Local Recurrence of Renal Cancer After Surgery: Prime Time for Percutaneous Thermal Ablation?

Abstract

The purpose of the study was to retrospectively assess the safety and efficacy of radiofrequency thermal ablation (RFA) for retroperitoneal relapse following surgery for renal cell carcinoma (RCC). After open radical nephrectomy or nephron-sparing surgery, eight patients with no evidence of distant metastases were treated for retroperitoneal relapse of RCC with RFA. A total of 16 lesions were ablated. Technical success, tumor response, follow-up duration, and complications were retrospectively analyzed. Disease progression after surgery occurred within a mean time of 57 months (range 9-120). Recurrent tumor size varied from 5 to 34 mm. Five patients previously underwent surgical resection of retroperitoneal recurrent lesions. Six patients were treated with percutaneous approach, while two with recurrent nodes located on the anterior pancreatic surface underwent laparotomic RFA approach. All lesions were completely ablated and patients were followed up with CT at 30 days, after 3 and every 6 months. There was no residual enhancement after a mean follow-up of 12 months (range 7-17). Both patients treated with laparotomic approach had a grade 2 complication according to the Clavien-Dindo classification. In our small series, RFA after relapse of surgically removed RCC was safe and effective. Percutaneous and laparotomic thermal ablation should be assessed as first line loco-regional treatment on a larger patient group.