Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Die Urologie
Erschienen in: Der Urologe 5/2016

27.04.2016 | Ablationstherapie | Leitthema

Fokale Therapie von kleinen Nierentumoren

Beobachtung, Ablation oder Operation

verfasst von: Dr. med. 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

Erschienen in: Die Urologie | Ausgabe 5/2016

Einloggen, um Zugang zu erhalten

Zusammenfassung

Hintergrund

Die gleichzeitig steigende Inzidenz des Nierenzellkarzinoms mit zunehmend häufigerer Diagnose im Frühstadium T1a und die zunehmende Prävalenz der chronischen Niereninsuffizienz mit konsekutiv erhöhter Morbidität sowie kürzerer Lebenserwartung bedingen die Notwendigkeit einer multimodalen fokalen Therapie mit Nierenerhalt.

Diskussion

In der letzten Dekade verschob sich der Goldstandard von der radikalen Nephrektomie hin zur Nierenteilresektion. Je nach Erfahrung des Operateurs, Patientenkonstitution und Lage des Tumors kann der Eingriff laparoskopisch mit entsprechenden Vorteilen der geringeren Invasivität erfolgen. Für ausgewählte Patienten mit hoher Morbidität, hohem Narkose- oder Operationsrisiko kann eine Behandlungsalternative von Vorteil sein. Eine entsprechende Risikostratifizierung macht die vorherige biotisch-histologische Sicherung des kleinen Nierentumors („small renal mass“, cT1a) notwendig. Die aktive Überwachung (Active Surveillance) stellt einen kontrolliert verzögerten Behandlungsbeginn dar.

