Table Of ContentDavid E. Neal (Ed.)
Tumours
in Urology
With 39 Figures
Springer-Verlag
London Berlin Heidelberg New York
Paris Tokyo Hong Kong
Barcelona Budapest
David E. Neal MS FRCS
Professor, Department of Surgery, The Medical School, University of
Newcastle upon Tyne, Newcastle upon Tyne NE2 4HH, UK
On the front cover is a colour illustration showing staging of bladder cancer and a
DNA Southern blot probed with c-erbB-2
ISBN-13:978-1-4471-2088-9 e-ISBN-13:978-1-4471-2086-5
DOl: 10.1007/978-1-4471-2086-5
British Library Cataloguing in Publication Data
Tumours in Urology: Biology and Clinical Management
I. Neal, David E.
616.9926
ISBN- 13 :978-1-4471-2088-9
Library of Congress Cataloging-in-Publication Data
Tumours in urology: biology and clinical management / David E. Neal (ed.).
p. cm.
Includes bibliographical references and index.
ISBN-13:978-1-4471-2088-9
1. Genitourinary organs-Thmors. I. Neal, David E., 1951-
[DNLM: 1. Bladder Neoplasms. 2. Prostatic Neoplasms. 3. Kidney
Neoplasms. WJ 504 T925 1994]
RC280.U74T851994
616.99'461-dc20
DNLMIDLC
for Library of Congress 94-14579
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© Springer-Verlag London Limited 1994
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Preface
The growth of uro-oncology has been one of the dramatic features of
the past decade in urology. Basic science research into the immunol
ogy and molecular biology of cancer is beginning to impact on clinical
urology and this poses a number of problems, both for practising
urologists and basic scientists. If they are going to contribute to future
research in this area they will have to communicate with each other:
at present there is a gap which is widening at an increasingly rapid
rate. One of the aims of this book is to bridge this gap by collating
the views of a group of internationally distinguished scientists and
clinicians in order to make this information more easily accessible.
It is intended that the book will be useful to any urologist interested
in recent developments in uro-oncology both at the clinical and basic
science level. I believe the book has a useful function not otherwise
fulfilled by present texts.
The first section of the book is directed towards bladder cancer.
Progress is being made in understanding risk factors for progression;
mucosal abnormalities are still a source of continuing controversy,
but flow cytometry and the use of monoclonal antibodies to label
specific subsets of tumour cells may improve our ability to assess
these risks. The use of BeG may allow some patients to preserve
bladder function who would otherwise require cystectomy. On the
other hand, systemic chemotherapy has yet to find a role in standard
management of locally advanced, non-metastatic disease. Whether it
will be shown to augment survival in patients treated either by radio
therapy or cystectomy or whether it will permit bladder preservation
in selected patients remains uncertain. However, recent progress in
bladder reconstruction is allowing patients to be treated radically, but
to retain voiding function. The role of molecular biology in assessing
bladder cancer behaviour and improving our understanding of tumour
formation is proceeding at a great pace and the time is not far off when
the use of toxins directed at specific receptors will be tried.
Prostate cancer remains a difficult topic, for although techniques of
radical prostatectomy have been refined its role has yet to be defined
clearly. In addition, many patients present with advanced disease and
the use of new medical methods of androgen deprivation is reviewed
along with the role of "complete androgen blockade".
vi Preface
The final section reviews renal and testis cancer. The role of
conservative surgery for specific patients with renal cancer is dis
cussed together with immunotherapy for advanced renal cell cancer
- both topics of immense interest to urologists. Early biochemical
abnormalities in Wilms' tumour and hereditary forms of renal cancer
are leading to a better understanding of sporadic forms of the disease.
Finally, the role of radical retroperitoneal lymphadenectomy in the
treatment of advanced testis tumours is reviewed.
The intended audience will include urologists in Europe and North
America. Those basic scientists interested in clinical tumour work
should find this book a useful reference.
