R.E.N.A.L., PADUA, and (MC)2 scoring systems correlate with increased complication risks in renal tumor ablationScoring systems help predict complications after renal tumor ablation

ObjectiveTo evaluate the predictive value of the R.E.N.A.L., PADUA, and (MC)2 scoring systems for complications after renal tumor ablation.MethodThis systematic review and meta-analysis was reported in accordance with PRISMA and registered in PROSPERO. PubMed, Embase, the Cochrane Library, and Web of Science were searched from inception to May 1, 2025. The primary outcomes were overall, major, and minor complications after renal ablation in relation to the R.E.N.A.L., PADUA, or (MC)2 scoring systems.ResultsA total of 25 retrospective studies involving 5,583 patients were included. Higher R.E.N.A.L., PADUA, and (MC)2 score categories were associated with higher odds of major complications after renal ablation. Exploratory analyses suggested that larger tumor diameter, closer proximity to the collecting system, central tumor location, complicated diabetes mellitus, and history of myocardial infarction may be associated with increased odds of complications, although several of these analyses were based on only a small number of studies.ConclusionsThe R.E.N.A.L., PADUA, and (MC)2 scoring systems may help stratify complication risk after renal ablation, particularly for major complications. Findings regarding individual risk factors, especially complicated diabetes mellitus, history of myocardial infarction, and central tumor location, should be considered hypothesis-generating and require validation in larger prospective studies.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024551193.