Vol 8, No 1 (2012)

The results of treatment were analyzed in 53 patients with high-risk non-muscle invasive bladder cancer (BC), who had undergone radical cystectomy (RCE) and bilateral pelvic lymphadenectomy. Histological hypostaging was noted in 20.7% of the patients; 13.2% of them had regional lymph node metastases, which confirms the problems associated with the accurate determination of a BC stage in clinical stage T1. The predictors of lower cancer-specific survival were identified in patients after RCE for pT1 cancer. In our study, 5- and 10-year cancer-specific survival was 90.5 and 88.6% in cT1 stage and 98.2 and 96.3% in pT1 stage, respectively. The findings strongly suggest that RCE can afford a long-term high cancer-specific survival in patients with non-muscle invasive BC.

Objective: to develop nomogram based on clinical variables, that predicts pathological lymph node involvement (рN+) in bladder cancer patients.

Material and methods: We used data of 511 patients with bladder cancer, that have undergone radical cystectomy between 1999 and 2008 at N.N. Alexandrov National Cancer Centre. Mono- and multivariate logistic regression analyses were used for pN+ prediction on preoperative data. Coefficients from logistic regression equation were used to construct the nomogram. Nomogram accuracy was evaluated with concordance index and construction of the calibration plot. Internal validation by bootstrap method with 200 variants of dataset was performed.

Results: We developed nomogram, that includes: clinical stage сТ, tumor grade, tumor macroscopic appearance, and creatinine level. Bootstrap-corrected prognostic accuracy of nomogram was 71,6%, that was 9,4% better than clinical stage accuracy.

Conclusion: utilization of developed nomogram can significantly improve pathologic tumor stage prediction accuracy that may be used to select patients for neoadjuvant chemotherapy.

As of now, about 40-60% of the first detected kidney tumors are accidentally diagnosed. These are most often asymptomatic small kidney tumors (SKT) without distant metastases; 15–20% of them are benign. A number of studies have revealed that kidney malignant tumors grow slowly and spread extremely rarely, as evidenced by a histological study. These and other data formed the basis for the active observation tactic that became possible and acceptable in well-selected patients, in elderly patients with SKT and severe comorbidity in particular.

 Despite the progress of diagnostic possibilities, the interpretation of renal cysts is still difficult and may have false negative results. So far there is no algorithm of renal cysts patients examination and treatment. Further diagnostic process improvement and an exact knowledge of the possibilities of each method are needed. The main factor for choosing the right tactics of treatment and giving the prognosis of the disease is not only the diagnosis, but also the exact gradation of the renal cysts according to the Bosniak classification. 

Prostate cancer (PC) has been recently the most common male cancer disease. At the same time, its incidence is ever increasing. In this connection, PS screening is highly pressing.

Objective: to study and assess the first results of a regional goal-oriented PC screening program in the Penza Region.

Subjects and methods. The regional goal-oriented “Male Health” program for PC screening was launched in the Penza Region in February 2008. The serum level of prostate-specific antigen (PSA) was detected in all 45-to-70-year men who had visited the region’s polyclinics and hospitals for any disease. Digital rectal and transrectal ultrasound studies were additionally performed in patients having the symptoms of lower urinary tract dysfunction. When the PSA level was > 4 ng/ml, multifocal biopsy was made through transperineal and transrectal accesses under ultrasound guidance, by using 12-24 points.

Results. In February 2008 to June 2010, blood was tested for PSA in 55 of 103 patients. In 5910 (10.7%) of them, its level (> 4 ng/ml) was above the allowable limit. Multifocal prostate puncture biopsy was performed in 1695 patients with elevated PSA levels for further examination to rule out PC. The latter was established by the results of biopsy in 737 patients. The percentage of biopsy results positive for cancer was 38.9%. That of PC detected among all the men examined for serum PSA level was 1.3%.

Conclusion. To elaborate programs for the early diagnosis and screening of PC is one of the priorities of the development of oncourology, which can considerably improve the results of treatment for this disease.

In September 2011, the Research Institute of Uronephrology and Human Reproductive Health began to use an apparatus for the early diagnosis of prostate cancer. One hundred and fifty-six studies have been conducted by now. In the examinees, the level of prostate-specific antigen was estimated to be in the range of 1.09 to 209 ng/ml. The results of the studies confirm European data on the sensitivity and specificity of this procedure.

Мероприятия РООУ в 2012 г.

Renal cell carcinoma (RCC) is one of the most urgent topics in modern oncourology. This is attributable to the high morbidity and mortality rates associated with this pathology. Renal dystopia is a rather rare developmental anomaly. The literature data describing cases of the diagnosis and treatment in patients with dystopic kidney malignancies are scarce. Moreover, if a tumor is present in the solitary dystopic kidney, it is often extremely difficult to perform an organ-saving operation for a number of features of the anatomic structure of the dystopic kidney and its vascular architectonics. The paper describes a clinical case of S-shaped crossed dystopic kidney resection in a patient with RCC.

The paper considers the state-of-the-art of BCG vaccine treatment for non-muscle invasive bladder cancer. It gives data on the meta-analyses of foreign studies of the efficiency of BCG therapy in this pathology.

К 70-летию со дня рождения Юрия Геннадьевича Аляева