World Journal of Urology

, Volume 37, Issue 12, pp 2727–2736 | Cite as

Impact of routine imaging in the diagnosis of recurrence for patients with localized and locally advanced renal tumor treated with nephrectomy

  • Baptiste GiresEmail author
  • Zine-Eddine Khene
  • Pierre Bigot
  • Quentin Alimi
  • Benoit Peyronnet
  • Grégory Verhoest
  • Andrea Manunta
  • Karim Bensalah
  • Romain Mathieu
Original Article



Modalities of surveillance to detect recurrence after nephrectomy for localized or locally advanced renal tumor are not standardized. The aim was to assess the impact of surveillance scheme on oncological outcomes.


Patients treated for localized or locally advanced renal tumor with total or partial nephrectomy between 2006 and 2010 in an academic institution were included retrospectively. According to the University of California Los Angeles Integrated Staging System (UISS) protocol, follow-up was considered adequate or not. Symptoms, location and number of lesions at recurrence diagnosis were collected. Recurrence-free, cancer-specific and overall survivals were estimated using the Kaplan–Meier method and compared with the log-rank test. Cox proportional hazards regression models were calculated to identify prognostic factors.


A total of 267 patients were included. Median follow-up was 72 months. Recurrence rate was 23.2% (62/267 patients). Recurrences were local (16%), single metastatic (23%), oligo-metastatic (15%) or multi-metastatic (46%). 72.6% of the recurrences occurred within the 3 years after surgery. No recurrence was diagnosed by chest X-ray or abdominal ultrasound. One hundred and twenty-one patients had inadequate follow-up. They had similar recurrence-free survival, cancer-specific survival and overall survival as patients with adequate follow-up. In multivariable analysis, the presence of multi-metastatic lesions was an independent prognostic factor of worse cancer-specific mortality after recurrence diagnosis (HR = 10.15, 95% CI: 2.29–44.82, p = 0.002).


Role of chest X-ray and abdominal ultrasound for the detection of recurrences is limited. Rigorous follow-up according to the UISS protocol does not improve oncological outcomes. Follow-up schedules with less frequent imaging should be discussed.


Renal tumor Follow-up Recurrence Survival Tomography 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

345_2019_2724_MOESM1_ESM.docx (15 kb)
Supplementary material 1 (DOCX 15 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of UrologyRennes University HospitalRennesFrance
  2. 2.Department of UrologyAngers University HospitalAngersFrance
  3. 3.CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) UMR_S 1085Univ RennesRennesFrance
  4. 4.Service d’urologieHôpital PontchaillouRennesFrance

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