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RCC Surveillance — SCE Medical Oncology MCQ

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HardUrological CancersRCC SurveillanceSCE Medical Oncology

A 58-year-old man with clear cell RCC undergoes radical nephrectomy. Pathology shows Fuhrman grade 4, pT3b (renal vein extension). He recovers well and asks about follow-up. What surveillance schedule is recommended for high-risk resected RCC?

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Correct answer: A — Use risk-adapted cross-sectional chest and abdominal surveillance beyond three years

pT3b grade-4 RCC needs risk-adapted cross-sectional surveillance of chest and abdomen extending beyond the earliest postoperative years. Use annual abdominal ultrasound and chest radiography for three postoperative years: high-risk RCC needs cross-sectional chest and abdominal surveillance and a longer horizon. Use six-monthly abdominal CT and chest radiography for two postoperative years: the chest modality and duration under-stage a high-risk recurrence pattern. Use annual whole-body PET-CT for five postoperative years: routine PET-CT is not the standard risk-adapted surveillance modality. Use symptom-triggered chest and abdominal CT after one postoperative baseline scan: high-risk surveillance is scheduled rather than purely symptom triggered.

Reference: EAU renal-cell-carcinoma guideline: follow-up (2026 limited update): https://uroweb.org/guidelines/renal-cell-carcinoma/chapter/followup-in-rcc; NICE NG256 kidney cancer: managing advanced renal-cell carcinoma (Published March 2026): https://www.nice.org.uk/guidance/NG256/chapter/managing-advanced-renal-cell-carcinoma