Nonmetastatic renal-cell carcinoma: is it really possible to define rational guidelines for post-treatment follow-up?

<!DOCTYPE html> <html lang="en" class="grade-c"> <head> <title>Nonmetastatic renal-cell carcinoma: is it really possible to define rational guidelines for post-treatment follow-up? | Nature Reviews Clinical Oncology</title> <link rel="alternate" type="application/rss+xml" href="https://www.nature.com/nrclinonc.rss"/> <script id="save-data-connection-testing"> function hasConnection() { return navigator.connection || navigator.mozConnection || navigator.webkitConnection || navigator.msConnection; } function createLink(src) { var preloadLink = document.createElement("link"); preloadLink.rel = "preload"; preloadLink.href = src; preloadLink.as = "font"; preloadLink.type = "font/woff2"; preloadLink.crossOrigin = ""; document.head.insertBefore(preloadLink, document.head.firstChild); } var connectionDetail = { saveDataEnabled: false, slowConnection: false }; var connection = hasConnection(); if (connection) { connectionDetail.saveDataEnabled = connection.saveData; if 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define rational guidelines for post-treatment follow-up?</h1> <ul class="c-article-author-list c-article-author-list--short" data-test="authors-list" data-component-authors-activator="authors-list"><li class="c-article-author-list__item"><a data-test="author-name" data-track="click" data-track-action="open author" data-track-label="link" href="#auth-Olivier-Rouvi_re-Aff1" data-author-popup="auth-Olivier-Rouvi_re-Aff1" data-author-search="Rouvière, Olivier" data-corresp-id="c1">Olivier Rouvière<svg width="16" height="16" focusable="false" role="img" aria-hidden="true" class="u-icon"><use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="#icon-eds-i-mail-medium"></use></svg></a><sup class="u-js-hide"><a href="#Aff1">1</a></sup>, </li><li class="c-article-author-list__item"><a data-test="author-name" data-track="click" data-track-action="open author" data-track-label="link" href="#auth-Raymonde-Bouvier-Aff2-Aff3-Aff4-Aff5" data-author-popup="auth-Raymonde-Bouvier-Aff2-Aff3-Aff4-Aff5" data-author-search="Bouvier, Raymonde">Raymonde Bouvier</a><sup class="u-js-hide"><a href="#Aff2">2</a>,<a href="#Aff3">3</a>,<a href="#Aff4">4</a>,<a href="#Aff5">5</a></sup>, </li><li class="c-article-author-list__item c-article-author-list__item--hide-small-screen"><a data-test="author-name" data-track="click" data-track-action="open author" data-track-label="link" href="#auth-Sylvie-N_grier-Aff2-Aff3-Aff4-Aff5" data-author-popup="auth-Sylvie-N_grier-Aff2-Aff3-Aff4-Aff5" data-author-search="Négrier, Sylvie">Sylvie Négrier</a><sup class="u-js-hide"><a href="#Aff2">2</a>,<a href="#Aff3">3</a>,<a href="#Aff4">4</a>,<a href="#Aff5">5</a></sup>, </li><li class="c-article-author-list__item c-article-author-list__item--hide-small-screen"><a data-test="author-name" data-track="click" data-track-action="open author" data-track-label="link" href="#auth-Lionel-Badet-Aff2-Aff3-Aff4-Aff5" data-author-popup="auth-Lionel-Badet-Aff2-Aff3-Aff4-Aff5" data-author-search="Badet, Lionel">Lionel Badet</a><sup class="u-js-hide"><a href="#Aff2">2</a>,<a href="#Aff3">3</a>,<a href="#Aff4">4</a>,<a href="#Aff5">5</a></sup> & </li><li class="c-article-author-list__show-more" aria-label="Show all 5 authors for this article" title="Show all 5 authors for this article">…</li><li class="c-article-author-list__item"><a data-test="author-name" data-track="click" data-track-action="open author" data-track-label="link" href="#auth-Denis-Lyonnet-Aff2-Aff3-Aff4-Aff5" data-author-popup="auth-Denis-Lyonnet-Aff2-Aff3-Aff4-Aff5" data-author-search="Lyonnet, Denis">Denis Lyonnet</a><sup class="u-js-hide"><a href="#Aff2">2</a>,<a href="#Aff3">3</a>,<a href="#Aff4">4</a>,<a href="#Aff5">5</a></sup> </li></ul><button aria-expanded="false" class="c-article-author-list__button"><svg width="16" height="16" focusable="false" role="img" aria-hidden="true" class="u-icon"><use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="#icon-eds-i-chevron-down-medium"></use></svg><span>Show authors</span></button> <p class="c-article-info-details" data-container-section="info"> <a data-test="journal-link" href="/nrclinonc" data-track="click" data-track-action="journal homepage" data-track-category="article body" data-track-label="link"><i data-test="journal-title">Nature Clinical Practice Oncology</i></a> <b data-test="journal-volume"><span class="u-visually-hidden">volume</span> 3</b>, <span class="u-visually-hidden">pages </span>200–213 (<span data-test="article-publication-year">2006</span>)<a href="#citeas" class="c-article-info-details__cite-as u-hide-print" data-track="click" data-track-action="cite this article" data-track-label="link">Cite this article</a> </p> <div class="c-article-metrics-bar__wrapper u-clear-both"> <ul class="c-article-metrics-bar u-list-reset"> <li class=" c-article-metrics-bar__item" data-test="access-count"> <p class="c-article-metrics-bar__count">103 <span class="c-article-metrics-bar__label">Accesses</span></p> </li> <li class="c-article-metrics-bar__item" data-test="altmetric-score"> <p class="c-article-metrics-bar__count">3 <span