Renal cell carcinoma
Adjuvant therapy in RCC

Antonia (83 years old)

Antonia, 83 years old and a retired jeweller and lifelong gem enthusiast, has an unmatched expertise when it comes to jewels. However, age occasionally played its tricks - like when she confused her polishing cloths with her cat's favourite napping blanket. Seeing her cat parade around with a freshly polished, gleaming coat of fur, she’d chuckle and say, “Well, at least he’s sparkling now, too!”

Unfortunately, she was recently diagnosed with RCC.

Assessment summary:

  • ECOG PS: 1
  • Hypertension
  • Diabetes mellitus type 2

She underwent radical nephrectomy of the right kidney 8 weeks ago.

Pathological findings:

  • pT3a tumour of 7.5 cm, renal vein invasion
  • WHO/ISUP grade 4 ccRCC
  • Tumour necrosis present
  • Sarcomatoid features
  • Negative surgical margins

The patient has recovered after surgery and comes to you for check-up. Post-surgery thoracoabdominal and pelvic CT scan: N0M0.

Which of the following options would you choose for this patient?