Quality indicators (QIs) are crucial for evaluating health care delivery, including effectiveness, safety, and patient-centered outcomes. In contrast to other fields, the definition and implementation of QIs for renal cell carcinoma (RCC) present distinct challenges and remain unmet needs.
We summarized the available data on QIs for RCC, focusing on their characterization throughout the care pathway and the potential areas for further development.
A systematic review of the English-language literature was conducted using the MEDLINE, Embase, and Cochrane databases from January 2000 to March 2025, according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (PROSPERO ID: CRD42024511924). Quality assessment was evaluated according to the Appraisal of Indicators through Research and Evaluation (AIRE) instrument.
Out of 58948 potentially relevant papers, 12 sets of QIs (including an overall number of 86 distinct QIs) were identified from 12 studies. QI sets had a large variation in development strategy and quality. Only five studies scored a total of ≥50% on the AIRE tool across four domains. The process employed to develop the set of QIs was heterogeneous across the included papers. The number of proposed QIs varied significantly across studies (range: 1-25). Only a few studies specified the target population explicitly. The QIs addressed different stages of RCC care pathways: diagnosis (33%), staging (25%), data collection (25%), treatment (67%), pathology (42%), outcomes (83%), hospital facilities (25%), and follow-up (17%). Although 83% (10/12) sets have been piloted in practice, none of these has been validated externally. Regardless of the domain, most studies did not specifically report any cutoff value to evaluate whether the proposed QIs were fulfilled or not.
Our review found a relative lack of evidence on QIs for RCC, as well as heterogeneity in their development strategy, definition, reporting, and the included domains of the RCC care pathway. Further efforts are needed to reach consensus on the appropriately developed QIs that could define the quality of care for RCC and to assess their association with clinical outcomes.
European urology oncology. 2025 Jun 06 [Epub ahead of print]
Alessio Pecoraro, Sara Costagli, Laura Marandino, Raghav Varma, Maarten Albersen, Umberto Capitanio, Michael Jewett, Alexander Kutikov, Steven MacLennan, Grant D Stewart, Patricia Zondervan, Lorenzo Masieri, Andrea Minervini, Sergio Serni, Axel Bex, Riccardo Campi
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Unit of Urology and Renal Transplantation, Oncology Department, Careggi University Hospital, Florence, Italy., Skin and Renal Units, The Royal Marsden NHS Foundation Trust, London, UK., Clinical Effectiveness Unit, Royal College of Surgeons, London, UK; Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK., Department of Urology, University Hospitals Leuven, Leuven, Belgium., IRCCS San Raffaele Scientific Institute, Urological Research Institute, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy., International Kidney Cancer Coalition and Clinician Investigator, Princess Margaret Cancer Centre and University Health Network, Department of Surgery (Urology), University of Toronto, Toronto, Ontario, Canada., Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA., Academic Urology Unit, University of Aberdeen, Aberdeen, UK., Department of Surgery, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK; CRUK Cambridge Centre, Cambridge Biomedical Campus, Cambridge, UK., Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands., Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Unit of Urology and Andrology, Oncology Department, Careggi University Hospital, Florence, Italy., Specialist Centre for Kidney Cancer, Royal Free Hospital, London, UK; Division of Surgery and Interventional Science, University College London, London, UK; The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Unit of Urology and Renal Transplantation, Oncology Department, Careggi University Hospital, Florence, Italy. Electronic address: .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/40483206