title: A Systematic Review of Research Gaps in the Evaluation and Management of Localized Renal Masses.
abstract: The management of clinically localized renal masses suspicious for renal cell carcinoma varies, partially because of gaps in the evidence base. We conducted a systematic review to summarize research gaps for the evaluation of composite models for predicting malignancy; use of percutaneous renal sampling for diagnosis; and comparative effectiveness of surgery, thermal ablation, and active surveillance. A total of 147 studies, published in 150 articles, were identified. To promote improved patient care and health outcomes, we recommend incorporation of emerging biomarkers into validated composite models, standardization of biopsy protocols, standard reporting of clinical stage, and performance of prospective studies with objective selection criteria.
authors.affiliation: James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD. Electronic address: hitenpatel@jhmi.edu.
authors.forename: Hiten D
authors.initials: HD
authors.lastname: Patel
authors.affiliation: Johns Hopkins Evidence-Based Practice Center, Johns Hopkins School of Public Health, Baltimore, MD.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Iyoha
authors.affiliation: James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Phillip M
authors.initials: PM
authors.lastname: Pierorazio
authors.affiliation: Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Sozio
authors.affiliation: James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Johnson
authors.affiliation: Johns Hopkins Evidence-Based Practice Center, Johns Hopkins School of Public Health, Baltimore, MD.
authors.forename: Ritu
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Johns Hopkins Evidence-Based Practice Center, Johns Hopkins School of Public Health, Baltimore, MD.
authors.forename: Eric B
authors.initials: EB
authors.lastname: Bass
authors.affiliation: James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Mohamad E
authors.initials: ME
authors.lastname: Allaf
mesh_terms: D035843:Biomedical Research / Q000458:organization & administration*; D003131:Combined Modality Therapy; D019468:Disease Management; D014943:Global Health; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D009017:Morbidity / Q000639:trends; D019984:Quality Indicators, Health Care; D015996:Survival Rate / Q000639:trends; D014572:Urology / Q000379:methods*