Ergebnisse

Die perkutane Radiofrequenzablation und die laparoskopische Kryoablation stellen die derzeit gängigsten Therapiealternativen dar, wobei sich v. a. Limitationen für zentral gelegene hilusnahe Nierentumoren ergeben. Jüngere Ablationsverfahren, wie der hochintensive fokussierte Ultraschall, die irreversible Elektroporation, Mikrowellenablation, perkutane stereotaktische ablative Radiotherapie und die Hochdosisbrachytherapie, weisen teilweise ein hohes Potenzial auf, gelten derzeit jedoch für die Therapie des Nierenzellkarzinoms als experimentell.
Literatur
1.
Robert Koch-Institut, Gesellschaft der epidemiologischen Krebsregister in Deutschland e. V. (2013) Krebs in Deutschland 2009/2010, 9. Aufl. ruksaldruck, Berlin
2.
Kirchberger I, Meisinger C, Heier M, Zimmermann AK, Thorand B, Autenrieth CS, Peters A, Ladwig KH, Döring A (2012) Patterns of multimorbidity in the aged population. Results from the KORA-Age study. PloS One 7(1):e30556 doi:10.1371/journal.pone.0030556CrossRefPubMedPubMedCentral
3.
4.
Tsili AC, Argyropoulou MI (2015) Advances of multidetector computed tomography in the characterization and staging of renal cell carcinoma. World J Radiol 7(6):110–127. doi:10.4329/wjr.v7.i6.110CrossRefPubMedPubMedCentral
5.
Olbert PJ, Maier M, Heers H, Hegele A, Hofmann R (2015) Indications for nephron-sparing surgery. Analysis over a 13-year period in the context of changing guidelines. Urologe A 54(6):804–810. doi:10.1007/s00120-014-3710-2CrossRefPubMed
6.
7.
8.
Volpe A, Finelli A, Gill IS, Jewett MA, Martignoni G, Polascik TJ, Remzi M, Uzzo RG (2012) Rationale for percutaneous biopsy and histologic characterisation of renal tumours. Eur Urol 62(3):491–504. doi:10.1016/j.eururo.2012.05.009CrossRefPubMed
9.
Warren KS, McFarlane J (2005) The Bosniak classification of renal cystic masses. BJU Int 95(7):939–942CrossRefPubMed
10.
Graumann O, Osther SS, Karstoft J, Hørlyck A, Osther PJ (2015) Bosniak classification system: a prospective comparison of CT, contrast-enhanced US, and MR for categorizing complex renal cystic masses. Acta Radiol 27:pii: 0284185115588124
11.
Visapää H, Glücker E, Haukka J, Taari K, Nisen H (2013) Papillary renal cell cancer is strongly associated with simple renal cysts. Urol Int 91(3):269–272. doi:10.1159/000351751CrossRefPubMed
12.
Robertson EG, Baxter G (2011) Tumour seeding following percutaneous needle biopsy: the real story! Clin Radiol 66(11):1007–1014. doi:10.1016/j.crad.2011.05.012CrossRefPubMed
13.
Horstmann M, Franiel T, Grimm MO (2014) Differential diagnosis of hematuria. Urologe A 53(8):1215–1226. doi:10.1007/s00120-014-3506-4CrossRefPubMed
14.
Remzi M, Marberger M (2009) Renal tumor biopsies for evaluation of small renal tumors: why, in whom, and how? Eur Urol 55(2):359–367. doi:10.1016/j.eururo.2008.09.053CrossRefPubMed
15.
Menogue SR, O’Brien BA, Brown AL, Cohen RJ (2013) Percutaneous core biopsy of small renal mass lesions: a diagnostic tool to better stratify patients for surgical intervention. BJU Int 111(4 Pt B):E146–E151. doi:10.1111/j.1464-410X.2012.11384.xCrossRefPubMed
16.
Höfflin R, Roth W, Sültmann H, Grüllich C, Hatiboglu G, Nyarangi-Dix J, Schönberg G, Teber D, Hadaschik B, Pahernik S, Hohenfellner M, Duensing S (2015) Intratumoral heterogeneity in renal cell carcinoma. Molecular basis and translational implications. Urologe A 54(6):800–803. doi:10.1007/s00120-015-3800-9CrossRefPubMed
17.
Trpkov K, Yilmaz A, Uzer D, Dishongh KM, Quick CM, Bismar TA, Gokden N (2010) Renal oncocytoma revisited: a clinicopathological study of 109 cases with emphasis on problematic diagnostic features. Histopathology 57(6):893–906. doi:10.1111/j.1365-2559.2010.03726.xCrossRefPubMed
18.
Maurice MJ, Zhu H, Kiechle JE, Kim SP, Abouassaly R (2015) Increasing Biopsy Utilization for Renal Cell Carcinoma Is Closely Associated With Treatment. Urology 86(5):906–913. doi:10.1016/j.urology.2015.08.020CrossRefPubMed
19.
Wein A, Kavoussi L, Partin A, Peters C (2016) Campbell-Walsh Urology, 11. Aufl. Elsevier, Philadelphia.
20.
Chawla SN, Crispen PL, Hanlon AL, Greenberg RE, Chen DY, Uzzo RG (2006) The natural history of observed enhancing renal masses: meta-analysis and review of the world literature. J Urol 175(2):425–431CrossRefPubMed
