Management of Urologic Cancer (eBook)

Focal Therapy and Tissue Preservation

Mark P. Schoenberg, Kara L. Watts (Herausgeber)

eBook Download: PDF

2017
John Wiley & Sons (Verlag)
9781118868096 (ISBN)

Infos

Managing urologic cancer by preserving, as opposed to removing, affected tissue, is rapidly becoming the favoured choice for urologists and oncologists.  Discover all available options and how to achieve the best possible patient management with this expert guide to the area. The editor, Mark Schoenberg, is an internationally-renown expert in this exciting new area and has recruited an outstanding team featuring some of the leading urologists/oncologists in North America and Europe to assist him.

MARK P. SCHOENBERG, MD, University Professor & Chair, Department of Urology, The Montefiore Medical Center and The Albert Einstein College of Medicine, Bronx, NY, USA

KARA L. WATTS, MD, Assistant Professor, Department of Urology, The Montefiore Medical Center and The Albert Einstein College of Medicine, Bronx, NY, USA

Inhalt

Title Page 5
Copyright Page 6
Contents 7
List of Contributors 11
Preface 15
Chapter 1 Cancer Genetics, Cancer Biology, and Tumor Growth and Metastasis:: The Interaction of Cancer and Its Host Environment 17
Renal Cell Carcinoma 17
Premalignant Lesions 17
Molecular Pathogenesis 17
Bladder Cancer 19
Cell-Cycle Regulation 19
FGFR3 and Receptor Tyrosine Kinases 20
Molecular Grading 20
Prostate Cancer 22
Epidemiology 22
Molecular Pathogenesis: Inflammation and Genomic and Protein Alterations 23
Gene Expression and Molecular-Modeling Concepts 26
References 28
Chapter 2 Pathological Basis of Tumor Characterization: Cytopathology, Surgical Pathology, and How Histo-Morphology Informs Treatment Decision Making 35
The Prostate 35
The Kidney 39
The Urothelium 43
The Testis 45
References 46
Chapter 3 The Immunobiology of Tumor Ablation 49
Manipulating the Immune System to Fight Cancer 49
Can We Take Advantage of Ablative Therapies to Activate the Immune System? 50
Immunomodulatory Properties of HIFU 51
Immunomodulatory Properties of Cryotherapy 52
Immunomodulatory Properties of Radiation Therapy 53
References 54
Chapter 4 Computed Tomography of Urologic Malignancies: The Role of MDCT in Renal Cell Carcinoma and Transitional Cell Carcinoma 57
Introduction 57
MDCT Protocol Design 57
Three-Dimensional Reconstructions 60
Neoplasms of the Intrarenal Collecting Systems, Ureters, and Bladder 61
Transitional Cell Carcinoma 61
Other Less Common Tumors of the Collecting Systems, Ureters, and Bladder 64
Solid Renal Parenchymal Lesions 65
Renal Cell Carcinoma 65
Oncocytoma 66
Angiomyolipomas 68
Evaluation of Small Renal Masses 69
Infiltrative Renal Masses: Lymphoma and Transitional Cell Carcinoma 69
Conclusion 71
References 71
Chapter 5 MRI and Metabolic Imaging 75
Magnetic Resonance Imaging 75
MRI Sequences 75
Clinical Applications of MRI for Prostate Cancer 77
Introduction 77
mpMRI in Men with Suspected Prostate Cancer 77
mpMRI for Planning Focal Treatment for Prostate Cancer 78
Intraoperative mpMRI for Guiding Prostate Cancer Focal Therapy 78
MRI in the Follow-Up of Prostate Cancer Focal Therapy 79
Clinical Applications of MRI for Renal Cancer 79
Clinical Applications of MRI for Bladder Cancer 80
New Advances in MRI 81
Whole-Body MRI 81
Hyperpolarized 13-C MRI 82
Metabolic Imaging 82
Introduction 82
Bone Scan 82
PET–CT 84
Clinical Applications of PET–CT for Prostate Cancer 85
FDG 85
Choline 85
Acetate 86
18F-FACBC 87
18F-FDHT 88
Radiolabeled Antibodies to PSMA 88
Renal Cancer 88
FDG 88
Acetate 89
Radiolabeled Antibodies 89
