Abstract
Surgery remains the standard of care for patients with localized renal cell carcinoma (RCC). However, compared to patients with low-stage, low-grade disease, patients with locally advanced RCC, including venous involvement, extracapsular extension, and involvement of adjacent lymph nodes or organs, demonstrate a high risk for both recurrence and progression of disease with decreased survival despite surgical therapy. Regardless, aggressive surgical resection, when feasible, remains the best treatment for locally advanced RCC. Although surgical management of locally advanced disease may be challenging, excellent results, including improved cancer-specific survival, can be achieved.
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References
Zisman A, Pantuck AJ, Wieder J, et al. Risk group assessment and clinical outcome algorithm to predict the natural history of patients with surgically resected renal cell carcinoma. J Clin Oncol. 2002;20(23):4559–66.
Leibovich BC, Blute ML, Cheville JC, et al. Prediction of progression after radical nephrectomy for patients with clear cell renal cell carcinoma: a stratification tool for prospective clinical trials. Cancer. 2003;97(7):1663–71.
Zini L, Perrotte P, Jeldres C, et al. Nephrectomy improves the survival of patients with locally advanced renal cell carcinoma. BJU Int. 2008;102(11):1610–4.
Motzer RJ, Agarwal N, Beard C, et al. NCCN clinical practice guidelines in oncology: kidney cancer. J Natl Compr Canc Netw. 2009;7(6):618–30.
Marshall FF. Lymphadenectomy for renal cell carcinoma. BJU Int. 2005;95 Suppl 2:34.
Herrlinger A, Schrott KM, Schott G, Sigel A. What are the benefits of extended dissection of the regional renal lymph nodes in the therapy of renal cell carcinoma. J Urol. 1991;146(5):1224–7.
Motzer RJ, Bander NH, Nanus DM. Renal-cell carcinoma. N Engl J Med. 1996;335(12):865–75.
Hilton S. Imaging of renal cell carcinoma. Semin Oncol. 2000;27(2):150–9.
Studer UE, Scherz S, Scheidegger J, et al. Enlargement of regional lymph nodes in renal cell carcinoma is often not due to metastases. J Urol. 1990;144(2 Pt 1):243–5.
Johnson CD, Dunnick NR, Cohan RH, Illescas FF. Renal adenocarcinoma: CT staging of 100 tumors. Am J Roentgenol. 1987;148(1):59–63.
Giuliani L, Martorana G, Giberti C, Pescatore D, Magnani G. Results of radical nephrectomy with extensive lymphadenectomy for renal cell carcinoma. J Urol. 1983;130(4):664–8.
Zisman A, Pantuck AJ, Dorey F, et al. Improved prognostication of renal cell carcinoma using an integrated staging system. J Clin Oncol. 2001;19(6):1649–57.
Pantuck AJ, Zisman A, Dorey F, et al. Renal cell carcinoma with retroperitoneal lymph nodes. Impact on survival and benefits of immunotherapy. Cancer. 2003;97(12):2995–3002.
Giuliani L, Giberti C, Martorana G, Rovida S. Radical extensive surgery for renal cell carcinoma: long-term results and prognostic factors. J Urol. 1990;143(3):468–73 [discussion 73–4].
Margulis V, Tamboli P, Matin SF, Swanson DA, Wood CG. Analysis of clinicopathologic predictors of oncologic outcome provides insight into the natural history of surgically managed papillary renal cell carcinoma. Cancer. 2008;112(7):1480–8.
Delacroix SE, Jr., Chapin BF, Chen JJ, Nogueras-Gonzalez GM, Tamboli P, Matin SF, et al. Can a durable disease-free survival be achieved with surgical resection in patients with pathological node positive renal cell carcinoma? The Journal of urology. 2011;186(4):1236–41. Epub 2011/08/19.