21.
Thompson RH, Hill JR, Babayev Y, Cronin A, Kaag M, Kundu S, Bernstein M, Coleman J, Dalbagni G, Touijer K, Russo P (2009) Metastatic renal cell carcinoma risk according to tumor size. J Urol 182(1):41–45. doi:10.1016/j.juro.2009.02.128CrossRefPubMedPubMedCentral
22.
Camacho JC, Kokabi N, Xing M, Master VA, Pattaras JG, Mittal PK, Kim HS, R. E. N. A. L. (2015) Radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, and location relative to polar lines) nephrometry score predicts early tumor recurrence and complications after percutaneous ablative therapies for renal cell carcinoma: a 5‑year experience. J Vasc Interv Radiol 26(5):686–693. doi:10.1016/j.jvir.2015.01.008CrossRefPubMed
23.
Vargas HA, Delaney HG, Delappe EM, Wang Y, Zheng J, Moskowitz CS, Tan Y, Zhao B, Schwartz LH, Hricak H, Russo P, Akin O (2013) Multiphasic contrast-enhanced MRI: single-slice versus volumetric quantification of tumor enhancement for the assessment of renal clear-cell carcinoma fuhrman grade. J Magn Reson Imaging 37(5):1160–1167. doi:10.1002/jmri.23899CrossRefPubMedPubMedCentral
24.
Platzek I, Zastrow S, Deppe PE, Grimm MO, Wirth M, Laniado M, Stroszczynski C (2010) Whole-body MRI in follow-up of patients with renal cell carcinoma. Acta Radiol 51(5):581–589. doi:10.3109/02841851003724846CrossRefPubMed
25.
Hallscheidt PJ et al (2004) Diagnostic accuracy of staging renal cell carcinomas using multidetector-row computed tomography and magnetic resonance imaging: a prospective study with histopathologic correlation. J Comput Assist Tomogr 28(3):333–339CrossRefPubMed
26.
Jewett MA, Mattar K, Basiuk J, Morash CG, Pautler SE, Siemens DR, Tanguay S, Rendon RA, Gleave ME, Drachenberg DE, Chow R, Chung H, Chin JL, Fleshner NE, Evans AJ, Gallie BL, Haider MA, Kachura JR, Kurban G, Fernandes K, Finelli A (2011) Active surveillance of small renal masses: progression patterns of early stage kidney cancer. Eur Urol 60(1):39–44. doi:10.1016/j.eururo.2011.03.03CrossRefPubMed
27.
Lane BR, Abouassaly R, Gao T, Weight CJ, Hernandez AV, Larson BT, Kaouk JH, Gill IS, Campbell SC (2010) Active treatment of localized renal tumors may not impact overall survival in patients aged 75 years or older. Cancer 116(13):3119–3126. doi:10.1002/cncr.25184CrossRefPubMed
28.
Pierorazio P, McKiernan J, Allaf M (2013) Quality of life on active surveillance for small renal masses versus immediate intervention: interim analysis of the DISSRM (delayed intervention and surveillance for small renal masses) registry. J Urol 189(3S):e259CrossRef
29.
Whitson JM, Harris CR, Meng MV (2012) Population-based comparative effectiveness of nephron-sparing surgery vs ablation for small renal masses. BJU Int 110(10):1438–1443CrossRefPubMed
30.
31.
Zlotta AR, Wildschutz T, Wood BJ et al (1997) Radiofrequency interstitial tumor ablation (RITA) is a possible new modality for treatment of renal cancer: ex vivo and in vivo experience. J Endourol 11:251–258CrossRefPubMed
32.
Rendon RA, Kachura JR, Sweet JM, Gertner MR, Sherar MD, Robinette M, Tsihlias J, Trachtenberg J, Sampson H, Jewett MA (2002) The uncertainty of radio frequency treatment of renal cell carcinoma: findings at immediate and delayed nephrectomy. J Urol 167(4):1587–1592CrossRefPubMed
33.
Klingler HC, Marberger M, Mauermann J, Remzi M, Susani M (2007) „Skipping“ is still a problem with radiofrequency ablation of small renal tumours. BJU Int 99(5):998–1001CrossRefPubMed
34.
Varkarakis IM, Allaf ME, Inagaki T et al (2005) Percutaneous radio frequency ablation of renal masses: results at a 2‑year mean followup. JURO 174(460):456–460
35.
Clark TWI, Malkowicz B, Stavropoulos SW et al (2006) Radiofrequency ablation of small renal cell carcinomas using multitined expandable electrodes: preliminary experience. J Vasc Interv Radiol 17:513–519CrossRefPubMed
36.
Breen DJ, Rutherford EE, Stedman B et al (2007) Management of renal tumors by image-guided radiofrequency ablation: Experience in 105 tumors. Cardiovasc Intervent Radiol 30:936–942CrossRefPubMedPubMedCentral
37.
Ferakis N, Bouropoulos C, Granitsas T, Mylona S, Poulias I (2010) Longterm results after computed-tomography-guided percutaneous radiofrequency ablation for small renal tumors. J Endourol 24:1909–1913CrossRefPubMed
