Building a Roadmap for Surveillance of Renal Masses Using a Modified Delphi Method to Help Achieve Consensus

Area of Science:

• Urology
• Oncology
• Medical Consensus

Background:

• Active surveillance (AS) is a management option for T1 renal masses (T1RM).
• Standardized guidelines for AS of T1RM are needed for consistent patient care.
• Defining criteria for patient selection, imaging, and intervention is crucial.

Purpose of the Study:

• To establish a consensus for the initial evaluation and follow-up of patients undergoing active surveillance for T1 renal masses.
• To develop a roadmap for managing T1RM under AS.

Main Methods:

• Modified Delphi method utilized with a consensus panel of urologists.
• Three rounds of online questionnaires to achieve >80% agreement on AS protocols for T1RM.
• Focus on patient selection, imaging modalities, and intervention triggers.

Main Results:

• Consensus reached on 321/587 scenarios (54.7%) regarding T1RM AS.
• Life expectancy, age, comorbidity, and renal function are key for patient selection.
• Specific imaging protocols (CT/MRI) and follow-up intervals established; rapid tumor growth identified as an intervention trigger.

Conclusions:

• A consensus roadmap for active surveillance of T1 renal masses was established.
• Identified areas of agreement and areas requiring further discussion for AS of T1RM.
• Guidelines aim to improve clinical utility and specificity in AS management.