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Der Urologe

, Volume 55, Issue 5, pp 594–606 | Cite as

Fokale Therapie von kleinen Nierentumoren

Beobachtung, Ablation oder Operation
  • J. J. WendlerEmail author
  • 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
Leitthema

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.

Schlüsselwörter

Nierenzellkarzinom Fokale Therapie Nierenteilresektion Active Surveillance Ablation 

Focal therapy for small renal masses

Observation, ablation or surgery

Abstract

Background

The 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.

Discussion

During 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.

Results

Percutaneous 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.

Keywords

Renal cell carcinoma Focal therapy Partial kidney resection Active surveillance Ablation 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

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 und M. Schostak geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Literatur

  1. 1.
    Robert Koch-Institut, Gesellschaft der epidemiologischen Krebsregister in Deutschland e. V. (2013) Krebs in Deutschland 2009/2010, 9. Aufl. ruksaldruck, BerlinGoogle Scholar
  2. 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.0030556CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
  4. 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.i6.110CrossRefPubMedPubMedCentralGoogle Scholar
  5. 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/s00120-014-3710-2CrossRefPubMedGoogle Scholar
  6. 6.
    Ljungberg B, Bensalah K, Bex A, Canfield S, Dabestani S, Giles RH, Hofmann F, Hora M, Kuczyk MA, Lam T, Marconi L, Merseburger AS, Powles T, Staehler M, Volpe A (2015) Guidelines on Renal Cell Carcinoma. European Association of Urology (EAU) 2015, Update March 2015, S 8–23. http://uroweb.org/wp-content/uploads/10-Renal-Cell-Carcinoma_LR1.pdf. Zugegriffen: 19. Jan. 2016
  7. 7.
    Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF) (2015) Diagnostik, Therapie und Nachsorge des Nierenzellkarzinoms, S3-Leitlinie, Langversion 1.0, 2015, AWMF Registernummer: 043/017OL. http://leitlinienprogramm-onkologie.de/Leitlinien.7.0.html. Zugegriffen: 19. Jan. 2016
  8. 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.2012.05.009CrossRefPubMedGoogle Scholar
  9. 9.
    Warren KS, McFarlane J (2005) The Bosniak classification of renal cystic masses. BJU Int 95(7):939–942CrossRefPubMedGoogle Scholar
  10. 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: 0284185115588124Google Scholar
  11. 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:10.1159/000351751CrossRefPubMedGoogle Scholar
  12. 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.2011.05.012CrossRefPubMedGoogle Scholar
  13. 13.
    Horstmann M, Franiel T, Grimm MO (2014) Differential diagnosis of hematuria. Urologe A 53(8):1215–1226. doi:10.1007/s00120-014-3506-4CrossRefPubMedGoogle Scholar
  14. 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.2008.09.053CrossRefPubMedGoogle Scholar
  15. 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.xCrossRefPubMedGoogle Scholar
  16. 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/s00120-015-3800-9CrossRefPubMedGoogle Scholar
  17. 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.xCrossRefPubMedGoogle Scholar
  18. 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.2015.08.020CrossRefPubMedGoogle Scholar
  19. 19.
    Wein A, Kavoussi L, Partin A, Peters C (2016) Campbell-Walsh Urology, 11. Aufl. Elsevier, Philadelphia.Google Scholar
  20. 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):425–431CrossRefPubMedGoogle Scholar
  21. 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.2009.02.128CrossRefPubMedPubMedCentralGoogle Scholar
  22. 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.2015.01.008CrossRefPubMedGoogle Scholar
  23. 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.23899CrossRefPubMedPubMedCentralGoogle Scholar
  24. 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:10.3109/02841851003724846CrossRefPubMedGoogle Scholar
  25. 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):333–339CrossRefPubMedGoogle Scholar
  26. 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.2011.03.03CrossRefPubMedGoogle Scholar
  27. 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.25184CrossRefPubMedGoogle Scholar
  28. 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):e259CrossRefGoogle Scholar
  29. 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):1438–1443CrossRefPubMedGoogle Scholar
  30. 30.