38.
Zagoria RJ, Pettus JA, Rogers M, Werle DM, Childs D, Leyendecker JR (2011) Long-term outcomes after percutaneous radiofrequency ablation for renal cell carcinoma. URL 77:1393–1397
39.
Kunkle DA, Uzzo RG (2008) Cryoablation or radiofrequency ablation of the small renal mass : a meta-analysis. Cancer 113(10):2671–2680. doi:10.1002/cncr.23896CrossRefPubMedPubMedCentral
40.
Wah T, Irving H, Gregory W, Cartledge J, Joyce A, Selby P (2014) Radiofrequency ablation (RFA) of renal cell carcinoma (RCC): experience in 200 tumours. BJU Int 113(3):416–428. doi:10.1111/bju.12349CrossRefPubMedPubMedCentral
41.
Olweny EO, Park SK, Tan YK, Best SL, Trimmer C, Cadeddu JA (2012) Radiofrequency ablation versus partial nephrectomy in patients with solitary clinical T1a renal cell carcinoma: comparable oncologic outcomes at a minimum of 5 years of follow-up. Eur Urol 61:1156–1161CrossRefPubMed
42.
Psutka SP, Feldman AS, McDougal WS, McGovern FJ, Mueller P, Gervais DA (2013) Long-term oncologic outcomes after radiofrequency ablation for T1 renal cell carcinoma. Eur Urol 63:486–492CrossRefPubMed
43.
Kroeger N, Choueiri TK, Lee JL, Bjarnason GA, Knox JJ, Mackenzie MJ, Wood L, Srinivas S, Vaishamayan UN, Rha SY, Pal SK, Yuasa T, Donskov F, Agarwal N, Tan MH, Bamias A, Kollmannsberger CK, North SA, Rini BI, Heng DY (2013) Survival outcome and treatment response of patients with late relapse from renal cell carcinoma in the era of targeted therapy. Eur Urol 65:1086–1092. doi:10.1016/j.eururo.2013.07.031CrossRefPubMed
44.
Tracy CR, Raman JD, Donnally C, Trimmer CK, Cadeddu JA (2010) Durable oncologic outcomes after radiofrequency ablation: experience from treating 243 small renal masses over 7.5 years. Cancer 116:3135–3142CrossRefPubMed
45.
46.
Gervais DA, McGovern FJ, Arellano RS, McDougal WS, Mueller PR (2005) Radiofrequency ablation of renal cell carcinoma: part 1, indications, results, and role in patient management over a 6‑year period and ablation of 100 tumors. AJR 185:64–71CrossRefPubMed
47.
Takaki H, Yamakado K, Soga N et al (2010) Midterm results of radiofrequency ablation versus nephrectomy for T1a renal cell carcinoma. Jpn J Radiol 28(6):460–468 (Jul)CrossRefPubMed
48.
Uchida M, Imaide Y, Sugimoto K, Uehara H, Watanabe H (1995) Percutaneous cryosurgery for renal tumours. Br J Urol 75(2):132–137 (Feb)CrossRefPubMed
49.
Bischoff JT, Chen RB, Lee BR et al (1999) Laparoscopic renal cryoablation: acute and long-term clinical radiographic, and pathologic effects in an animal model and application in a clinical trial. J Endourol 13:233–239CrossRef
50.
Berger A, Kamoi K, Gill IS, Aron M (2009) Cryoablation for renal tumors: current status. Curr Opin Urol 19(2):138–142CrossRefPubMed
51.
Gill IS, Matin SF, Desai MM, Kaouk JH, Steinberg A, Mascha E et al (2003) Comparative analysis of laparoscopic versus open partial nephrectomy for renal tumors in 200 patients. J Urol 170:64–68CrossRefPubMed
52.
Atwell TD, Farrell MA, Leibovich BC et al (2008) Percutaneous renal cryoablation: experience treating 115 tumors. J Urol 179:2136–2140 (discussion 2140–2141)CrossRefPubMed
53.
Georgiades CS, Hong K, Bizzell C, Geschwind JF, Rodriguez R (2008) Safety and efficacy of CT-guided percutaneous cryoablation for renal cell carcinoma. J Vasc Interv Radiol 19:1302–1310CrossRefPubMed
54.
Pirasteh A, Snyder L, Boncher N, Passalacqua M, Rosenblum D, Prologo JD (2011) Cryoablation vs. radiofrequency ablation for small renal masses. Acad Radiol 18:97–100CrossRefPubMed
55.
Atwell TD, Schmit GD, Boorjian SA et al (2013) Percutaneous ablation of renal masses measuring 3.0 cm and smaller: comparative local control and complications after radiofrequency ablation and cryoablation. AJR 200:461–466CrossRefPubMed
56.
Gill IS, Remer EM, Hasan WA, Strzempkowski B, Spaliviero M, Steinberg AP et al (2005) Renal cryoablation: outcome at 3 years. J Urol 173:1903–1907CrossRefPubMed
57.
Finley DS, Beck S, Box G, Chu W, Deane L, Vajgrt DJ et al (2008) Percutaneous and laparoscopic cryoablation of small renal masses. J Urol 180:492–498CrossRefPubMed
58.
