The role of redo minimally invasive partial nephrectomy (rMIPN) for single ipsilateral renal cancer recurrences (RCRs) after prior nephron-sparing surgery (NSS) remains debated. rMIPN offers the potential for renal preservation but carries substantial surgical complexity and perioperative risk. This dual-institutional study compared perioperative, functional, and oncologic outcomes of rMIPN versus redo minimally invasive radical nephrectomy (rMIRN) for solitary ipsilateral RCRs.
From January 2004 to October 2024, 2 prospectively maintained renal cancer databases were queried for patients with solitary, localized RCRs treated with rMIPN (n = 63) or rMIRN (n = 41). Baseline demographics, operative data, renal function, and pathologic findings were retrospectively extracted. Kaplan-Meier analysis tested overall survival (OS), cancer-specific survival (CSS), and progression to stage ≥ 3b chronic kidney disease (CKD), with log-rank test comparisons.
Baseline demographics and tumor characteristics were similar between groups. rMIPN was associated with longer hospital stay (median 3 vs. 2 days), higher complication rates (22.2% vs. 4.9%), and greater transfusion requirements (7.9% vs. 0%; all P < 0.05). At a median follow-up of 47.5 months [IQR 22.2-75], OS, CSS, and CKD progression did not differ significantly between rMIPN and rMIRN (all P > 0.05).
rMIPN provides oncologic and functional outcomes comparable to rMIRN but at the cost of higher perioperative morbidity. Surgical selection should be individualized, weighing the potential benefits of nephron preservation against the higher surgical risks.
Urologic oncology. 2026 Mar 20 [Epub ahead of print]
Umberto Anceschi, Eugenio Bologna, Daniele Amparore, Rocco Simone Flammia, Aldo Brassetti, Leslie Claire Licari, Flavia Proietti, Alfredo Maria Bove, Gabriele Tuderti, Riccardo Mastroianni, Maria Consiglia Ferriero, Antonio Tufano, Giuseppe Spadaro, Silvia Cartolano, Maddalena Iori, Federico Piramide, Alexandru Turcan, Salvatore Guaglianone, Costantino Leonardo, Cristian Fiori, Michele Gallucci, Francesco Porpiglia, Giuseppe Simone
Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy. Electronic address: ., Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy; Department of Maternal-Child and Urological Sciences, Sapienza University Rome, Policlinico Umberto I Hospital, Rome, Italy., Department of Urology, San Luigi Hospital, Turin, Italy., Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy., Department of Maternal-Child and Urological Sciences, Sapienza University Rome, Policlinico Umberto I Hospital, Rome, Italy.