title: [The interdisciplinary approach to improve treatment quality of prostate cancer. Optimized nerve sparing in radical prostatectomy].
abstract: BACKGROUND
  After sufficient oncological treatment of prostate cancer the life quality becomes most important. A multi disciplinary research network aims to optimize the diagnostics and the resulting treatment of prostate cancer.
  
  
  METHODS
  Main characteristics of the interdisciplinary cooperation are the interlocked individual projects. A major research field is investigation of the whole mounted prostate sections to study the peripheral nerves and the comparison of histological tumor locations with the MRI. Using serial sections of prostate specimens, three-dimensional computer-animated models are created illustrating the tumors histological and immunohistochemical distributions. For nodal staging, a new methodology is investigated to demonstrate single tumor cells in lymphatic tissue lysates. A retrospective evaluation of life quality including the functional outcome is performed by using questionnaire surveys.
  
  
  RESULTS
  Anatomical studies gave new insights into the exact localizations of peripheral nerves which may lead to an improvement of the surgical approach in nerve-sparing radical prostatectomy. For the preoperative planning the MRI imaging might need a different interpretation in relation to the topographic location. Studies using molecular markers and their relation and distribution patterns gave new insights regarding interpretation of histological biopsy results concerning the tumor extension. Numerical quantification of tumor cells in each lymph node demonstrated micro metastases in histological negative nodes contributing to the nodal staging. A close connection of the nerve-sparing technique was demonstrated with quality of life aspects and functional results.
  
  
  CONCLUSIONS
  An interdisciplinary approach is mandatory for translational prostate cancer research. As a result, individualized diagnostic and therapeutic approaches improve oncological results and at the same time provide the best quality of life in these patients.
authors: Universitätsklinik für Urologie, Universitätsklinikum Tübingen, Hoppe-Seyler-Strasse 3, 72076 Tübingen. karl.sievert@med.uni-tuebingen.de
authors: K-D
authors: KD
authors: Sievert
authors: A G
authors: AG
authors: Anastasiadis
authors: J
authors: J
authors: Hennenlotter
authors: D
authors: D
authors: Schilling
authors: A S
authors: AS
authors: Merseburger
authors: U
authors: U
authors: Nagele
authors: M P
authors: MP
authors: Lichy
authors: H-P
authors: HP
authors: Schlemmer
authors: A
authors: A
authors: Ulmer
authors: U
authors: U
authors: Vogel
authors: K
authors: K
authors: Sotlar
authors: M
authors: M
authors: Kuczyk
authors: A
authors: A
authors: Stenzl
mesh_terms: D003299:Cooperative Behavior; D007172:Erectile Dysfunction / Q000517:prevention & control* / Q000523:psychology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008197:Lymph Node Excision / Q000379:methods; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery / Q000379:methods* / Q000523:psychology; D009367:Neoplasm Staging; D010348:Patient Care Team; D010525:Peripheral Nerves / Q000473:pathology; D011183:Postoperative Complications / Q000517:prevention & control* / Q000523:psychology; D011467:Prostate / Q000294:innervation / Q000473:pathology; D011468:Prostatectomy / Q000379:methods* / Q000523:psychology; D011471:Prostatic Neoplasms / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D011785:Quality Assurance, Health Care; D011788:Quality of Life / Q000523:psychology; D014549:Urinary Incontinence / Q000473:pathology / Q000517:prevention & control* / Q000523:psychology
references: Radiology. 2004 Jul;232(1):133-9
references: 15166321
references: Curr Opin Urol. 2005 May;15(3):163-6
references: 15815192
references: Eur Urol. 2007 Jan;51(1):105-10; discussion 110-1
references: 16814455
references: Clin Cancer Res. 2005 Aug 1;11(15):5425-32
references: 16061857
references: Eur Urol. 2006 Feb;49(2):280-5
references: 16364536
references: Eur Radiol. 2005 Apr;15(4):653-60
references: 15627193
references: Oncol Rep. 2006 Jul;16(1):79-83
references: 16786126