Skip to main content

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

Erschienen in: Urologie in der Praxis 4/2022

29.11.2022 | Originalien

Onkologische Nachsorge des nicht metastasierten Nierenzellkarzinoms (RCC) nach kurativ intendierter Therapie

verfasst von: Dr. med. Andre Zitz, Dr. med. univ. Lukas Prause

Erschienen in: Urologie in der Praxis | Ausgabe 4/2022

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die onkologische Nachsorge des nicht metastasierten Nierenzellkarzinoms (RCC) nach kurativ intendierter chirurgischer Therapie ist bislang unter den Fachgesellschaften nicht standardisiert, und die Empfehlungen unterscheiden sich aufgrund mangelnder Evidenz mitunter erheblich. Gemeinsam ist jedoch das Ziel, ein Rezidiv bzw. Metastasen frühzeitig zu erkennen, um das Gesamtüberleben zu verlängern. Das individuelle Risiko, im postoperativen Verlauf ein Rezidiv oder Metastasen zu entwickeln, kann anhand validierter Risikokalkulatoren zur Einteilung in Prognosegruppen genutzt werden, um eine stadiengerechte Nachsorge zu ermöglichen.
Grundsätzlich lassen sich aus der vorliegenden Literatur und anhand der aktuellen Leitlinien der europäischen Gesellschaft für Urologie (EAU) folgende Schlussfolgerungen ziehen: Bei einem geringen bis mittleren Rezidivrisiko sollte die Tumornachsorge über mindestens 3–5 Jahre durchgeführt werden. Anschliessend ist eine individuelle Anpassung der Nachsorge unter Berücksichtigung des Alters des Patienten sowie seiner Komorbiditäten durchzuführen. Bei einem hohen Rezidivrisiko sollte die Nachsorge lebenslang weitergeführt werden, da in der Literatur Fälle mit sehr später Metastasierung (14–38 Jahre) beschrieben sind.
Literatur
2.
Zurück zum Zitat Beisland C et al (2016) 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(8):1087–1099 CrossRef Beisland C et al (2016) 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(8):1087–1099 CrossRef
5.
Zurück zum Zitat Motzer RJ et al (2022) Kidney cancer, version 3.2022, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 20(1):71–90 CrossRef Motzer RJ et al (2022) Kidney cancer, version 3.2022, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 20(1):71–90 CrossRef
6.
Zurück zum Zitat Campbell SC et al (2021) Renal mass and localized renal cancer: evaluation, management, and follow-up: AUA guideline: part I. J Urol 206(2):199–208 CrossRef Campbell SC et al (2021) Renal mass and localized renal cancer: evaluation, management, and follow-up: AUA guideline: part I. J Urol 206(2):199–208 CrossRef
7.
Zurück zum Zitat Patard JJ et al (2004) Safety and efficacy of partial nephrectomy for all T1 tumors based on an international multicenter experience. J Urol 171(6):2181–2185 (quiz 2435) CrossRef Patard JJ et al (2004) Safety and efficacy of partial nephrectomy for all T1 tumors based on an international multicenter experience. J Urol 171(6):2181–2185 (quiz 2435) CrossRef
8.
Zurück zum Zitat Badalato GM et al (2012) Survival after partial and radical nephrectomy for the treatment of stage T1bN0M0 renal cell carcinoma (RCC) in the USA: a propensity scoring approach. BJU Int 109(10):1457–1462 CrossRef Badalato GM et al (2012) Survival after partial and radical nephrectomy for the treatment of stage T1bN0M0 renal cell carcinoma (RCC) in the USA: a propensity scoring approach. BJU Int 109(10):1457–1462 CrossRef
9.
Zurück zum Zitat Klett DE et al (2021) Partial versus radical nephrectomy in clinical T2 renal masses. Int J Urol 28(11):1149–1154 CrossRef Klett DE et al (2021) Partial versus radical nephrectomy in clinical T2 renal masses. Int J Urol 28(11):1149–1154 CrossRef
12.
Zurück zum Zitat Dabestani S et al (2016) Renal cell carcinoma recurrences and metastases in primary non-metastatic patients: a population-based study. World J Urol 34(8):1081–1086 CrossRef Dabestani S et al (2016) Renal cell carcinoma recurrences and metastases in primary non-metastatic patients: a population-based study. World J Urol 34(8):1081–1086 CrossRef
13.
Zurück zum Zitat Dabestani S et al (2019) Long-term outcomes of follow-up for initially localised clear cell renal cell carcinoma: RECUR database analysis. Eur Urol Focus 5(5):857–866 CrossRef Dabestani S et al (2019) Long-term outcomes of follow-up for initially localised clear cell renal cell carcinoma: RECUR database analysis. Eur Urol Focus 5(5):857–866 CrossRef
