Is chest X-Ray necessary for renal cell carcinoma surveillance after partial nephrectomy and radical nephrectomy?

Abstract

Objective: To evaluate the detection rateof chest radiographs (CXR) and thoraxcomputer tomography (CT) for asymp-tomatic lung metastasis during surveillancefollow-up of renal cell carcinoma (RCC)after partial nephrectomy (PN) and radicalnephrectomy (RN).Patients and Methods: A retrospectivereview of PN and RN for RCC between2001 and 2014 was done to identify theincidence of lung metastasis, patientdemographics, tumour characteristics andtotal number of chest radiographs. Patientswho had concomitant malignancies andcyto-reductive nephrectomies wereexcluded.Results: 269 patients were included (114PN and 155 RN). In the PN group, therewere 82% T1a, 16% T1b and 2% T2a dis-eases. The RN group had 50% T1, 27% T2and 22% T3 diseases. The median follow-up was at least 54 months. 1691 and 2761CXR were done for PN and RN groupsrespectively. 55 and 224 CT thorax weredone for PN and RN groups respectively.For PN, the pickup rate of lung metastasiswas 0.06% by CXR and 0% by CT thorax.That of RN was 0.29% and 5.8% respec-tively.Conclusion: Routine surveillance withCXR is not useful in surveillance after PNor RN regardless of risk group. CT thoraxshould be considered in surveillance of RNafter risk stratification.