Ablative treatment modalities for kidney tumours. Ankara, 6th November 2009

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Ablative treatment modalities for kidney tumours. Ankara, 6th November 2009"

Transcription

1 Ablative treatment modalities for kidney tumours Ankara, 6th November 2009

2 Vasa Central Hospital, Finland Peter Nylund

3 Nephronsparing cryoablation of kidneycancer Vasa Central Hospital Finland Preliminary five years experiance

4 Renal Cryosurgery From open transabdominal renal cryosurgery over percutaneus renal cryosurgery to laparoscopic renal cryosurgery and retroperitoneal renal cryosurgery

5 Result: All single tumour patients tumour free several years later on MRI Advantage: Less expensive Comfortable for the patient Small tumors 2 3 cm Cryoablation of kidney cancer December Sepember -09 If just one solitary kidney left Absolute need of haemodialysis in case of radical nephrectomy In one patient 5 multiple tumours in the same kidney Nephronsparing cryoablation with 6 cryoneedles 17G, 2 thermosensors, 2 cycles -70ºC

6 Patient 1 78 years old male Aortal valve insufficiency Post myocardial infarction CABG 1993 Microhematuria in fall 2002 Kidney US: lower pole right kidney tumour 3.7x 4,5 cm, 1 month before 2,4 x 2,7 cm Referred by GP

7 Preop MRI

8 Renal insufficiency Krea 176 Kidney MRI: renal tumour (carcinoma) in the right lower pole Preop Thorax-rtg: no metastases OPEN CRYOABLATION Open needlebiopsy-pad GI renal cell cancer Open nephronspearing cryoablation 2 times 5 min freezing to -40 and -70 C

9 Postop Preop Krea 184 (181202) Postop Krea 233 (221202) Preop Hb 131 (181202) Postop Hb 92 (201202) EPO IE s.c. + Spartocine 1x2 No transfusion Delivery Hb 103 (261202)

10 MRI 1 year 3 months later

11 Follow up Urol pkl (3 month) Krea 221, Hb 127 No dialysis Kidney US : 1,9 cm cystic process in the right lower pole Kidney MRI : no tumour left, just fibrosis Kidney US : same cystic process Kidney MRI : no tumour Kidney US : same cystic process Kidney US : no tumor, Krea 208 Kidney US : still no tumour, Krea 223 Kidney US : still no tumour, Krea 123

12 Patient 2 79 years old female (Jehova witness) Arterial hypertension Back pain Rising Krea from 95 to 174 Abdominal US: bilateral renal cysts Kidney MRI: 4,5 cm cyst in right kidney 3 cm tumour in the medioposterior part of the right kidney. Left kidney hydronefrotic with duplexsystem and parenchymal reduction

13 Preop MRI

14 Good renal function only in the right affected kidney OPEN CRYOABLATION Open nephronspearing cryoablation with 6 ultrathin 17 G cryoneedles 10 min 2 cycles -40 C Pull back 1 cm 10 min 2 cycles -41 C

15 Postop Postop Krea 122 no dialysis needed Postop Hb 82 EPO IE s.c. + Spartocine 1x2 No transfusion needed

16 MRI 1 year later

17 Follow up Kidney US : no solid tumour left Kidney function normal : Krea 89 Kidney CT scan : no tumour Kidney US : no tumour Kidney US : no tumour Kidney MRI : still no tumour Kidney US : still no tumour, Krea 106

18 MRI 4 years later

19 First 2 patients with kidney cryoablation Still free from tumour 8 years later Still kidney function not impaired

20 Patient 3 51 years old male leftside transabdominal radical nephrectomy PAD: 5 cm renal cancer Right kidney US : hyperdensitive focus 15 mm Kidney : 3 focus in the lower pole, one focus in the middle and one in the upper pole multiple tumours single kidney

21 Preop: Multiple tumours

22 Single kidney cancer OPEN CRYOABLATION Open needle biopsy: PAD: clarocellular renal adenoca open nephronspearing cryoablation with ultrathin 17 G cryoneedles 5 up to 2 cm tumours are freezed down to -70 C each

23 MRI 6 months later

24 Follow up Preop Krea 96 (050603) Postop Krea 295 (080603) Krea 110 (250803) 2 months later No dialysis needed Kidney MRI : rest after cryoresection Kidney MRI :no contrast concentration in resection area Patient uptaking sports activities: Vasaloppet in spring 2004 Kidney MRI and : same status

25 Multiple tumor recidives MRI 20th september 2005

26 Postop: MRI

27 Second open transabdominal multiple cryoablation on right kidney 17th November 2005 Preop Krea 108 Postop Krea 360 Controlled Krea 214 2nd January 2006 MRI : no tumour Still no dialysis

28 Nephrectomy l.dx Kidney MRI : 3 new right renal tumours, of which one close to hilus Radical right nephrectomy PAD pt3n0g2 renal adenocarcinoma Thoraxrtg : small suspect findings in both lungs Cerebral CT : 3 cerebral metastasis Rx and Sutent in our oncologic unit

29 Percutaneus ultrasound guided cryoablation of renal cell carcinoma 85 years old male Severe aorta valve stenosis with dyspnea Debuted with hematuria und right flan pain elevated Krea >200 US right kidney hydronepfrotic, lower pole 3 cm tumour double pigtail to the right side Krea down to 176 US needle biopsy PAD: clarocellular renal adenocarcinoma GI

30 Lower pole tumour in the right kidney

31 Inoperable due to cardiac disease New option needed: Nephronspearing in local anesthesia Percutaneus cryoneedle ablation of right lowerpole tumour in ultrasound control 22nd March 2005

32 Collaboration between urologist and radiologist

33 Ultrasound guided needle insertion

34 Template guided

35 Freezing shadow on ultrasound

36 Follow up MRI at one year 14th February 2006

37 MRI : no tumour

38 Follow up Pig-tail withdrawel Cystoscopi OK No more haematuria MRI : Tumour shrinking MRI : No tumour US : No evident tumour Krea 136, Still alive MRI 2008, no tumour

39 Laparoscopic cryoablation of kidney tumour 14th March 2006

40 2 cm tumour in right kidney, 70 year old male, Krea 127

41 Laparoscopic exploration of the right renal tumour

42 Percutaneus needle insertion after laparoscopic exploration

43 Freezing first needle for fixation of the tumor

44 Transabdominal intraoperative US Mandatory to find and define endophytic tumours. Guiding needles placement in all tumours, exophytic as endophytic.

