PICOTS (population, interventions, comparators, outcomes, timing, and setting) for the Key Questions

Population(s)	Newly diagnosed adults (18 years or older) with solid renal masses (or cystic renal masses with a solid component) suspicious for stage I and II renal cell carcinoma, which corresponds to clinical stage T1 (less than 7 cm and organ confined) or T2 (greater than 7 cm and organ confined) renal masses
Interventions	Radical nephrectomy (open and minimally invasive) Partial nephrectomy (open and minimally invasive) Thermal ablation (e.g., radiofrequency ablation, cryoablation; surgical versus image-guided) Active surveillance Minimally invasive surgery may refer to standard laparoscopy or robot-assisted laparoscopy No microwave ablation
Comparators	Comparisons include all of the management options listed above
Outcomes	Final health outcomes Oncologic efficacy: Local recurrence-free survival, Metastasis-free survival, Cancer-specific survival Renal functional outcomes: Glomerular filtration rate decline, Incidence of chronic kidney disease, Incidence of end-stage renal disease Overall survival Quality of life Adverse effects of management strategies Urologic complications: Acute kidney Injury, Hemorrhage, Urine leak, Hematuria, Loss of kidney, Ureteral injury (any injury of collecting system and ureter), Urinary tract infection Non-urologic complications (by organ system): Hematologic (thromboembolic), Gastrointestinal, Cardiovascular, Respiratory, Neurologic, Wound complications (e.g. hernia and dehiscence), Infectious disease, Listed by severity of complications (using the Clavien Grading System if available): Minor versus major Minor (Clavien 1–2)*: conservative management or medications only Major (Clavien 3–4)**: requiring intervention, resulting in permanent disability or death Need for subsequent interventions: embolization, drain placement, stent placement, etc. Perioperative outcomes: Blood loss (cc or mL), Blood transfusion (yes or no), Conversion to open surgery (%), Conversion to radical nephrectomy (%), Length of stay (days)
Type of study	Controlled studies (randomized controlled trials, non-randomized controlled trials, and comparative cohort studies): All comparisons between interventions Uncontrolled studies (single cohort studies): Data from uncontrolled studies that addressed active surveillance are described in the report. Every other uncontrolled study that addressed Key Question 3 is listed in the appendix with the following data: Author, publication year, Study design, Intervention name, Number of patients, Followup, List of outcomes
Timing and Setting	Any time point and setting

Clavien-Dindo system currently used for reporting of complications related to urologic surgical interventions (http://www.surgicalcomplication.info/index-2.html).