Abstract
Objective: Modality and frequency of image-based renal cell carcinoma (R.C.C.) follow-up strategies are based on risk of recurrence. Using the R.E.C.U.R.-database, frequency of imaging was studied in regard to prognostic risk groups. Furthermore, it was investigated whether imaging modality utilized in contemporary follow-up were associated with outcome after detection of recurrence. Moreover, outcome was compared based on whether the assessment of potential curability was a pre-defined set of criteria’s (per-protocol) or stated by the investigator.Materials and methods: Consecutive non-metastatic R.C.C. patients (n = 1,612) treated with curative intent at 12 institutes across eight European countries between 2006 and 2011 were included. Leibovich or U.I.S.S. risk group, recurrence characteristics, imaging modality, frequency and survival were recorded. Primary endpoints were overall survival (O.S.) after detection of recurrence and frequency of features associated with favourable outcome (non-symptomatic recurrences and detection within the follow-up-programme).Results: Recurrence occurred in 336 patients. Within low, intermediate and high risk for recurrence groups, the frequency of follow-up imaging was highest in the early phase of follow-up and decreased significantly over time (p < 0.001). However, neither the image modality for detection nor ≥ 50% cross-sectional imaging during follow-up were associated with improved O.S. after recurrence. Differences between per protocol and investigator based assessment of curability did not translate into differences in O.S.Conclusions: As expected, the frequency of imaging was highest during early follow-up. Cross-sectional imaging use for detection of recurrences following surgery for localized R.C.C. did not improve O.S. post-recurrence. Prospective studies are needed to determine the value of imaging in follow-up.
Highlights
Among the purposes for follow-up after radical treatment of renal cell carcinoma (RCC) are observation of renal function, recovery from surgery, oncological control to detect recurrence of disease manifestations and a psychosocial need for both patient and physician following cancer treatment [1].It seems deeply rooted that early detection of cancer recurrences results in more effective treatment which improves survival
The overall CT Abdomen (CTA):US-ratio decreased from the high to the low Risk Group (RG) (3.2, 1.7 and 1.7, respectively; p
Irrespective of risk group, the highest frequency of imaging was during early follow-up, and decreased significantly with longer follow-up
Summary
It seems deeply rooted that early detection of cancer recurrences results in more effective treatment which improves survival. Based on this assumption, most of the readily used RCC follow-up strategies adapt their imaging modality and frequency to the risk and potential site of recurrence [2,3,4]. The literature investigating the impact of follow-up imaging after RCC treatment is limited [13,14,15], but a recent study failed to show superiority in regard to post-recurrence survival for more intensive use of follow-up imaging [12]. To our knowledge, there are no comparative studies exploring if a specific imaging modality translates into improved overall survival after RCC recurrence
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
