Abstract
Purpose
Patients with localised renal cell carcinoma (RCC) receiving curative surgery, either radical or partial nephrectomy, have been shown in contemporary studies to develop recurrence within 5 years in 20–30% of case. Therefore, post-operative follow-up (FU) imaging plays a crucial role in detecting recurrent or metastatic disease. A number of prognostic scores have been developed to predict risk of recurrence. This review summarises the current knowledge on established FU protocols and their limitations.
Methods
A non-systematic literature search was conducted using Medline. Furthermore, major guidelines [European Association of Urology (EAU), American Urological Association (AUA) and National Comprehensive Cancer Network (NCCN)] were reviewed and assessed.
Results
The EAU, AUA and NCCN post-operative follow-up guidelines differ in the frequency and type of imaging modalities recommended. The optimal duration of follow-up remains to be elucidated as does the impact of follow-up protocols on patient outcomes and quality of life. Established follow-up protocols do not take non-RCC-related factors, such as patient age and performance status into account. However, in the future individualised duration of FU based on competing risks of cancer recurrence and non-RCC death may be optimised, maximising resources and patient quality of life.
Conclusion
There is a clear need to establish evidence-based follow-up protocols and to assess the impact of follow-up protocols on individual patients and society.
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SD: project development, data collection, manuscript writing and editing. LM: data collection, manuscript writing and editing. TK: data collection, manuscript writing and editing. AB: project development, data collection, manuscript writing and editing.
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Dabestani, S., Marconi, L., Kuusk, T. et al. Follow-up after curative treatment of localised renal cell carcinoma. World J Urol 36, 1953–1959 (2018). https://doi.org/10.1007/s00345-018-2338-z
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DOI: https://doi.org/10.1007/s00345-018-2338-z