class="c-article-metrics-bar__label">Altmetric</span></p> </li> <li class="c-article-metrics-bar__item"> <p class="c-article-metrics-bar__details"><a href="/articles/ncponc0479/metrics" data-track="click" data-track-action="view metrics" data-track-label="link" rel="nofollow">Metrics <span class="u-visually-hidden">details</span></a></p> </li> </ul> </div> </header> </div> <div class="c-article-body"> <section aria-labelledby="Abs2" data-title="Abstract" lang="en"><div class="c-article-section" id="Abs2-section"><h2 class="c-article-section__title js-section-title js-c-reading-companion-sections-item" id="Abs2">Abstract</h2><div class="c-article-section__content" id="Abs2-content"><p>Defining rational follow-up guidelines in patients treated for cancer is important, from both a medical and an economical perspective. Renal-cell carcinoma is reputed to be unpredictable in its course and only a few, and often contradictory, follow-up guidelines exist for patients treated for nonmetastatic renal-cell carcinoma. Recent advances in tumor biology have contributed to a better understanding of this cancer and have indicated that personalized follow-up regimens, based on tumor and host molecular characteristics, might be possible in the near future.</p></div></div></section><section aria-labelledby="Abs3" data-title="Key Points" lang="en"><div class="c-article-section" id="Abs3-section"><h2 class="c-article-section__title js-section-title js-c-reading-companion-sections-item" id="Abs3">Key Points</h2><div class="c-article-section__content" id="Abs3-content"> <ul class="u-list-style-bullet"> <li> <p>Conventional prognostic factors (e.g. TNM stage, histological subtype and grade) are robust parameters with appropriate validation but cannot entirely explain the complex natural history of renal-cell carcinoma</p> </li> </ul> <ul class="u-list-style-bullet"> <li> <p>Comprehensive nomograms that combine recognized outcome predictors seem to dramatically improve recurrence prognostication and should be widely used in the near future</p> </li> </ul> <ul class="u-list-style-bullet"> <li> <p>Many promising molecular markers with prognostic value have been described, but further validation is needed before they can be used in clinical practice</p> </li> </ul> <ul class="u-list-style-bullet"> <li> <p>Metastases usually appear within 2 years after radical nephrectomy, but 9–11% of the patients surviving at 10 years will experience late recurrence</p> </li> </ul> <ul class="u-list-style-bullet"> <li> <p>The promising preliminary results obtained with antiangiogenic treatments emphasize the need for early identification of recurrence and thus for rational follow-up protocols</p> </li> </ul> <ul class="u-list-style-bullet"> <li> <p>It is hoped that prognostic nomograms combining conventional and molecular markers will help to customize the follow-up strategy to the actual risk of recurrence for each patient</p> </li> </ul> </div></div></section> <div class="js-context-bar-sticky-point-mobile" 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id="author-information-content"><h3 class="c-article__sub-heading" id="affiliations">Authors and Affiliations</h3><ol class="c-article-author-affiliation__list"><li id="Aff1"><p class="c-article-author-affiliation__address">Senior Radiologist in the Department of Urinary, Vascular and Interventional Radiology at the Edouard Herriot Hospital, and Researcher in Unit 556 of the Institut National de la Santé et de la Recherche Médicale (INSERM), Lyon, France</p><p class="c-article-author-affiliation__authors-list">Olivier Rouvière</p></li><li id="Aff2"><p class="c-article-author-affiliation__address">Head of the Department of Urologic Pathology, </p><p class="c-article-author-affiliation__authors-list">Raymonde Bouvier, Sylvie Négrier, Lionel Badet & Denis Lyonnet</p></li><li id="Aff3"><p class="c-article-author-affiliation__address">Deputy Director at the Léon Bérard Comprehensive Cancer Center, </p><p class="c-article-author-affiliation__authors-list">Raymonde Bouvier, Sylvie Négrier, Lionel Badet & Denis Lyonnet</p></li><li id="Aff4"><p class="c-article-author-affiliation__address">Assistant Professor of Urology and Transplant Surgery, </p><p class="c-article-author-affiliation__authors-list">Raymonde Bouvier, Sylvie Négrier, Lionel Badet & Denis Lyonnet</p></li><li id="Aff5"><p class="c-article-author-affiliation__address">Head of the Department of Urinary, Vascular and Interventional Radiology, Edouard Herriot Hospital, Lyon, France</p><p class="c-article-author-affiliation__authors-list">Raymonde Bouvier, Sylvie Négrier, Lionel Badet & Denis Lyonnet</p></li></ol><div class="u-js-hide u-hide-print" data-test="author-info"><span class="c-article__sub-heading">Authors</span><ol class="c-article-authors-search u-list-reset"><li id="auth-Olivier-Rouvi_re-Aff1"><span class="c-article-authors-search__title u-h3 js-search-name">Olivier Rouvière</span><div class="c-article-authors-search__list"><div class="c-article-authors-search__item 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Nonmetastatic renal-cell carcinoma: is it really possible to define rational guidelines for post-treatment follow-up? | Nature Reviews Clinical Oncology