A Systematic Review of Research Gaps in the Evaluation and Management of Localized Renal Masses - 19/04/17

Doi : 10.1016/j.urology.2016.08.013

Hiten D. Patel ^a,^* , Emmanuel Iyoha ^b, Phillip M. Pierorazio ^a, Stephen M. Sozio ^c,^d, Michael H. Johnson ^a, Ritu Sharma ^b, Eric B. Bass ^b, Mohamad E. Allaf ^a
^a James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD
^b Johns Hopkins Evidence-Based Practice Center, Johns Hopkins School of Public Health, Baltimore, MD
^c Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD
^d Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD

^*Address correspondence to: Hiten D. Patel, M.D., M.P.H., 600 N. Wolfe Street, Park Building, Room 223, Baltimore, MD 21287.600 N. Wolfe Street, Park Building, Room 223BaltimoreMD21287

Abstract

The management of clinically localized renal masses suspicious for renal cell carcinoma varies, partially because of gaps in the evidence base. We conducted a systematic review to summarize research gaps for the evaluation of composite models for predicting malignancy; use of percutaneous renal sampling for diagnosis; and comparative effectiveness of surgery, thermal ablation, and active surveillance. A total of 147 studies, published in 150 articles, were identified. To promote improved patient care and health outcomes, we recommend incorporation of emerging biomarkers into validated composite models, standardization of biopsy protocols, standard reporting of clinical stage, and performance of prospective studies with objective selection criteria.

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Plan

Methods

Search Strategy

Study Selection

Data Abstraction and Management

Research Gaps Identification

Results

KQ1: Efficacy of Composite Models in the Diagnosis of a Renal Mass Suspicious for Renal Cell Carcinoma

KQ2: Accuracy and Efficacy of Renal Mass Biopsy in the Diagnosis of a Renal Mass Suspicious for Localized RCC

KQ3a: Efficacy and Comparative Effectiveness of Different Interventions for the Management of a Renal Mass Suspicious for Localized RCC

KQ3b: Comparative Benefits and Harms of Management Strategies Based on Patient Demographics, Clinical Characteristics, or Disease Severity

Discussion

KQ1: Efficacy of Composite Models in the Diagnosis of a Renal Mass Suspicious for RCC

KQ2: Accuracy and Efficacy of Renal Mass Biopsy in the Diagnosis of a Renal Mass Suspicious for Localized RCC

KQ3a: Efficacy and Comparative Effectiveness of Different Interventions for the Management of a Renal Mass Suspicious for Localized RCC

KQ3b: Comparative Benefits and Harms of Management Strategies Based on Patient Demographics, Clinical Characteristics, or Disease Severity

Conclusion

	Financial Disclosure: Emmanuel Iyoha, Ritu Sharma, and Eric B. Bass are members of Evidence-Based Practice center, which was funded to conduct the systematic review by Contract No. HHSA290201200007I from the Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services. The remaining authors declare that they have no relevant financial interests.
	The authors of this report are responsible for this work's content. Statements in the report should not be construed as endorsement by the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

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Vol 98

P. 14-20 - décembre 2016 Retour au numéro

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A Systematic Review of Research Gaps in the Evaluation and Management of Localized Renal Masses - 19/04/17

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