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Follow-up after curative treatment of localised renal cell carcinoma

  • Saeed Dabestani
  • Lorenzo Marconi
  • Teele Kuusk
  • Axel Bex
Invited Review

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.

Keywords

Localised renal cell carcinoma Prognosis Post-operative follow-up Review 

Notes

Author contributions

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.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

The following manuscript is a review of existing data. Therefore, this article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study (review) formal consent is not required.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Saeed Dabestani
    • 1
  • Lorenzo Marconi
    • 2
  • Teele Kuusk
    • 3
  • Axel Bex
    • 3
  1. 1.Department of Clinical Sciences Lund, Skane University HospitalLund UniversityLundSweden
  2. 2.Department of UrologyCoimbra University HospitalCoimbraPortugal
  3. 3.Division of Surgical Oncology, Department of UrologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands

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