Radiofrequency Ablation for Recurrent Renal Tumors After Partial Nephrectomy: A Retrospective Cohort Study of Technical Considerations and Oncologic Outcomes.

OBJECTIVES: 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.