Literature DB >> 17229521

A review on follow-up strategies for renal cell carcinoma after nephrectomy.

Andreas Skolarikos1, Gerasimos Alivizatos, Pilar Laguna, Jean de la Rosette.   

Abstract

OBJECTIVES: 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.

Entities:  

Mesh:

Year:  2007        PMID: 17229521     DOI: 10.1016/j.eururo.2006.12.031

Source DB:  PubMed          Journal:  Eur Urol        ISSN: 0302-2838            Impact factor:   20.096


  16 in total

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