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A prospective risk-stratified follow-up programme for radically treated renal cell carcinoma patients: evaluation after eight years of clinical use

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Abstract

Purpose

In mid-2007, we introduced a new risk-stratified follow-up programme (FUP) for surgically treated localized renal cell carcinoma. After inclusion, the patients have been followed prospectively. In this study, we present the results in regard to stratification, completeness of the FUP and recurrences.

Methods

The FUP consists of three risk groups: low risk (LR), intermediate risk (IR) and high risk (HR), based on the risk stratification model introduced by Leibovich et al. (Cancer 97(7):1663–1671, 2003). In all risk groups, the patients are scheduled for ten follow-up visits (FUV) over 5 years, but seven, five and three FUVs, respectively, are outsourced to the patient’s general practitioner (GP). Chest X-ray and abdomen CT are the imaging modalities used in the FUP.

Results

Of 312 included patients, 195 (62.5 %) had a complete FUP. However, in 86 patients the scheduled FUP had to be reduced, leaving 86.3 % of the remaining patients with a complete FUP. By including GPs, the number of FUVs at the hospital was reduced by ~60 %. The 5-year probability for freedom of recurrence is 0.98, 0.84 and 0.52 for the LR, IR and HR groups, respectively. Of 31 recurrences, 20 patients (65 %) were diagnosed within the FUP. Eleven patients (35 %) were diagnosed due to symptoms, and five of these had recurrences in locations not covered by standard imaging. Patients diagnosed within the FUP showed a better prognosis for survival and could in greater part receive tumour-directed treatment.

Conclusions

After 8 years of clinical use, the outcome measures of the FUP seem to be within acceptable ranges.

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Authors’ contribution

C. Beisland and K. Hjelle were involved in protocol/project development. C. Beisland, G. Guðbrandsdottir, L. Reisæter, L. Bostad and K. Hjelle took part in data collection or management. C. Beisland and L. Reisæter performed data analysis. C. Beisland, L. Bostad, L. Reisæter, K. Hjelle and G. Guðbrandsdottir were involved in manuscript writing/editing.

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Authors and Affiliations

  1. Department of Urology, Haukeland University Hospital, 5021, Bergen, Norway

    Christian Beisland, Gigja Guðbrandsdottir & Karin M. Hjelle

  2. Department of Radiology, Haukeland University Hospital, Bergen, Norway

    Lars A. R. Reisæter

  3. Department of Pathology, Haukeland University Hospital, Bergen, Norway

    Leif Bostad

  4. Department of Clinical Medicine, University of Bergen, Bergen, Norway

    Christian Beisland, Lars A. R. Reisæter, Leif Bostad & Karin M. Hjelle

Authors
  1. Christian Beisland
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  2. Gigja Guðbrandsdottir
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  3. Lars A. R. Reisæter
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  4. Leif Bostad
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  5. Karin M. Hjelle
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Corresponding author

Correspondence to Christian Beisland.

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Conflict of interest

The authors have nothing to disclose.

Informed consent

All included patients have signed informed conforms.

Ethical standards

The study was carried out with no funding from sources other than the institutions mentioned on the title page. The study was carried out in accordance with the permission given by the Norwegian Social Science Data Services and the Regional Committee for Medical and Health Research Ethics in Western Norway (78/05 and 2015/875). The research is done in accordance with the ethical standards described in the “instructions for authors” on the webpage (accessed 2 December 2015).

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Beisland, C., Guðbrandsdottir, G., Reisæter, L.A.R. et al. A prospective risk-stratified follow-up programme for radically treated renal cell carcinoma patients: evaluation after eight years of clinical use. World J Urol 34, 1087–1099 (2016). https://doi.org/10.1007/s00345-016-1796-4

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  • DOI: https://doi.org/10.1007/s00345-016-1796-4

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