Blute ML, Leibovich BC, Cheville JC, Lohse CM, Zincke H. A protocol for performing extended lymph node dissection using primary tumor pathological features for patients treated with radical nephrectomy for clear cell renal cell carcinoma. J Urol. 2004;172(2):465–9.
Canfield SE, Kamat AM, Sanchez-Ortiz RF, Detry M, Swanson DA, Wood CG. Renal cell carcinoma with nodal metastases in the absence of distant metastatic disease (clinical stage TxN1-2M0): the impact of aggressive surgical resection on patient outcome. J Urol. 2006;175(3 Pt 1):864–9.
Terrone C, Guercio S, De Luca S, et al. The number of lymph nodes examined and staging accuracy in renal cell carcinoma. BJU Int. 2003;91(1):37–40.
Joslyn SA, Sirintrapun SJ, Konety BR. Impact of lymphadenectomy and nodal burden in renal cell carcinoma: retrospective analysis of the National Surveillance, Epidemiology, and End Results database. Urology. 2005;65(4):675–80.
Dimashkieh HH, Lohse CM, Blute ML, Kwon ED, Leibovich BC, Cheville JC. Extranodal extension in regional lymph nodes is associated with outcome in patients with renal cell carcinoma. J Urol. 2006;176(5):1978–82 [discussion 82–3].
Raj GV, Bochner BH. Radical cystectomy and lymphadenectomy for invasive bladder cancer: towards the evolution of an optimal surgical standard. Semin Oncol. 2007;34(2):110–21.
Stephenson AJ, Bosl GJ, Motzer RJ, Bajorin DF, Stasi JP, Sheinfeld J. Nonrandomized comparison of primary chemotherapy and retroperitoneal lymph node dissection for clinical stage IIA and IIB nonseminomatous germ cell testicular cancer. J Clin Oncol. 2007;25(35):5597–602.
Hulten L, Rosencrantz M, Seeman T, Wahlqvist L, Ahren C. Occurrence and localization of lymph node metastases in renal carcinoma. A lymphographic and histopathological investigation in connection with nephrectomy. Scand J Urol Nephrol. 1969;3(2):129–33.
Saitoh H, Hida M, Nakamura K, Satoh T. Distant metastasis of urothelial tumors of the renal pelvis and ureter. Tokai J Exp Clin Med. 1982;7(3):355–64.
Freedland SJ, Dekernion JB. Role of lymphadenectomy for patients undergoing radical nephrectomy for renal cell carcinoma. Rev Urol. 2003;5(3):191–5.
DeKernion JB. Lymphadenectomy for renal cell carcinoma. Therapeutic implications. Urolog Clin North Am. 1980;7(3):697–703.
Robson CJ, Churchill BM, Anderson W. The results of radical nephrectomy for renal cell carcinoma. |J Urol. 1969;101(3):297–301.
Wood Jr DP. Role of lymphadenectomy in renal cell carcinoma. Urol Clin North Am. 1991;18(3):421–6.
Peters PC, Brown GL. The role of lymphadenectomy in the management of renal cell carcinoma. Urol Clin North Am. 1980;7(3):705–9.
Pantuck AJ, Zisman A, Dorey F, et al. Renal cell carcinoma with retroperitoneal lymph nodes: role of lymph node dissection. J Urol. 2003;169(6):2076–83.
Johnsen JA, Hellsten S. Lymphatogenous spread of renal cell carcinoma: an autopsy study. J Urol. 1997;157(2):450–3.
Minervini A, Lilas L, Morelli G, et al. Regional lymph node dissection in the treatment of renal cell carcinoma: is it useful in patients with no suspected adenopathy before or during surgery? BJU Int. 2001;88(3):169–72.
Schafhauser W, Ebert A, Brod J, Petsch S, Schrott KM. Lymph node involvement in renal cell carcinoma and survival chance by systematic lymphadenectomy. Anticancer Res. 1999;19(2C):1573–8.