45 6 cryoneedles 2 cm deep and 2 termosensors in place

46 Freezing down to -70 degrees Celcius 10 minutes

47 Thawing before a second cycle of freezing

48 Second cycle of freezing

49 Follow up CT scanning : no more tumour CT scannig : no tumour US : no tumour

50 Futher experience By now 5 lapaoscopic renal cryoablations Successfull results Iceseed or Icerods Termosensor in the middle of the tumour and 0,5 cm outside the tumour

51 Retroperitoneal approch 3 patients with a small kidney tumour on the back side of the kidney A minimal lumbotomy was made to get direct approach to the tumor Cryo needles inserted percutaneusly under open vision PresIce controlled freezing

52 78 year old male Nephrectomy of the left kidney 2001 due to renal cancer US and CT 3 cm tumour on the backside of the right kidney Krea 131 before cryoablation Krea 217 half a year later

53 Retroperitoneal Cryoablation

54 Postop follow up: MRI : no tumour left MRI : no tumour

55 64 year old female US due to abdominal discomfort 2006 Preop CT ,5 cm tumour in the right kidney Cryoablation PresIce Tacozil for control of bleeding PAD: oncocytom MRI : no tumour US : no tumour

56 72 year old female Backpain fall 2006 Preop CT ,5 cm tumour in the right kidney Cryoablation PresIce Tacozil for control of bleeding PAD: Adenoca G1 MRI : no tumour

57 Next step Retroperitonel lapascopic approach as in Heilbronn, Germany

58 Laparoscopic approach standard Transabdominal laparoscopy for cryoablation of tumours on the anterior side of the kidney Retroperitoneal laparoscopy for cryoablation of tumours on the posterior side of the kidney If robotic surgery availabel it can be used equally

59 Conclusion 1 All nephronspearing cryoablation is a safe option of kidneycancer treatment in patients with small tumors < 4 cm and risk of renal failure No dialysis needed cheep Good quality of life

60 Conclusion 2 Nowadays cryoablation of small kidneytumors < 4 cm cm is used on regular bases as a nephronsparing method Percutaneus, laparoscopic or open surgery routes can be used equally, depending on the site of the tumor and the possible approach

61 Marberger,EAU Milan 08 Pooled 5 years followup data showes cryoablation of small kidney tumors as superior to RF. Cryo patients 98% disease free RF patients 80% disease free

62 Cryoablation of small renal tumours produces recurrences rates approaching, and morbidity rates significantly less, than those of LPN. Kyle J. Weld and Jaime Landman 2005 BJU International / 96,

63 5 years results of laparoscopic renal cryoablation seem to be sustained over time. Robert J. Stein and Jihad H. Kaouk 2007 BJU International / 99,

64 Jean de la Rosette, Amsterdam 2008 Cryablation can safely be offered to all patients with small kidney tumors

65 Cryoablation of renal tumours should be limited to lesions not greater than 4 cm D. Brooke Johnson et al The Journal of Urology /04/ /0 Vol. 172, , September 2004

66 Pegasus The winning ice sculpture on the marketplace in Vaasa The international ice sculpture competition 2004

67

68 Welcome to Vaasa

Kidney Cancer OVERVIEW

Kidney Cancer OVERVIEW Kidney Cancer OVERVIEW Kidney cancer is the third most common genitourinary cancer in adults. There are approximately 54,000 new cancer cases each year in the United States, and the incidence of kidney

More information

Contact Maryann Verrillo Diane Shnitzler (703) 691-1805. Interventional Radiology Treatments for Kidney Cancer

Contact Maryann Verrillo Diane Shnitzler (703) 691-1805. Interventional Radiology Treatments for Kidney Cancer Interventional Radiology Treatments for Kidney Cancer FACT SHEET Contact Maryann Verrillo Diane Shnitzler (703) 691-1805 Kidney cancer is the eighth most common cancer in men and the tenth in women. 1

More information

Metastatic Renal Cell Carcinoma: Staging and Prognosis of Three Separate Cases.

Metastatic Renal Cell Carcinoma: Staging and Prognosis of Three Separate Cases. Metastatic Renal Cell Carcinoma: Staging and Prognosis of Three Separate Cases. Abstract This paper describes the staging, imaging, treatment, and prognosis of renal cell carcinoma. Three case studies

More information

Treating your kidney tumour by percutaneous thermal tumour ablation using radiofrequency ablation (RFA)

Treating your kidney tumour by percutaneous thermal tumour ablation using radiofrequency ablation (RFA) Information for patients Treating your kidney tumour by percutaneous thermal tumour ablation using radiofrequency ablation (RFA) Introduction This leaflet tells you about the procedure known as percutaneous

More information

Localized Kidney Cancer

Localized Kidney Cancer Patient Information English 3 Localized Kidney Cancer The underlined terms are listed in the glossary. If you are diagnosed with localized kidney cancer, your doctor can recommend treating the cancer with

More information

A PATIENT S GUIDE TO ABLATION THERAPY

A PATIENT S GUIDE TO ABLATION THERAPY A PATIENT S GUIDE TO ABLATION THERAPY THE DIVISION OF VASCULAR/INTERVENTIONAL RADIOLOGY THE ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL Treatment options for patients with cancer continue to expand, providing

More information

Case Number: RT2009-124(M) Potential Audiences: Intent Doctor, Oncology Special Nurse, Resident Doctor

Case Number: RT2009-124(M) Potential Audiences: Intent Doctor, Oncology Special Nurse, Resident Doctor Renal Cell Carcinoma of the Left Kidney Post Radical Surgery with pt4 Classification with Multiple Lung and Single Brain Metastases: the Role and Treatment Consideration of Radiotherapy Case Number: RT2009-124(M)

More information

Renal Cysts What should I do now?

