Maze of Medical Scans: Finding the Path to Better RCC Surveillance

Rethinking RCC Surveillance: Is Less Really More?

Beau Callahan in Health & Wellness November 2025 • 4 min read.

"A New Perspective on Renal Cell Carcinoma Follow-Up"

For individuals who've battled localized renal cell carcinoma (RCC), the journey doesn't quite end with the final surgery. Oncologic surveillance—regular check-ups and tests—becomes the new normal. But here's the catch: there's surprisingly little hard evidence to guide exactly how much surveillance is needed. This is largely based on the idea that by keeping a close eye on things, recurrence is caught early, leading to better outcomes. However, this approach may not always be the best one.

Several organizations have developed their own sets of surveillance guidelines for RCC, including the European Association of Urology (EAU), the National Comprehensive Cancer Network (NCCN), and others. The challenge, however, lies in the lack of high-quality evidence to back a specific frequency, duration, or type of surveillance testing. The result is a lack of consensus, leaving doctors and patients to navigate this phase with uncertainty.

Against this backdrop of uncertainty, research is stepping in to find the path forward. A recent study by Dabestani et al., published in European Urology, is stirring up the debate. It questions whether more intensive imaging during follow-up truly provides a benefit for patients who have undergone surgery for localized RCC. Their findings suggest that the answer isn't as straightforward as we might think.

The Great Imaging Debate: How Much is Too Much?

Maze of Medical Scans: Finding the Path to Better RCC Surveillance

The study delved into the RECUR database, a collection of information from 12 centers across eight European countries. The researchers looked at 336 RCC recurrences that were surgically treated between 2006 and 2011. They aimed to determine the number of images needed to spot recurrences and whether more imaging led to better survival rates. The question: Did patients who underwent more frequent imaging, as compared to the 2017 EAU guidelines, fare better?

The findings revealed that a hefty 52 imaging procedures were needed to detect just one recurrence. And to identify a high-risk patient who was still recurrence-free after treatment? A staggering 697 images! These figures prompt a serious consideration of resource allocation and patient burden.

Quantity vs. Quality: It took 52 imaging procedures to detect a single recurrence.
Resource Intensive: Identifying a recurrence-free, high-risk patient required 697 images.
No Survival Advantage: More intensive imaging didn't significantly improve overall survival.

Interestingly, the study found no significant differences in overall survival, regardless of whether patients underwent more or less intensive surveillance imaging compared to the 2017 EAU guidelines. The study also revealed that conventional imaging methods (chest X-ray/ultrasound) were used in over half of the cases (53%). The EAU guidelines recommend cross-sectional imaging for better detection of recurrences.

Time to Rethink RCC Surveillance?

The study by Dabestani et al. highlights a crucial point: more surveillance isn't always better. The current guidelines, which often take a one-size-fits-all approach, may not be the most effective or efficient way to monitor patients after RCC treatment. What's needed is a more individualized strategy that takes into account a patient's specific risk factors, preferences, and overall health. This will allow for a more balanced approach that prioritizes medical necessity and economic sustainability.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.eururo.2018.10.052, Alternate LINK

Title: More Isn’T Always Better: Time To Derive A Different Strategy For Renal Cell Carcinoma Surveillance

Subject: Urology

Journal: European Urology

Publisher: Elsevier BV

Authors: Suzanne B. Merrill

Published: 2019-02-01

Everything You Need To Know

What does oncologic surveillance mean for individuals who have been treated for renal cell carcinoma (RCC), and what are the challenges with current surveillance guidelines?

Oncologic surveillance for renal cell carcinoma (RCC) involves regular check-ups and tests post-surgery to monitor for recurrence. However, current guidelines lack solid evidence for optimal frequency, duration, and type of testing. This has led to varied approaches among doctors and patients, creating uncertainty about the best course of action. Further research is needed to establish evidence-based surveillance strategies.

How were the 2017 European Association of Urology (EAU) guidelines used in the study mentioned, and what are the implications of the study's findings in relation to these guidelines?

The 2017 European Association of Urology (EAU) guidelines are used as a benchmark in the study by Dabestani et al. to assess the intensity of imaging surveillance. The study compared patient outcomes based on whether they underwent more or less intensive imaging compared to these guidelines. However, it's important to note that the study found no significant differences in overall survival, suggesting that adhering strictly to these guidelines might not always result in improved patient outcomes.

What is the RECUR database, and how was it used in the study to assess the effectiveness of imaging for renal cell carcinoma (RCC) recurrence?

The RECUR database is a collection of information from 12 centers across eight European countries, containing data on 336 surgically treated renal cell carcinoma (RCC) recurrences between 2006 and 2011. Researchers used this database to determine the number of images needed to spot recurrences and whether more imaging led to better survival rates. It served as the basis for the study's conclusions about the effectiveness of intensive imaging surveillance.

According to the study, how many imaging procedures are typically needed to detect a recurrence of renal cell carcinoma (RCC), and what are the implications of these findings?

The study by Dabestani et al. found that it took a large number of imaging procedures to detect even a single recurrence of renal cell carcinoma (RCC). Specifically, 52 imaging procedures were needed to detect one recurrence, and an astonishing 697 images were required to identify a recurrence-free, high-risk patient. These findings raise concerns about the efficient allocation of resources and the burden placed on patients undergoing frequent imaging.

What does it mean to shift toward more individualized surveillance strategies for renal cell carcinoma (RCC), and how could this approach improve patient care and resource allocation?

The shift toward individualized surveillance for renal cell carcinoma (RCC) acknowledges that a 'one-size-fits-all' approach may not be optimal. Individualized strategies would consider a patient's specific risk factors, preferences, and overall health to tailor surveillance plans. Such an approach aims to balance medical necessity and economic sustainability, ensuring that patients receive the most appropriate level of monitoring without unnecessary burden or resource expenditure.