Blom JH, van Poppel H, Marechal JM, et al. Radical nephrectomy with and without lymph-node dissection: final results of European Organization for Research and Treatment of Cancer (EORTC) randomized phase 3 trial 30881. Eur Urol. 2009;55(1):28–34.
Blom JH, van Poppel H, Marechal JM, et al. Radical nephrectomy with and without lymph node dissection: preliminary results of the EORTC randomized phase III protocol 30881. EORTC Genitourinary Group. Eur Urol. 1999;36(6):570–5.
Crispen PL, Breau RH, Allmer C, et al. Lymph node dissection at the time of radical nephrectomy for high-risk clear cell renal cell carcinoma: indications and recommendations for surgical templates. Eur Urol. 2011;59(1):18–23.
Hutterer GC, Patard JJ, Perrotte P, et al. Patients with renal cell carcinoma nodal metastases can be accurately identified: external validation of a new nomogram. Int J Cancer. 2007;121(11):2556–61.
Kearney GP, Waters WB, Klein LA, Richie JP, Gittes RF. Results of inferior vena cava resection for renal cell carcinoma. J Urol. 1981;125(6):769–73.
Hatcher PA, Anderson EE, Paulson DF, Carson CC, Robertson JE. Surgical management and prognosis of renal cell carcinoma invading the vena cava. J Urol. 1991;145(1):20–3 [discussion 3–4].
Marshall FF. Renal cell carcinoma: surgical management of regional lymph nodes and inferior vena-caval tumor thrombus. Semin Surg Oncol. 1988;4(2):129–32.
Skinner DG, Pfister RF, Colvin R. Extension of renal cell carcinoma into the vena cava: the rationale for aggressive surgical management. J Urol. 1972;107(5):711–6.
Wszolek MF, Wotkowicz C, Libertino JA. Surgical management of large renal tumors. Nat Clin Pract. 2008;5(1):35–46.
Martinez-Salamanca JI, Huang WC, Millan I, et al. Prognostic impact of the 2009 UICC/AJCC TNM staging system for renal cell carcinoma with venous extension. Eur Urol. 2011;59(1):120–7.
Kirkali Z, Van Poppel H. A critical analysis of surgery for kidney cancer with vena cava invasion. Eur Urol. 2007;52(3):658–62.
Oto A, Herts BR, Remer EM, Novick AC. Inferior vena cava tumor thrombus in renal cell carcinoma: staging by MR imaging and impact on surgical treatment. Am J Roentgenol. 1998;171(6):1619–24.
Goldfarb DA, Lorig R, Zelch M, Patrone P, Bukowski RM, Pontes JE. Right renal mass with vena caval thrombus. J Urol. 1990;143(3):574–7.
Mizoguchi T, Koide Y, Ohara M, Okumura F. Multiplane transesophageal echocardiographic guidance during resection of renal cell carcinoma extending into the inferior vena cava. Anesth Analg. 1995;81(5):1102–5.
Mootha RK, Butler R, Laucirica R, Scardino PT, Lerner SP. Renal cell carcinoma with an infrarenal vena caval tumor thrombus. Urology. 1999;54(3):561.
Otaibi MA, Tanguay S. Locally advanced renal cell carcinoma. Can Urol Assoc J. 2007;1(2 Suppl):S55–61.
Staehler G, Brkovic D. The role of radical surgery for renal cell carcinoma with extension into the vena cava. J Urol. 2000;163(6):1671–5.
Blute ML, Leibovich BC, Lohse CM, Cheville JC, Zincke H. The Mayo Clinic experience with surgical management, complications and outcome for patients with renal cell carcinoma and venous tumour thrombus. BJU Int. 2004;94(1):33–41.
Gettman MT, Boelter CW, Cheville JC, Zincke H, Bryant SC, Blute ML. Charlson co-morbidity index as a predictor of outcome after surgery for renal cell carcinoma with renal vein, vena cava or right atrium extension. J Urol. 2003;169(4):1282–6.
