Allaf and Pierorazio: New standards reflect the Brady’s evidence-based, individualized approach
The new guidelines reflect the personalized approach to localized kidney cancer pioneered at the Brady.
The American Urological Association (AUA)’s guidelines for how to treat localized kidney cancer have changed – in large part due to the work of two Brady faculty members, Mohamad Allaf, M.D., and Phillip Pierorazio, M.D.
Last year, Allaf and Pierorazio led an eight-person team of Hopkins investigators, including Michael Johnson, M.D., and Hiten Patel, M.D., M.P.H., to create recommendations for the treatment of this disease, based on the existing literature and data – including important findings from the DISSRM study (see story on this page). This report served as the bedrock for the AUA’s new guidelines, “Renal Mass and Localized Renal Cancer.”
Major changes include “an increased focus on evaluation and preservation of renal function during evaluation and management, more clear guidance to help patients and physicians select partial or radical nephrectomy for the management of these masses, and an expanded role for active surveillance in the management of small, clinically localized renal masses,” says Pierorazio.
Importantly, notes Allaf, Director of Kidney Cancer at the Brady, “the guidelines are no longer built around index patients,” but are geared more toward personalized medicine. “They recognize that an individualized assessment of a patient’s general health, risk of cancer and aggressive cancer, and potential harms of each management strategy is more appropriate than generalizing treatment.”
The AUA Guidelines are available online (www.auanet.org/guidelines/renal-massand- localized-renal-cancer-new-(2017)) and are summarized in the Journal of Urology.
“I am extremely proud of the role the Brady played in the development of these guidelines,” Allaf continues. “Not only do they reflect rigorous, evidence-based practices that are useful for patients and any practicing urologist; they reflect how we approach the management of renal masses at the Brady. We treat all of our patients as individuals and work with them to make the best choices together.”