Renal Cysts What should I do now? Renal Cysts What should I do now? Dr Edmund Chiong Asst. Professor & Consultant Department of Urology National University Hospital What are renal cysts? Fluid-filled structures in the kidney that are not

More information

Renal Cell Carcinoma The New Frontier (To boldly go... ) Sean A. Pierre, MD, RCPSC (Urology)

Renal Cell Carcinoma The New Frontier (To boldly go... ) Sean A. Pierre, MD, RCPSC (Urology) The New Frontier (To boldly go... ) Sean A. Pierre, MD, RCPSC (Urology) QUEENSWAY CARLETON HOSPITAL DIVISION OF UROLOGY NEPEAN, ON, CANADA Disclosures None Objectives Advances in the field of Renal Cell

More information

Corporate Medical Policy

Corporate Medical Policy Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: microwave_tumor_ablation 12/2011 11/2015 11/2016 11/2015 Description of Procedure or Service Microwave ablation

More information

androbotic Kidney Surgery

androbotic Kidney Surgery Laparoscopic androbotic Kidney Surgery Commonly asked questions by Dr Gerald Tan Dr Gerald Tan Yau Min is a Senior Consultant Urologist at Mt Elizabeth Novena Hospital and has more than 19 years of clinical

More information

Clinical Practice Assessment Robotic surgery

Clinical Practice Assessment Robotic surgery Clinical Practice Assessment Robotic surgery Background: Surgery is by nature invasive. Efforts have been made over time to reduce complications and the trauma inherently associated with surgery through

More information

A912: Kidney, Renal cell carcinoma

A912: Kidney, Renal cell carcinoma A912: Kidney, Renal cell carcinoma General facts of kidney cancer Renal cell carcinoma, a form of kidney cancer that involves cancerous changes in the cells of the renal tubule, is the most common type

More information

Minimally Invasive Kidney Cryotherapy

Minimally Invasive Kidney Cryotherapy Minimally Invasive Kidney Cryotherapy [ mini mal ly in va sive ] minimally: [adv] to a minimal degree; the least or smallest possible invasive: [adj ] relating to a technique in which the body is entered

More information

PADUA score guided surgery for T1 RCC

PADUA score guided surgery for T1 RCC PADUA score guided surgery for T1 RCC - Renal Cell Carcinoma - Vassilis Poulakis MD, PhD, FEBU Ass. Professor of Urology, University of Frankfurt, Germany Director of Urologic Clinic Metropolitan Hospital

More information

Clinical Management Guideline Management of locally advanced or recurrent Renal cell carcinoma. Protocol for Planning and Treatment

Clinical Management Guideline Management of locally advanced or recurrent Renal cell carcinoma. Protocol for Planning and Treatment Protocol for Planning and Treatment The process to be followed in the management of: LOCALLY ADVANCED OR METASTATIC RENAL CELL CARCINOMA Patient information given at each stage following agreed information

More information

Microwave ablation for the treatment of liver metastases

Microwave ablation for the treatment of liver metastases Microwave ablation for the treatment of liver Issued: August 2011 guidance.nice.org.uk/ipg NICE has accredited the process used by the NICE Interventional Procedures Programme to produce interventional

More information

These rare variants often act aggressively and may respond differently to therapy than the more common prostate adenocarcinoma.

These rare variants often act aggressively and may respond differently to therapy than the more common prostate adenocarcinoma. Prostate Cancer OVERVIEW Prostate cancer is the second most common cancer diagnosed among American men, accounting for nearly 200,000 new cancer cases in the United States each year. Greater than 65% of

More information

Guidelines for Management of Renal Cancer

Guidelines for Management of Renal Cancer Guidelines for Management of Renal Cancer Date Approved by Network Governance July 2012 Date for Review July 2015 Changes Between Versions 2 and 3 Section 5 updated bullets 5.3 and 5.4 Section 6 updated

More information

Frequently Asked Questions about Kidney Cancer

Frequently Asked Questions about Kidney Cancer Patient Information English Frequently Asked Questions about Kidney Cancer The underlined terms are listed in the glossary. Here is an overview of the most frequently asked questions about kidney cancer.

More information

Case Number: RT2009 124-2(M) Potential Audiences: Intent Doctor, Oncology Special Nurse, Resident Doctor

Case Number: RT2009 124-2(M) Potential Audiences: Intent Doctor, Oncology Special Nurse, Resident Doctor Renal Cell Carcinoma of the Left Kidney Post Radical Surgery with pt4 Classification with Multiple Lung and Single Brain Metastases Post Chemotherapy and Brain RT with Local-Regional Recurrence with Bilateral

More information

Uterus myomatosus. 10-May-15. Clinical presentation. Incidence. Causes? 3 out of 4 women. Growth rate vary. Most common solid pelvic tumor in women

Uterus myomatosus. 10-May-15. Clinical presentation. Incidence. Causes? 3 out of 4 women. Growth rate vary. Most common solid pelvic tumor in women Uterus myomatosus A.J. Henriquez March 14, 2015 Uterus myomatosus Definition, incidence, clinical presentation and diagnosis. New FIGO classification for uterine leiomyomas Brief description on treatment

More information

da Vinci Prostatectomy (Robotically Assisted Radical Prostatectomy)

da Vinci Prostatectomy (Robotically Assisted Radical Prostatectomy) Peninsula Urology Center, Inc. Dieter Bruno, M.D, F.A.C.S Chris Threat, M.D. 3351 El Camino. Real, Suite 101 Atherton, CA 94027 (650) 306-1016 dbrunomd@pucenter.com http://www.pucenter.com/ da Vinci Prostatectomy

More information

Medullary Renal Cell Carcinoma Case Report

Medullary Renal Cell Carcinoma Case Report Bahrain Medical Bulletin, Vol. 27, No. 4, December 2005 Medullary Renal Cell Carcinoma Case Report Mohammed Abdulla Al-Tantawi MBBCH, CABS* Abdul Amir Issa MBBCH, CABS*** Mohammed Abdulla MBBCH, CABS**

