Follow-up after focal therapy in renal masses: an international multidisciplinary Delphi consensus project
Por:
Zondervan, PJ, Wagstaff, PGK, Desai, MM, de Bruin, DM, Fraga, AF, Hadaschik, BA, Kollermann, J, Liehr, UB, Pahernik, SA, Schlemmer, HP, Wendler, JJ, Algaba, F, de la Rosette, JJMCH, Pes, MPL
Publicada:
1 dic 2016
Resumen:
Purpose To establish consensus on follow-up (FU) after focal therapy (FT) in renal masses. To formulate recommendations to aid in clinical practice and research.
Methods Key topics and questions for consensus were identified from a systematic literature research. A Web-based questionnaire was distributed among participants selected based on their contribution to the literature and/or known expertise. Three rounds according to the Delphi method were performed online. Final discussion was conducted during the "8th International Symposium on Focal Therapy and Imaging in Prostate and Kidney Cancer" among an international multidisciplinary expert panel.
Results Sixty-two participants completed all three rounds of the online questionnaire. The panel recommended a minimum follow-up of 5 years, preferably extended to 10 years. The first FU was recommended at 3 months, with at least two imaging studies in the first year. Imaging was recommended biannually during the second year and annually thereafter. The panel recommended FU by means of CT scan with slice thickness <= 3 mm (at least three phases with excretory phase if suspicion of collecting system involvement) or mpMRI. Annual checkup for pulmonary metastasis by CT thorax was advised. Outside study protocols, biopsy during follow-up should only be performed in case of suspicion of residual/persistent disease or radiological recurrence.
Conclusions The consensus led to clear FU recommendations after FT of renal masses supported by a multidisciplinary expert panel. In spite of the low level of evidence, these recommendations can guide clinicians and create uniformity in the follow-up practice and for clinical research purposes.
Filiaciones:
Zondervan, PJ:
AMC Univ Hosp, Dept Urol, POB 22660, NL-1100 DD Amsterdam, Netherlands
Wagstaff, PGK:
AMC Univ Hosp, Dept Urol, POB 22660, NL-1100 DD Amsterdam, Netherlands
Desai, MM:
Keck Sch Med USC, Dept Urol, Los Angeles, CA USA
de Bruin, DM:
AMC Univ Hosp, Dept Urol, POB 22660, NL-1100 DD Amsterdam, Netherlands
AMC Univ Hosp, Dept Biomed Engn & Phys, Amsterdam, Netherlands
Fraga, AF:
Ctr Hosp Porto, Dept Urol, Oporto, Portugal
Hadaschik, BA:
Univ Heidelberg Hosp, Dept Urol, Heidelberg, Germany
Kollermann, J:
Sana Klinikum Offenbach, Dept Pathol, Offenbach, Germany
Liehr, UB:
Otto von Guericke Univ, Dept Urol, Magdeburg, Germany
Schlemmer, HP:
Otto von Guericke Univ, Dept Urol, Magdeburg, Germany
Wendler, JJ:
German Canc Res Ctr, Dept Radiol, Heidelberg, Germany
Algaba, F:
Fundacio Puigvert, Dept Pathol, Barcelona, Spain
de la Rosette, JJMCH:
AMC Univ Hosp, Dept Urol, POB 22660, NL-1100 DD Amsterdam, Netherlands
Pes, MPL:
AMC Univ Hosp, Dept Urol, POB 22660, NL-1100 DD Amsterdam, Netherlands
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