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• W1484681618 abstract "The goals of cancer therapy are either to cure or con-trol disease while minimizing side effects to the pa-tient.Onemustbalancethenumberoflifeyearsgained(quantity) with the risk of morbidity and mortality ofa given treatment technique (quality). The ultimategoal is to match treatment type with the biological ag-gressiveness of the disease in an individual patient. Adifficult initial hurdle is predicting disease aggressive-ness.Radiographicstaginghasbeenthecornerstoneinrenal cancer prediction, while nomograms incorporat-ing multiple pathologic, laboratory, and clinical mea-sures have become the basis for prostate cancer pre-diction. The predictions made from this informationhave, to a substantial extent, guided modern treat-ment. In modern urologic oncology practice, a con-tinuing movement toward maximizing survival whileminimizing morbidity has been seen.This movement is seen clearly when examiningthe increasing use of laparoscopic and, more re-cently, robot-assisted laparoscopic techniques in thetreatment of renal and prostate cancers as well asconformal and intensity-modulated radiation therapy(IMRT), cryotherapy, high-intensity focused ultra-sound (HIFU), and brachytherapy in the treatment ofprostate cancer. More recent interest in focal, percuta-neous techniques (i.e., radiofrequency or cryotherapy)reflects this evolution in management.Minimally invasive interventional techniques areattractive since the risks of local progression andthus metastasis are, in theory, decreased comparedto surveillance, while the morbidity associated withradical (partial or complete) resection are also de-creased. Other advantages regarding localized renaltumor management include technical ease comparedto minimally invasive partial nephrectomy, no renalischemia requirement, relative ease in locating endo-phytic lesions, the unique opportunity for retreatmentwith no significant increased morbidity of a secondprocedure and, finally, decreased convalescence.The morbidity associated with radical prostatec-tomyandradiotherapyiswelldescribedandisprimar-ily a result of treatment effects on adjacent structures[1]. Therefore, minimally invasive interventional tech-niques stand to have the greatest impact with respectto cavernosal nerve preservation, and limitation of ex-traprostatic radiation leading to advantages in erectilefunction preservation, improved continence, as wellas hospital stay and return to normal daily activitiesand work. These techniques hold similar advantagesto those for renal cell carcinoma with the added ben-efits of relatively easy access to the gland and discreteablation that could facilitate less than whole-glandtreatment.Renal and prostate tumors are biologically uniqueand demand individual consideration for possiblesurveillance, local tumor treatment, or radical tumor" @default.
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• W1484681618 date "2011-03-08" @default.
• W1484681618 modified "2023-10-13" @default.
• W1484681618 title "Rationale for Minimally Invasive Interventional Techniques in Urological Cancer" @default.
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• W1484681618 doi "https://doi.org/10.1002/9781444329896.ch1" @default.
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