More information

Correct Coding to Maximize Reimbursements: Hone your Uro-Oncology Skills. Michael A. Ferragamo, MD, FACS

Correct Coding to Maximize Reimbursements: Hone your Uro-Oncology Skills. Michael A. Ferragamo, MD, FACS Correct Coding to Maximize Reimbursements: Hone your Uro-Oncology Skills Michael A. Ferragamo, MD, FACS Coding and Reimbursement Consultant; Assistant Clinical Professor of Urology, University Hospital,

More information

Genetics Gender plays a role in kidney cancer, as men are twice as likely as women to develop RCC

Genetics Gender plays a role in kidney cancer, as men are twice as likely as women to develop RCC What is kidney cancer? Renal cell carcinoma (RCC) is the most common kind of kidney cancer. 1 Normally, your kidneys filter your blood and excrete waste in urine. Although our kidneys are important, we

More information

Transperitoneal laparoscopic adrenalectomy for metachronous contralateral

Transperitoneal laparoscopic adrenalectomy for metachronous contralateral Transperitoneal laparoscopic adrenalectomy for metachronous contralateral adrenal metastasis from renal cell carcinoma: a case report Evangelos Zacharakis* 1, Maria Jose Ribal 1, Emmanouil Zacharakis 2

More information

CONTEMPORARY MANAGEMENT OF RENAL ANGIOMYOLIPOMA

CONTEMPORARY MANAGEMENT OF RENAL ANGIOMYOLIPOMA CONTEMPORARY MANAGEMENT OF RENAL ANGIOMYOLIPOMA Stephen A. Boorjian, MD Professor of Urology Vice Chair of Research Director, Urologic Oncology Fellowship Department of Urology Mayo Clinic, Rochester,

More information

Renal Cell Carcinoma. Background 1. General information. Pathophysiology 1. Pathology of disease. Diagnostics 1. History

Renal Cell Carcinoma. Background 1. General information. Pathophysiology 1. Pathology of disease. Diagnostics 1. History Renal Cell Carcinoma Background 1. General information o Accounts for 2-3 % of all malignancies o 5 variants 75-85% clear cell tumors 12-14% chromophilic 4-6% chromophobic 2-4% oncocytic 1% collecting

More information

CASE OF THE MONTH AUGUST-2015 DR. GURUDUTT GUPTA HEAD HISTOPATHOLOGY

CASE OF THE MONTH AUGUST-2015 DR. GURUDUTT GUPTA HEAD HISTOPATHOLOGY CASE OF THE MONTH AUGUST-2015 DR. GURUDUTT GUPTA HEAD HISTOPATHOLOGY CASE HISTORY 52Y MALE RIGHT RADICAL NEPHERECTOMY Case of right renal mass with IVC thrombus. History of surgery and RT for right occipital

More information

Types of surgery for kidney cancer

Types of surgery for kidney cancer Useful information for cancer patients Contents This information is about the different operations that you may have for kidney cancer. Surgery can be used to treat almost any stage of kidney cancer. There

More information

Translocation Renal Cell Carcinomas

Translocation Renal Cell Carcinomas Translocation Renal Cell Carcinomas Cora N. Sternberg, MD, FACP Chair, Department of Medical Oncology San Camillo and Forlanini Hospitals Rome, Italy Kidney cancer is not a single disease Clear cell (75%)

More information

Prostate Cancer Guide. A resource to help answer your questions about prostate cancer

Prostate Cancer Guide. A resource to help answer your questions about prostate cancer Prostate Cancer Guide A resource to help answer your questions about prostate cancer Thank you for downloading this guide to prostate cancer treatment. We know that all the information provided online

More information

Ovarian cysts Diagnosis and Management

Ovarian cysts Diagnosis and Management Ovarian cysts Diagnosis and Management Mr P K Athanasias MRCOG Consultant Gynaecologist St Anthony s Hospital pathanasias@gmail.com Introduction ovary is an ovum-producing reproductive organ located in

More information

Radiofrequency ablation for colorectal liver metastases

Radiofrequency ablation for colorectal liver metastases Radiofrequency ablation for colorectal liver Issued: December 2009 www.nice.org.uk/ipg NHS Evidence has accredited the process used by the NICE Interventional Procedures Programme to produce interventional

More information

da Vinci Prostatectomy Information Guide (Robotically-Assisted Radical Prostatectomy)

da Vinci Prostatectomy Information Guide (Robotically-Assisted Radical Prostatectomy) da Vinci Prostatectomy Information Guide (Robotically-Assisted Radical Prostatectomy) Prostate Cancer Overview Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the

More information

2004 3 25 3 Chin J Urol March 2004 Vol 25 No. 3 175 (15 ) 15 3971 59 14 1 5 2 2 ; ; ; 45 cm 50 cm M 1 cm 6 4 11 510 h 6. 5 h ; 2001000 ml 387 ml 3 KUB IVU : 300 ml 46 ; ; ; ; Laparoscopic radical cystectomy

More information

Comparison of CT analyses of primary renal cell carcinoma and of metastatic neoplasms of the kidney

Comparison of CT analyses of primary renal cell carcinoma and of metastatic neoplasms of the kidney Comparison of CT analyses of primary renal cell carcinoma and of metastatic neoplasms of the kidney Ingrid Prkačin, Slavica Naumovski-Mihalić, Nives Dabo, Iva Palčić, Svetozar Vujanić, Zdravko Babić Department

More information

Smoking and misuse of certain pain medicines can affect the risk of developing renal cell cancer.