Clinical Applications of PET–CT for Bladder Cancer 89
FDG 89
Choline 90
Novel Advances in PET Imaging: PET–MRI 90
Summary 92
References 92
Chapter 6 Biopsy Strategies in the Analysis of Urologic Neoplasia 99
Kidney 99
Background 99
The Evolution and Performance of Renal Biopsy 100
Biopsy in the Settings of Diagnosis, Focal Therapy, or Metastatic Disease 100
Current Challenges 101
Laparoscopic Biopsy 102
Future Directions 102
Penile 102
Introduction 102
Assessing Nodal Involvement at Time of Diagnosis 103
Nodal Involvement after Primary Resection 104
Prostate 105
Background 105
The Refinement of Needle-Guided Biopsy 105
Issues with TRUS-Guided Biopsy 107
Transperineal Biopsy 107
MRI-Guided Biopsy 107
Alternative Prostate Biopsy Modalities 109
Seminal Vesicle Biopsy 110
Testis 110
Background 110
Assessment of the Contralateral Testicle 110
Urothelium 111
Bladder 111
Upper-Tract Urothelial Carcinoma 115
Primary Urethral Carcinoma 115
References 116
Chapter 7 Active Surveillance for Low-Risk Prostate Cancer 129
Introduction and Background 129
Rationale 129
Genetic Features of Low-Grade Prostate Cancer 130
Metastatic Potential 131
Biomarkers 132
Limitations of PSA Kinetics 132
Role of MRI 132
Implications for Patient Management 133
Eligibility for Surveillance 134
Who Is a Candidate? 134
Outcome of Surveillance 135
Modeling 135
AS in Practice 137
Conclusions 137
References 138
Chapter 8 Tissue-Preserving Surgical Approaches in Urologic Oncology: The Therapeutic Mechanism for Tumor Ablation 143
Introduction 143
Cryoablation: Extreme Cold for Tumor Necrosis 144
History 144
Mechanism of Action 144
Current and Future Trends 145
Conclusion 146
References 146
Chapter 9 Focal Therapy for Prostate Cancer: An Evidence-Based Approach to Tissue?Preserving Strategies 149
Introduction 149
Key Concepts in FT for PCa 150
Patient Selection for FT 150
PCa Lesion Detection for FT 150
Follow up after FT 151
Tissue-Preserving FTs 151
Cryotherapy 151
Primary Focal Cryotherapy 152
Salvage Focal Cryotherapy 153
HIFU 153
Primary Focal HIFU 155
Salvage Focal/Hemiablation HIFU 156
IRE 157
Radiation 158
Primary Focal Radiotherapy 158
Salvage Focal Radiotherapy 159
Additional Therapies 159
Implications for Research 160
Conclusions 160
References 161
Chapter 10 The Modern Basis for Nephron-Sparing Surgery in Patients with Renal Cancer: Biologic Heterogeneity, the Significance of Tumor Biopsy, and the Changing Roles of Partial Nephrectomy and Tumor Ablation 167
Introduction 167
Principal Treatment Options for SRMs and the Basis for Nephron Preservation 168
Comparative Effectiveness of Radical versus NSS 169
Impact of PN and RN on Survival 169
Rationale for Ablative Therapies 170
CA and RFA 170
Follow-up of Renal Ablation 171
Outcomes of Renal Ablation 171
Other Ablative Techniques 173
Treatment Trends for Stage I RCC 173
The Role of RMB 174
RMB: Safety 174
RMB: Diagnostic Accuracy for Malignancy 175
RMB: Inaccuracy 175
Challenges Posed by Intratumoral Heterogeneity 177
Conclusions 177
References 178
Chapter 11 Bladder-Preserving Strategies in the Treatment of Urothelial Cancer: The Disease Spectrum and the Dawn of Molecular Surgical Guidance 185
Augmented Cystoscopy 186
Fiber-Optic Probe Technology 187
OCT 187
CLE 188
RS 188
Conclusion 188
References 188
Chapter 12 Image-Guided Thermal Ablation of Adrenal Malignancies 191
Introduction 191
Clinical Results 191
Preprocedural Evaluation 192
Technical Considerations 194
RFA 194
Microwave Ablation 195
Cryoablation 196
Complications 196
Follow-up 197
Conclusion 198
References 198
