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Purpose: The Panel sought to create evidence-based guidelines for the follow-upand surveillance of clinically localized renal cancers treated with surgery or renalablative procedures, biopsy-proven untreated clinically localized renal cancersfollowed on surveillance, and radiographically suspicious but biopsy-unprovenrenal neoplasms either treated with renal ablative procedures or followed onactive surveillance.  These guidelines are not meant to address hereditary orpediatric kidney cancers, although they must take into account that a proportionof adult patients may harbor a yet unrecognized hereditary form of renal cancer.

Methods: A systematic review was conducted to identify published articlesrelevant to key questions specified by the Panel related to kidney neoplasms andtheir follow-up (imaging, renal function, markers, biopsy, prognosis). This searchcovered English-language articles published between January 1999 and 2011. Anupdated query was later conducted to include studies published through August2012. These publications were used to inform the statements presented in theguideline as Standards, Recommendations or Options. When sufficient evidenceexisted, the body of evidence for a particular treatment was assigned a strengthrating of A (high), B (moderate) or C (low). In the absence of sufficient evidence,additional information is provided as Clinical Principles and Expert Opinion.

GUIDELINE STATEMENTS

1.Patients undergoing follow-up for treated or observed renal masses shouldundergo a history and physical examination directed at detecting signs andsymptoms of metastatic spread or local recurrence. (Clinical Principle)

2.Patients undergoing follow-up for treated or observed renal masses shouldundergo basic laboratory testing to include blood urea nitrogen (BUN)/creatinine, urine analysis (UA) and estimated glomerular filtration rate (eGFR).Other laboratory evaluations, including complete blood count (**), lactatedehydrogenase (LDH), liver function tests (LFTs), alkaline phosphatase (ALP)and calcium level, may be used at the discretion of the clinician. (ExpertOpinion)

完整版下載    2013AUA腎癌隨訪指南