What is the NCCN recommended monitoring schedule for active surveillance in patients with pT1a renal cell carcinoma (RCC)?

Updated: Jun 08, 2020
  • Author: Kush Sachdeva, MD; Chief Editor: E Jason Abel, MD  more...
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Answer

In patients with a clinically localized renal neoplasm who have chosen active surveillance, the American Urological Association (AUA) [74]  and the National Comprehensive Cancer Network (NCCN) [21]  recommend similar follow-up measures. The NCCN monitoring schedule for active surveillance in patients with pT1a disease is as follows [21] :

  • History and physical examination annually
  • Laboratory tests annually, as clinically indicated
  • Abdominal imaging: Abdominal CT or MRI with contrast if no contraindication within 6 mo of surveillance initiation, then CT, MRI, or US at least annually
  • Chest imaging: Chest x-ray or CT at baseline and annually as clinically indicated to assess for pulmonary metastases
  • Consider renal mass biopsy at initiation of active surveillance or at follow-up, as clinically indicated
  • Follow-up may be individualized based on surgical status, treatment schedules, side effects, comorbidities, and symptoms

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