Radiofrequency Ablation for Recurrent Renal Tumors After Partial Nephrectomy: A Retrospective Cohort Study of Technical Considerations and Oncologic Outcomes
Jiyu Yang, Xiang Wang, Zhihua Li, Zibo Zhang, Man Zhang, Zhaohui Sun, Kaifeng Yao, Derun Li, Xuesong Li, Kai ZhangObjectives:
To evaluate the technical feasibility, safety profile, and oncologic outcomes of radiofrequency ablation (RFA) in managing locally recurrent renal tumors following partial nephrectomy (PN).
Design:
A retrospective cohort study.
Methods:
A retrospective cohort of 46 patients with post-PN tumor recurrence treated with RFA (April 2017–August 2024) was analyzed, with a median of 58 years and 87.0% male. Baseline characteristics, perioperative data, and follow-up outcomes were collected. Surgical strategies and therapeutic efficacy, including tumor recurrence and incomplete ablation, were evaluated.
Results:
Among 46 patients (39 with single tumors and 7 with multiple tumors), postoperative pathological evaluation following PN confirmed malignancy in 46 cases, predominantly clear cell carcinomas (91.3%). The median interval between PN and RFA was 42.7 months (interquartile range [IQR]: 15.4–73.3). The median tumor size was 2.1 cm (IQR: 1.6–2.4). The median RENAL nephrometry score for recurrent tumors was 6 (IQR: 5–7). The median procedure time was 19.0 minutes (IQR: 16.0–22.6), with a median postoperative hospital stay of 1 day (IQR: 1-1). With a median follow-up of 29.3 months (IQR: 15.5–64.5), the incidences of severe complications, tumor recurrence, and incomplete ablation were 2.2%, 17.4%, and 10.9%, respectively. Limitations include modest cohort size, retrospective design, and predominant ultrasound guidance potentially affecting targeting accuracy.
Conclusion:
RFA demonstrates safety and efficacy as a nephron-sparing therapeutic option for recurrent renal tumors post-PN. However, the observed risks of incomplete ablation and recurrence underscore the necessity of enhanced postoperative surveillance for those patients.