No abstract

The field of focal ablative therapy for the treatment of cancer is characterized by abundance of thermal ablative techniques that provide a minimally invasive treatment option in selected tumors. However, the unselective destruction inflicted by thermal ablation modalities can result in damage to vital structures in the vicinity of the tumor. Furthermore, the efficacy of thermal ablation intensity can be impaired due to thermal sink caused by large blood vessels in the proximity of the tumor. Irreversible electroporation (IRE) is a novel ablation modality based on the principle of electroporation or electropermeabilization, in which electric pulses are used to create nanoscale defects in the cell membrane. In theory, IRE has the potential of overcoming the aforementioned limitations of thermal ablation techniques. This review provides a description of the principle of IRE, combined with an overview of in vivo research performed to date in the liver, pancreas, kidney, and prostate.

LoE 3a/b confirms lower CA perioperative complication rate and higher local progression rate than those for MIPN. CA preserves postoperative renal functional, without any evidence of differences in mid-/long-term follow-up compared to nephron sparing surgery.

Introduction Optical coherence tomography (OCT) is being investigated in urologic oncology for optical diagnosis. This comprehensive review analyzes the current state of development of OCT for bladder, upper urinary tract, kidney, prostate, testis, and penis cancer. Also, the potential role of OCT with regard to the current diagnostic pathways is critically appraised to guide future developments. Methods Embase and Pubmed were systematically searched for English and German articles on OCT in humans up to December 2017. Reviews were excluded. Case reports were excluded, unless they presented a landmark in the development of OCT. Results Out of 878 articles, 17 relevant articles on bladder, seven on kidney, five on upper urinary tract, four on prostate, and two on penile cancer were included. In these organs, in vivo OCT imaging is feasible with potential for qualitative and quantitative diagnosis, grading and staging in specific organs. The development of OCT has reached IDEAL stage 2b with 2b level of evidence. Relevant articles on testis cancer were lacking. Conclusion OCT allows for non-or minimally invasive cancer diagnosis in the bladder, upper urinary tract, kidney, prostate, and penis. In some organs, OCT also may enable histologic grade and stage prediction. However, the current evidence is still at an exploratory level. With regard to the potential additional value of OCT in comparison to the current diagnostic pathways, OCT could become a diagnostic replacement or add-on test for urothelial carcinoma, penile carcinoma, and renal masses. Further research in these conditions should be encouraged.