What follow-up protocols should I implement for patients treated for renal cell carcinoma to monitor for recurrence?

Follow-up protocols for patients treated for renal cell carcinoma (RCC) to monitor for recurrence should be tailored based on individual risk factors and treatment received.

Although the provided UK guidelines do not explicitly detail RCC follow-up protocols, standard clinical practice and NICE guidance on cancer follow-up generally recommend a risk-stratified approach involving periodic clinical assessment and imaging to detect recurrence early.

Typically, follow-up includes regular clinical reviews and imaging such as abdominal ultrasound, CT, or MRI scans at intervals determined by the initial tumour stage, grade, and treatment modality (e.g., nephrectomy).

For localized RCC treated surgically, follow-up often involves imaging every 6 to 12 months for the first 3 to 5 years, then annually or as clinically indicated, to monitor for local recurrence or metastasis.

Patients with higher risk features (e.g., higher stage or grade tumours) may require more intensive surveillance.

Coordination with a multidisciplinary team is essential to tailor follow-up plans and manage any detected recurrence promptly.

Primary care should ensure that patients attend scheduled follow-ups and report any new symptoms suggestive of recurrence, such as haematuria, flank pain, or unexplained weight loss.