    Duffey BG, Kyle AJ (2010) Current and future technology for minimally invasive ablation of renal cell carcinoma. Indian J Urol 26(3):410–417CrossRefPubMedPubMedCentralGoogle Scholar
  31. 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 11:251–258CrossRefPubMedGoogle Scholar
  32. 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):1587–1592CrossRefPubMedGoogle Scholar
  33. 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):998–1001CrossRefPubMedGoogle Scholar
  34. 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):456–460Google Scholar
  35. 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 17:513–519CrossRefPubMedGoogle Scholar
  36. 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 30:936–942CrossRefPubMedPubMedCentralGoogle Scholar
  37. 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 24:1909–1913CrossRefPubMedGoogle Scholar
  38. 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 77:1393–1397Google Scholar
  39. 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.23896CrossRefPubMedPubMedCentralGoogle Scholar
  40. 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.12349CrossRefPubMedPubMedCentralGoogle Scholar
  41. 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 61:1156–1161CrossRefPubMedGoogle Scholar
  42. 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 63:486–492CrossRefPubMedGoogle Scholar
  43. 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.2013.07.031CrossRefPubMedGoogle Scholar
  44. 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 116:3135–3142CrossRefPubMedGoogle Scholar
  45. 45.
    Georgiades C, Rodriguez R (2013) Renal tumor ablation. Tech Vasc Interv Radiol 16:230–238CrossRefPubMedGoogle Scholar
  46. 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 185:64–71CrossRefPubMedGoogle Scholar
  47. 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)CrossRefPubMedGoogle Scholar
  48. 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)CrossRefPubMedGoogle Scholar
  49. 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 13:233–239CrossRefGoogle Scholar
  50. 50.
    Berger A, Kamoi K, Gill IS, Aron M (2009) Cryoablation for renal tumors: current status. Curr Opin Urol 19(2):138–142CrossRefPubMedGoogle Scholar
  51. 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 170:64–68CrossRefPubMedGoogle Scholar
  52. 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)CrossRefPubMedGoogle Scholar
  53. 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 19:1302–1310CrossRefPubMedGoogle Scholar
  54. 54.
    Pirasteh A, Snyder L, Boncher N, Passalacqua M, Rosenblum D, Prologo JD (2011) Cryoablation vs. radiofrequency ablation for small renal masses. Acad Radiol 18:97–100CrossRefPubMedGoogle Scholar
  55. 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 200:461–466CrossRefPubMedGoogle Scholar
  56. 56.
    Gill IS, Remer EM, Hasan WA, Strzempkowski B, Spaliviero M, Steinberg AP et al (2005) Renal cryoablation: outcome at 3 years. J Urol 173:1903–1907CrossRefPubMedGoogle Scholar
  57. 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 180:492–498CrossRefPubMedGoogle Scholar
  58. 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):991–997CrossRefGoogle Scholar
  59. 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 25:371–375CrossRefGoogle Scholar
  60. 60.
    Haber GP, Lee MC, Crouzet S et al (2012) Tumour in solitary kidney: laparoscopic partial nephrectomy vs laparoscopic cryoablation. BJU Int 109(1):118–124CrossRefPubMedGoogle Scholar
  61. 61.
    Desai MM, Aron M, Gill IS (2005) Laparoscopic partial nephrectomy versuslaparoscopic cryoablation for the small renal tumor. Urology 66(5 Suppl):23–28CrossRefPubMedGoogle Scholar
  62. 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):2237–2240CrossRefPubMedGoogle Scholar
  63. 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.xCrossRefPubMedGoogle Scholar
  64. 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)CrossRefPubMedGoogle Scholar
  65. 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.xCrossRefPubMedGoogle Scholar
  66. 66.
    Rubinsky B (2010) Irreversible Electroporation. Series in Biomedical Engineering. Springer, Berlin HeidelbergCrossRefGoogle Scholar
  67. 67.
    Narayanan G, Doshi MH (2016) Irreversible Electroporation (IRE) in Renal Tumors. Curr Urol Rep 17(2):15 doi:10.1007/s11934-015-0571-1CrossRefPubMedGoogle Scholar
  68. 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.2010.12.014CrossRefPubMedGoogle Scholar
  69. 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.2015.06.028CrossRefPubMedGoogle Scholar
  70. 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 39:239–250CrossRefPubMedGoogle Scholar
