Treatment options for localised renal cell carcinoma of the transplanted kidney

Table 1 Summary of conservative treatments of localised allograft renal cell carcinoma¹

	RFA	CA	MWA	HIFU	IRE	NSS
Ref.	Charboneau et al[107]	Shingleton et al[60]	Gul et al[63]	Chakera et al[77]	Gul[63]	Chambade et al[11]
	Baughman et al[108]	Cornelis et al[61]	Favi et al[69]	Di Candio et al[76]		Varotti et al[39]
	Roy et al[35]	Ploussard et al[62]				Tillou et al[42]
	Goeman et al[109]	Guleryuz et al[34]				Barama et al[47]
	Aron et al[106]	Gul et al[63]				Kaouk et al[41]
	Matevossian et al[110]					Mundel et al[122]
	Veltri et al[111]					Ribal et al[123]
	Sanchez et al[112]					Lamb et al[124]
	Elkentaoui et al[113]
	Olivani et al[114]
	Cornelis et al[61]
	Leveridge et al[115]
	Tillou et al[18]
	Swords et al[116]
	Végső et al[117]
	Su et al[118]
	Christensen et al[119]
	Hernández-Socorro et al[120]
	Guleryuz et al[34]
	Cool et al[121]
	Iezzi et al[48]
	Di Candio et al[76]
Patients (n)	70	11	5	3	1	61
Lesions (n)	78	11	5	3	1	63
FU (range)	3-71 mo	1-59 mo	8-61 mo	73-81 mo	34 mo	5-109 mo
RCC type
CC (n)	10	7	2	1	1	24
PA (n)	41	3	3	2	0	33
Other (n)	5	1	0	0	0	2
NA (n)	22	0	0	0	0	4
Size (range)	0.5-4.0 cm	1-4.1 cm	2.2-3.1 cm	0.8-5.5 cm	1.6 cm	0.9-7.0 cm
TNM2
T1aN0M0 (n)	78	10	5	2	1	60
T1bN0M0 (n)	0	1	0	1	0	3
PTF (n)	2	0	0	1	0	0
Relapse (n)	1	0	0	0	0	0
DSM (n)	0	0	0	0	0	0

¹Summaries based on individual cases should not considered as an estimate of the “real world”.

²American Joint Committee on Cancer Tumour Node Metastasis Staging System. RFA: Radiofrequency ablation; CA: Cryoablation; MWA: Microwave ablation; HIFU: High-intensity focused ultrasound; IRE: Irreversible electroporation; NSS: Nephron-sparing surgery; FU: Follow-up; RCC: Renal cell carcinoma; CC: Clear cell; PA: Papillary; NA: Not available; TNM: Tumour node metastasis; PTF: Primary treatment failure; DSM: Disease-specific mortality.

Table 2 Advantages and limitations of conservative treatments of localised allograft renal cell carcinoma

	Advantages	Limitations
Nephron-sparing surgery	Complete tumour removal	Technically demanding
	Definitive histology	Invasive
	Easy imaging-based follow-up	Higher peri-operative complication rate
	Good preliminary results with T1bN0M0	Higher risk of allograft dysfunction
Focal ablation	Minimally invasive	Higher risk of primary treatment failure
	Highly selective	Lack of definitive histology
	Can treat centrally located lesions	Difficult imaging-based follow-up
	Lower peri-operative complication rate	Dubious results with T1bN0M0
	Better allograft function preservation