Postoperative surveillance is an integral part of renal cell carcinoma (RCC) care. However, evidence supporting the practice is lacking. RCC guidelines offer disparate recommendations leading to variation in care. Recently, the effectiveness of guidelines has been questioned and a debate has ignited over whether current protocols merit optimization. Guidelines show limitations in RCC risk assessment, protocol stratification, and definition of duration of follow-up. Alternative strategies have addressed some of these limitations, but further analysis is warranted. Until challenges with assessing a survival benefit are negotiated, efforts should be made to optimize and standardize guidelines and learn of more tangible benefits to surveillance.
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