Within 2 weeks after undergoing radical nephrectomy, you should review your blood work, liver function, renal function, and electrolytes (including blood calcium) to evaluate surgical complications and postoperative recovery, and to assess the function of the remaining kidney to ensure that you can begin follow-up treatment. Approximately 1 week after surgery, you will receive a final pathology report, from which you will be given a pathology stage. The follow-up schedule will be based on your risk of recurrence related to pathologic staging.
Patients with early-stage kidney cancer will be reviewed every 3 months for 2 years after surgery; this may change to every 6 months after 2 years; and then annually for the rest of their lives starting in year 5. Review items include:
- History (diet, sleep, bowel movements, weight changes, etc.);
- Physical examination (general condition, presence of masses in surgical incisions, enlargement of superficial lymph nodes, etc.);
- Blood count, sedimentation, liver function, kidney function, electrolytes (including calcium), X-ray (frontal and lateral chest films), ultrasound (liver, gallbladder, pancreas, spleen, kidney, adrenal glands);
- Add CT (plain + enhanced) of both kidney areas for partial nephrectomy;
- Add ECT bone scan if ALP (alkaline phosphatase) is elevated or if bone pain is present;
- Add ECT bone scan if there is elevated ALP (alkaline phosphatase) or bone pain;
- Lung CT on X-rays with pulmonary nodularity.
Because most renal tumor recurrences lack clinical symptoms, imaging is particularly important, such as chest X-rays or occasional abdominal and thoracic CTs. In patients with advanced metastases, this subset of patients is selected for enrollment in appropriate follow-up treatment, with review, follow-up, and evaluation of outcome as required by the treatment protocol, typically every 6 to 8 weeks.
In addition, patients with slightly poor postoperative renal function require follow-up by both urologists and nephrologists. The nephrologist will provide appropriate treatment strategies to protect residual kidney function and prevent or delay decompensation.