A survey of follow-up practice of urologists across Britain and Ireland following nephrectomy for renal cell carcinoma.

Abstract:

AIM:To determine the follow-up protocol for interval assessment of patients following radical nephrectomy for renal cell cancer and to compare them with the recommendations proposed in the literature. METHODS:Consultant urologists across Britain and Ireland completed a postal questionnaire. One follow-up mailing was used to encourage non-responders. The responses were analysed in the light of the recommendations from European Association of Urology and American guidelines. Also information was collected from the respondents on the choice of follow-up investigations for renal cell cancer and the total duration of follow-up. RESULTS:Of the 480 urologists surveyed 292 (60.8%) responded. Most respondents recommended regular follow-up with chest radiography (CR), ultrasound and computed tomography (CT). For T1 disease CR was requested by 28, 62 and 55%; for T2 disease by 30, 66 and 51%; for T3 disease by 39, 63, and 48% at 3, 6 and 12 months, respectively. For T1 disease US was requested by 5, 23 and 30%; for T2 disease 6, 27 and 30%; for T3 disease 8, 25, and 26% at 3, 6 and 12 months, respectively. For T1 disease an abdominal CT was requested by 2, 17 and 21%; for T2 disease 3.7, 19.5 and 26%; for T3 disease 10, 31, and 33% at 3, 6 and 12 months, respectively. Only one respondent followed the guidelines suggested in the literature. Further follow-up after 12 months for 5 and 10 years was suggested by 58.2 and 21.3% for T1, 53 and 24.73% for T2, and 45.5 and 25.5% for T3, respectively. There is appreciable variation in the frequency of use and timing of imaging. CONCLUSIONS:Most respondents perform follow-up after radical nephrectomy in patients with renal cancer, with considerable variability in their practices. In the current increasingly cost-conscious healthcare industry a scientifically justified follow-up should be considered.

journal_name

Clin Radiol

journal_title

Clinical radiology

authors

Basu S,Biyani CS,Sundaram SK,Spencer J

doi

10.1016/j.crad.2006.05.006

subject

Has Abstract

pub_date

2006-10-01 00:00:00

pages

854-60; discussion 861-2

issue

10

eissn

0009-9260

issn

1365-229X

pii

S0009-9260(06)00165-6

journal_volume

61

pub_type

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