Guidelines for review and follow-up of kidney cancer patients

  1. The first follow-up can be performed 4 to 6 weeks after surgery, mainly to assess renal function, recovery status after blood loss and any surgical complications. For patients who underwent partial nephrectomy, a renal CT scan is recommended 4 to 6 weeks after surgery to understand the morphological changes of the kidney and for future review for comparison.  T1-T2: follow-up every 3-6 months for 3 consecutive years and annually thereafter.  T3-T4: follow-up every 3 months for 2 years, every 6 months in the third year, and annually thereafter.  (Note: It is better for the attending physician to explain to the patient’s family the patient’s pathological staging, grading and tumor stage (T) when the patient is discharged from the hospital, so that the patient and the family can understand the condition and the content and time limit of the need for review and follow-up) 2. Review items: ① history inquiry ② physical examination ③ routine blood, liver function, kidney function, serum ion, lactate dehydrogenase (LDH), alkaline phosphatase, blood sedimentation and preoperative abnormal indicators. (If preoperative blood alkaline phosphatase is abnormal, further review is usually required because recurrent or persistent alkaline phosphatase abnormalities are usually indicative of distant metastases or residual tumor. If there is an abnormal elevation of alkaline phosphatase and/or symptoms of bone metastases such as bone pain, a bone scan is required. Elevated alkaline phosphatase may also be a sign of liver metastasis or paraneoplastic syndrome).  ④ Chest X-ray and abdominal ultrasound (Chest CT examination is preferable for patients with conditions or high risk) ⑤ Patients with abnormal findings on chest X-ray examination are recommended to undergo chest CT scan examination. Patients with abnormalities found by abdominal ultrasound examination, after partial nephrectomy and after surgery for T3-T4 stage renal cancer need to have abdominal CT scan examination, which can be done once every 6 months for 2 years, and thereafter depending on the specific situation.