SURGICAL TREATMENT OF LOCAL RENAL CELL CARCINOMA RECURRENCE. SURGICAL ASPECTS AND ONCOLOGICAL RESULTS

Introduction. Treatment of local RCC recurrence is a serious surgical and therapeutic problem. There is no single standard strategy for the treatment of locally recurrent RCC. Objective: to evaluate the short-and long-term results of surgical treatment of patients with local RCC recurrence. Material and Methods. Among all participants (n=53), 48 patients had isolated local RCC recurrence (group 1), and 5 had synchronous metastases (group 2). All patients had one or more local foci of RCC and underwent radical removal of all foci from May 2007 to January 2024. In distant metastases, metastasectomy was performed. Results. Laparotomy was the preferred access (75.4 %). The average duration of surgery was 167.5 minutes in group 1 and 300 minutes in group 2 (p=0.008). In the early postoperative period, 10 people had postoperative complications. The median follow-up period was 68.17 ± 9.17 (95 % CI 17.00; 112.50) months in group 1 and 79.60 ± 12.17 (95 % CI 47.50; 123.50) in group 2 (p=0.493). The median RFS in group 1 was 139.86 ± 11.02 (95 % CI 119.00; 154.50) months and 100.67 ± 10.22 (95 % CI 91.00; 121.00) months in group 2 (p=0.375), while the local RFS was 174.80 ± 12.22 (95 % CI 139.00; 194.50) and 126.00 ± 11.40 (95 % CI 109.20; 142.40) months in groups 1 and 2, respectively (p=0.352). The median PFS was 193.00 ± 11.22 (95 % CI 172.02; 209.50) months in group 1 and 121.13 ± 11.14 (95 % CI 111.00; 146.43) months in group 2 (p=0.266). The median OS was 149.70 ± 11.20 (95 % CI 123.12; 161.43) months in the group 1 and 56.50 ± 11.20 (95 % CI 33.20; 78.42) months in the group 2 (p=0.169). The 5-year CSS was 85.7 % in group 1 and 40 % in group 2 (p=0.096). The 10-year CSS rate was 81 % and 4 % in groups 1 and 2, respectively (p=0.109). Conclusion. Surgical intervention is effective treatment for local recurrence, providing good oncological outcomes; however, size and proximity to neighboring organs can significantly impact the risk of perioperative complications. © 2025, Tomsk National Research Medical Center of the Russian Academy of Sciences. All rights reserved.