Glazer AA, Novick AC. Long-term followup after surgical treatment for renal cell carcinoma extending into the right atrium. J Urol. 1996;155(2):448–50.
Zisman A, Wieder JA, Pantuck AJ, et al. Renal cell carcinoma with tumor thrombus extension: biology, role of nephrectomy and response to immunotherapy. J Urol. 2003;169(3):909–16.
Skinner DG, Pritchett TR, Lieskovsky G, Boyd SD, Stiles QR. Vena caval involvement by renal cell carcinoma. Surgical resection provides meaningful long-term survival. Ann Surg. 1989;210(3):387–92 [discussion 92–4].
Swierzewski DJ, Swierzewski MJ, Libertino JA. Radical nephrectomy in patients with renal cell carcinoma with venous, vena caval, and atrial extension. Am J Surg. 1994;168(2):205–9.
Sweeney P, Wood CG, Pisters LL, et al. Surgical management of renal cell carcinoma associated with complex inferior vena caval thrombi. Urol Oncol. 2003;21(5):327–33.
Zini L, Haulon S, Decoene C, et al. Renal cell carcinoma associated with tumor thrombus in the inferior vena cava: surgical strategies. Ann Vasc Surg. 2005;19(4):522–8.
Schwartz MJ, Smith EB, Trost DW, Vaughan Jr ED. Renal artery embolization: clinical indications and experience from over 100 cases. BJU Int. 2007;99(4):881–6.
Novick AC, Kaye MC, Cosgrove DM, et al. Experience with cardiopulmonary bypass and deep hypothermic circulatory arrest in the management of retroperitoneal tumors with large vena caval thrombi. Ann Surg. 1990;212(4):472–6 [discussion 6–7].
Wotkowicz C, Wszolek MF, Libertino JA. Resection of renal tumors invading the vena cava. Urol Clin North Am. 2008;35(4):657–71. vii.
Gallucci M, Borzomati D, Flammia G, et al. Liver harvesting surgical technique for the treatment of retro-hepatic caval thrombosis concomitant to renal cell carcinoma: perioperative and long-term results in 15 patients without mortality. Eur Urol. 2004;45(2):194–202.
Ciancio G, Hawke C, Soloway M. The use of liver transplant techniques to aid in the surgical management of urological tumors. J Urol. 2000;164(3 Pt 1):665–72.
Ciancio G, Soloway M. Renal cell carcinoma invading the hepatic veins. Cancer. 2001;92(7):1836–42.
Burt JD, Bowsher WG, Joyce G, et al. The management of renal cell carcinoma with inferior vena-caval involvement. Aust N Z J Surg. 1993;63(1):25–9.
Marshall FF, Reitz BA, Diamond DA. A new technique for management of renal cell carcinoma involving the right atrium: hypothermia and cardiac arrest. J Urol. 1984;131(1):103–7.
Vaislic CD, Puel P, Grondin P, et al. Cancer of the kidney invading the vena cava and heart. Results after 11 years of treatment. J Thorac Cardiovasc Surg. 1986;91(4):604–9.
Marshall VF, Middleton RG, Holswade GR, Goldsmith EI. Surgery for renal cell carcinoma in the vena cava. J Urol. 1970;103(4):414–20.
Stewart JR, Carey JA, McDougal WS, Merrill WH, Koch MO, Bender Jr HW. Cavoatrial tumor thrombectomy using cardiopulmonary bypass without circulatory arrest. Ann Thorac Surg. 1991;51(5):717–21 [discussion 21–2].
Al Otaibi M, Abou Youssif T, Alkhaldi A, et al. Renal cell carcinoma with inferior vena caval extention: impact of tumour extent on surgical outcome. BJU Int. 2009;104(10):1467–70.
Boorjian SA, Sengupta S, Blute ML. Renal cell carcinoma: vena caval involvement. BJU Int. 2007;99(5 Pt B):1239–44.