14.
Zurück zum Zitat Brookman-May S et al (2013) Features associated with recurrence beyond 5 years after nephrectomy and nephron-sparing surgery for renal cell carcinoma: development and internal validation of a risk model (PRELANE score) to predict late recurrence based on a large multicenter database (CORONA/SATURN project). Eur Urol 64(3):472–477 CrossRef Brookman-May S et al (2013) Features associated with recurrence beyond 5 years after nephrectomy and nephron-sparing surgery for renal cell carcinoma: development and internal validation of a risk model (PRELANE score) to predict late recurrence based on a large multicenter database (CORONA/SATURN project). Eur Urol 64(3):472–477 CrossRef
15.
Zurück zum Zitat Brookman-May SD et al (2013) Time to recurrence is a significant predictor of cancer-specific survival after recurrence in patients with recurrent renal cell carcinoma—results from a comprehensive multi-centre database (CORONA/SATURN-project). BJU Int 112(7):909–916 Brookman-May SD et al (2013) Time to recurrence is a significant predictor of cancer-specific survival after recurrence in patients with recurrent renal cell carcinoma—results from a comprehensive multi-centre database (CORONA/SATURN-project). BJU Int 112(7):909–916
16.
Zurück zum Zitat Kim SP et al (2011) Outcomes and clinicopathologic variables associated with late recurrence after nephrectomy for localized renal cell carcinoma. Urology 78(5):1101–1106 CrossRef Kim SP et al (2011) Outcomes and clinicopathologic variables associated with late recurrence after nephrectomy for localized renal cell carcinoma. Urology 78(5):1101–1106 CrossRef
17.
Zurück zum Zitat Levy DA et al (1998) Stage specific guidelines for surveillance after radical nephrectomy for local renal cell carcinoma. J Urol 159(4):1163–1167 CrossRef Levy DA et al (1998) Stage specific guidelines for surveillance after radical nephrectomy for local renal cell carcinoma. J Urol 159(4):1163–1167 CrossRef
18.
Zurück zum Zitat Kassouf W et al (2009) Follow-up guidelines after radical or partial nephrectomy for localized and locally advanced renal cell carcinoma. Can Urol Assoc J 3(1):73–76 CrossRef Kassouf W et al (2009) Follow-up guidelines after radical or partial nephrectomy for localized and locally advanced renal cell carcinoma. Can Urol Assoc J 3(1):73–76 CrossRef
19.
Zurück zum Zitat Zhu Y et al (2020) Metastatic renal cell carcinoma: a clinicopathological analysis of 196 cases. Zhonghua Bing Li Xue Za Zhi 49(12):1255–1260 Zhu Y et al (2020) Metastatic renal cell carcinoma: a clinicopathological analysis of 196 cases. Zhonghua Bing Li Xue Za Zhi 49(12):1255–1260
20.
Zurück zum Zitat Ljungberg B et al (1999) Follow-up guidelines for nonmetastatic renal cell carcinoma based on the occurrence of metastases after radical nephrectomy. BJU Int 84(4):405–411 CrossRef Ljungberg B et al (1999) Follow-up guidelines for nonmetastatic renal cell carcinoma based on the occurrence of metastases after radical nephrectomy. BJU Int 84(4):405–411 CrossRef
21.
Zurück zum Zitat Hafez KS, Novick AC, Campbell SC (1997) Patterns of tumor recurrence and guidelines for followup after nephron sparing surgery for sporadic renal cell carcinoma. J Urol 157(6):2067–2070 CrossRef Hafez KS, Novick AC, Campbell SC (1997) Patterns of tumor recurrence and guidelines for followup after nephron sparing surgery for sporadic renal cell carcinoma. J Urol 157(6):2067–2070 CrossRef
22.
Zurück zum Zitat Rabinovitch RA et al (1994) Patterns of failure following surgical resection of renal cell carcinoma: implications for adjuvant local and systemic therapy. J Clin Oncol 12(1):206–212 CrossRef Rabinovitch RA et al (1994) Patterns of failure following surgical resection of renal cell carcinoma: implications for adjuvant local and systemic therapy. J Clin Oncol 12(1):206–212 CrossRef
23.
Zurück zum Zitat Doornweerd BH et al (2014) Chest X‑ray in the follow-up of renal cell carcinoma. World J Urol 32(4):1015–1019 Doornweerd BH et al (2014) Chest X‑ray in the follow-up of renal cell carcinoma. World J Urol 32(4):1015–1019
24.
