Vol 7, No 4 (2011)
- Year: 2011
- Published: 30.12.2011
- Articles: 17
- URL: https://oncourology.abvpress.ru/oncur/issue/view/22
DIAGNOSIS AND TREATMENT OF URINARY SYSTEM TUMORS. URINARY BLADDER CANCER
COMPARATIVE ANALYSIS OF THE THERAPEUTIC EFFICACY OF PROSPIDINE AND CISPLATIN IN NEOADJUVANT INTRAVESICAL CHEMOTHERAPY FOR NON-MUSCLE INVASIVE BLADDER CANCER
Abstract
Objective: to evaluate the antitumor efficiency of the intravesical administration of prospiridine versus cisplatin in the treatment of nonmuscle invasive bladder cancer (NMIBC).
Subjects and methods. The therapeutic effect of neoadjuvant intravesical chemotherapy (CT) was comparatively analyzed in 74 patients with transitional cell NMIBC. Thirty-four patients were given prospidine in a single dose of 200 mg to the total dose of 4000 mg; 40 patients received cisplatin in a single dose of 20 mg to the total dose of 500 mg.
Results. There was a preponderance of moderate dysuretic manifestations (55 %) during CH with prospidine and mild cystitis (62.5 %) during that with cisplatin. In the prospidine group, mild leukopenia was observed in 5 (14.7 %) patients receiving intravesical CT with prospidine and in none patients treated with cisplatin. In the same group, 11.7 and 23.5 % achieved complete or partial regression, respectively. The total effect of intravesical CT with prospidine was 32.4 % and that with cisplatin was 50 % (complete or partial regression was seen in 22.5 and 27.5 %, respectively).
Conclusion. The study has demonstrated that intravesical CT with prospidine is effective and well tolerated and may be recommended for the treatment of NMIBC.
32-36
REPEAT TRANSURETHRAL RESECTION OF THE BLADDER AND THE RESULTS OF TREATMENT IN PATIENTS WITH NON-MUSCLE INVASIVE BLADDER CANCER
Abstract
A comprehensive analysis was made to study whether it was expedient to use repeat transurethral resection (TUR) of the bladder to treat patients with non-muscle invasive bladder cancer (NMIBC) in routine practice, by clarifying the impact of repeat TUR of the bladder on relapse-free survival time and estimating the prognostic value of this procedure. A prospective study enrolled 2 groups of patients with NMIBC (Т1NxM0 G1 3) made up according to the scope of surgical treatment (single and repeat TUR of the bladder) with a median follow-up of 26 months. The therapeutic effect of TUR carried out 4-6 weeks after primary TUR was noted only in patients at low and moderate risk for recurrence. The possibilities of using repeat TUR are also shown to predict risk for early recurrence and to choose the optimal surgical policy for patients with NMIBC, which make it possible to recommend its incorporation into routine clinical practice.
37-41
DIFFERENT TYPES OF URINE DERIVATION AFTER SMALL PELVIC EVISCERATION
Abstract
47-49
CHOICE OF A PROCEDURE FOR FORMATION OF URETEROILEAL ANASTOMOSIS DURING BRICKER URINE DERIVATION IN ELDERLY AND SENILE PATIENTS
Abstract
Background. How to derive urine is stemmed from removal of the bladder and from the necessity of its disengaging from the process of urination. Most surgeons prefer to do incontinent urine derivation in elderly and senile patients.
Subjects and methods. In 2007 to 2009, the Leningrad Regional Oncology Dispensary treated 103 patients with diseases requiring the bladder be removed. All these patients underwent cystectomy as an independent operation or one of the surgical stages, followed by incontinent urine derivation described by Bricker. The patients were divided into 2 groups: 1) Bricker-type end-to-side ureteroileal anastomosis; 2) Wallace-type one. Group 1 comprised 50 patients: 37 (74 %) women and 13 (26 %) men; Group 2 included 53 patients: 48 (90.6 %) women and 5 (9.6 %) men. These were elderly and senile patients aged 60 to 79 years (mean age 65 ± 3.71).
Results. In Group 1, 36 (72 %) patients were preoperatively diagnosed as having hydroureteronephrosis (HUN). Of them, 23 (64%) patients underwent preoperative percutaneous puncture nephrostomy (PPN). In Group 2, HUN was diagnosed in 43 (81 %) patients; of them 27 (63 %) had PPN. Complications and resurgeries were more common in Group 1 (p < 0.001). In Group 2, there were a larger number of cases of incompetence of the ureteroileal anastomosis. This complication required no surgical correction, but a longer drainage standing.
Conclusion. The Bricker operation is the safest urine derivation in elderly and senile patients after surgery involving cystectomy. Wallacetype ureteroileal anastomosis during the Bricker operation is accompanied by a considerable reduction in the number of early and late postoperative complications and resurgeries. Wallace-type ureteroileal anastomosis is considered the method of choice in cancer patients.
42-46
DIAGNOSIS AND TREATMENT OF URINARY SYSTEM TUMORS. RENAL CANCER
EVALUATION OF RENAL FUNCTION IN PATIENTS WITH RENAL CELL CARCINOMA BEFORE AND AFTER RADICAL NEPHRECTOMY
Abstract
There is an increase in the number of patients with renal cell carcinoma (RCC) every year. At the same time radical nephrectomy (RN) remains the standard treatment of renal malignancies and the most common surgical procedure for this pathology. A considerable number of patients with kidney cancer have diminished renal function that worsens after removal of functioning kidney tissue together with a tumor. This promotes retained low overall survival rates in patients with RCC, by improving cancer-specific survival. Renal function was studied in 48 patients with RCC prior to and 1 year after RN. In all the patients, glomerular filtration rate (GFR) was estimated using the Cockroft-Gault equation with and without protein load. Renal parenchyma volume was calculated by spiral computed tomography. Patients aged over 60 years had decreased baseline renal function as compared to those aged under 60 years (GFR 77.4 versus 103.6 ml/min/1.73 m2). The postoperative reduction in female renal function was more pronounced (GFR, 84.92 versus 92.54 ml/min/1.73 m2). Patients with metastatic RCC had lower baseline renal function and its significant postoperative loss than those with the non-metastatic forms of a tumor. A load test showed a substantially decreased renal reserve in patients with RCC.
16-20
TUMOR ANGIOGENESIS IN THE PERITUMOR AREA IN KIDNEY CANCER PATIENTS: CLINICAL ASPECTS
Abstract
21-23




