ISSN:0963-0643    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Purpose of reviewThis paper focuses on demonstrating the power of magnetic resonance spectroscopy when used as a clinical tool in the medical sciences. The main goal is to illustrate the potential of proton magnetic resonance spectroscopy in renal oncology.Recent findingsThe broad application of spectroscopy to the study of tumors in human brain, breast and prostate is well documented in the literature; however, the method is not yet widely utilized in the study of renal tumors. The analysis of the in-vitro high-resolution magnetic resonance spectroscopy of specimens removed during surgery shows promise for identifying biochemical profiles characteristic of benign renal tumors and renal cancers of different grades. In particular, resonances of creatine, acetate, choline compounds, and lipid components seem to vary between benign and malignant tissue.SummaryThe identification of specific metabolites that differentiate benign from malignant tissuein vivowould spare the patient with a solid renal mass from unnecessary biopsies prior to surgery, or from surgery when a lesion would best be treated medically.

ISSN:0963-0643    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Purpose of reviewThe present review addresses technical improvements in [18F]deoxyglucose positron emission tomography (PET) and new tracer developments that may increase detection in prostate cancer and renal cell carcinoma. In addition, we discuss the future of molecular imaging in prostate cancer.Recent findingsPET has proven useful in imaging primary and metastatic cancer in a variety of tumor types. Previous work suggested that the most common radiopharmaceutical used in PET imaging - [18F]deoxyglucose - has a limited role in diagnosing primary prostate cancer and renal cell carcinoma. Technical improvements in scanning techniques and in PET scanners have increased detection of primary and metastatic lesions in both tumor types with [18F]deoxyglucose PET, as compared with previous studies. These improvements include increased scanner resolution and improved processing algorithms. In both prostate and renal cell carcinoma, however, better detection may result from the development of new tracers, particularly those that are not excreted into renal collecting systems. Labeled choline shows promise, as does [11C]acetate. New tracers for prostate cancer could be developed to detect changes that signal malignant transformation, as well as tracers that could show expression of genes administered for therapy.SummaryTechnical improvements and the development of new tracers will probably make PET imaging a viable diagnostic tool in prostate cancer and renal cell carcinoma.

ISSN:0963-0643    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Energy based ablative procedures have triggered considerable interest in the treatment of select renal tumors. Renal cryoablation is the most studied of all the energy based ablative procedures and shows considerable promise. Radiofrequency ablation has also been recently reported as a potential treatment option. This manuscript reviews the current literature, experimental and clinical, on the application of cryoablation and radiofrequency ablation for the treatment of renal tumors.

ISSN:0963-0643    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Purpose of reviewMicroarray technologies are now being used to analyse prostate tumors and to gain insights into prostate cancer biology. This review provides a background on microarray technology, reviews recent applications of these techniques in prostate cancer research, and discusses the potential application of this technology to patient care.Recent findingsAn analysis of genome-wide changes in expression has identified several hundred genes differentially expressed by normal and malignant prostate tissues. Some, such ashepsin, not only show increased expression in cancer, but can also provide prognostic information on prostate tumors based on their level of expression. Microarrays have also been used to characterize gene expression changes associated with androgen stimulation, the activation ofEGR1pathways, and prostate epithelial cellular senescence.SummaryMicroarray analysis of gene expression in prostate cancer is in its infancy. Future work will probably yield new diagnostic and prognostic markers, provide insight into prostate cancer biology, and aid in identifying new therapeutic strategies.

ISSN:0963-0643    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Purpose of reviewThe identification of cell surface antigens is critical to the development of future prognostic and therapeutic modalities for the treatment of prostate cancer. Several prostate-specific proteins have been identified and are under investigation. This review reports on prostate stem cell antigen (PSCA), a protein with restricted expression that may have prognostic and therapeutic utility.Recent findingsPSCA is a glycosylphosphatidylinositol-anchored cell-surface protein belonging to the Ly-6/Thy-1 family of cell surface antigens, and a murine homologue has been described. It is expressed in the normal human prostate and overexpressed in human prostate cancers. Its overexpression has been correlated with increased Gleason score, advanced stage and bone metastasis. PSCA is co-amplified with MYC, an independent predictor of progression and death. PSCA may therefore be a useful predictor of tumor biology and a useful target of immunotherapy against prostate cancer. Evidence suggests a potential role in strategies employing cytotoxic T cell lymphocytes. Anti-tumor activity has been demonstrated with monoclonal antibodies in tumor take and established tumor xenograft models. Conjugated antibody has recently been reported to have anti-tumor activity in preclinical models.SummaryPSCA may serve as a tool in refining the prognosis of an individual cancer and may be a useful therapeutic target for immunotherapy. Future studies will be required to confirm its clinical utility as a prognostic factor. Future animal and clinical studies will be required to test various immunotherapy strategies for safety and efficacy. The study of PSCA regulation and expression may provide information on normal prostate development and prostate carcinogenesis.

