How is the diagnosis of renal cell carcinoma made?

  The main purpose of follow-up is to check whether there are recurrence, metastasis and new tumor. It is not yet possible to determine the economical and reasonable follow-up contents and follow-up time frame. The competent physician may refer to the following contents in the light of local medical conditions and patient’s condition The main assessment is renal function, recovery status after blood loss and the presence of surgical complications. For patients with NSS, renal CT scan will be performed 4-6 weeks after surgery to understand the morphological changes of the kidney for future review.  Routine follow-up includes: 1) medical history; 2) physical examination; 3) routine blood and blood biochemical examination: liver and kidney function and blood biochemical indexes of abnormal preoperative examination, such as abnormal preoperative blood alkaline phosphatase, usually need 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 scans of the 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.