Purpose of review: To summarize the recent literature on ablative therapies for the management of renal tumors.
Recent findings: Recent studies show excellent long-term oncological outcome data for cryoablation and radiofrequency ablation with a minimal risk of major complications and excellent preservation of renal function. For properly selected patients, oncological outcomes appear to be similar to partial nephrectomy. Ablation is also feasible in T1b tumors and for metastatic sites. In case of local recurrence, salvage surgery is challenging because of perinephric fibrosis but offers excellent oncological control. Papillary renal cell carcinoma may respond better to ablation than clear cell. Microwave ablation and irreversible electroporation are evolving ablation techniques, but their efficacy needs to be proven.
Summary: Although high-quality randomized data are lacking, evidence shows that ablation of renal tumors achieves excellent long-term oncological results in properly selected patients. Cryoablation and radiofrequency ablation are the standard procedures, while other techniques require further evaluation.