Thermal ablation for local tumor recurrence after previous partial nephrectomy: Perioperative and oncological outcomes

Objectives: Percutaneous thermal ablation (PTA) has emerged as an alternative to salvage radical nephrectomy (RN) for the treatment of renal cell carcinoma (RCC) local recurrence. We report perioperative and oncological outcomes of patients treated with PTA for RCC local recurrence. Materials and methods: Twenty-seven patients with on-site recurrence received PTA from 2008 to 2022. Primary endpoints were perioperative outcomes, complications, and readmission rates. Secondary endpoints were on site and out site tumor recurrence. Last, we collected renal function outcomes after PTA. Results: Median (IQR) treatment time was 75 (63–106) minutes. Intraoperative complications occurred in 1 (3.7%) patient, while postoperative in 2 (7.4%). Three patients (11%) received incomplete ablation, which required in one an adjunctive PTA and in 2 RN. Overall, 4 (16%) patients developed on site recurrence after a median follow-up of 30 (23–43) months: complete local control was achieved with subsequent PTA in 3 patients, while one developed bone metastases and, therefore, no other local treatments were performed. Moreover, 6 (24%) patients developed out-site recurrence after a median follow-up of 16 (10–23) months. Last, median creatinine drop at 1 month and at 1 year after PTA was -0.03 (-0.11 to 0.01) and -0.11 (-0.20 to -0.05), while median eGFR drop was 2 (0–7.65) and 9.5 (5–13.45). Conclusion: PTA is a safe and feasible approach for management of on-site recurrences after PN. Low perioperative complication rates and optimal local cancer control were achieved in most patients, with no significant impairment of residual renal function.