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<p>List of Contributors xiii</p> <p>Preface xvii</p> <p><b>Cancer Genetics, Cancer Biology, and Tumor Growth and Metastasis: The Interaction of Cancer and Its Host Environment 1<br /></b><i>Mark C. Markowski and Kenneth J. Pienta</i></p> <p>Renal Cell Carcinoma 1</p> <p>Bladder Cancer 3</p> <p>Prostate Cancer 6</p> <p>References 12</p> <p><b>Pathological Basis of Tumor Characterization: Cytopathology, Surgical Pathology,  and How Histo?]Morphology Informs Treatment Decision Making 19<br /></b><i>Oleksandr N. Kryvenko and Fadi Brimo</i></p> <p>The Kidney 23</p> <p>The Urothelium 27</p> <p>The Testis 29</p> <p>References 30</p> <p><b>The Immunobiology of Tumor Ablation</b> 33<br /><i>Rafi Kabarriti and Chandan Guha</i></p> <p>Manipulating the Immune System to Fight Cancer 33</p> <p>Can We Take Advantage of Ablative Therapies to Activate the Immune System? 34</p> <p>Immunomodulatory Properties of HIFU 35</p> <p>Immunomodulatory Properties of Cryotherapy 36</p> <p>Immunomodulatory Properties of Radiation Therapy 37</p> <p>References 38</p> <p><b>Computed Tomography of Urologic Malignancies: The Role of MDCT in Renal Cell Carcinoma and Transitional Cell Carcinoma 41<br /></b><i>Siva P. Raman and Elliot K. Fishman</i></p> <p>Introduction 41</p> <p>MDCT Protocol Design 41</p> <p>Three?]Dimensional Reconstructions 44</p> <p>Neoplasms of the Intrarenal Collecting Systems, Ureters, and Bladder 45</p> <p>Solid Renal Parenchymal Lesions 49</p> <p>Conclusion 55</p> <p>References 55</p> <p><b>MRI and Metabolic Imaging 59<br /></b><i>Louise Dickinson, Francesco Fraioli, Athar Haroon, and Clare Allen</i></p> <p>Magnetic Resonance Imaging 59</p> <p>MRI Sequences 59</p> <p>Clinical Applications of MRI for Prostate Cancer 61</p> <p>Clinical Applications of MRI for Renal Cancer 63</p> <p>Clinical Applications of MRI for Bladder Cancer 64</p> <p>New Advances in MRI 65</p> <p>Metabolic Imaging 66</p> <p>Clinical Applications of PET–CT for Prostate Cancer 69</p> <p><b>Active Surveillance for Low?]Risk Prostate Cancer 113<br /></b><i>Laurence Klotz</i></p> <p>Introduction and Background 113</p> <p>Rationale 113</p> <p>Genetic Features of Low?]Grade Prostate Cancer 114</p> <p>Metastatic Potential 115</p> <p>Limitations of PSA Kinetics 116</p> <p>Role of MRI 116</p> <p>Implications for Patient Management 117</p> <p>Eligibility for Surveillance 118</p> <p>Outcome of Surveillance 119</p> <p>Modeling 119</p> <p>AS in Practice 121</p> <p>Conclusions 121</p> <p>References 122</p> <p><b>Tissue?]Preserving Surgical Approaches in Urologic Oncology: The Therapeutic Mechanism for Tumor Ablation 127<br /></b><i>Ganesh Kartha and J. Stephen Jones</i></p> <p>Introduction 127</p> <p>Cryoablation: Extreme Cold for Tumor Necrosis 128</p> <p>Conclusion 130</p> <p>References 130</p> <p><b>Focal Therapy for Prostate Cancer: An Evidence?]Based Approach to Tissue?]Preserving Strategies 133<br /></b><i>Kara L. Watts, Yaalini Shanmugabavan, Victoria Chernyak, and Hashim Uddin Ahmed</i></p> <p>Introduction 133</p> <p>Key Concepts in FT for PCa 134</p> <p>Tissue?]Preserving FTs 135</p> <p>Cryotherapy 135</p> <p>HIFU 137</p> <p>Salvage Focal/Hemiablation HIFU 140</p> <p>IRE 141</p> <p>Radiation 142</p> <p>Additional Therapies 143</p> <p>Implications for Research 144</p> <p>Conclusions 144</p> <p>References 145</p> <p><b>The Modern Basis for Nephron?]Sparing Surgery in Patients with Renal Cancer: Biologic Heterogeneity, the Significance of Tumor Biopsy, and the Changing Roles of Partial Nephrectomy and Tumor Ablation 151<br /></b><i>Jeffrey J. Tomaszewski, Robert G. Uzzo, and David Y.T. Chen</i></p> <p>Introduction 151</p> <p>Principal Treatment Options for SRMs and the Basis for Nephron Preservation 152</p> <p>Comparative Effectiveness of Radical versus NSS 153</p> <p>Rationale for Ablative Therapies 154</p> <p>Treatment Trends for Stage I RCC 157</p> <p>The Role of RMB 158</p> <p>Challenges Posed by Intratumoral Heterogeneity 161</p> <p>Conclusions 161</p> <p>References 162</p> <p><b>Bladder?]Preserving Strategies in the Treatment of Urothelial Cancer: The Disease Spectrum and the Dawn of Molecular Surgical Guidance 169<br /></b><i>Stephan Kruck and Arnulf Stenzl</i></p> <p>Augmented Cystoscopy 170</p> <p>Fiber?]Optic Probe Technology 171</p> <p>Conclusion 172</p> <p>References 172</p> <p><b>Image?]Guided Thermal Ablation of Adrenal Malignancies 175<br /></b><i>Kyungmouk Steve Lee, Bradley B. Pua, and Stephen B. Solomon</i></p> <p>Introduction 175</p> <p>Clinical Results 175</p> <p>Preprocedural Evaluation 176</p> <p>Technical Considerations 178</p> <p>RFA 178</p> <p>Microwave Ablation 179</p> <p>Cryoablation 180</p> <p>Complications 180</p> <p>Follow?]up 181</p> <p>Conclusion 182</p> <p>References 182</p> <p><b>Managing Penile Cancer: Integrating Tissue Preservation, Energy?]Based Therapeutics, and Surgical Reconstruction 185<br /></b><i>Arthur L. Burnett</i></p> <p>Introduction 185</p> <p>Description 186</p> <p>Diagnosis and Staging 186</p> <p>Treatment 189</p> <p>References 193</p> <p><b>Testis Cancer: Testis?]Sparing Cancer Surgery 199<br /></b><i>Nilay M. Gandhi and Pravin K. Rao</i></p> <p>Introduction 199</p> <p>Imaging of Testicular Tumors 199</p> <p>Bilateral Tumors 201</p> <p>The Advent of Testis?]Sparing Surgery 201</p> <p>Concerns about TSS 201</p> <p>Indications for TSS 204</p> <p>Preoperative Considerations and Surgical Technique 204</p> <p>Postoperative Care and Follow?]Up 207</p> <p>Considerations Regarding Surgical Technique 207</p> <p>Outcomes of TSS 208</p> <p>Summary 209</p> <p>References 210</p> <p><b>Nanotechnology: An Evolution in Tissue Preservation and Focal?]Targeted Oncologic Therapy 213<br /></b><i>Kara L. Watts and Joshua M. Stern</i></p> <p>Introduction 213</p> <p>Introduction to Nanotechnology 214</p> <p>Types of Nanoparticles 214</p> <p>Delivery and Use of Nanoparticles 217</p> <p>Nanotechnology in Prostate Cancer 219</p> <p>Imaging in Prostate Cancer 219</p> <p>Therapeutics in Prostate Cancer 221</p> <p>Nanotechnology in Renal Cancer 223</p> <p>Nanotechnology in Other Urologic Cancers 224</p> <p>Limitations of Nanoparticles 224</p> <p>Future Directions and Conclusions 225</p> <p>References 226</p> <p><b>Trial Design Issues in the Study of Focal Therapy in Prostate and Kidney Cancer 233<br /></b><i>John B. Eifler and David F. Penson</i></p> <p>Issues around Endpoints in Studies of Focal Therapy 234</p> <p>Issues around Defining the Study Population and the Control Arms of Comparative Studies in Focal Therapy 237</p> <p>Issues around Selecting the Optimal Study Design in Focal Therapy 238</p> <p>Conclusion 238</p> <p>References 239</p> <p>Index 000</p>

