Table 1.
Consensus topic statements and results as voted at the CKCF Meeting on February 10, 2024
| Statement | Consensus |
|---|---|
| 1. nccRCC tumors should be classified according to the WHO Classification of Tumors, 5th Edition. | Achieved: 100% |
| 2. Patients diagnosed with nccRCC following renal mass biopsy should receive similar preoperative investigations and staging as those with ccRCC. | Achieved: 97% |
| 3. For patients diagnosed with a ≤2 cm in diameter localized papillary or chromophobe RCC following renal mass biopsy, active surveillance is considered the preferred management option. | Achieved: 94% |
| 4. For patients diagnosed with a 2–4 cm in diameter localized papillary or chromophobe RCC following renal mass biopsy, active surveillance or definitive treatment are considered the preferred management options. | Achieved: 97% |
| 5. For patients diagnosed with >4 cm in diameter localized papillary or chromophobe RCC following renal mass biopsy, surgery (radical or partial nephrectomy, when feasible) is considered the preferred management option. | Achieved: 97% |
| 6. In patients receiving definitive therapy for localized papillary or chromophobe RCC, postoperative surveillance should be similar to ccRCC. | Achieved: 94% |
| 7. Patients with resected nccRCC should not be offered adjuvant systemic therapy, unless as part of a clinical trial. | Achieved: 100% |
| 8. Most patients diagnosed with nccRCC should be offered germline genetic testing and/or counseling. | Achieved: 83% |
| 9. Patients diagnosed with metastatic papillary or chromophobe RCC should be counseled and managed according to the IMDC prognostic model. | Achieved: 100% |
| 10. Patients diagnosed with metastatic nccRCC should be offered the opportunity to participate in a clinical trial when available. | Achieved: 100% |
| 11. In select patients with de novo metastatic papillary or chromophobe RCC, upfront cytoreductive nephrectomy may be considered after multidisciplinary discussion. | Achieved: 100% |
| 12. Patients with de novo metastatic papillary or chromophobe RCC may be considered for deferred cytoreductive nephrectomy depending on the response to initial systemic therapy and after multidisciplinary discussion. | Achieved: 100% |
| 13. For patients with oligometastatic papillary or chromophobe RCC, MDT may be considered. | Achieved: 100% |
| 14. In patients with metastatic papillary or chromophobe RCC with favorable/intermediaterisk disease and low volume/asymptomatic or minimally symptomatic disease, active surveillance may be considered. | Achieved: 100% |
| 15. Patients with metastatic papillary RCC who are not eligible for clinical trials and require systemic therapy should be offered ICI-based combination therapy or monotherapy with cabozantinib. | Achieved: 100% |
| 16. In patients with metastatic chromophobe RCC who require systemic therapy, there is currently no standard of care, and these patients should be offered clinical trial enrollment when available. | Achieved: 100% |
| 17. Patients with metastatic nccRCC (excluding SMARCB1-deficient renal medullary carcinoma and collecting duct RCC) with sarcomatoid or rhabdoid dedifferentiation should be offered combination ICI-based therapy. | Achieved: 100% |
ICI: immune checkpoint inhibitor; IMDC: International Metastatic RCC Database Consortium; MDT: metastasis-directed therapy; nccRCC: non-clear cell renal cell carcinoma; WHO: World Health Organization.