Skip to main content

Advertisement

SpringerLink
Log in

Surveillance following radical or partial nephrectomy for renal cell carcinoma

  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Renal cell carcinoma (RCC) is the most lethal of the common urologic malignancies, with approximately 40% of patients eventually dying of cancer progression. Approximately one third of patients present with metastatic disease and up to 50% treated for localized disease have a recurrence. Although the prognosis generally is poor in these patients, some may respond to immunotherapy and a subset of patients who develop solitary metastases can achieve long-term survival. Therefore, the timely identification of recurrences following surgical extirpation is imperative in the treatment of patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Jemal A, Tiwari RC, Murray T, et al.: Cancer statistics, 2004. CA Cancer J Clin 2004, 54:8–29.

    Article  PubMed  Google Scholar 

  2. Pisani P, Parkin DM, Bray F, Ferlay J: Estimates of the worldwide mortality from 25 cancers in 1990. Int J Cancer 1999, 83:18–29.

    Article  PubMed  CAS  Google Scholar 

  3. Chow WH, Devesa SS, Warren JL, Fraumeni JF Jr: Rising incidence of renal cell cancer in the United States. JAMA 1999, 281:1628–1631.

    Article  PubMed  CAS  Google Scholar 

  4. Janzen NK, Kim HL, Figlin RA, Belldegrun AS: Surveillance after radical or partial nephrectomy for localized renal cell carcinoma and management of recurrent disease. Urol Clin North Am 2003, 30:843–852.

    Article  PubMed  Google Scholar 

  5. Lam JS, Shvarts O, Figlin RA, Belldegrun AS: Renal cell carcinoma 2004: new frontiers in staging, prognostication, and targeted molecular therapy. J Urol 2005, in press. A comprehensive, state of the art review on the current concepts of staging, prognostication, and targeted molecular therapy for renal cell carcinoma.

  6. Sandock DS, Seftel AD, Resnick MI: A new protocol for the follow-up of renal cell carcinoma based on pathological stage. J Urol 1995, 154:28–31.

    Article  PubMed  CAS  Google Scholar 

  7. Levy DA, Slaton JW, Swanson DA, Dinney CP: Stage-specific guidelines for surveillance after radical nephrectomy for local renal cell carcinoma. J Urol 1998, 159:1163–1167.

    Article  PubMed  CAS  Google Scholar 

  8. Ljungberg B, Alamdari FI, Rasmuson T, Roos G: Follow-up guidelines for nonmetastatic renal cell carcinoma based on the occurrence of metastases after radical nephrectomy. BJU Int 1999, 84:405–411.

    Article  PubMed  CAS  Google Scholar 

  9. Hafez KS, Novick AC, Campbell SC: Patterns of tumor recurrence and guidelines for follow-up after nephronsparing surgery for sporadic renal cell carcinoma. J Urol 1997, 157:2067–2070.

    Article  PubMed  CAS  Google Scholar 

  10. Uzzo RG, Novick AC: Surveillance strategies following surgery for renal cell carcinoma. In Renal and Adrenal Tumors: Biology and Management. Edited by Belldegrun A, Ritchie AW, Figlin RA, et al. New York: Oxford University Press; 2003:324–330.

    Google Scholar 

  11. Stephenson AJ, Chetner MP, Rourke K, et al.: Guidelines for the surveillance of localized renal cell carcinoma based on the patterns of relapse after nephrectomy. J Urol 2004, 172:58–62.

    Article  PubMed  Google Scholar 

  12. Shvarts O, Lam JS, Pantuck AJ, et al.: Postoperative surveillance protocol for patients with localized and locally advanced renal cell carcinoma based on a validated prognostic nomogram and risk group stratification system. Submitted.

  13. Figlin RA: Renal cell carcinoma: management of advanced disease. J Urol 1999, 161:381–387.

    Article  PubMed  CAS  Google Scholar 

  14. Motzer RJ, Russo P: Systemic therapy for renal cell carcinoma. J Urol 2000, 163:408–417.

    Article  PubMed  CAS  Google Scholar 

  15. Kozlowski JM: Management of distant solitary recurrence in the patient with renal cancer contralateral kidney and other sites. Urol Clin North Am 1994, 21:601–624.

    PubMed  CAS  Google Scholar 

  16. Kavolius JP, Mastorakos DP, Pavlovich C, et al.: Resection of metastatic renal cell carcinoma. J Clin Oncol 1998, 16:2261–2266.

    PubMed  CAS  Google Scholar 

  17. Tanguay S, Pisters LL, Lawrence DD, Dinney CP: Therapy of locally recurrent renal cell carcinoma after nephrectomy. J Urol 1996, 155:26–29.

    Article  PubMed  CAS  Google Scholar 

  18. Esrig D, Ahlering TE, Lieskovsky G, Skinner DG: Experience with fossa recurrence of renal cell carcinoma. J Urol 1992, 147:1491–1494.

