title: A review on follow-up strategies for renal cell carcinoma after nephrectomy.
abstract: OBJECTIVE
  To provide a comprehensive review of the evidence supporting the necessity for follow-up after nephrectomy for renal cell carcinoma.
  
  
  METHODS
  We searched the Medline, MeSH, EMBASE, and Cochrane databases using the terms "renal cell cancer," "kidney neoplasm," "follow-up," "surveillance," "prognosis," and "staging" to look for human/English language/Randomized Controlled Trials/Clinical trials/Review articles/Meta-analysis/Practiced Guidelines, and Editorials.
  
  
  RESULTS
  No consensus currently exists on surveillance guidelines after radical or partial nephrectomy for renal cell carcinoma. The rationale for follow-up strategies is to detect local recurrence or metastatic disease and to allow appropriate treatment. Most of the surveillance protocols recommend various follow-up strategies for all tumour stages. The emphasis on follow-up should be during the first 3-5 yr after nephrectomy. There is no consensus about which investigations should be performed and at what intervals. Most surgeons rely on symptom enquiry, physical examination, chest x-ray, and computed tomography scanning. A protocol based on the stage of the initial tumour is adapted by the majority of the investigators. Patients should be followed similarly after radical or partial nephrectomy on the basis of stage-oriented protocols. The combination of various prognostic factors requires further validation over stage-based protocols. There is a paucity of guidelines in the literature regarding follow-up for patients with hereditary forms of renal cell carcinoma.
  
  
  CONCLUSIONS
  Current guidelines for follow-up are based on observational and case studies. While this fact precludes a high level of evidence-based guidelines, we have to conclude that this is the best available evidence to date.
authors.affiliation: Athens Medical School, 2nd Department of Urology, Sismanoglio Hopsital, Athens, Greece. andskol@yahoo.com
authors.forename: Andreas
authors.initials: A
authors.lastname: Skolarikos
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Alivizatos
authors.forename: Pilar
authors.initials: P
authors.lastname: Laguna
authors.forename: Jean
authors.initials: J
authors.lastname: de la Rosette
mesh_terms: D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D002985:Clinical Protocols; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009392:Nephrectomy; D011379:Prognosis