An Effective Followup Protocol of Renal Cell Carcinoma after Radical Nephrectomy Based on Pathological Stage

Kim, Yong Woo; Yoon, Duck Ki; Cho, Jae Heung

Abstract

There is little information about which laboratory and imaging study and when should be taken to assess patients after nephrectomy of renal cell carcinoma. Commonly ordered tests during the postoperative followup include serum liver function studies, chest X-ray, and abdominal pelvic computerized tomography, Less commonly used test include bone scans and chest computerized tomography. To define better which patients require more intensive followup, we retrospectively reviewed 52 patients who underwent radical nephrectomy with a final pathological diagnosis of renal cell carcinoma. Of the patients 8 were excluded for node positive or extension to an adjacent organ. Among the remaining 44 patients, localized disease 15 cases with stage TlN0M0 recurred null, 16 cases with stage T2N0M0 recurred in 12.5%, 9 cases with T3aN0M0 and 4 cases with T3bN0M0 recurred in 55.6% and 100% respectively. The average interval to recur was 22 months for patients with stage T2 tumor and 16.8 months with stage T3a, and 5.7 months for those with stage T3b disease. Based on our data, followup studies should be done appropriately and cost effectively according to the pathological stage of disease.