Salvage treatment of local recurrence following radical and partial nephrectomy.

Abstract

Purpose of review: Standardized definition of local recurrence after radical or partial nephrectomy is still lacking. Due to its rarity, data on natural history, oncological outcomes and prognostic factors are scarce and specific treatment recommendations cannot be made.

Recent findings: Surgery is still the preferred option to treat a local recurrence of renal cell carcinoma, with favorable survival outcomes. However, nonsurgical options like thermal ablation techniques may represent a valid alternative mainly in patients where a nephron-sparing treatment is imperative. Systemic therapy seems to have a limited role in this setting.

Summary: According to available data, surgical excision of local recurrence should be attempted whenever feasible. Alternatively, thermal ablation represents a reliable and repeatable option after partial nephrectomy, with low complication rate and good oncologic outcomes. However, the evidence comes mainly from limited, heterogeneous case series. Further high-quality studies are needed to properly define the most appropriate for each individual patient.