Karnes RJ, Blute ML. Surgery insight: management of renal cell carcinoma with associated inferior vena cava thrombus. Nat Clin Pract. 2008;5(6):329–39.
Rigaud J, Hetet JF, Braud G, et al. Surgical care, morbidity, mortality and follow-up after nephrectomy for renal cancer with extension of tumor thrombus into the inferior vena cava: retrospective study since 1990s. Eur Urol. 2006;50(2):302–10.
Goetzl MA, Goluboff ET, Murphy AM, et al. A contemporary evaluation of cytoreductive nephrectomy with tumor thrombus: morbidity and long-term survival. Urol Oncol. 2004;22(3):182–7.
Parekh DJ, Cookson MS, Chapman W, et al. Renal cell carcinoma with renal vein and inferior vena caval involvement: clinicopathological features, surgical techniques and outcomes. J Urol. 2005;173(6):1897–902.
Rabbani F, Hakimian P, Reuter VE, Simmons R, Russo P. Renal vein or inferior vena caval extension in patients with renal cortical tumors: impact of tumor histology. J Urol. 2004;171(3):1057–61.
Bensalah K, Rioux-Leclercq N, Vincendeau S, Guille F, Patard JJ. Is tumour expression of VEGF associated with venous invasion and survival in pT3 renal cell carcinoma? Prog Urol. 2007;17(2):189–93.
Rey D, Pfister C, Gobet F, Martinez S, Staerman F, Grise P. Study of the prognostic value of DNA ploidy and proliferation index (Ki-67) in renal cell carcinoma with venous thrombus. Prog Urol. 2003;13(6):1300–6.
Klatte T, Pantuck AJ, Riggs SB, et al. Prognostic factors for renal cell carcinoma with tumor thrombus extension. J Urol. 2007;178(4 Pt 1):1189–95 [discussion 95].
Kim HL, Zisman A, Han KR, Figlin RA, Belldegrun AS. Prognostic significance of venous thrombus in renal cell carcinoma. Are renal vein and inferior vena cava involvement different? J Urol. 2004;171(2 Pt 1):588–91.
Ciancio G, Livingstone AS, Soloway M. Surgical management of renal cell carcinoma with tumor thrombus in the renal and inferior vena cava: the University of Miami experience in using liver transplantation techniques. Eur Urol. 2007;51(4):988–94 [discussion 94–5].
Lambert EH, Pierorazio PM, Shabsigh A, Olsson CA, Benson MC, McKiernan JM. Prognostic risk stratification and clinical outcomes in patients undergoing surgical treatment for renal cell carcinoma with vascular tumor thrombus. Urology. 2007;69(6):1054–8.
Wagner B, Patard JJ, Mejean A, et al. Prognostic value of renal vein and inferior vena cava involvement in renal cell carcinoma. Eur Urol. 2009;55(2):452–9.
Moinzadeh A, Libertino JA. Prognostic significance of tumor thrombus level in patients with renal cell carcinoma and venous tumor thrombus extension. Is all T3b the same? J Urol. 2004;171(2 Pt 1):598–601.
Klaver S, Joniau S, Suy R, Oyen R, Van Poppel H. Analysis of renal cell carcinoma with subdiaphragmatic macroscopic venous invasion (T3b). BJU Int. 2008;101(4):444–9.
Ciancio G, Soloway M. Resection of the abdominal inferior vena cava for complicated renal cell carcinoma with tumour thrombus. BJU Int. 2005;96(6):815–8.
Marshall FF, Reitz BA. Supradiaphragmatic renal cell carcinoma tumor thrombus: indications for vena caval reconstruction with pericardium. J Urol. 1985;133(2):266–8.
Caldarelli G, Minervini A, Guerra M, Bonari G, Caldarelli C, Minervini R. Prosthetic replacement of the inferior vena cava and the iliofemoral vein for urologically related malignancies. BJU Int. 2002;90(4):368–74.