Chapter 13 Managing Penile Cancer: Integrating Tissue Preservation, Energy-Based Therapeutics, and Surgical Reconstruction 201
Introduction 201
Description 202
Diagnosis and Staging 202
Treatment 205
Primary Tumor of Low Adverse Prognostic Risk 205
Primary Tumor of High Adverse Prognostic Risk 206
Regional Lymph Node Metastasis 207
Surgical Procedures 207
Partial and Total Penectomy 208
Wide Local Excision 208
Neophalloplasty 208
References 209
Chapter 14 Testis Cancer: Testis-Sparing Cancer Surgery 215
Introduction 215
Imaging of Testicular Tumors 215
Bilateral Tumors 217
The Advent of Testis-Sparing Surgery 217
Concerns about TSS 217
Presence of Intratubular Germ Cell Neoplasia or Multifocal Invasive Germ Cell Tumor 217
Accuracy of FSE 218
Preexisting Infertility in Men with Germ Cell Tumors 219
The Importance of Aesthetics 219
Development of Antisperm Antibodies 219
Indications for TSS 220
Criteria in Previous Studies and Guidelines 220
Preoperative Considerations and Surgical Technique 220
Postoperative Care and Follow-Up 223
Considerations Regarding Surgical Technique 223
The Impact of Cold/Warm Ischemia Compared with No Ischemia 223
Use of Intraoperative Ultrasound 224
Use of Microsurgical Technique 224
Hook Wire Localization and Enucleation 224
Outcomes of TSS 224
Oncologic Outcomes 224
Fertility and Hypogonadism Outcomes 225
Summary 225
References 226
Chapter 15 Nanotechnology: An Evolution in Tissue Preservation and Focal-Targeted Oncologic Therapy 229
Introduction 229
Introduction to Nanotechnology 230
Types of Nanoparticles 230
Delivery and Use of Nanoparticles 233
Nanotechnology in Prostate Cancer 235
Imaging in Prostate Cancer 235
Therapeutics in Prostate Cancer 237
Nanotechnology in Renal Cancer 239
Nanotechnology in Other Urologic Cancers 240
Limitations of Nanoparticles 240
Future Directions and Conclusions 241
References 242
Chapter 16 Trial Design Issues in the Study of Focal Therapy in Prostate and Kidney Cancer 249
Issues around Endpoints in Studies of Focal Therapy 250
Prostate Cancer 250
Kidney Cancer: Small Renal Masses 251
Functional Outcomes 252
Issues around Defining the Study Population and the Control Arms of Comparative Studies in Focal Therapy 253
Prostate Cancer 253
SRMs 253
Issues around Selecting the Optimal Study Design in Focal Therapy 254
Conclusion 254
References 255
Index 259
EULA 268

Produkt-Details

• Erscheint lt. Verlag: 8.6.2017
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Chirurgie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Onkologie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Urologie
• Schlagworte: advanced endoscopic technologies • biopsy strategies • bladder cancer • Cancer Management • Chirurgie • Chirurgie u. chirurgische Spezialgebiete • Cryotherapy • Focal therapy • High Intensity Focused Ultrasound • kidney cancer • localised cancer • Management of Urologic Cancer • Medical Science • Medizin • multimodality therapy • Nephron-Sparing Surgery • oncologists • Oncology • Oncology & Radiotherapy • Onkologie • Onkologie u. Strahlentherapie • organ-confined disease • organ removal • Patient Management • photodynamic therapy • preservation therapy • Prostate Cancer • radiation therapy • Radiofrequency ablation • Surgery & Surgical Specialities • tissue preservation • tissue preserving surgical approaches • tissue preserving treatments • urologic cancer • Urologic malignancies • urologic oncology surgery • urologic surgery • Urologie • urologist • urologists • Urology • uro-oncology • Urothelial Cancer • uterus cancer
• ISBN-13: 9781118868096 / 9781118868096