Smoking and misuse of certain pain medicines can affect the risk of developing renal cell cancer. Renal cell cancer Renal cell cancer is a disease in which malignant (cancer) cells form in tubules of the kidney. Renal cell cancer (also called kidney cancer or renal adenocarcinoma) is a disease in which

More information

Case Log Information for Urology Programs Review Committee for Urology

Case Log Information for Urology Programs Review Committee for Urology Case Log Information for Urology Programs Review Committee for Urology Index Categories, Minimum Numbers, and Common CPT Codes The Committee has reviewed the minimum number of procedures required for resident

More information

Role of surgery in the management of Ovarian cancer. Waseem Kamran Sub-speciality Fellow Surgical Gynaecological Oncology St James Hospital

Role of surgery in the management of Ovarian cancer. Waseem Kamran Sub-speciality Fellow Surgical Gynaecological Oncology St James Hospital Role of surgery in the management of Ovarian cancer Waseem Kamran Sub-speciality Fellow Surgical Gynaecological Oncology St James Hospital Role of surgery Prevention Diagnosis Staging Treatment Palliative

More information

Lung Cancer Treatment Guidelines

Lung Cancer Treatment Guidelines Updated June 2014 Derived and updated by consensus of members of the Providence Thoracic Oncology Program with the aid of evidence-based National Comprehensive Cancer Network (NCCN) national guidelines,

More information

The Role of Laparoscopy in Endometrial Cancer

The Role of Laparoscopy in Endometrial Cancer The Role of Laparoscopy in Endometrial Cancer Prof. Dr. Tugan BEŞE İstanbul University, Cerrahpaşa Medical Faculty Gynecologic Oncology Department Surgical staging in Endometrial Cancer Laparoscopic surgery

More information

Kidney Cryoablation Information for patients and their families

Kidney Cryoablation Information for patients and their families Kidney Cryoablation Information for patients and their families A clinically proven treatment for kidney cancer that avoids open surgery and protects your quality of life Kidney Cryoablation Patient Comments

More information

Ovarian Cancer. Andreas Obermair. Gynaecological Oncologist

Ovarian Cancer. Andreas Obermair. Gynaecological Oncologist Ovarian Cancer Andreas Obermair Gynaecological Oncologist www.obermair.info Ovarian cancer in QLD Five patients with ovarian cancer per week in QLD. Two patients will be diagnosed in early stage (stage

More information

Northern European Multidisciplinary RCC Meeting Copenhagen June 17 th and 18 th 2016

Northern European Multidisciplinary RCC Meeting Copenhagen June 17 th and 18 th 2016 Subject to modification The Northern European Multidisciplinary RCC meeting will take place at Hotel Phoenix in Copenhagen on June 17 th and 18 th 2016. http://www.phoenixcopenhagen.dk/. The hotel is located

More information

Testicular Disease Henry Yao HMO2, Royal Melbourne Hospital

Testicular Disease Henry Yao HMO2, Royal Melbourne Hospital Testicular Disease Henry Yao HMO2, Royal Melbourne Hospital Vitals 1 Overview! Testicular cancer! Case Study! Epidemiology! Risk factors! Types! Presenting symptoms! Examination findings! Investigations!

More information

PSA Screening for Prostate Cancer Information for Care Providers

PSA Screening for Prostate Cancer Information for Care Providers All men should know they are having a PSA test and be informed of the implications prior to testing. This booklet was created to help primary care providers offer men information about the risks and benefits

More information

Introduction. Case History

Introduction. Case History NAOSITE: Nagasaki University's Ac Title Author(s) A Case Report of Renal Cell Carcino Shimajiri, Shouhei; Shingaki, Yoshi Masaya; Tamamoto, Tooru; Toda, Taka Citation Acta Medica Nagasakiensia. 1992, 37

More information

Understanding Kidney Cancer

Understanding Kidney Cancer Understanding Kidney Cancer Guest Expert: Harriet, MD Associate Professor of Medical Oncology www.wnpr.org www.yalecancercenter.org Welcome to Yale Cancer Center Answers with Drs. Ed and Francine Foss,

More information

Saturation Biopsy vs. 3D Spatial Biopsy vs. Free Hand Ultrasound biopsy for Targeted Prostate Cancer Therapies

Saturation Biopsy vs. 3D Spatial Biopsy vs. Free Hand Ultrasound biopsy for Targeted Prostate Cancer Therapies Saturation Biopsy vs. 3D Spatial Biopsy vs. Free Hand Ultrasound biopsy for Targeted Prostate Cancer Therapies John F. Ward, MD Assistant Professor University of Texas M. D. Anderson Cancer Center Ablation

More information

Renal Cancer: Symptoms, diagnosis, pathology & prognosis

Renal Cancer: Symptoms, diagnosis, pathology & prognosis Renal Cancer: Symptoms, diagnosis, pathology & prognosis Mark Johnson Consultant Urological Surgeon Newcastle upon Tyne Hospitals NHS Foundation Trust Plan for today: How renal tumours present What investigations

More information

Treatment and Surveillance of Non- Muscle Invasive Bladder Cancer

Treatment and Surveillance of Non- Muscle Invasive Bladder Cancer Treatment and Surveillance of Non- Muscle Invasive Bladder Cancer David Josephson, MD FACS Fellowship Director, Urologic Oncology and Robotic Surgery Program Staging Most important in risk assessment and

More information

Open the Flood Gates Urinary Obstruction and Kidney Stones. Dr. Jeffrey Rosenberg Dr. Emilio Lastarria Dr. Richard Kasulke

Open the Flood Gates Urinary Obstruction and Kidney Stones. Dr. Jeffrey Rosenberg Dr. Emilio Lastarria Dr. Richard Kasulke Open the Flood Gates Urinary Obstruction and Kidney Stones Dr. Jeffrey Rosenberg Dr. Emilio Lastarria Dr. Richard Kasulke Nephrology vs. Urology Nephrologist a physician who has been trained in the diagnosis

More information

National Medical Policy

National Medical Policy National Medical Policy Subject: Policy Number: Radiofrequency Ablation for Renal Cell Cancer NMP213 Effective Date*: March 2005 Updated: August 2015 This National Medical Policy is subject to the terms

More information

Innovations in Kidney Cancer

Innovations in Kidney Cancer Innovations in Kidney Cancer Guest Expert: Harriet, MD Associate Professor of Medical Oncology Edward, MD Assistant Professor of Surgical Urology www.wnpr.org www.yalecancercenter.org Welcome to Yale Cancer