KlatteT, Mauermann J, Heinz-Peer G, Waldert M, Weibl P, Klingler HC, Remzi M (2011) Perioperative, oncological and functional outcomes of laparoscopic renal cryoablation and open partial nephrectomy: a matched pair analysis. J Endourol 25(6):991–997CrossRef
59.
Strom KH, Derweesh I, Stroup SP, Malcolm JB, L’Esperance J, Wake RW et al (2011) Second prize: recurrence rates after percutaneous and laparoscopic renal cryoablation of small renal masses: does the approach make a difference? J Endour 25:371–375CrossRef
60.
Haber GP, Lee MC, Crouzet S et al (2012) Tumour in solitary kidney: laparoscopic partial nephrectomy vs laparoscopic cryoablation. BJU Int 109(1):118–124CrossRefPubMed
61.
Desai MM, Aron M, Gill IS (2005) Laparoscopic partial nephrectomy versuslaparoscopic cryoablation for the small renal tumor. Urology 66(5 Suppl):23–28CrossRefPubMed
62.
Wu F, Wang ZB, Chen WZ, Bai J, Zhu H, Qiao TY (2003) Preliminary experience using high intensity focused ultrasound for the treatment of patients with advanced stage renal malignancy. J Urol 170(6 Pt 1):2237–2240CrossRefPubMed
63.
Ritchie RW, Leslie T, Phillips R, Wu F, Illing R, ter Haar G, Protheroe A, Cranston D (2010) Extracorporeal high intensity focused ultrasound for renal tumours: a 3‑year follow-up. BJU Int 106(7):1004–1009. doi:10.1111/j.1464-410X.2010.09289.xCrossRefPubMed
64.
Klingler HC, Susani M, Seip R, Mauermann J, Sanghvi N, Marberger MJ (2008) A novel approach to energy ablative therapy of small renal tumours: laparoscopic high-intensity focused ultrasound. Eur Urol 53(4):810–816 (discussion 817–818)CrossRefPubMed
65.
Ritchie RW, Leslie TA, Turner GD, Roberts IS, D’Urso L, Collura D, Demarchi A, Muto G, Sullivan ME (2011) Laparoscopic high-intensity focused ultrasound for renal tumours: a proof of concept study. BJU Int 107(8):1290–1296. doi:10.1111/j.1464-410X.2010.09620.xCrossRefPubMed
66.
Rubinsky B (2010) Irreversible Electroporation. Series in Biomedical Engineering. Springer, Berlin HeidelbergCrossRef
67.
Narayanan G, Doshi MH (2016) Irreversible Electroporation (IRE) in Renal Tumors. Curr Urol Rep 17(2):15 doi:10.1007/s11934-015-0571-1CrossRefPubMed
68.
Thomson KR, Cheung W, Ellis SJ, Federman D, Kavnoudias H, Loader-Oliver D, Roberts S, Evans P, Ball C, Haydon A (2011) Investigation of the safety of irreversible electroporation in humans. J Vasc Interv Radiol 22(5):611–621. doi:10.1016/j.jvir.2010.12.014CrossRefPubMed
69.
Trimmer CK, Khosla A, Morgan M, Stephenson SL, Ozayar A, Cadeddu JA (2015) Minimally Invasive Percutaneous Treatment of Small Renal Tumors with Irreversible Electroporation: A Single-Center Experience. J Vasc Interv Radiol 26(10):1465–1471. doi:10.1016/j.jvir.2015.06.028CrossRefPubMed
70.
Wendler JJ, Ricke J, Pech M, Fischbach F, Jürgens J, Siedentopf S, Roessner A, Porsch M, Baumunk D, Schostak M, Köllermann J, Liehr UB (2015) First Delayed Resection Findings After Irreversible Electroporation (IRE) of Human Localised Renal Cell Carcinoma (RCC) in the IRENE Pilot Phase 2a Trial. Cardiovasc Intervent Radiol 39:239–250CrossRefPubMed
71.
Wendler JJ, Porsch M, Nitschke S, Köllermann J, Siedentopf S, Pech M, Fischbach F, Ricke J, Schostak M, Liehr UB (2015) A prospective Phase 2a pilot study investigating focal percutaneous irreversible electroporation (IRE) ablation by NanoKnife in patients with localised renal cell carcinoma (RCC) with delayed interval tumour resection (IRENE trial). Contemp Clin Trials 43:10–19. doi:10.1016/j.cct.2015.05.002CrossRefPubMed
72.
73.
Floridi C, De Bernardi I, Fontana F, Muollo A, Ierardi AM, Agostini A, Fonio P, Squillaci E, Brunese L, Fugazzola C, Carrafiello G (2014) Microwave ablation of renal tumors: state of the art and development trends. Radiol Med 119(7):533–540. doi:10.1007/s11547-014-0426-8CrossRefPubMed
74.
Yu J, Zhang G, Liang P, Yu XL, Cheng ZG, Han ZY, Zhang X, Dong J, Li QY, Mu MJ, Li X (2015) Midterm results of percutaneous microwave ablation under ultrasound guidance versus retroperitoneal laparoscopic radial nephrectomy for small renal cell carcinoma. Abdom Imaging 40(8):3248–3256. doi:10.1007/s00261-015-0500-2CrossRefPubMed
75.
