Abstract
BACKGROUND: Localised renal cell carcinoma (RCC) is usually treated surgically, with post-operative imaging-based surveillance to monitor for recurrence. However, surveillance practices vary widely, and patients often lack a clear understanding of their risk of recurrence and follow-up care. The PREDICT Kidney tool has been developed to enhance risk communication by providing individualised recurrence and mortality risk estimates. The tool uses the Leibovich score augmented with English national data to provide a personalised risk assessment of cancer recurrence and death from other causes, presented in both numerical and visual formats. STUDY DESIGN: A multicentre, prospective feasibility study of incorporating the PREDICT Kidney risk communication tool into the first follow-up consultation for localised RCC patients post-surgery. ENDPOINTS: Patient uptake into the study, completeness of data collection, consultation duration, the acceptability of the tool to both patients and clinicians, clinician adherence to the study "best-practice" guide, variability in tool usage across clinicians and sites and patient-level clinical outcomes including subjective and objective comprehension of risk of recurrence and follow-up, perceived risk of cancer recurrence, risk conviction, satisfaction with the information provided on risk of recurrence and follow-up, and fear of cancer recurrence. PATIENTS AND METHODS: We aim to recruit 60 patients from three hospitals in England and Scotland. Patients treated with surgery for primary localised clear-cell RCC awaiting their first follow-up appointment will be invited to take part. Participants will be allocated into two groups: standard care and standard care supplemented with the use of the PREDICT Kidney tool. Data will be collected through questionnaires, audio/video recordings of consultations and interviews with a subset of patients and clinicians. The study period is planned from September 2024 to July 2025. The findings will guide the design of a future randomised controlled trial to evaluate the tool's efficacy in clinical settings.