More information

Diagnosis and Prognosis of Pancreatic Cancer

Diagnosis and Prognosis of Pancreatic Cancer Main Page Risk Factors Reducing Your Risk Screening Symptoms Diagnosis Treatment Overview Chemotherapy Radiation Therapy Surgical Procedures Lifestyle Changes Managing Side Effects Talking to Your Doctor

More information

FREEDOM INGUINAL Hernia Repair System TECHNIQUE GUIDE

FREEDOM INGUINAL Hernia Repair System TECHNIQUE GUIDE FREEDOM INGUINAL Hernia Repair System TECHNIQUE GUIDE The following describes the open surgical preparation and implantation technique for the Freedom Inguinal Hernia Repair System. 1) Anesthesia can be

More information

Management of Localized Prostate Cancer. Treatment Options

Management of Localized Prostate Cancer. Treatment Options Management of Localized Prostate Cancer Surgery James A. Eastham, MD Chief, Urology Service Memorial lsloan Kettering Cancer Center Treatment Options 1. Active surveillance/watchful waiting 2. Focal therapy

More information

PANCREATIC AND PERIAMPULLARY TUMORS: PANCREATICODUODENECTOMY. Dr. Shailesh V. Shrikhande

PANCREATIC AND PERIAMPULLARY TUMORS: PANCREATICODUODENECTOMY. Dr. Shailesh V. Shrikhande PANCREATIC AND PERIAMPULLARY TUMORS: PANCREATICODUODENECTOMY Dr. Shailesh V. Shrikhande Associate Professor & Consultant Surgeon GI and HPB Surgical Oncology Tata Memorial Hospital, Mumbai INDIA HELICAL

More information

KIDNEY FUNCTION RELATION TO SIZE OF THE TUMOR IN RENAL CELL CANCINOMA

KIDNEY FUNCTION RELATION TO SIZE OF THE TUMOR IN RENAL CELL CANCINOMA KIDNEY FUNCTION RELATION TO SIZE OF THE TUMOR IN RENAL CELL CANCINOMA O.E. Stakhvoskyi, E.O. Stakhovsky, Y.V. Vitruk, O.A. Voylenko, P.S. Vukalovich, V.A. Kotov, O.M. Gavriluk National Canсer Institute,

More information

Work up of the focal liver lesion

Work up of the focal liver lesion Work up of the focal liver lesion Milan Kinkhabwala, MD Professor of Surgery Chief, Division of Transplantation Montefiore Einstein Center for Transplantation 2 Incidental findings are common with increasing

More information

Clinical Practice Guidelines for Hepatocellular Carcinoma, List of Clinical Questions/Recommendations. Chapter. Grade. CQ No. 1 Interferon Therapy

Clinical Practice Guidelines for Hepatocellular Carcinoma, List of Clinical Questions/Recommendations. Chapter. Grade. CQ No. 1 Interferon Therapy Clinical Practice Guidelines for Hepatocellular Carcinoma, List of Clinical Questions/Recommendations Chapter Chapter 1 Prevention Sectio n CQ No. 1 Interferon Therapy Clinical Question 1 Does interferon

More information

Objectives. Mylene T. Truong, MD. Malignant Pleural Mesothelioma Background

Objectives. Mylene T. Truong, MD. Malignant Pleural Mesothelioma Background Imaging of Pleural Tumors Mylene T. Truong, MD Imaging of Pleural Tumours Mylene T. Truong, M. D. University of Texas M.D. Anderson Cancer Center, Houston, TX Objectives To review tumors involving the

More information

Chirurgie des métastases cérébrales. Dr Mark Dexter Head, Department of Neurosurgery The Westmead Hospitals

Chirurgie des métastases cérébrales. Dr Mark Dexter Head, Department of Neurosurgery The Westmead Hospitals Chirurgie des métastases cérébrales Dr Mark Dexter Head, Department of Neurosurgery The Westmead Hospitals The Westmead patient population THE INCONVENIENT TRUTHS Cerebral metastases occur in 10 16 % of

More information

Liver Cancer What is the liver? What is liver cancer?

Liver Cancer What is the liver? What is liver cancer? Liver Cancer What is the liver? The liver is the largest internal organ in the body and is important in digesting food. The liver performs many other functions, including collecting and filtering blood

More information

After reviewing this module, the student will have the ability to:

After reviewing this module, the student will have the ability to: LEARNING OBJECTIVES After reviewing this module, the student will have the ability to: - Approach History & physical exam of patients with thyroid pathology - Understand which patients require surgery

More information

A Very Rare Indication in Urology: Ablation of all the Urinary Organs: About A Case

A Very Rare Indication in Urology: Ablation of all the Urinary Organs: About A Case Article ID: WMC002102 ISSN 2046-1690 A Very Rare Indication in Urology: Ablation of all the Urinary Organs: About A Case Author(s):Dr. Hatim El Karni, Dr. Bezzaz Aicha, Dr. El Ghanmi Jihad, Dr. Koutani

More information

A PATIENT S GUIDE TO SELECTIVE INTERNAL RADIATION THERAPY (RADIOEMBOLIZATION)

A PATIENT S GUIDE TO SELECTIVE INTERNAL RADIATION THERAPY (RADIOEMBOLIZATION) A PATIENT S GUIDE TO SELECTIVE INTERNAL RADIATION THERAPY (RADIOEMBOLIZATION) DIVISION OF VASCULAR INTERVENTIONAL RADIOLOGY DEPARTMENT OF RADIOLOGY AND DEPARTMENT OF RADIATION ONCOLOGY ROBERT WOOD JOHNSON

More information

Rotation Specific Goals & Objectives: University Health Network-Princess Margaret Hospital/ Sunnybrook Breast/Melanoma

Rotation Specific Goals & Objectives: University Health Network-Princess Margaret Hospital/ Sunnybrook Breast/Melanoma Rotation Specific Goals & Objectives: University Health Network-Princess Margaret Hospital/ Sunnybrook Breast/Melanoma Medical Expert: Breast Rotation Specific Competencies/Objectives 1.0 Medical History

