Monitoring

Close follow-up for at least 60 months is necessary to identify local relapse, contralateral Wilms' tumour development, distant metastases, and serious, rare adverse effects of treatment such as secondary malignancies, renal failure, congestive heart failure, restrictive lung disease, and infertility.[133][134][135][136]

Tumour surveillance includes abdominal and chest computed tomography and should be obtained serially until 18 months after completion of therapy. Abdominal ultrasound and chest x-ray are sufficient to identify any late relapses thereafter.[94][96]​[102]​​[137]​​

Echocardiogram (identifies anthracycline-induced cardiac adverse effects) and creatinine clearance should also be obtained serially (i.e., at diagnosis, midway through treatment, at the end of therapy, and then at 1, 3, and 5 years off-treatment).

If patient has bilateral Wilms' tumour, an associated genetic syndrome or if nephrogenic rests are identified, a lengthier surveillance regimen is advisable.[78][138]

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