Moreland AJ, Ziemlewicz TJ, Best SL, Hinshaw JL, Lubner MG, Alexander ML, Brace CL, Kitchin DR, Hedican SP, Nakada SY, Lee FT Jr, Abel EJ (2014) High-powered microwave ablation of t1a renal cell carcinoma: safety and initial clinical evaluation. J Endourol 28(9):1046–1052. doi:10.1089/end.2014.0190CrossRefPubMed
76.
Carrafiello G, Dionigi G, Ierardi AM, Petrillo M, Fontana F, Floridi C, Boni L, Rovera F, Rausei S, Mangano A, Spampatti S, Marconi A, Carcano G, Dionigi R (2013) Efficacy, safety and effectiveness of image-guided percutaneous microwave ablation in cystic renal lesions Bosniak III or IV after 24 months follow up. Int J Surg 11(Suppl 1):S30–S35. doi:10.1016/S1743-9191(13)60010-2CrossRefPubMed
77.
Campbell SP, Song DY, Pierorazio PM, Allaf ME, Gorin MA (2015) Stereotactic Ablative Radiotherapy for the Treatment of Clinically Localized Renal Cell Carcinoma. J Oncol 2015:1–6. doi:10.1155/2015/547143CrossRef
78.
Bretschneider T, Peters N, Hass P, Ricke J (2012) Update on interstitial brachytherapy. Radiologe 52(1):70–73. doi:10.1007/s00117-011-2213-zCrossRefPubMed
79.
Gill IS, Kavoussi LR, Lane BR et al (2007) Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol 178(1):41–46CrossRefPubMed
80.
Lane BR, Gill IS (2010) 7‑year oncological outcomes after laparoscopic and open partial nephrectomy. J Urol 183(2):473–479CrossRefPubMed
81.
Gong EM, Orvieto MA, Zorn KC et al (2008) Comparison of laparoscopic and open partial nephrectomy in clinical T1a renal tumors. J Endourol 22(5):953–957CrossRefPubMed
82.
Marszalek M, Meixl H, Polajnar M et al (2009) Laparoscopic and open partial nephrectomy: a matchedpair comparison of 200 Patients. Eur Urol 55(5):1171–1178CrossRefPubMed
83.
Muramaki M, Miyake H, Sakai I et al (2012) Prognostic factors influencing postoperative development of chronic kidney disease in patients with small renal tumors who underwent partial nephrectomy. Curr Urol 6:129–135CrossRefPubMedPubMedCentral
84.
Gill IS et al (2011) „Zero ischemia“ partial nephrectomy: novel laparoscopic and robotic technique. Eur Urol 59(1):128–134CrossRefPubMed
85.
Minervini A, Serni S, Tuccio A et al (2012) Simple enucleation versus radical nephrectomy in the treatment of pT1a and pT1b renal cell carcinoma. Ann Surg Oncol 19(2):694–700CrossRefPubMed
86.
Minervini A, Ficarra V, Rocco F et al (2011) SATURN Project-LUNA Foundation. Simple enucleation is equivalent to traditional partial nephrectomy for renal cell carcinoma: results of a nonrandomized, retrospective, comparative study. J Urol 185(5):1604–1610CrossRefPubMed
87.
Steinestel J, Steffens S, Steinestel K, Schrader AJ (2014) Positive surgical margins in nephron-sparing surgery: risk factors and therapeutic consequences. World J Surg Oncol 8(12):252 doi:10.1186/1477-7819-12-252CrossRef
88.
Marszalek M, Carini M, Chlosta P, Jeschke K, Kirkali Z, Knüchel R, Madersbacher S, Patard JJ, Van Poppel H (2012) Positive surgical margins after nephron-sparing surgery. Eur Urol 61(4):757–763. doi:10.1016/j.eururo.2011.11.028CrossRefPubMed
89.
Bazzi WM, Stroup SP, Kopp RP et al (2012) Comparison of laparoendoscopic single-site and multiport laparoscopic radical and partial nephrectomy: a prospective, nonrandomized study. Urology 80(5):1039–1045CrossRefPubMed
90.
Masson-Lecomte A, Bensalah K, Seringe E et al (2013) A prospective comparison of surgical and pathological outcomes obtained after robot-assisted or pure laparoscopic partial nephrectomy in moderate to complex renal tumours: results from a French multicentre collaborative study. BJU Int 111(2):256–263CrossRefPubMed
91.
Aboumarzouk OM, Stein RJ, Eyraud R et al (2012) Robotic versus laparoscopic partial nephrectomy: a systematic review and meta-analysis. Eur Urol 62(6):1023–1033CrossRefPubMed
92.
Froghi S et al (2013) Evaluation of robotic and laparoscopic partial nephrectomy for small renal tumours (T1a). BJU Int 112(4):E322–E333CrossRefPubMed
Metadaten
Titel
Fokale Therapie von kleinen Nierentumoren
Beobachtung, Ablation oder Operation
verfasst von
Dr. med. 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
Publikationsdatum
27.04.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Die Urologie / Ausgabe 5/2016
Print ISSN: 2731-7064
Elektronische ISSN: 2731-7072
DOI
https://doi.org/10.1007/s00120-016-0075-8

