Percutaneous ablation of renal tumors in patients with a solitary kidney: medium- to long-term outcomes.

Background: This work aims to evaluate safety, medium- and long-term efficacy, and renal function outcomes of percutaneous ablation (PA) of renal masses in patients with a solitary kidney (PSK).

Methods: This retrospective, single-center study enrolled 53 consecutive tumors in 33 PSK from April 2004 to October 2021. Renal tumors were treated with image-guided PA. Clinical data, radiographic characteristics, and complications at 30 days were collected. Follow-up involved clinical and radiological imaging to assess technical efficacy and recurrence. Serum creatine and glomerular filtration rate (GFR) for measuring renal function were determined at baseline, 12 months, and end of follow-up.

Results: Thirty-three PSK (21 male) aged 35 to 85 years were treated for 53 renal tumors. The mean size was 25.8 mm (IQR 17.5-30). The mean RENAL and PADUA scores were 6.3 (IQR 4.5-8) and 8 (IQR 6-10). Nine complications (Clavien-Dindo grade I, II, III) occurred in 42 sessions. RENAL and PADUA scores and endophytic localization were significantly associated with complications. Technical efficacy after one session was 88.7%; The mean follow-up time was 45.8 months (IQR 18-48). There were five local recurrences (10%) at a mean of 28 months (IQR 17-40). GFR declined 14.8% at 12 months. GFR declines were 13 mL/min/m² in patients with one lesion and 26.9 mL/min/m² with two or more (P=0.048). Two patients required hemodialysis.

Conclusions: PA is a safe treatment option in PSK that provides good long-term cancer control and minimal clinical impact on postoperative renal function.