PURPOSE: This study was conducted to identify time to and type of recurrence in relation to scheduled follow-up (FU) imaging after nephrectomy or nephron-sparing surgery for localized renal cell carcinoma (RCC).
Using this information, future guidelines could improve the early detection of metastases.
METHODS: Measured from moment of treatment, all recurrences after (partial) nephrectomy performed between 2000 and 2010 were categorized as being detected early (< 6 months), late (>5 year for T1/T2 and >10 year for T3/T4), or intermediate (time within those two) based on European Association of Urology (EAU) guidelines. Also symptomatic presentation was screened.
RESULTS: Recurrent disease developed in 80 of 396 patients after (partial) tumor nephrectomy. Mean time to recurrence in months was 56 (n = 21) for T1, 24 (n = 18) for T2, 21 (n = 38) for T3, and 11 (n = 2) for T4 tumors. Detection of early recurrence occurred in 22 patients (28 %), of which 20 (91 %) were T2-T4 tumors. In 10 (48 %) of T1 tumors, late recurrence was found. Of the patients with symptoms due to recurrence, 65 % (17/26) were detected outside the FU surveillance protocol (P = 0.01).
CONCLUSION: A more intensive FU the first 6 months after nephrectomy for T2-T4 and FU imaging ≥5 years after surgery for T1 tumors might improve early and asymptomatic detection of recurrent disease after nephrectomy for RCC.
Written by:
van Oostenbrugge TJ, Kroeze SG, Bosch JL, van Melick HH. Are you the author?
Department of Urology, Radboud University Medical Center, P.O. box 9101, 6525 GA, Nijmegen, The Netherlands.
Reference: World J Urol. 2014 Sep 2. Epub ahead of print.
doi: 10.1007/s00345-014-1390-6
PubMed Abstract
PMID: 25179013