A Follow-up Guideline after Radical Nephrectomy for Renal Cell Carcinoma

Kim, Eun Tak; Park, Chang Myon; Chai, Soo Eung; Choi, Han Yong

Abstract

PURPOSE: To establish the stage specific follow-up guideline for renal cell carcinoma (RCC), we evaluated the pattern of metastases and the clinical course of patients who had underwent radical nephrectomy.
MATERIALS AND METHODS
We reviewed retrospectively the records of 165 patients who underwent radical nephrectomy with a final pathologic diagnosis of RCC. We compared the time of the first recurrence, the site of metastasis and detection modality according to the pathologic stages.
RESULTS
Metastases were found in 18 patients in an average of 12.9 9.5 months after nephrectomy. None of the 77 patients with pT1 (< or = 5cm) had recurrences or metastases, while metastases developed in 3 of the 30 patients with pT1 (> or = 5cm), 4 of the 47 patients with pT2 disease and 10 of the 20 patients with pT3 disease.
CONCLUSIONS
The risk of recurrence and metastasis in RCC is stage-dependent. Therefore, a different follow-up guideline should be applied for each stage of RCC after surgical treatment. There is no need for follow-up in patients with pT1 tumors smaller than 5cm. For patients with pT1 tumor larger than 5cm, pT2, pT3 diseases, follow-up studies including history of symptoms, laboratory studies, chest x-ray, and computerized tomography are indicated at defined intervals.