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However, EAU guidelines have given a weak recommendation that CT chest can be omitted in incidental T1a tumours (\u22644\u00a0cm) without systemic symptoms, due to the low incidence of pulmonary metastases. This study aimed to assess if a baseline staging CT chest has been clinically useful in a cohort with T1a renal tumours.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients with solid and cystic cT1a renal tumours were prospectively screened for eligibility to the NEST study (ISRCTN 18156881) at a single tertiary referral centre multidisciplinary team meeting (MDT). Four hundred consecutive eligible patients between 28\/05\/2019 and 13\/01\/2021 were included in this study. Electronic records were reviewed retrospectively for follow\u2010up data. Seventeen patients with incomplete follow\u2010up data were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 383 included patients (63% male, median age 65\u2009years, median tumour diameter 2.4\u00a0cm), 264 (69%) had a baseline CT chest as part of their clinical staging investigations. No thoracic renal metastases were diagnosed. Abnormalities were reported in 37\/264 cases (14%), including indeterminate lung lesions in 32 patients that were deemed benign on further investigations, three synchronous primary lung tumours, one pre\u2010existing mesothelioma and one pleural effusion related to known renal failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CT chest is of limited value in clinical staging investigations for cT1a renal tumours and has a negligible impact on subsequent renal tumour management. Rather, it triggered further investigations and follow\u2010up for 14% of incidentalomas and ultimately detected concurrent incidental primary lung tumours in 1% of patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bco2.70068","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T02:21:10Z","timestamp":1758594070000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Staging CT chest for cT1a renal masses: Does it change management?"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3429-3986","authenticated-orcid":false,"given":"Sanjana","family":"Ilangovan","sequence":"first","affiliation":[{"name":"Specialist Centre for Kidney Cancer Royal Free Hospital NHS Trust  London UK"},{"name":"Queen Elizabeth University Hospital Glasgow  UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Warren","sequence":"additional","affiliation":[{"name":"Specialist Centre for Kidney Cancer Royal Free Hospital NHS Trust  London UK"},{"name":"Division of Surgery and Interventional Sciences University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6286-2430","authenticated-orcid":false,"given":"Federica","family":"Sordelli","sequence":"additional","affiliation":[{"name":"Specialist Centre for Kidney Cancer Royal Free Hospital NHS Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thet Paing","family":"Oo","sequence":"additional","affiliation":[{"name":"Specialist Centre for Kidney Cancer Royal Free Hospital NHS Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pyae Phyo","family":"Tun","sequence":"additional","affiliation":[{"name":"Specialist Centre for Kidney Cancer Royal Free Hospital NHS Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prasad","family":"Patki","sequence":"additional","affiliation":[{"name":"Specialist Centre for Kidney Cancer Royal Free Hospital NHS Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0211-3936","authenticated-orcid":false,"given":"Faiz","family":"Mumtaz","sequence":"additional","affiliation":[{"name":"Specialist Centre for Kidney Cancer Royal Free Hospital NHS Trust  London UK"},{"name":"Division of Surgery and Interventional Sciences University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ravi","family":"Barod","sequence":"additional","affiliation":[{"name":"Specialist Centre for Kidney Cancer Royal Free Hospital NHS Trust  London UK"},{"name":"Division of Surgery and Interventional Sciences University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Axel","family":"Bex","sequence":"additional","affiliation":[{"name":"Specialist Centre for Kidney Cancer Royal Free Hospital NHS Trust  London UK"},{"name":"Division of Surgery and Interventional Sciences University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6034-4433","authenticated-orcid":false,"given":"Maxine","family":"Tran","sequence":"additional","affiliation":[{"name":"Division of Surgery and Interventional Sciences University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.14740\/wjon1279"},{"key":"e_1_2_8_3_1","unstructured":"EAU Guidelines. 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