ISSN:0963-0643    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Purpose of reviewThe purpose of this review is to discuss early and recent reports investigating microsatellite instability and mismatch repair expression in prostate cancer.Recent findingsHuman mismatch repair genes encode highly conserved interacting proteins that suppress genetic instability by correcting misincorporated nucleotides and insertion/deletion mispairs formed during DNA replication. Mismatch repair deficiency causes genetic instability at microsatellite sequences because of the cell's inability to correct errors caused by DNA polymerase slippage at repetitive sequences. Microsatellite instability is characteristic of mismatch repair deficiency, and has been used as a surrogate marker for the inactivation of mismatch repair genes. Inherited mismatch repair gene mutations predispose to gastrointestinal and genitourinary malignancies in a cancer predisposition syndrome known as hereditary non-polyposis colorectal carcinoma. Although strong evidence for an inherited predisposition to prostate cancer does not exist in hereditary non-polyposis colorectal carcinoma, mismatch repair deficiency and mismatch repair gene mutations have been described in sporadic prostate cancer and prostate cancer cell lines. Early reports detected microsatellite instability in prostate cancer, and correlated this genetic alteration to clinical and pathological findings in men diagnosed with this malignancy. Recent reports have identified mismatch repair gene mutations, mismatch repair deficiency and differential mismatch repair gene expression in prostate cancer. In addition, a prognostic role for mismatch repair gene expression in prostate cancer has been suggested.SummaryThe early identification of microsatellite instability in prostate cancer led to more specific investigation of mismatch repair gene expression. Although additional research is required, mismatch repair gene expression may have important biological and clinical significance in prostate cancer.

ISSN:0963-0643    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Purpose of reviewThe use of androgen deprivation therapy has increased because of its use as part of multimodality therapy for high-risk early stage disease and in recurrent nonmetastatic disease. Hormonal therapy is associated with secondary osteoporosis and increased skeletal morbidity. Furthermore, in patients with established bone metastases, osseous complications are a significant problem. Bisphosphonates have been investigated in the prevention of bone density loss and skeletal morbidity. Results of these studies are now becoming available.Recent findingsData are emerging that demonstrate that bisphosphonates can prevent skeletal morbidity, such as pathologic fractures and spinal cord compression in men with hormone-refractory prostate cancer. The early use of bisphosphonates has also been shown to prevent bone loss due to androgen deprivation therapy. Current third-generation bisphosphonates are several hundred times more potent than their predecessors. Evidence is emerging that these drugs not only inhibit bone resorption but also are cytotoxic to prostate cancer cells.SummaryBisphosphonates are assuming a prominent ancillary role in prostate cancer therapy through their ability to prevent skeletal morbidity. Their potential to interfere with the formation of osseous tumor deposits has lead to investigations into the capacity of these drugs to prevent bone metastasis.

ISSN:0963-0643    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Purpose of reviewIn the present review we outline the use of different staging methods and highlight future possibilities in the management of testicular germ cell cancer.Recent findingsThe 5-year survival for testicular cancer has improved dramatically over the past 30 years, with cure rates approaching 95%. This success is attributed to the appropriate integration of effective treatments and staging modalities. Staging currently represents the cornerstone on which treatment is based. Because most patients will be cured, attention has shifted toward reducing morbidity of treatment while maintaining high cure rates. This implies that staging must be accurate before any change to the treatment regimen can be instituted.SummaryEffective management of testicular germ cell cancer continues to pose a major challenge. Early and accurate diagnosis is very important because it will influence the choice of treatment and thus may impact on prognosis.

ISSN:0963-0643    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Purpose of reviewThe optimal management for clinical stage I nonseminomatous testicular germ-cell tumors is still a subject open to controversy. The main options of standard-care surveillance and primary nerve-sparing retroperitoneal lymph node dissection result in the same high cure rate (close to 100%). It is the purpose, here, to present a critical review of recent developments concerning primary therapy for clinical stage I nonseminomatous testicular germ-cell tumors and to identify potential new prognostic risk factors predicting occult metastatic retroperitoneal lymph node disease.Recent findingsIn accordance with the primary goal to improve quality of life, to protect fertility and to reduce long-term toxicity in survivors of testicular cancer, the major advantage of surveillance protocols is that adjuvant therapy will be administered only to those patients who require therapy. This advantage has to be balanced against a constant psychological threat and a relapse rate of 20-25% necessitating extensive polychemotherapy. Primary nerve-sparing retroperitoneal lymph-node dissection has diagnostic and therapeutic capabilities in low-volume disease; as local relapses are extremely rare, an effective and cost-saving follow-up concentrating on pulmonary recurrences can be initiated. Nerve-sparing retroperitoneal lymph node dissection represents the initial approach for mature teratomas; patients with purely embryonal carcinoma have a high risk for systemic relapses and might be better served by primary chemotherapy. The advantages of nerve-sparing retroperitoneal lymph-node dissection have to be balanced against surgery-related complications, which develop in about 17% of the patients. With regard to prognostic risk factors, the percentages of embryonal carcinoma and vascular invasion remain the most significant predictors for lymph node metastases.SummarySurveillance and primary nerve-sparing retroperitoneal lymph-node dissection result in the same high cure rate (approaching 100%). The advantages and disadvantages of both treatment modalities must be discussed extensively with the patient, and it will be basically his decision as to which therapeutic approach is chosen.

ISSN:0963-0643    

出版商:OVID    

年代:2002

数据来源: OVID