Outcomes of Salvage Treatment After Primary Treatment for Renal Cell Cancer: A Systematic Review

<b>Background/Objective</b>: The grade of recommendation for renal cell carcinoma (RCC) salvage treatment options is weak. The aim of the current study is to summarize available evidence about the surgical, oncological, and functional outcomes of salvage renal options after previous trea...

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Main Authors: Nicola Longo, Francesco Di Bello, Luigi Napolitano, Ernesto Di Mauro, Simone Morra, Giuliano Granata, Federico Polverino, Agostino Fraia, Gabriele Pezone, Roberto La Rocca, Claudia Collà Ruvolo, Gianluigi Califano, Massimiliano Creta
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Language:English
Published: MDPI AG 2025-03-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/7/838
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author Nicola Longo
Francesco Di Bello
Luigi Napolitano
Ernesto Di Mauro
Simone Morra
Giuliano Granata
Federico Polverino
Agostino Fraia
Gabriele Pezone
Roberto La Rocca
Claudia Collà Ruvolo
Gianluigi Califano
Massimiliano Creta
author_facet Nicola Longo
Francesco Di Bello
Luigi Napolitano
Ernesto Di Mauro
Simone Morra
Giuliano Granata
Federico Polverino
Agostino Fraia
Gabriele Pezone
Roberto La Rocca
Claudia Collà Ruvolo
Gianluigi Califano
Massimiliano Creta
author_sort Nicola Longo
collection DOAJ
description <b>Background/Objective</b>: The grade of recommendation for renal cell carcinoma (RCC) salvage treatment options is weak. The aim of the current study is to summarize available evidence about the surgical, oncological, and functional outcomes of salvage renal options after previous treatments for RCC. <b>Methods</b>: A systematic search (PROSPERO: CRD42024618629) was performed according to the PRISMA statement. A pooled analysis was performed to quantify the effect size (ES) for an overall postoperative Clavien–Dindo (CD) grade ≥ III and postoperative and intraoperative complications for either partial or radical nephrectomy (PN or RN) subgroups. <b>Results</b>: Overall, 11 studies involving 331 patients were included in the final analysis. The median age ranged from 44 to 75 years. Primary treatments for RCC included 267 (80.6%) PNs, 40 (12.0%) radiofrequency ablations (RFAs), 23 (6.9%) cryotherapies, and 1 (0.3%) stereotactic radiotherapy. Overall, the median time of local recurrence for RCC patients was from 25 to 99 months for PNs, 13 months for RFA and cryotherapy, and 6 months for stereotactic radiotherapy. The overall pooled analysis was associated with an ES of 0.28 for overall postoperative complications and of 0.11 for CD ≥ III postoperative complications (all <i>p</i> < 0.001). Within subgroup analyses, RN was invariably associated with less complications (the ES ranged from 0.05 to 0.17). <b>Conclusions</b>: The profile of oncological safety as well as the morbidity and mortality of salvage treatment options for RCC may justify considering such procedures in a salvage setting.
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spelling doaj-art-196bf54f08d04b7aa0dbb1a37b1243482025-08-20T02:09:18ZengMDPI AGDiagnostics2075-44182025-03-0115783810.3390/diagnostics15070838Outcomes of Salvage Treatment After Primary Treatment for Renal Cell Cancer: A Systematic ReviewNicola Longo0Francesco Di Bello1Luigi Napolitano2Ernesto Di Mauro3Simone Morra4Giuliano Granata5Federico Polverino6Agostino Fraia7Gabriele Pezone8Roberto La Rocca9Claudia Collà Ruvolo10Gianluigi Califano11Massimiliano Creta12Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80055 Naples, ItalyDepartment of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80055 Naples, ItalyDepartment of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80055 Naples, ItalyDepartment of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80055 Naples, ItalyDepartment of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80055 Naples, ItalyDepartment of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80055 Naples, ItalyDepartment of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80055 Naples, ItalyDepartment of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80055 Naples, ItalyDepartment of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80055 Naples, ItalyDepartment of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80055 Naples, ItalyDepartment of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80055 Naples, ItalyDepartment of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80055 Naples, ItalyDepartment of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80055 Naples, Italy<b>Background/Objective</b>: The grade of recommendation for renal cell carcinoma (RCC) salvage treatment options is weak. The aim of the current study is to summarize available evidence about the surgical, oncological, and functional outcomes of salvage renal options after previous treatments for RCC. <b>Methods</b>: A systematic search (PROSPERO: CRD42024618629) was performed according to the PRISMA statement. A pooled analysis was performed to quantify the effect size (ES) for an overall postoperative Clavien–Dindo (CD) grade ≥ III and postoperative and intraoperative complications for either partial or radical nephrectomy (PN or RN) subgroups. <b>Results</b>: Overall, 11 studies involving 331 patients were included in the final analysis. The median age ranged from 44 to 75 years. Primary treatments for RCC included 267 (80.6%) PNs, 40 (12.0%) radiofrequency ablations (RFAs), 23 (6.9%) cryotherapies, and 1 (0.3%) stereotactic radiotherapy. Overall, the median time of local recurrence for RCC patients was from 25 to 99 months for PNs, 13 months for RFA and cryotherapy, and 6 months for stereotactic radiotherapy. The overall pooled analysis was associated with an ES of 0.28 for overall postoperative complications and of 0.11 for CD ≥ III postoperative complications (all <i>p</i> < 0.001). Within subgroup analyses, RN was invariably associated with less complications (the ES ranged from 0.05 to 0.17). <b>Conclusions</b>: The profile of oncological safety as well as the morbidity and mortality of salvage treatment options for RCC may justify considering such procedures in a salvage setting.https://www.mdpi.com/2075-4418/15/7/838RCCpartial nephrectomyClavien–Dindocomplications
spellingShingle Nicola Longo
Francesco Di Bello
Luigi Napolitano
Ernesto Di Mauro
Simone Morra
Giuliano Granata
Federico Polverino
Agostino Fraia
Gabriele Pezone
Roberto La Rocca
Claudia Collà Ruvolo
Gianluigi Califano
Massimiliano Creta
Outcomes of Salvage Treatment After Primary Treatment for Renal Cell Cancer: A Systematic Review
Diagnostics
RCC
partial nephrectomy
Clavien–Dindo
complications
title Outcomes of Salvage Treatment After Primary Treatment for Renal Cell Cancer: A Systematic Review
title_full Outcomes of Salvage Treatment After Primary Treatment for Renal Cell Cancer: A Systematic Review
title_fullStr Outcomes of Salvage Treatment After Primary Treatment for Renal Cell Cancer: A Systematic Review
title_full_unstemmed Outcomes of Salvage Treatment After Primary Treatment for Renal Cell Cancer: A Systematic Review
title_short Outcomes of Salvage Treatment After Primary Treatment for Renal Cell Cancer: A Systematic Review
title_sort outcomes of salvage treatment after primary treatment for renal cell cancer a systematic review
topic RCC
partial nephrectomy
Clavien–Dindo
complications
url https://www.mdpi.com/2075-4418/15/7/838
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