Follow-up guidelines after radical or partial nephrectomy for localized and locally advanced renal cell carcinoma

Renal cell carcinoma (RCC) comprises approximately 2% of all malignancies. It is the seventh most common cancer and tenth most common cause of cancer-related deaths among men.1 Risk factors for RCC include smoking, obesity, and hereditary conditions associated with a mutation in the von-Hippel-Lindau gene (level 2).2,3 Surgical resection (radical or partial nephrectomy) remains the only effective therapy for clinically localized RCC. Publications that address surveillance after surgical extirpation are based on retrospective analysis, including some larger multicentre studies and well-designed controlled studies.4 Randomized prospective studies are sparse, rendering it difficult to obtain qualified evidence-based data. Although there is no clear consensus on surveillance after surgical extirpation for patients with RCC, this document attempts to provide some clarity and guidance for the practising urologist based on the current literature. Where possible, levels of evidence and grades of recommendations are provided employing the modified Oxford Centre for Evidence-based Medicine scheme.