Intensive Imaging-based Follow-up of Surgically Treated Localised Renal Cell Carcinoma Does Not Improve Post-recurrence Survival: Results from a European Multicentre Database (RECUR)

Forskningsoutput: TidskriftsbidragLetter

Abstract

The optimal follow-up (FU) strategy for patients treated for localised renal cell carcinoma (RCC) remains unclear. Using the RECUR database, we studied imaging intensity utilised in contemporary FU to evaluate its association with outcome after detection of disease recurrence. Consecutive patients with nonmetastatic RCC (n = 1612) treated with curative intent at 12 institutes across eight European countries between 2006 and 2011 were included. Recurrence occurred in 336 patients. Cross-sectional (computed tomography, magnetic resonance imaging) and conventional (chest X-ray, ultrasound) methods were used in 47% and 53%, respectively. More intensive FU imaging (more than twofold) than recommended by the European Association of Urology (EAU) was not associated with improved overall survival (OS) after recurrence. Overall, per patient treated for recurrence remaining alive with no evidence of disease, the number of FU images needed was 542, and 697 for high-risk patients. The study results suggest that use of more imaging during FU than that recommended in the 2017 EAU guidelines is unlikely to improve OS after recurrence. Prospective studies are needed to design optimal FU strategies for the future. Patient summary: After curative treatment for localised kidney cancer, follow-up is necessary to detect any recurrence. This study illustrates that increasing the imaging frequency during follow-up, even to double the number of follow-up imaging procedures recommended by the European Association of Urology guidelines, does not translate into improved survival for those with recurrence. After curative treatment for localised kidney cancer, a more intensive follow-up regimen than that recommended in the 2017 European Association of Urology guidelines did not improve overall survival among those experiencing recurrence, irrespective of the risk of recurrence. This suggests that an increase in follow-up imaging frequency is not cost-efficient. Prospective studies to identify more optimal follow-up strategies are needed.

Detaljer

Författare
  • Saeed Dabestani
  • Christian Beisland
  • Grant D. Stewart
  • Karim Bensalah
  • Eirikur Gudmundsson
  • Thomas B. Lam
  • William Gietzmann
  • Paimaun Zakikhani
  • Lorenzo Marconi
  • Sergio Fernandéz-Pello
  • Serenella Monagas
  • Samuel Paul Williams
  • Christian Torbrand
  • Thomas Powles
  • Erik Van Werkhoven
  • Richard Meijer
  • Alessandro Volpe
  • Michael Staehler
  • Börje Ljungberg
  • Axel Bex
Enheter & grupper
Externa organisationer
  • Haukeland University Hospital
  • University of Bergen
  • University of Cambridge
  • National University Hospital of Iceland
  • University of Aberdeen
  • University Hospital of Coimbra
  • Queen Mary University
  • Netherlands Cancer Institute
  • University Medical Center Utrecht
  • University of Eastern Piedmont
  • Umeå University
  • Skåne University Hospital
  • University of Rennes I
  • Aberdeen Royal Infirmary
  • University Hospital Cabueñes
  • San Agustin University Hospital
  • Ludwig-Maximilian University of Munich
  • University Hospital Munich
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Kirurgi
  • Urologi och njurmedicin

Nyckelord

Originalspråkengelska
Sidor (från-till)261-264
TidskriftEuropean Urology
Volym75
Utgivningsnummer2
StatusPublished - 2019
PublikationskategoriForskning
Peer review utfördJa