Follow-up after focal therapy in renal masses: an international multidisciplinary Delphi consensus project

To establish consensus on follow-up (FU) after focal therapy (FT) in renal masses. To formulate recommendations to aid in clinical practice and research.

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.

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.

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.

World journal of urology. 2016 Apr 22 [Epub ahead of print]

P J Zondervan, P G K Wagstaff, M M Desai, D M de Bruin, A F Fraga, B A Hadaschik, J Köllermann, U B Liehr, S A Pahernik, H P Schlemmer, J J Wendler, F Algaba, J J M C H de la Rosette, M P Laguna Pes

Department of Urology, AMC University Hospital, PO box 22660, 1100DD, Amsterdam, The Netherlands. ., Department of Urology, AMC University Hospital, PO box 22660, 1100DD, Amsterdam, The Netherlands., Department of Urology, Keck School of Medicine USC, Los Angeles, CA, USA., Department of Urology, AMC University Hospital, PO box 22660, 1100DD, Amsterdam, The Netherlands., Department of Urology, Centro Hospitalar do Porto, Porto, Portugal., Department of Urology, University Hospital Heidelberg, Heidelberg, Germany., Department of Pathology, Sana Klinikum Offenbach, Offenbach, Germany., Department of Urology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany., Department of Urology, University Hospital Heidelberg, Heidelberg, Germany., Department of Urology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany., Department of Radiology, German Cancer Research Center, Heidelberg, Germany., Department of Pathology, Fundació Puigvert, Barcelona, Spain., Department of Urology, AMC University Hospital, PO box 22660, 1100DD, Amsterdam, The Netherlands., Department of Urology, AMC University Hospital, PO box 22660, 1100DD, Amsterdam, The Netherlands.

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