The follow‐up management of non‐metastatic renal cell carcinoma: definition of a surveillance protocol

OBJECTIVE To define a follow‐up protocol based on the University of California Los Angeles Integrated Staging System (UISS) for patients undergoing surgery for N0M0 renal cell carcinoma (RCC). PATIENTS AND METHODS The clinical records of patients treated with radical surgery for N0/NXM0 RCC and monitored through periodic follow‐up studies (≥24 months in disease‐free patients) were reviewed retrospectively from 1399 patients surgically treated for renal neoplasms between 1983 and 2005. Each case was assigned a UISS risk category; recurrence features, time and site were recorded. In particular, recurrence sites were categorized into local, renal (ipsilateral or contralateral) and distant (single‐site or disseminated). RESULTS The records were reviewed of 814 patients with a mean follow‐up of 75.6 months. UISS risk categories were distributed as follows: high‐risk (HR) 17.2%, intermediate‐risk (IR) 51.6% and low‐risk (LR) 31.2%. Disease‐free survival rates at 5 years were 63.9%, 88.3% and 96.5% (log‐rank test P