Many centers determine their follow-up schedule based on tumor stage. Patients with localized tumors that are less than 7 cm in diameter (T1) are at lowest risk for recurrence. Such patients should undergo annual evaluation that consists of a physical examination, chest radiograph, and laboratory testing of liver and kidney function. Some experts recommend measurement of serum alkaline phosphatase concentrations to monitor for bone metastases; however, the sensitivity and specificity of this laboratory marker are poor.

Patients with masses that are larger than 7 cm or extend into adjacent structures (T2-4) are at higher risk for recurrence and, in addition to the above, should also undergo annual CT scan. Finally, all patients who have undergone a nephron-sparing procedure require an additional CT scan 3 months after the procedure to evaluate the tumor resection site for local disease recurrence.