Hardwigsen J, Baque P, Crespy B, Moutardier V, Delpero JR, Le Treut YP. Resection of the inferior vena cava for neoplasms with or without prosthetic replacement: a 14-patient series. Ann Surg. 2001;233(2):242–9.
Zini L, Destrieux-Garnier L, Leroy X, et al. Renal vein ostium wall invasion of renal cell carcinoma with an inferior vena cava tumor thrombus: prediction by renal and vena caval vein diameters and prognostic significance. J Urol. 2008;179(2):450–4 [discussion 4].
Kume H, Kameyama S, Kasuya Y, Tajima A, Kawabe K. Surgical treatment of renal cell carcinoma associated with Budd-Chiari syndrome: report of four cases and review of the literature. Eur J Surg Oncol. 1999;25(1):71–5.
Roberts WW, Bhayani SB, Allaf ME, Chan TY, Kavoussi LR, Jarrett TW. Pathological stage does not alter the prognosis for renal lesions determined to be stage T1 by computerized tomography. J Urol. 2005;173(3):713–5.
Jung SJ, Ro JY, Truong LD, Ayala AG, Shen SS. Reappraisal of T3N0/NxM0 renal cell carcinoma: significance of extent of fat invasion, renal vein invasion, and adrenal invasion. Hum Pathol. 2008;39(11):1689–94.
Fujita T, Iwamura M, Yanagisawa N, et al. Prognostic impact of perirenal fat or adrenal gland involvement in patients with pT3b renal cell carcinoma. Urology. 2007;69(5):839–42.
Ficarra V, Galfano A, Guille F, et al. A new staging system for locally advanced (pT3-4) renal cell carcinoma: a multicenter European study including 2,000 patients. J Urol. 2007;178(2):418–24 [discussion 23–4].
Thompson RH, Cheville JC, Lohse CM, et al. Reclassification of patients with pT3 and pT4 renal cell carcinoma improves prognostic accuracy. Cancer. 2005;104(1):53–60.
Satyapal KS. Classification of the drainage patterns of the renal veins. J Anat. 1995;186(Pt 2):329–33.
Bonsib SM, Gibson D, Mhoon M, Greene GF. Renal sinus involvement in renal cell carcinomas. Am J Surg Pathol. 2000;24(3):451–8.
Thompson RH, Leibovich BC, Cheville JC, et al. Is renal sinus fat invasion the same as perinephric fat invasion for pT3a renal cell carcinoma? J Urol. 2005;174(4 Pt 1):1218–21.
Margulis V, Tamboli P, Matin SF, Meisner M, Swanson DA, Wood CG. Location of extrarenal tumor extension does not impact survival of patients with pT3a renal cell carcinoma. J Urol. 2007;178(5):1878–82.
Terrone C, Cracco C, Guercio S, et al. Prognostic value of the involvement of the urinary collecting system in renal cell carcinoma. Eur Urol. 2004;46(4):472–6.
Klatte T, Chung J, Leppert JT, et al. Prognostic relevance of capsular involvement and collecting system invasion in stage I and II renal cell carcinoma. BJU Int. 2007;99(4):821–4.
Lam JS, Breda A, Belldegrun AS, Figlin RA. Evolving principles of surgical management and prognostic factors for outcome in renal cell carcinoma. J Clin Oncol. 2006;24(35):5565–75.
Connolly J, Eisner D, Goldman S, Stutzman R, Steiner M. Benign retroperitoneal fibrosis and renal cell carcinoma. J Urol. 1993;149(6):1535–7.
Margulis V, Wood CG. Update on staging controversies for locally advanced renal cell carcinoma. Expert Rev Anticancer Ther. 2007;7(7):909–14.
Dekernion JB, Ramming KP, Smith RB. The natural history of metastatic renal cell carcinoma: a computer analysis. J Urol. 1978;120(2):148–52.
