK Cambridge Centre, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK; Department of Urology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. Electronic address: gds35@cam.ac.uk.
² Department of Surgery, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK; Department of Urology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
³ Division of Nephrology and Dialysis, ASST Fatebenefratelli Sacco, Fatebenefratelli Hospital, Milan, Italy.
⁴ Specialist Centre for Kidney Cancer, Royal Free Hospital, London, UK; Division of Surgery and Interventional Science, University College London, London, UK; The Netherlands Cancer Institute, Amsterdam, Netherlands.
⁵ Department of Urology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; School of Allied Health, Anglia Ruskin University, Cambridge, UK.
⁶ Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland.
⁷ CRUK Cambridge Centre, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK; Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
⁸ Sir Peter MacCallum Department of Oncology, University of Melbourne, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
⁹ Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy; Division of Medical Oncology, AOU Consorziale Policlinico di Bari, Bari, Italy.
¹⁰ Division of Nephrology and Dialysis, ASST Fatebenefratelli Sacco, Fatebenefratelli Hospital, Milan, Italy; Department of Clinical and Biomedical Sciences, Università di Milano, Milan, Italy.

PMID: 35868329
DOI: 10.1016/S0140-6736(22)01059-5

Abstract

Historically, kidney cancer was approached in a siloed single-speciality way, with urological surgeons managing the localised stages of the disease and medical oncologists caring for patients if metastases developed. However, improvements in the management of localised kidney cancer have occurred rapidly over the past two decades with greater understanding of the disease biology, diagnostic options, and innovations in curative treatments. These developments are favourable for patients but provide a substantially more complex landscape for patients and clinicians to navigate, with associated challenging decisions about who to treat, how, and when. As such, the skill sets needed to manage the various aspects of the disease and guide patients appropriately outstrips the capabilities of one particular specialist, and the evolution of a multispeciality approach to the management of kidney cancer is now essential. In this Review, we summarise the current best multispeciality practice for the management of localised kidney cancer and the areas in need of further research and development.

Publication types

Review

MeSH terms

Humans
Kidney Neoplasms* / diagnosis
Kidney Neoplasms* / surgery