    PubMed  CAS  Google Scholar 

  19. Han KR, Pantuck AJ, Bui MH, et al.: Number of metastatic sites rather than location dictates overall survival of patients with node-negative metastatic renal cell carcinoma. Urology 2003, 61:314–319.

    Article  PubMed  Google Scholar 

  20. Janzen NK, Laifer-Narin S, Han KR, et al.: Emerging technologies in uroradiologic imaging. Urol Oncol 2003, 21:317–326.

    PubMed  Google Scholar 

  21. Ramdave S, Thomas GW, Berlangieri SU, et al.: Clinical role of F-18 fluorodeoxyglucose positron-emission tomography for detection and management of renal cell carcinoma. J Urol 2001, 166:825–830.

    Article  PubMed  CAS  Google Scholar 

  22. Sandock DS, Seftel AD, Resnick MI: Adrenal metastases from renal cell carcinoma: role of ipsilateral adrenalectomy and definition of stage. Urology 1997, 49:28–31.

    Article  PubMed  CAS  Google Scholar 

  23. Han KR, Bui MH, Pantuck AJ, et al.: TNM T3a renal cell carcinoma: adrenal gland involvement is not the same as renal fat invasion. J Urol 2003, 169:899–903.

    Article  PubMed  Google Scholar 

  24. Moinzadeh A, Libertino JA: Prognostic significance of tumor thrombus level in patients with renal cell carcinoma and venous tumor thrombus extension. Is all T3b the same? J Urol 2004, 171:598–601.

    Article  PubMed  Google Scholar 

  25. Kim HL, Zisman A, Han KR, et al.: Prognostic significance of venous thrombus in renal cell carcinoma: Are renal vein and inferior vena cava involvement different? J Urol 2004, 171:588–591.

    Article  PubMed  Google Scholar 

  26. Patard JJ, Shvarts O, Lam JS, et al.: Safety and efficacy of partial nephrectomy for all T1 tumors based on an international multicenter experience. J Urol 2004, 171:2181–2185; quiz 2435. A retrospective analysis of 1454 patients undergoing partial or radical nephrectomy for T1N0M0 renal tumors from seven international academic centers that demonstrated no difference in cancer-specific survival or recurrence rates between patients undergoing partial or radical nephrectomy for renal tumors up to 7 cm.

    Article  PubMed  Google Scholar 

  27. Pantuck AJ, Zisman A, Dorey F, et al.: Renal cell carcinoma with retroperitoneal lymph nodes: role of lymph node dissection. J Urol 2003, 169:2076–2083.

    Article  PubMed  Google Scholar 

  28. Pantuck AJ, Zisman A, Dorey F, et al.: Renal cell carcinoma with retroperitoneal lymph nodes: impact on survival and benefits of immunotherapy. Cancer 2003, 97:2995–3002.

    Article  PubMed  Google Scholar 

  29. Vasselli JR, Yang JC, Linehan WM, et al.: Lack of retroperitoneal lymphadenopathy predicts survival of patients with metastatic renal cell carcinoma. J Urol 2001, 166:68–72.

    Article  PubMed  CAS  Google Scholar 

  30. Terrone C, Guercio S, De Luca S, et al.: The number of lymph nodes examined and staging accuracy in renal cell carcinoma. BJU Int 2003, 91:37–40.

    Article  PubMed  CAS  Google Scholar 

  31. Han KR, Bleumer I, Pantuck AJ, et al.: Validation of an integrated staging system toward improved prognostication of patients with localized renal cell carcinoma in an international population. J Urol 2003, 170:2221–2224.

    Article  PubMed  Google Scholar 

  32. Tsui KH, Shvarts O, Smith RB, et al.: Prognostic indicators for renal cell carcinoma: a multivariate analysis of 643 patients using the revised 1997 TNM staging criteria. J Urol 2000, 163:1090–1095; quiz 1295.

    Article  PubMed  CAS  Google Scholar 

  33. Bolkier M, Moskovitz B, Munichor M, et al.: Metastatic renal cell carcinoma to the bladder. Urol Int 1993, 50:101–103.

    PubMed  CAS  Google Scholar 

  34. Ovesen H, Gerstenberg T: Vaginal metastasis as the first sign of renal cell carcinoma: a case report and review of the literature. Scand J Urol Nephrol 1990, 24:237–238.

    Article  PubMed  CAS  Google Scholar 

  35. Fallick ML, Long JP, Ucci A: Metachronous renal cell carcinoma metastases to spermatic cord and penis. Scand J Urol Nephrol 1997, 31:299–300.

    PubMed  CAS  Google Scholar 

  36. Frank I, Blute ML, Cheville JC, et al.: An outcome-prediction model for patients with clear cell renal cell carcinoma treated with radical nephrectomy based on tumor stage, size, grade and necrosis: the SSIGN score. J Urol 2002, 168:2395–2400.

