The routine follow-up visit includes: ①History inquiry. (2) Physical examination. (3) Laboratory tests, including urine routine, blood routine, urea nitrogen, creatinine, glomerular filtration rate, lactate dehydrogenase, liver function, alkaline phosphatase, and serum calcium. Bone scan is indicated if there is an abnormal elevation of alkaline phosphatase and/or if there are signs of bone metastases such as bone pain. (iv) CT scan of the chest. Patients with renal tumors with acute neurological signs or symptoms should have an immediate cross-sectional CT or MRI scan of the head or a spinal cord scan based on the appropriate segmental symptoms.
(i) Postoperative follow-up.
Patients with pT1N0/NxM0 stage renal cell carcinoma treated with surgery should have abdominal CT or MRI examination as baseline film within 3-12 months after the guideline for treatment of renal cell carcinoma, and then once a year for 3 consecutive years for abdominal imaging ultrasound, CT or MRI examination, and once a year for 3 consecutive years for chest CT to determine whether there is lung metastasis. For patients with pT2-4N0/NxM0 renal cell carcinoma treated with surgery, the time limit for imaging was changed to once every 6 months for at least 3 years, and then once a year thereafter.
(ii) Follow-up of patients with local treatment.
For patients with pT1aN0/NxM0 stage renal cell carcinoma who received local treatment such as cryopreservation and radiofrequency, abdominal CT or MRI should be done as baseline films within 3-6 months after surgery, and then once a year thereafter (including abdominal and chest imaging); if the original renal lesions are found to be enlarged, new enhancement appears, or new lesions appear during follow-up, puncture biopsy of the lesions is required.
(iii) Follow-up of patients with advanced disease.
For patients with recurrent/metastatic stage IV renal cell carcinoma receiving systemic therapy, CT or MRI imaging should be performed on all evaluable lesions (lesions larger than 1 cm in maximum diameter) throughout the body as baseline films before systemic therapy if possible, and the same imaging should be performed every 6 to 16 weeks thereafter to compare the changes in size and number of lesions according to the condition and treatment plan to evaluate the The efficacy of systemic therapy should be evaluated by comparing the size and number of lesions with the same imaging every 6 to 16 weeks according to the disease and treatment plan.