Follow-up surveillance strategies for genitourinary malignancies.
BACKGROUND
Genitourinary cancers account for more than 20% of all malignancies in the United States. These cancers do not usually yield rapid mortality, thereby necessitating longer-term surveillance strategies.


METHODS
A review and analysis of relevant studies were performed. Follow-up strategies are proposed to reflect effective methods to detect recurrent prostate, bladder, renal, and testicular cancers. Cost analysis was performed using Medicare reimbursement rates.


RESULTS
For genitourinary tumors, follow-up tests can be planned rationally based on detection rates and patterns. Tumor grade and stage drive follow-up strategies, along with therapeutic implications of detecting a recurrence. Symptomatic recurrences often obviate the need for radiographic tests and can minimize costs. Stage- specific plans for these four urologic malignancies are outlined specifically.


CONCLUSIONS
Not all surveillance approaches have been critically tested for follow-up of genitourinary tumors, but ample data are available to propose sound medical and economic strategies.
Department of Urology, University of California, Davis, School of Medicine, Sacramento, California 95817, USA. cpevans@ucdavis.edu
Christopher P
CP
Evans
D002986:Clinical Trials as Topic; D003365:Costs and Cost Analysis; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000191:economics / Q000628:therapy; D014481:United States; D014565:Urogenital Neoplasms / Q000175:diagnosis* / Q000191:economics / Q000628:therapy