San Diego, CA USA (UroToday.com) Currently, AUA guidelines for the surveillance of patients treated with partial nephrectomy for renal cell malignancies recommend follow-up imaging within 3 to 12 months post-op. However, some expected post-operative changes can be difficult to interpret and lead to abnormal imaging.
This can in turn lead to increased patient anxiety regarding their results, as well as uncertainty for the urologist. To evaluate this hypothesis, Dr. Tubre and colleagues performed a retrospective review of partial nephrectomy cases at their institution and they presented their finding in their podium presentation. Their objectives for this study were to examine if abnormal findings are associated with earlier post-operative imaging and if it also leads to earlier additional imaging or an increase in the rate of earlier detection of recurrence.
From 2006 to 2013, the authors reported a total of 180 partial nephrectomy cases with a minimum of 2 years of follow-up imaging. Approximately, 70% of the total patients were considered to have normal findings in their initial post-op images and approximately 30% were considered to be abnormal at initial post-op images.
Of the abnormal imaging group, 60% were deemed normal on subsequent imaging. Significant differences were observed for median time initial follow-up for normal vs abnormal imaging (205 vs 133 days) and the median time interval between imaging (188 vs 157 days).
Their results of this review revealed that imaging obtained prior to 6 months post-op resulted in more abnormal findings than images obtained more than 6 months post-op. Overall, this led to closer follow-up and earlier repeat imaging but there was no increase in the rate of recurrence detection. The authors concluded from their findings that post-operative imaging can potentially be delayed up to 1 year after surgery to reduce the number of unnecessary additional imaging as well as patient anxiety due to their indeterminate imaging.
Presented By: Ryan Tubre, MD
Written By: Renai Yoon; Research Associate, Department of Urology, University of California, Irvine at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA