Mays Cancer Center is at the forefront of technology-assisted surgical treatments that are improving patient recovery.<\/p>\n
Kidney cancer is not always confined to the kidney. In advanced cases, this cancer invades the body\u2019s biggest vein, the inferior vena cava (IVC), which carries blood out of the kidneys back to the heart. Via the IVC, cancer may infiltrate the liver and heart.<\/p>\n
In a study published in the Journal of Urology<\/em>, researchers from the Mays Cancer Center and the Department of Urology at UT Health San Antonio show that robotic IVC thrombectomy (removal of cancer from the inferior vena cava) is a highly safe and effective alternative approach to standard open IVC thrombectomy. During surgery, the affected kidney is removed along with the tumor.<\/p>\n The open surgery requires an incision that begins two inches below the ribcage and extends downward on both sides of the ribcage.<\/p>\n \u201cIt looks like an inverted V,\u201d said Dharam Kaushik, MD, urologic oncologist and senior author of the study. Next, organs that surround the IVC, such as the liver, are mobilized, and the IVC is clamped above and below the cancer. In this way, surgeons gain control of the inferior vena cava for cancer resection.<\/p>\n \u201cOpen surgery has an excellent success rate, and most cases are performed in this manner,\u201d Kaushik said. \u201cBut now, with the robotic approach, we can achieve similar results with smaller incisions.\u201d<\/p>\n The study is a systematic review and meta-analysis of data from 28 studies that enrolled 1,375 patients at different medical centers. Of these patients, 439 had robotic IVC thrombectomy and 936 had open surgery. Kaushik and his team collaborated with Memorial Sloan Kettering Cancer Center, New York; Cedars-Sinai Medical Center, Los Angeles; and the University of Washington, Seattle, to perform this study.<\/p>\n \u201cWe pulled the data together to draw conclusions because, before this, only small studies from single institutions had been conducted to compare the IVC thrombectomy approaches,\u201d Kaushik said. \u201cIn more than 1,300 patients, we found that overall complications were lower with the robotic approach and the blood transfusion rate was also lower with this approach.\u201d<\/p>\n Among the outcomes:<\/p>\n \u201cThat tells us there is more room for us to grow and refine this robotic procedure and to offer it to patients who are optimal candidates for it,\u201d Kaushik said.<\/p>\n An MRI scan called restriction spectrum imaging greatly improves the detection of prostate cancer progression, according to a study published in the Journal of Urology by researchers at the Mays Cancer Center.<\/p>\n The technique, called RSI-MRI, improves the pictures produced from more traditional scanning to reveal biological features, or biomarkers, showing changing conditions of existing prostate cancer patients. By detecting changes in patients more accurately, physicians can move ahead more quickly with potentially life-saving treatment.<\/p>\n In a study enrolling 123 patients from January 2016 to June 2019, researchers developed a targeted, short-duration RSI-MRI scan of less than five minutes that can be added to standard multi-parametric magnetic resonance imaging, or mpMRI, which has been more effective in diagnosing prostate cancer by detecting changes in existing patients.<\/p>\n The study participants on \u201cactive surveillance,\u201d or observation, underwent both mpMRI and RSI-MRI scanning reviewed by a urological radiologist for lesions, followed by an MRI-guided prostate biopsy by a urologist.<\/p>\n The RSI-MRI analysis generated biomarkers called restricted signal map (RSM) values, which were then compared with more traditional measures, for detection of worsening grades of prostate cancer. That analysis revealed better accuracy, including a higher level of true-positive lesions and fewer false-positives.<\/p>\n \u201cWe found that the RSI-MRI scan provides a more sophisticated analysis and a more sensitive and specific imaging biomarker of aggressive prostate cancer,\u201d said Michael A. Liss, MD, MAS, FACS, a urologic oncologist at the Mays Cancer Center, and the study\u2019s senior author.<\/p>\n \u201cThe findings show that using a simple acquisition technique of measuring and storing data can substantially enhance MRI,\u201d Liss said. \u201cAlso important is that RSI-MRI acquisition does not need hardware or contrast material and can be deployed within the current MRI workflow.\u201d<\/p>\n <\/p>\n Testicular cancer mainly affects young men, and its treatment requires multidisciplinary care and significant coordination between surgeons and medical oncologists. The disease itself has excellent cure rates. However, it commonly spreads to abdominal lymph nodes.<\/p>\n With an innovative approach using an enhanced robotics system, surgeons at the Mays Cancer Center can now treat testicular cancer patients without the traditional open surgery. The process includes inserting cameras and surgical instruments inside the abdomen and controlling them using robotic systems to remove cancerous lymph nodes.<\/p>\n \u201cThis is great news for testicular cancer patients,\u201d said Ahmed Mansour, MD, MRCS, urologic oncologist.<\/p>\n Not that long ago, standard surgery required 10-inch incisions across the abdomen and led to lengthier and more painful hospital stays and recovery. The newer procedure is called robotic retroperitoneal lymph node dissection, or robotic RPLND.<\/p>\n \u201cIt is a challenging procedure,\u201d Mansour said. \u201cAfter chemotherapy, the lymph nodes become closely attached to the major blood vessels, and taking them out involves risk of injury.\u201d<\/p>\n For that reason, robotic RPLND largely has been reserved for cases in which chemotherapy hasn\u2019t been done or nodes aren\u2019t visibly enlarged. However, Mays Cancer Center researchers hit upon a novel approach, developing technical improvements to make it safer, more effective and applicable in new indications.<\/p>\n \u201cWith some technical modifications, we are able to mimic open surgery in patients with bulky lymph nodes who have already received chemotherapy, Mansour said. Precisely maneuvering instruments with the help of robotics requires only small, half-inch incisions. Moreover, robotic RPLND now can be performed to remove nodes from both sides of the body in one setting.<\/p>\n While both RPLND procedures remain challenging and continue to take eight to 10 hours to perform, patients now can leave the hospital after two days, and the smaller incisions heal faster and with less scarring. Evaluation of long-term outcomes of patients undergoing robotic RPLND is underway.<\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" Mays Cancer Center is at the forefront of technology-assisted surgical treatments that are improving patient recovery.<\/p>\n","protected":false},"author":598,"featured_media":2340,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[52],"magazine":[22],"issue-year":[49],"featured-story":[],"class_list":["post-2259","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-new-therapies","magazine-cancer-center","issue-year-49"],"yoast_head":"\n\n
\nMRI technique improves detection of prostate cancer<\/strong><\/h2>\n
Enhanced robotics system speeds recovery for testicular cancer patients<\/strong><\/h2>\n