Continuous efforts have been made to optimise treatment approaches for renal cell carcinoma (RCC), including locally advanced (la)RCC and metastatic (m)RCC. To update their joint consensus statements on the management of la/mRCC, the Hong Kong Urological Association and the Hong Kong Society of Uro-Oncology convened a series of Delphi meetings.
A panel of six urologists and eight clinical oncologists was formed, addressing five areas: (i) surgical and (neo)adjuvant treatment in laRCC; (ii) first-line management of clear cell mRCC; (iii) second- and later-line treatment of clear cell mRCC; (iv) management of mRCCs with sarcomatoid features or non-clear cell histology; and (v) management of oligometastatic RCC. Consensus statements were drafted based on an extensive literature review and panel discussions. A consensus statement was established only if ≥ 80% of the panellists selected 'accept completely' or 'accept with some reservation' from a five-point Likert scale through anonymous voting.
A total of 42 consensus statements were accepted. Compared with the previous version, this set of consensus statements asserted the use of adjuvant therapy for laRCC and the use of immunotherapy-based combination therapy across different types of mRCC; multiple new areas were also added, including active surveillance in mRCC patients with very favourable prognosis, a novel therapeutic agent for mRCC (belzutifan), and the definitions and management of oligometastatic/oligoprogressive RCC.
While several research gaps remain to be addressed, this set of consensus statements reflects contemporary approaches for la/mRCC management, offering practical references for clinicians in Hong Kong and the Asia-Pacific region.
Frontiers in oncology. 2026 Apr 23*** epublish ***
Darren M C Poon, Philip W K Kwong, Samson Y S Chan, Brian S H Ho, Martin H C Lam, K S Law, Angus K C Leung, Clarence L H Leung, David K W Leung, W K Ma, Barry B W Wo, Kenneth C W Wong, Philip Y Wu, Peter K F Chiu
Department of Clinical Oncology, State Key Laboratory of Translational Oncology, Sir YK Pao Centre for Cancer, Hong Kong Cancer Institute, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China., Hong Kong Integrated Oncology Centre, Hong Kong, Hong Kong SAR, China., S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China., Minimal Access Urology, Hong Kong, Hong Kong SAR, China., Department of Clinical Oncology, Princess Margaret Hospital, Hong Kong, Hong Kong SAR, China., AMO Oncology Centre, Hong Kong, Hong Kong SAR, China., eFLO Urology, Hong Kong, Hong Kong SAR, China., Hong Kong Urology Clinic, Hong Kong, Hong Kong SAR, China., Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong, Hong Kong SAR, China., Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China., Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong SAR, China.