<p><b> MARK P. SCHOENBERG, MD,</b> University Professor & Chair, Department of Urology, The Montefiore Medical Center and The Albert Einstein College of Medicine, Bronx, NY, USA <p><b> KARA L. WATTS, MD,</b> Assistant Professor, Department of Urology, The Montefiore Medical Center and The Albert Einstein College of Medicine, Bronx, NY, USA

<p> Preservation of functioning, non-malignant tissue has become a mainstay of modern oncologic surgery in the past 30 years. Refinements in axial imaging technology coupled with the development of minimally invasive techniques such as laparoscopy and robot-assisted surgery have ushered in an era characterized by the fundamental re-evaluation of the role of the surgeon in cancer care and the manner in which cancers should be treated. <p> Edited by Mark P. Schoenberg and Kara L. Watts,<i> Management of Urologic Cancer: Focal Therapy and Tissue Preservation</i> offers a unique overview of this exciting new area in the management of urologic malignancies. An international faculty of experts provide insights into the current state of tissue-preserving surgery on an organ-by-organ basis. <p> Providing a vital introduction to the growing discipline of tissue-preserving and image-guided therapy, <i>Management of Urologic Cancer: Focal Therapy and Tissue Preservation</i> is valuable reading for urologists, radiologists, oncologists and practitioners advising patients about the complex issues related to the treatment of urologic cancers.

GB