Karellas ME, Jang TL, Kagiwada MA, Kinnaman MD, Jarnagin WR, Russo P. Advanced-stage renal cell carcinoma treated by radical nephrectomy and adjacent organ or structure resection. BJU Int. 2009;103(2):160–4.
Margulis V, Sanchez-Ortiz RF, Tamboli P, Cohen DD, Swanson DA, Wood CG. Renal cell carcinoma clinically involving adjacent organs: experience with aggressive surgical management. Cancer. 2007;109(10):2025–30.
Tsui KH, Shvarts O, Smith RB, Figlin RA, deKernion JB, Belldegrun A. Prognostic indicators for renal cell carcinoma: a multivariate analysis of 643 patients using the revised 1997 TNM staging criteria. J Urol. 2000;163(4):1090–5. quiz 295.
Antonelli A, Cozzoli A, Simeone C, et al. Surgical treatment of adrenal metastasis from renal cell carcinoma: a single-centre experience of 45 patients. BJU Int. 2006;97(3):505–8.
Han KR, Bui MH, Pantuck AJ, et al. TNM T3a renal cell carcinoma: adrenal gland involvement is not the same as renal fat invasion. J Urol. 2003;169(3):899–903 [discussion 4].
Ito K, Nakazawa H, Marumo K, et al. Risk factors for ipsilateral adrenal involvement in renal cell carcinoma. Urology. 2008;72(2):354–8.
Paul R, Mordhorst J, Busch R, Leyh H, Hartung R. Adrenal sparing surgery during radical nephrectomy in patients with renal cell cancer: a new algorithm. J Urol. 2001;166(1):59–62.
Tsui KH, Shvarts O, Barbaric Z, Figlin R, de Kernion JB, Belldegrun A. Is adrenalectomy a necessary component of radical nephrectomy? UCLA experience with 511 radical nephrectomies. J Urol. 2000;163(2):437–41.
Lam JS, Shvarts O, Leppert JT, Figlin RA, Belldegrun AS. Renal cell carcinoma 2005: new frontiers in staging, prognostication and targeted molecular therapy. J Urol. 2005;173(6):1853–62.
Levy DA, Slaton JW, Swanson DA, Dinney CP. Stage specific guidelines for surveillance after radical nephrectomy for local renal cell carcinoma. J Urol. 1998;159(4):1163–7.
Stephenson AJ, Chetner MP, Rourke K, et al. Guidelines for the surveillance of localized renal cell carcinoma based on the patterns of relapse after nephrectomy. J Urol. 2004;172(1):58–62.
Sandock DS, Seftel AD, Resnick MI. A new protocol for the followup of renal cell carcinoma based on pathological stage. J Urol. 1995;154(1):28–31.
Ljungberg B, Hanbury DC, Kuczyk MA, et al. Renal cell carcinoma guideline. Eur Urol. 2007;51(6):1502–10.
Saidi JA, Newhouse JH, Sawczuk IS. Radiologic follow-up of patients with T1–3a, b, c or T4N  +  M0 renal cell carcinoma after radical nephrectomy. Urology. 1998;52(6):1000–3.
Han KR, Pantuck AJ, Bui MH, et al. Number of metastatic sites rather than location dictates overall survival of patients with node-negative metastatic renal cell carcinoma. Urology. 2003;61(2):314–9.
Lam JS, Shvarts O, Leppert JT, Pantuck AJ, Figlin RA, Belldegrun AS. Postoperative surveillance protocol for patients with localized and locally advanced renal cell carcinoma based on a validated prognostic nomogram and risk group stratification system. J Urol. 2005;174(2):466–72 [discussion 72; quiz 801].
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Culp, S.H., Wood, C.G. (2013). Locally Advanced Renal Cell Carcinoma. In: Campbell, S., Rini, B. (eds) Renal Cell Carcinoma. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-062-5_11
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