Weitere Artikel der Ausgabe 5/2016

Der Urologe 5/2016 Zur Ausgabe

Einführung zum Thema

Fokale Therapie

Übersichten

Kardiovaskuläre Risiken der Androgendeprivationstherapie beim Prostatakarzinom

Mitteilungen der DGU - Termine

Mitteilungen der DGU - Termine

Journal Club

Hilft der STHLM3-Test das Prostatakarzinomscreening zu verbessern?

Urologie aktuell

DPKK-Jahrestagung zu „liquid biopsies“, zirkulierenden Tumorzellen und zur Rolle des Androgenrezeptors

Mitteilungen der DGU

Mitteilungen der DGU

Das könnte Sie auch interessieren

03.05.2016 | Brachytherapie | Leitthema

Fokale Therapie des Prostatakarzinoms in Deutschland

27.04.2016 | Harnblasenkarzinom | Leitthema

Organerhaltende Therapie des Harnblasenkarzinoms

27.04.2016 | Brachytherapie | Leitthema

Fokale Therapie beim Peniskarzinom

Neu im Fachgebiet Onkologie

24.04.2024 | DGIM 2024 | Nachrichten

Bei Senioren mit Prostatakarzinom auf Anämie achten!

23.04.2024 | Medikamente in Schwangerschaft und Stillzeit | Nachrichten

ICI-Therapie in der Schwangerschaft wird gut toleriert

22.04.2024 | DGIM 2024 | Kongressbericht | Nachrichten

Krebspatienten impfen: Was? Wen? Und wann nicht?

22.04.2024 | DGIM 2024 | Kongressbericht | Nachrichten

Müde im Alter? Auch an die Nebenniere denken
weitere anzeigen

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen