Limitations of Available Studies Prevent Reliable Comparison Between Tumour Ablation and Partial Nephrectomy for Patients with Localised Renal Masses: A Systematic Review from the European Association of Urology Renal Cell Cancer Guideline Panel Yasmin Abu-Ghanem a , Sergio Ferna´ndez-Pello b , Axel Bex c,d , Bo¨rje Ljungberg e , Laurence Albiges f , Saeed Dabestani g , Rachel H. Giles h , Fabian Hofmann i , Milan Hora j , Markus A. Kuczyk k , Teele Kuusk l , Lorenzo Marconi m , Axel S. Merseburger n , Rana Tahbaz o , Michael Staehler p , Alessandro Volpe q , Thomas Powles l , Thomas B. Lam r,s,y , Karim Bensalah t,y, * a Department of Urology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel; b Department of Urology, Cabueñes Hospital, Gijón, Spain; c The Royal Free London NHS Foundation Trust and UCL Division of Surgery and Interventional Science, London, UK; d Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; e Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden; f Department of Cancer Medicine, Institut Gustave Roussy, Villejuif, France; g Department of Urology, Skåne University Hospital, Malmö, Sweden; h Department of Nephrology and Hypertension, Patient Advocate International Kidney Cancer Coalition (IKCC), University Medical Center Utrecht, Utrecht, The Netherlands; i Department of Urology, Sunderby Hospital, Sunderby, Sweden; j Department of Urology, Faculty Hospital and Faculty of Medicine in Pilsen, Charles University in Prague, Prague, Czech Republic; k Department of Urology and Urologic Oncology, Hannover Medical School, Hannover, Germany; l Department of Urology, Royal Free Hospital, London, UK; m Department of Urology, Coimbra University Hospital, Coimbra, Portugal; n Department of Urology, University Hospital Schleswig-Holstein, Lübeck, Germany; o Department of Urology, Elbe Kliniken Stade, Stade, Germany; p Department of Urology, Ludwig-Maximilians University, Munich, Germany; q Division of Urology, Maggiore della Carita Hospital, University of Eastern Piedmont, Novara, Italy; r The Royal Free NHS Trust and Barts Cancer Institute, Queen Mary University of London, London, UK; s Academic Urology Unit, University of Aberdeen, Aberdeen, UK; t Department of Urology, University of Rennes, Rennes, France E U R O P E A N U R O L O G Y O N C O L O G Y X X X ( 2 0 1 9 ) X X X – X X X ava ilable at www.sciencedirect.com journa l homepage: euoncology.europeanurology .com Article info Article history: Received 27 October 2019Re- ceived in revised form 3 February 2020Accepted Febru- ary 18, 2020 Associate Editor: Alberto Bri- ganti Keywords: Renal cell cancer Ablative therapy Partial nephrectomy Prognosis European Association of Urology guidelines Abstract The European Association of Urology (EAU) Renal Cell Carcinoma (RCC) Guideline Panel performed a protocol-driven systematic review (SR) on thermal ablation (TA) compared with partial nephrectomy (PN) for T1N0M0 renal masses, in order to provide evidence to support its recommendations. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed, and only comparative studies published between 2000 and 2019 were included. Twenty-six nonrandomised comparative studies were included, recruiting a total of 167 80 patients. Risk of bias (RoB) assessment revealed high or uncertain RoB across all studies, with the vast majority being retrospective, observational studies with poorly matched controls and short follow-up. Limited data showed TA to be safe, but its long-term oncological effectiveness compared with PN remains uncertain. A quality assessment of pre-existing SRs (n = 11) on the topic, using AMSTAR, revealed that all SRs had low confidence rating, with all but two SRs being rated critically low. In conclusion, the current data are inadequate to make any strong and clear conclusions regarding the clinical effectiveness of TA for treating T1N0M0 renal masses compared with PN. Therefore, TA may be cautiously y These authors contributed equally to the work. * Corresponding author. Department of Urology, University of Rennes, Rennes, France. E-mail address: Charles-karim.BENSALAH@chu-rennes.fr (K. Bensalah). EUO-302; No. of Pages 26 Please cite this article in press as: Fernández-Pello S, et al. Limitations of Available Studies Prevent Reliable Comparison Between Tumour Ablation and Partial Nephrectomy for Patients with Localised Renal Masses: A Systematic Review from the European Association of Urology Renal Cell Cancer Guideline Panel. Eur Urol Oncol (2020), https://doi.org/10.1016/j.euo.2020.02.001 https://doi.org/10.1016/j.euo.2020.02.001 2588-9311/© 2020 Published by Elsevier B.V. on behalf of European Association of Urology.