  71. 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.2015.05.002CrossRefPubMedGoogle Scholar
  72. 72.
    Brace CL (2009) Microwave ablation technology: what every user should know. Curr Probl Diagn Radiol 38(2):61–67CrossRefPubMedPubMedCentralGoogle Scholar
  73. 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/s11547-014-0426-8CrossRefPubMedGoogle Scholar
  74. 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/s00261-015-0500-2CrossRefPubMedGoogle Scholar
  75. 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.2014.0190CrossRefPubMedGoogle Scholar
  76. 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)60010-2CrossRefPubMedGoogle Scholar
  77. 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:10.1155/2015/547143CrossRefGoogle Scholar
  78. 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-zCrossRefPubMedGoogle Scholar
  79. 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):41–46CrossRefPubMedGoogle Scholar
  80. 80.
    Lane BR, Gill IS (2010) 7‑year oncological outcomes after laparoscopic and open partial nephrectomy. J Urol 183(2):473–479CrossRefPubMedGoogle Scholar
  81. 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):953–957CrossRefPubMedGoogle Scholar
  82. 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):1171–1178CrossRefPubMedGoogle Scholar
  83. 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 6:129–135CrossRefPubMedPubMedCentralGoogle Scholar
  84. 84.
    Gill IS et al (2011) „Zero ischemia“ partial nephrectomy: novel laparoscopic and robotic technique. Eur Urol 59(1):128–134CrossRefPubMedGoogle Scholar
  85. 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):694–700CrossRefPubMedGoogle Scholar
  86. 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):1604–1610CrossRefPubMedGoogle Scholar
  87. 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:10.1186/1477-7819-12-252CrossRefGoogle Scholar
  88. 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.2011.11.028CrossRefPubMedGoogle Scholar
  89. 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):1039–1045CrossRefPubMedGoogle Scholar
  90. 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):256–263CrossRefPubMedGoogle Scholar
  91. 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):1023–1033CrossRefPubMedGoogle Scholar
  92. 92.
    Froghi S et al (2013) Evaluation of robotic and laparoscopic partial nephrectomy for small renal tumours (T1a). BJU Int 112(4):E322–E333CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • J. J. Wendler
    • 1
    • 2
    Email author
  • B. Friebe
    • 3
  • D. Baumunk
    • 1
    • 2
  • A. Blana
    • 1
    • 6
  • T. Franiel
    • 1
    • 7
  • R. Ganzer
    • 1
    • 4
  • B. Hadaschik
    • 1
    • 5
  • T. Henkel
    • 1
    • 8
  • K. U. Köhrmann
    • 1
    • 9
  • J. Köllermann
    • 1
    • 17
  • T. Kuru
    • 1
    • 10
  • S. Machtens
    • 1
    • 11
  • A. Roosen
    • 1
    • 12
  • G. Salomon
    • 1
    • 13
  • H. P. Schlemmer
    • 1
    • 16
  • L. Sentker
    • 1
    • 14
  • U. Witzsch
    • 1
    • 15
  • U. B. Liehr
    • 1
    • 2
  • J. Ricke
    • 3
  • M. Schostak
    • 1
    • 2
  1. 1.Arbeitskreis für fokale und Mikrotherapie der Akademie (AKFM)Deutsche Gesellschaft für Urologie (DGU) e. V.DüsseldorfDeutschland
  2. 2.Universitätsklinik für Urologie und KinderurologieOtto-von-Guericke-Universität MagdeburgMagdeburgDeutschland
  3. 3.Universitätsklinik für Radiologie und NuklearmedizinOtto-von-Guericke-Universität MagdeburgMagdeburgDeutschland
  4. 4.Urologische Klinik und PoliklinikUniversität LeipzigLeipzigDeutschland
  5. 5.Urologische Klinik und PoliklinikRuprecht-Karls-Universität HeidelbergHeidelbergDeutschland
  6. 6.Klinik für Urologie und KinderurologieKlinikum FürthFürthDeutschland
  7. 7.Institut für Diagnostische und Interventionelle RadiologieUniversitätsklinikum JenaJenaDeutschland
  8. 8.Urologische Praxis Dr. Henkel & Dr. KahmannBerlinDeutschland
  9. 9.Klinik für UrologieTheresien-Krankenhaus MannheimMannheimDeutschland
  10. 10.Universitätsklinik für UrologieUniversitätsklinikum KölnKölnDeutschland
  11. 11.Klinik für UrologieMarien-Krankenhaus gGmbHBergisch-GladbachDeutschland
  12. 12.Klinik für UrologieAugusta-Krankenanstalt gGmbH BochumBochumDeutschland
  13. 13.Martini-KlinikUKE GmbHHamburgDeutschland
  14. 14.Urologische GemeinschaftspraxisSinsheimDeutschland
  15. 15.Klinik für Urologie und KinderurologieKrankenhaus NordwestFrankfurt/MainDeutschland
  16. 16.Abteilung für RadiologieDeutsches Krebsforschungszentrum HeidelbergHeidelbergDeutschland
  17. 17.Institut für PathologieSana Klinikum OffenbachOffenbach am MainDeutschland

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