title: Local Recurrence of Renal Cancer After Surgery: Prime Time for Percutaneous Thermal Ablation?
abstract: OBJECTIVE
  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).
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Interventional Radiology, European Institute of Oncology, Via Ripamonti 435, 20100, Milan, Italy. lorenzo.monfardini@ieo.it.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Monfardini
authors.affiliation: Sant'Andrea University Hospital, "Sapienza" University of Rome, Via di Grottarossa 1055, 00189, Rome, Italy. gianluca.varano@gmail.com.
authors.forename: Gianluca Maria
authors.initials: GM
authors.lastname: Varano
authors.affiliation: Department of Health Sciences, University of Milan, Via A. di Rudinì 8, 20142, Milan, Italy. riccardo.foa@ieo.it.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Foà
authors.affiliation: Department of Interventional Radiology, European Institute of Oncology, Via Ripamonti 435, 20100, Milan, Italy. paolo.dellavigna@ieo.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Della Vigna
authors.affiliation: Department of Interventional Radiology, European Institute of Oncology, Via Ripamonti 435, 20100, Milan, Italy. guido.bonomo@ieo.it.
authors.forename: Guido
authors.initials: G
authors.lastname: Bonomo
authors.affiliation: Department of Interventional Radiology, European Institute of Oncology, Via Ripamonti 435, 20100, Milan, Italy. franco.orsi@ieo.it.
authors.forename: Franco
authors.initials: F
authors.lastname: Orsi
mesh_terms: D002292:Carcinoma, Renal Cell / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000601:surgery; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D012189:Retrospective Studies
keywords: Radiofrequency thermal ablation; Renal cell carcinoma; Retroperitoneal relapse