    Article  PubMed  Google Scholar 

  37. Shvarts O, Lam JS, Kim HL, et al.: Eastern Cooperative Oncology Group performance status predicts bone metastasis in patients presenting with renal cell carcinoma: implication for preoperative bone scans. J Urol 2004, 172:867–870. A retrospective analysis of 1801 patients with clear cell RCC treated with radical nephrectomy in which an outcome-prediction model based on all available clinical and pathologic features significantly associated with death from RCC was generated. In patients with clear cell RCC, 1997 TNM stage, tumor size, nuclear grade, and histologic tumor necrosis were significantly associated with cancer-specific survival.

    Article  PubMed  Google Scholar 

  38. Itano NB, Blute ML, Spotts B, Zincke H: Outcome of isolated renal cell carcinoma fossa recurrence after nephrectomy. J Urol 2000, 164:322–325.

    Article  PubMed  CAS  Google Scholar 

  39. Steinbach F, Novick AC, Zincke H, et al.: Treatment of renal cell carcinoma in von Hippel-Lindau disease: a multicenter study. J Urol 1995, 153:1812–1816.

    Article  PubMed  CAS  Google Scholar 

  40. Walther MM, Lubensky IA, Venzon D, et al.: Prevalence of microscopic lesions in grossly normal renal parenchyma from patients with von Hippel-Lindau disease, sporadic renal cell carcinoma, and no renal disease: clinical implications. J Urol 1995, 154:2010–2015.

    Article  PubMed  CAS  Google Scholar 

  41. McNichols DW, Segura JW, De Weerd JH: Renal cell carcinoma: long-term survival and late recurrence. J Urol 1981, 126:17–23.

    PubMed  CAS  Google Scholar 

  42. Giuliani L, Giberti C, Martorana G, Rovida S: Radical extensive surgery for renal cell carcinoma: long-term results and prognostic factors. J Urol 1990, 143:468–473.

    PubMed  CAS  Google Scholar 

  43. Montie JE: Follow-up after partial or total nephrectomy for renal cell carcinoma. Urol Clin North Am 1994, 21:589–592.

    PubMed  CAS  Google Scholar 

  44. Kattan MW, Reuter V, Motzer RJ, et al.: A postoperative prognostic nomogram for renal cell carcinoma. J Urol 2001, 166:63–67. A retrospective analysis of 601 patients with RCC treated with nephrectomy. A postoperative nomogram combining various prognostic factors to predict the likelihood of recurrence after surgery for RCC was constructed.

    Article  PubMed  CAS  Google Scholar 

  45. Leibovich BC, Blute ML, Cheville JC, et al.: Prediction of progression after radical nephrectomy for patients with clear cell renal cell carcinoma: a stratification tool for prospective clinical trials. Cancer 2003, 97:1663–1671.

    Article  PubMed  Google Scholar 

  46. Zisman A, Pantuck AJ, Dorey F, et al.: Improved prognostication of renal cell carcinoma using an integrated staging system. J Clin Oncol 2001, 19:1649–1657. A retrospective analysis of 661 patients with RCC treated with nephrectomy. A novel integrated staging system was developed combining stage, grade, and Eastern Cooperative Oncology Group (ECOG) PS capable of stratifying the survival of RCC patients.

    PubMed  CAS  Google Scholar 

  47. Patard JJ, Kim HL, Lam JS, et al.: Use of the University of California Los Angeles integrated staging system to predict survival in renal cell carcinoma: an international multicenter study. J Clin Oncol 2004, 22:3316–3322. An analysis of 4202 patients with RCC from eight international academic centers, which defines the general applicability of the University of California-Los Angeles staging system (UISS) for predicting survival in patients with RCC.

    Article  PubMed  Google Scholar 

  48. Zisman A, Pantuck AJ, Wieder J, et al.: Risk group assessment and clinical outcome algorithm to predict the natural history of patients with surgically resected renal cell carcinoma. J Clin Oncol 2002, 20:4559–4566. This study describes a comprehensive algorithm that stratifies RCC patients into high-, intermediate-, and low-risk subgroups to predict postoperative patient outcomes and response to therapy.

    Article  PubMed  Google Scholar 

  49. Piltz S, Meimarakis G, Wichmann MW, et al.: Long-term results after pulmonary resection of renal cell carcinoma metastases. Ann Thorac Surg 2002, 73:1082–1087.

    Article  PubMed  Google Scholar 

  50. Wronski M, Arbit E, Russo P, Galicich JH: Surgical resection of brain metastases from renal cell carcinoma in 50 patients. Urology 1996, 47:187–193.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, David Geffen School of Medicine at University of California, Los Angeles, 10833 Le Conte Avenue, 66-118 CHS, Box 951738, 90095-1738, Los Angeles, CA, USA

    Arie S. Belldegrun MD

Authors
  1. John S. Lam MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. John T. Leppert MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert A. Figlin MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Arie S. Belldegrun MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lam, J.S., Leppert, J.T., Figlin, R.A. et al. Surveillance following radical or partial nephrectomy for renal cell carcinoma. Curr Urol Rep 6, 7–18 (2005). https://doi.org/10.1007/s11934-005-0062-x

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11934-005-0062-x

Keywords

Search

Navigation