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Fokale Therapie von kleinen Nierentumoren: Beobachtung, Ablation oder Operation = Focal therapy for small renal masses

BackgroundThe rising incidence of renal cell carcinoma, its more frequent early detection (stage T1a) and the increasing prevalence of chronic renal failure with higher morbidity and shorter life expectancy underscore the need for multimodal focal nephron-sparing therapy.DiscussionDuring the past de...

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Main Authors: Wendler, Johann J. (Author) , Friebe, Björn (Author) , Baumunk, Daniel (Author) , Blana, Andreas (Author) , Franiel, Tobias (Author) , Ganzer, Roman (Author) , Hadaschik, Boris (Author) , Henkel, Thomas (Author) , Köhrmann, Kai-Uwe (Author) , Köllermann, Jens (Author) , Kuru, Timur Hasan (Author) , Machtens, Stefan (Author) , Roosen, Alexander (Author) , Salomon, Georg (Author) , Schlemmer, Heinz-Peter (Author) , Sentker, Ludger Josef (Author) , Witzsch, Ulrich (Author) , Liehr, Uwe-Bernd (Author) , Ricke, Jens (Author) , Schostak, Martin (Author)
Format: Article (Journal)
Language:German
Published: 27. April 2016
In: Der Urologe
Year: 2016, Volume: 55, Issue: 5, Pages: 594-606
DOI:10.1007/s00120-016-0075-8
Online Access:Verlag, Volltext: https://doi.org/10.1007/s00120-016-0075-8
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Author Notes:J.J. Wendler, B. Friebe, D. Baumunk, A. Blana, T. Franiel, R. Ganzer, B. Hadaschik, T. Henkel, K.U. Köhrmann, J. Köllermann, T. Kuru, S. Machtens, A. Roosen, G. Salomon, H.P. Schlemmer, L. Sentker, U. Witzsch, U.B. Liehr, J. Ricke, M. Schostak
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Summary:BackgroundThe rising incidence of renal cell carcinoma, its more frequent early detection (stage T1a) and the increasing prevalence of chronic renal failure with higher morbidity and shorter life expectancy underscore the need for multimodal focal nephron-sparing therapy.DiscussionDuring the past decade, the gold standard shifted from radical to partial nephrectomy. Depending on the surgeon’s experience, the patient’s constitution and the tumor’s location, the intervention can be performed laparoscopically with the corresponding advantages of lower invasiveness. A treatment alternative can be advantageous for selected patients with high morbidity and/or an increased risk of complications associated with anesthesia or surgery. Corresponding risk stratification necessitates previous confirmation of the small renal mass (cT1a) by histological examination of biopsy samples. Active surveillance represents a controlled delay in the initiation of treatment.ResultsPercutaneous radiofrequency ablation (RFA) and laparoscopic cryoablation are currently the most common treatment alternatives, although there are limitations particularly for renal tumors located centrally near the hilum. More recent ablation procedures such as high intensity focused ultrasound (HIFU), irreversible electroporation, microwave ablation, percutaneous stereotactic ablative radiotherapy and high-dose brachytherapy have high potential in some cases but are currently regarded as experimental for the treatment of renal cell carcinoma.
Item Description:Gesehen am 14.06.2019
Physical Description:Online Resource
DOI:10.1007/s00120-016-0075-8

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