Surveillance after radical or partial nephrectomy for localized renal cell carcinoma and management of recurrent disease.
Surveillance after surgery for RCC is important because approximately 50% of these patients will develop a disease recurrence, two thirds of who will recur within the first year. Although the prognosis is generally poor in these patients, some may respond favorably to immunotherapy. The small subset of patients who develop solitary metastases has the greatest chance to achieve long-term survival. Aggressive surgical resection is an integral part of this success. Proposed surveillance protocols using a stage-based approach or an integrated approach combining stage with other important prognostic factors attempt to provide a rational approach to identifying treatable recurrences while minimizing unnecessary examinations and patient anxiety. However, strict adherence to follow-up guidelines may not be appropriate for all patients. Factors including patient comorbidities and patient willingness to pursue aggressive management in the event of recurrence may alter the follow-up for each individual.
Janzen
Nicolette K
NK
Department of Urology, University of California at Los Angeles School of Medicine, 10833 Le Conte Avenue, CHS 66-118, Los Angeles, CA 90095-1738, USA.
Kim
Hyung L
HL
Figlin
Robert A
RA
Belldegrun
Arie S
AS
D001859:Bone Neoplasms / Q000556:secondary; D001932:Brain Neoplasms / Q000556:secondary; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000556:secondary; D009364:Neoplasm Recurrence, Local; D009392:Nephrectomy