What are the precautions to be taken in the follow-up of kidney cancer patients?

  The main purpose of follow-up is to check for recurrence, metastasis and neoplastic tumors. The physician in charge may refer to the following with reference to the local medical conditions and the patient’s condition.  The first follow-up can be performed 4-6 weeks after surgery to assess renal function, recovery from blood loss and any surgical complications. A renal CT scan will be performed 4-6 weeks after surgery for patients undergoing NSS to understand the morphological changes of the kidney for comparison in future reviews.  Routine follow-up includes: 1. history questioning; 2. physical examination; 3. routine blood and blood biochemical tests: liver and kidney function as well as blood biochemical indicators of abnormal preoperative examination, such as abnormal preoperative blood alkaline phosphatase, usually require further review because recurrent or persistent abnormal alkaline phosphatase usually indicates distant metastasis or residual tumor. A bone scan is required if there is an abnormal elevation of alkaline phosphatase and/or if there are symptoms of bone metastases such as bone pain. Elevated alkaline phosphatase may also be a sign of liver metastasis or paraneoplastic syndrome; 4. Chest X-ray (frontal and lateral) Patients with abnormal findings on chest X-ray examination are recommended to undergo CT scan examination of the chest; 5. Abdominal ultrasound examination. Patients with abnormalities found in abdominal ultrasound examination, NSS and post-surgical patients with T3-T4 stage kidney cancer need to undergo abdominal CT scan examination, which can be performed once every 6 months for 2 years, and later depending on the specific situation.  Follow-up time frame for each stage of kidney cancer: 1. T1-T2: follow-up every 3-6 months for 3 consecutive years, and annually thereafter; 2. T3-T4: follow-up every 3 months for 2 consecutive years, every 6 months in the third year, and annually thereafter; 3. After treatment of VHL syndrome: CT scan of abdomen and head should be performed once every 6 months. MRI of the central nervous system, urinary catecholamine measurement, ophthalmology and hearing examination should be performed once a year.