More information

Department of Radiology Renal tumour ablation Information for patients

Department of Radiology Renal tumour ablation Information for patients Department of Radiology Renal tumour ablation Information for patients What is ablation? Your doctor has recommended that you have ablation treatment for your renal (kidney) tumour. Ablation is a technique

More information

NUCLEAR MEDICINE PROCEDURE QUICK GUIDE

NUCLEAR MEDICINE PROCEDURE QUICK GUIDE NUCLEAR CARDIAC STRESS TEST -78452- -93017- -A9502- (X2) + W/LEXISCAN (IF INDICATED) -J2785-3-PHASE -78315- LIMITED -78300- MULTIPLE -78305- WHOLE BODY (TOTAL) -78306- - NPO AFTER MIDNIGHT - BRING A LIST

More information

A Practical Guide to Advances in Staging and Treatment of NSCLC

A Practical Guide to Advances in Staging and Treatment of NSCLC A Practical Guide to Advances in Staging and Treatment of NSCLC Robert J. Korst, M.D. Director, Thoracic Surgery Medical Director, The Blumenthal Cancer Center The Valley Hospital Objectives Revised staging

More information

Frozen Section Diagnosis

Frozen Section Diagnosis Frozen Section Diagnosis Dr Catherine M Corbishley Honorary Consultant Histopathologist St George s Healthcare NHS Trust and lead examiner final FRCPath Practical 2008-2011 Frozen Section Diagnosis The

More information

The prostate and kidney cancer specialists. Robot-assisted surgery for prostate and kidney cancer

The prostate and kidney cancer specialists. Robot-assisted surgery for prostate and kidney cancer The prostate and kidney cancer specialists Robot-assisted surgery for prostate and kidney cancer ROBOT-ASSISTED SURGERY AT HARLEY STREET UROLOGY Mr Marc Laniado, Consultant Urologist Robot-assisted prostatectomy,

More information

Facing Kidney Surgery? Learn about minimally invasive da Vinci Surgery

Facing Kidney Surgery? Learn about minimally invasive da Vinci Surgery Facing Kidney Surgery? Learn about minimally invasive da Vinci Surgery The Condition: Kidney Cancer Your kidneys are two, fist-sized organs located behind the abdomen on each side of your spine. Kidneys

More information

Detection and staging of recurrent prostate cancer is still one of the important clinical problems in prostate cancer. A rise in PSA or biochemical

Detection and staging of recurrent prostate cancer is still one of the important clinical problems in prostate cancer. A rise in PSA or biochemical Summary. 111 Detection and staging of recurrent prostate cancer is still one of the important clinical problems in prostate cancer. A rise in PSA or biochemical recurrence (BCR) is the first sign of recurrent

More information

Types of treatment for liver cancer

Types of treatment for liver cancer Useful information for cancer patients Contents This information is an overview of treatments for primary liver cancer. There are sections on Primary or secondary cancer The main treatments for primary

More information

Radiofrequency Ablation. A Patient s Guide

Radiofrequency Ablation. A Patient s Guide Radiofrequency Ablation A Patient s Guide TITLE Introduction to This Guide Each year, 530,000 people worldwide are diagnosed with liver disease.* Sometimes, the disease occurs first in the liver and is

More information

Appropriate Use Criteria (By Rating) Table 1. Venous Duplex of the Upper Extremities for Patency and Thrombosis

Appropriate Use Criteria (By Rating) Table 1. Venous Duplex of the Upper Extremities for Patency and Thrombosis ACCF 2013 Use Criteria for Peripheral Vascular Ultrasound and Physiological Testing Part II: Testing for Venous Disease and Evaluation of Hemodialysis Access Section 1: Upper Extremity Venous Evaluation

More information

Ultrasonography of the Adrenal Glands CVM 6105 Kari L. Anderson, DVM, Diplomate ACVR Associate Clinical Professor of Veterinary Radiology

Ultrasonography of the Adrenal Glands CVM 6105 Kari L. Anderson, DVM, Diplomate ACVR Associate Clinical Professor of Veterinary Radiology 1: US of adrenal glands, KLA Ultrasonography of the Adrenal Glands CVM 6105 Kari L. Anderson, DVM, Diplomate ACVR Associate Clinical Professor of Veterinary Radiology Ultrasound has quickly become an important

More information

بسم هللا الرحمن الرحيم

بسم هللا الرحمن الرحيم بسم هللا الرحمن الرحيم Updates in Mesothelioma By Samieh Amer, MD Professor of Cardiothoracic Surgery Faculty of Medicine, Cairo University History Wagner and his colleagues (1960) 33 cases of mesothelioma

More information

* * * This matter was opened before the New Jersey State. Board of Medical Examiners (the "Board") upon its receipt of a

* * * This matter was opened before the New Jersey State. Board of Medical Examiners (the Board) upon its receipt of a . FILED October 31, 2011 NEW JERSEY STATE BOARD OF MEDICAL EXAMINERS STATE OF NEW JERSEY DEPARTMENT OF LAW & PUBLIC SAFETY DIVISION OF CONSUMER AFFAIRS STATE BOARD OF MEDICAL EXAMINERS In the Matter of:

More information

Minimally Invasive Mitral Valve Surgery

Minimally Invasive Mitral Valve Surgery Minimally Invasive Mitral Valve Surgery Stanford Health Care offers leading, superior options in cardiac surgery, including the latest techniques and research for Minimally Invasive Cardiac surgery. Advanced

More information

2011 Radiology Diagnosis Coding Update Questions and Answers

2011 Radiology Diagnosis Coding Update Questions and Answers 2011 Radiology Diagnosis Coding Update Questions and Answers How can we subscribe to the Coding Clinic for ICD-9 guidelines and updates? The American Hospital Association publishes this quarterly newsletter.

