Status of pretreatment evaluation, treatment and follow-up regimens for renal cell carcinoma in the Nordic countries

Abstract

OBJECTIVE: One prerequisite for performing multicentre studies is that the clinical handling of the patients must be uniform. We therefore evaluated possible differences in pretreatment evaluation, surgical treatment and follow-up regimes between the Nordic countries and between the different departments that performed nephrectomy due to renal cell carcinoma. MATERIAL AND METHODS: A questionnaire comprising 21 different questions was sent to all hospitals in the five Nordic countries performing nephrectomy. The questionnaires were returned by 195/226 (86%) departments. RESULTS: In total, 24% of the departments performed fewer than five tumour nephrectomies per year. The main differences were as follows. I.v. pyelography was never used in Finland in clinics with urologists while preoperative CT scans were performed by most departments and in most countries. Cytology/biopsy examinations were never used in urological clinics in Finland and Iceland in contrast to 31% of urological clinics in Denmark. In Finland, 69% of the departments performed nephrectomy in patients with multiple distant metastases, compared to only 15% in the other Nordic countries. Follow-up after nephrectomy was done in 38% of Danish departments and in 96% of departments in the other Nordic countries. CONCLUSION: There were evident differences between the urological/surgical departments in the five Nordic countries, especially concerning radiological evaluation, treatment of patients with metastases and postoperative follow-up.