Zurück zum Zitat Leibovich BC et al (2003) Prediction of progression after radical nephrectomy for patients with clear cell renal cell carcinoma: a stratification tool for prospective clinical trials. Cancer 97(7):1663–1671 CrossRef Leibovich BC et al (2003) Prediction of progression after radical nephrectomy for patients with clear cell renal cell carcinoma: a stratification tool for prospective clinical trials. Cancer 97(7):1663–1671 CrossRef
25.
Zurück zum Zitat Patard JJ et al (2004) Use of the University of California Los Angeles integrated staging system to predict survival in renal cell carcinoma: an international multicenter study. J Clin Oncol 22(16):3316–3322 CrossRef Patard JJ et al (2004) Use of the University of California Los Angeles integrated staging system to predict survival in renal cell carcinoma: an international multicenter study. J Clin Oncol 22(16):3316–3322 CrossRef
26.
Zurück zum Zitat Han KR et al (2003) Validation of an integrated staging system toward improved prognostication of patients with localized renal cell carcinoma in an international population. J Urol 170(6):2221–2224 CrossRef Han KR et al (2003) Validation of an integrated staging system toward improved prognostication of patients with localized renal cell carcinoma in an international population. J Urol 170(6):2221–2224 CrossRef
27.
Zurück zum Zitat Kattan MW et al (2001) A postoperative prognostic nomogram for renal cell carcinoma. J Urol 166(1):63–67 CrossRef Kattan MW et al (2001) A postoperative prognostic nomogram for renal cell carcinoma. J Urol 166(1):63–67 CrossRef
28.
Zurück zum Zitat Pichler M et al (2011) External validation of the Leibovich prognosis score for nonmetastatic clear cell renal cell carcinoma at a single European center applying routine pathology. J Urol 186(5):1773–1777 CrossRef Pichler M et al (2011) External validation of the Leibovich prognosis score for nonmetastatic clear cell renal cell carcinoma at a single European center applying routine pathology. J Urol 186(5):1773–1777 CrossRef
29.
Zurück zum Zitat Vasudev NS et al (2020) UK multicenter prospective evaluation of the Leibovich score in localized renal cell carcinoma: performance has altered over time. Urology 136:162–168 CrossRef Vasudev NS et al (2020) UK multicenter prospective evaluation of the Leibovich score in localized renal cell carcinoma: performance has altered over time. Urology 136:162–168 CrossRef
30.
Zurück zum Zitat Baccala A et al (2007) Expression of prostate-specific membrane antigen in tumor-associated neovasculature of renal neoplasms. Urology 70(2):385–390 CrossRef Baccala A et al (2007) Expression of prostate-specific membrane antigen in tumor-associated neovasculature of renal neoplasms. Urology 70(2):385–390 CrossRef
31.
Zurück zum Zitat Merkx RIJ et al (2021) Phase I study to assess safety, biodistribution and radiation dosimetry for (89)Zr-girentuximab in patients with renal cell carcinoma. Eur J Nucl Med Mol Imaging 48(10):3277–3285 CrossRef Merkx RIJ et al (2021) Phase I study to assess safety, biodistribution and radiation dosimetry for (89)Zr-girentuximab in patients with renal cell carcinoma. Eur J Nucl Med Mol Imaging 48(10):3277–3285 CrossRef
32.
Zurück zum Zitat Zapała Ł et al (2022) Complete blood count-derived inflammatory markers and survival in patients with localized renal cell cancer treated with partial or radical nephrectomy: a retrospective single-tertiary-center study. Front Biosci 14(1):5 CrossRef Zapała Ł et al (2022) Complete blood count-derived inflammatory markers and survival in patients with localized renal cell cancer treated with partial or radical nephrectomy: a retrospective single-tertiary-center study. Front Biosci 14(1):5 CrossRef
Metadaten
Titel
Onkologische Nachsorge des nicht metastasierten Nierenzellkarzinoms (RCC) nach kurativ intendierter Therapie
verfasst von
Dr. med. Andre Zitz
Dr. med. univ. Lukas Prause
Publikationsdatum
29.11.2022
Verlag
Springer Vienna
Erschienen in
Urologie in der Praxis / Ausgabe 4/2022
Print ISSN: 2661-8737
Elektronische ISSN: 2661-8745
DOI
https://doi.org/10.1007/s41973-022-00195-w

Weitere Artikel der Ausgabe 4/2022

Urologie in der Praxis 4/2022 Zur Ausgabe

Editorial

Editorial

News-Screen Urologie

News-Screen Urologie