More information

Minimally Invasive Spine Surgery

Minimally Invasive Spine Surgery Chapter 1 Minimally Invasive Spine Surgery 1 H.M. Mayer Primum non nocere First do no harm In the long history of surgery it always has been a basic principle to restrict the iatrogenic trauma done to

More information

The degree of liver inflammation or damage (grade) Presence and extent of fatty liver or other metabolic liver diseases

The degree of liver inflammation or damage (grade) Presence and extent of fatty liver or other metabolic liver diseases ilearning about your health Liver Biopsy www.cpmc.org/learning What is a Liver Biopsy? A liver biopsy is a procedure where a specially trained doctor (typically a hepatologist, radiologist, or gastroenterologist)

More information

Prostate Cancer Action Plan: Choosing the treatment that s right for you

Prostate Cancer Action Plan: Choosing the treatment that s right for you Prostate Cancer Action Plan: Choosing the treatment that s right for you Segment 1: Introduction Trust me, there's a better way to choose a treatment for your prostate cancer. Watching this program is

More information

190.25 - Alpha-fetoprotein

190.25 - Alpha-fetoprotein Other Names/Abbreviations AFP 190.25 - Alpha-fetoprotein Alpha-fetoprotein (AFP) is a polysaccharide found in some carcinomas. It is effective as a biochemical marker for monitoring the response of certain

More information

REVIEW. Keywords : Sentinel Lymph node, Lymphatic mapping, Breast cancer, Esophageal cancer, Less invasive surgery

REVIEW. Keywords : Sentinel Lymph node, Lymphatic mapping, Breast cancer, Esophageal cancer, Less invasive surgery REVIEW Department of Oncological and Regenerative Surgery, Institute of Health Bioscience The University of Tokushima Graduate School, and Department of Adult and Gerontological Nursing, School of Health

More information

Sybile Val, MD Department of Surgery. October 29, 2009

Sybile Val, MD Department of Surgery. October 29, 2009 Soft Tissue Tumors Sybile Val, MD Department of Surgery SUNY Downstate Medical Center October 29, 2009 Case Presentation 52 YOM presented to ED on 7/22 with 52 YOM presented to ED on 7/22 with abdominal

More information

RCC. RENAL CELL CARCINOMA the most common form of kidney cancer UNDERSTANDINGRCC

RCC. RENAL CELL CARCINOMA the most common form of kidney cancer UNDERSTANDINGRCC RCC RENAL CELL CARCINOMA the most common form of kidney cancer UNDERSTANDINGRCC RENAL CELL CARCINOMA ABOUT THIS GUIDE This guide will: Help you understand renal cell carcinoma (RCC) Provide information

More information

Real Time MRI guided Focal Laser Ablation Therapy for Prostate Cancer

Real Time MRI guided Focal Laser Ablation Therapy for Prostate Cancer Real Time MRI guided Focal Laser Ablation Therapy for Prostate Cancer A/Prof Celi Varol and Dr Orit Raz Uro-Oncologist Nepean and Macquarie Hospital Trial at Macquarie University Hospital Ethics board

More information

Four Important Facts about Kidney Cancer

Four Important Facts about Kidney Cancer Volume Article.13-11 Publish Date: 24th June 2013 Author(s): MPUH - CRS Team Four Important Facts about Kidney Cancer ARTICLE hhh Muljibhai Patel Urological Hospital (MPUH) Centre For Robotic Surgery (CRS)

More information

Neoadjuvant radiotherapy: Necessary for treatment of rectal cancer. Shannon Acker April 4, 2011

Neoadjuvant radiotherapy: Necessary for treatment of rectal cancer. Shannon Acker April 4, 2011 Neoadjuvant radiotherapy: Necessary for treatment of rectal cancer Shannon Acker April 4, 2011 Rectal Cancer 40,870 new cases in the US in 2009 49,920 deaths from colorectal cancer Second leading cause

More information

Laparoscopic One Anastomosis Gastric Bypass (LOAGB) How I do it

Laparoscopic One Anastomosis Gastric Bypass (LOAGB) How I do it CENTER OF EXCELLENCE FOR THE STUDY AND OBESITY TREATMENT Laparoscopic One Anastomosis Gastric Bypass (LOAGB) How I do it Concepts and Results in a series of 11-years experience with 2,200 patients Miguel-A.

More information

Protocol. , / Cryosurgical Ablation of Miscellaneous Solid Tumors. Other Than Liver, Prostate, or Dermatologic Tumors

Protocol. , / Cryosurgical Ablation of Miscellaneous Solid Tumors. Other Than Liver, Prostate, or Dermatologic Tumors , / Cryosurgical Ablation of Miscellaneous Solid Tumors Protocol Other Than (70192) Medical Benefit Effective Date: 01/01/14 Next Review Date: 09/14 Preauthorization No Review Dates: 02/07, 02/08, 03/09,

More information

Multiple Primary and Histology Site Specific Coding Rules KIDNEY. FLORIDA CANCER DATA SYSTEM MPH Kidney Site Specific Coding Rules

Multiple Primary and Histology Site Specific Coding Rules KIDNEY. FLORIDA CANCER DATA SYSTEM MPH Kidney Site Specific Coding Rules Multiple Primary and Histology Site Specific Coding Rules KIDNEY 1 Prerequisites 2 Completion of Multiple Primary and Histology General Coding Rules 3 There are many ways to view the Multiple l Primary/Histology

More information

PROGNOSTIC FACTORS IN ADVANSED OVARIAN CANCER

PROGNOSTIC FACTORS IN ADVANSED OVARIAN CANCER PROGNOSTIC FACTORS IN ADVANSED OVARIAN CANCER Dr. Hisham Rahahle Gynecologist, MD, Ph.D Subspecialty in Gynecological Oncology E-mail: hisham_re@yahoo.com Abstract: This study includes (68) patient diagnosed

More information

Magnetic Resonance (Eg, Proton) Imaging, Temporomandibular Joint(S) MRI

Magnetic Resonance (Eg, Proton) Imaging, Temporomandibular Joint(S) MRI High Tech Radiology and s (Sorted by s) # Full Description 1 70336 Magnetic Resonance (Eg, Proton) Imaging, Temporomandibular Joint(S) 2 70450 Computed Tomography, Head Or Brain; Without Contrast Material

More information