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

The multispeciality approach to the management of localised kidney cancer

Grant D Stewart  1 , Tobias Klatte  2 , Laura Cosmai  3 , Axel Bex  4 , Benjamin W Lamb  5 , Holger Moch  6 , Evis Sala  7 , Shankar Siva  8 , Camillo Porta  9 , Maurizio Gallieni  10
Affiliations
Free article
Review

The multispeciality approach to the management of localised kidney cancer

Grant D Stewart et al. Lancet. .
Free article

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.

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Conflict of interest statement

Declaration of interests GDS has received educational grants from Pfizer and AstraZeneca; consultancy fees from MSD and EUSA Pharma; speaker fees from Pfizer; and has leadership roles for The Urology Foundation and Kidney Cancer UK. LC acted as a speaker and consultant for General Electric. AB has received honoraria for participation in advisory boards for Eisai and Ipsen and has an educational grant from Pfizer. BWL is a consultant for Digital Surgery; received speaker honoraria from AstraZeneca; and has a leadership role at the British Association of Urological Surgeons (Oncology). HM is a consultant for Roche; has received honoraria from Roche, Bayer, AstraZeneca, MSD, and Janssen; and has leadership roles for the International Agency for Research on Cancer WHO. ES has stock in Lucida Medical; is a research consultant for Amazon Web Services; and acted as a speaker for GE Healthcare. SS has received education grants from Varian, Reflexion, and Bayer Pharmaceuticals; is a speaker for AstraZeneca; and has leadership roles for RSS, TROG Cancer Research, and IASLC. CP acted as speaker or consultant, or both, for Eisai, MSD, Bristol Myers Squibb, AstraZeneca, Ipsen, EUSA Pharma, Angelini, and MSD. The contribution of GDS aand ES to this research was supported by the National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre (BRC-1215-20014) and the Cancer Research UK Cambridge Centre (C9685/A25177). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. As corresponding author, GDS confirms that he had full access to all the data in the study and had final responsibility for the decision to submit for publication. TK and MG declare no competing interests.

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