Newcastle, March 1994 D. E. Neal
Contents
List of Contributors ..................................................... ix
PART ONE: BLADDER CANCER
1 Advances in Bladder Cancer
D.E.Neal .................................................................. 3
2 Molecular Biology and Bladder Cancer
J. LunecandJ. K. Mellon ............................................... 19
3 Tumour Progression in Superficial Bladder Cancer
H. Wolf ..................................................................... 47
4 New Techniques in Management and Treatment of
Superficial Bladder Cancer
J. Franklin and M. C. Benson .......................................... 65
5 The Role of Chemotherapy in the Treatment of
Bladder Cancer
J. T. RobertsandR.R. Hall ............................................. 79
6 Cystectomy and Bladder Reconstruction for Bladder
Cancer
O. SeemanandP. M. Aiken ............................................ 91
PART TWO: PROSTATE CANCER
7 Prostate Cancer: More Questions Than Answers?
W. B. PeelingandK. Griffiths .......................................... 117
8 Biochemistry of Prostate Cancer
F. K. Habib ..................................... ............. ........... ... 145
9 The Endocrinology of Prostate Cancer
H. WasanandJ. Waxman ............................................... 163
10 Conservative Treatment of Localised Prostate Cancer
N. J. R. George ............................................................ 175
11 Radical Prostatectomy for Prostate Cancer
G. L. Andriole ............................................................ 197
viii Contents
PART THREE: RENAL CANCER
12 Overview of Renal Parenchymal Cancer
A. W. S. Ritchie ........................................................... 217
13 Molecular Genetics of Wilms' Tumour and Renal Cell
Carcinoma
E. R. Maher ................................................................ 225
14 Immunotherapy in the Management of Metastatic Renal
Cell Carcinoma
K. B. Pittman and P. J. Selby ............ ............ ................ . . . 243
15 Conservative Surgery for Renal Cell Carcinoma
A. C. Novick ............................................................... 263
PART FOUR: TESTIS CANCER
16 Retroperitoneal Lymphadenectomy in the Management of
Testis Cancer
W. F. Hendry .............................................................. 273
Subject Index .............................................................. 293
Contributors
P. M. AIken
Department of Urology, Klinikum Mannheim, Ruprecht-Karls
UniversiHit Heidelberg, 68135 Mannheim, Germany
G. L. Andriole
Division of Urologic Surgery, Washington University School of
Medicine, St Louis, Missouri 63110, USA
M. C. Benson
J Bentley Squier Urologic Clinic, Columbia Presbyterian Medical
Centre, Department of Urology, Columbia University College of
Physicians and Surgeons, New York, USA
J. Franklin
J Bentley Squier Urologic Clinic, Columbia Presbyterian Medical
Centre, Department of Urology, Columbia University College of
Physicians and Surgeons, New York, USA
N. J. R. George
Withington Hospital, West Didsbury, Manchester M20 8LR, UK
K. Griffiths
Tenovus Building, University of Wales College of Medicine,
Cardiff, South Glamorgan, UK
F. K. Habib
University Department of Surgery, Western General Hospital,
Edinburgh EH4 2XU, UK
R. R. Hall
Department of Urology, Freeman Hospital, Newcastle upon Tyne
NE77DN,UK
W. F. Hendry
149 Harley Street, London WIN 2DE, UK
x Contributors
J. Lunec
Cancer Research Unit, University of Newcastle upon Tyne,
Framlington Place, Newcastle upon Tyne NE2 4HH, UK
E. R. Maher
Department of Pathology, Cambridge University, Tennis Court
Road, Cambridge CB2 lQP, UK
J. K. Mellon
Department of Surgery, University of Newcastle upon Tyne, NE2 4HH
and Department of Urology, Freeman Group of Hospitals Trust,
Newcastle upon Tyne, UK
D. E. Neal
Department of Surgery, The Medical School, University of Newcastle
upon Tyne, Newcastle upon Tyne NE2 4HH, UK
A. C. Novick
Department of Urology, Cleveland Clinic Foundation, Cleveland,
Ohio, USA
W. B. Peeling
St Woolos Hospital, Newport, Gwent NP9 2UB, UK
K. B. Pittman
Institute of Cancer Studies, St James's University Hospital, Beckett
Street, Leeds LS9 7TF, UK
A. W. S. Ritchie
Urology Department, Gloucestershire Royal Hospital, Great
Western Road, Gloucester GLl 3NN, UK
J. T. Roberts
Northern Centre for Cancer Treatment, Newcastle General
Hospital, Westgate Road, Newcastle upon Tyne NE4 6BE, UK
O. Seeman
Department of Urology, Klinikum Mannheim, Ruprecht-Karls
Universitiit Heidelberg, 68135 Mannheim, Germany
P. J. Selby
Institute for Cancer Studies, St James's University Hospital, Beckett
Street, Leeds LS9 7TF, UK
H. Wasan
Department of Clinical Oncology, Royal Postgraduate Medical
School, Hammersmith Hospital, Du Cane Road, London
W120NN, UK
Contributors xi
J. Waxman
Department of Clinical Oncology, Royal Postgraduate Medical
School, Hammersmith Hospital, Du Cane Road, London
W120NN, UK
H. Wolf
Department of Urology, Skejby University Hospital,
Brendstrupgaardsvej, DK-8200 Aarhus N, Denmark
