ALESSANDRO POSA, VALENTİNA LANCELLOTTA, FİLİPPO PAOLETTI, ALESSANDRO TANZILLI, ANNA ACAMPORA, BARBARA ALİCJA JERECZEK FOSSA, MARİA ANTONİETTA GAMBACORTA, JACOPO ROMAGNOLI, ROSARİO FRANCESCO GRASSO, ANDREA VELTRI, GYÖRGY KOVACS, VİNCENZO VALENTINI, RİCCARDO MANFREDI, ROBERTO IEZZI, LUCA TAGLIAFERRI
Turkish Journal of Oncology - 2022;37(3):351-360
In patients with kidney graft neoplasms, the treatment of choice is still represented by surgical approach, mainly based on partial nephrectomy/nephron sparing surgery (NSS). In this oncologic setting, focal treatments (FT) are becoming more and more useful to avoid the risk of dialysis, considering graft viability of utmost importance. There is still little evidence on which is the best FT option in kidney graft neoplasms and on its therapeutic indications. We performed a systematic review to assess the role of FT such as thermal ablation, interventional radiotherapy, electrochemotherapy, and stereotactic body radiotherapy, as alternative to NSS in the treatment of Stage I kidney cancer. We searched PubMed, Scopus, and Web of Science for articles published between 2010 and 2020 focusing on kidney transplant recipients with kidney graft neoplasm who had undergone FT. The review is framed by the population, intervention, control, and outcomes criteria. The studies underlined safety and efficacy of FT, with low morbidity and good graft survival, but none of them provided a direct comparison with graft nephrectomy or NSS. There is still no clear evidence that FTs, and percutaneous ones in particular, are indicated as a standard treatment in kidney graft neoplasms as opposed to total or partial graft nephrectomy.
