| Partial nephrectomy (PN) and nephron-sparing approaches |
| Prioritize PN for the management of the cT1a renal mass when intervention is indicated. |
| Prioritize nephron-sparing approaches for patients with an anatomic or functionally solitary kidney, bilateral tumors, known familial RCC, preexisting CKD, or proteinuria. |
| Consider nephron-sparing approaches for patients who are young, have multifocal masses, or have comorbidities that are likely to impact kidney function in the future. |
| Radical nephrectomy (RN) |
Physicians should consider RN for patients where increased oncologic potential is suggested by tumor size, renal mass biopsy, and/or imaging characteristics. In this setting, RN is preferred if all of the following criteria are met: - High tumor complexity and PN would be challenging even in experienced hands.
- No preexisting CKD/proteinuria.
- Normal contralateral kidney and new baseline eGFR will likely be >45 mL/minute/1.73 m2.
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