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.

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.

The paper analyzes the data of 84 patients with bladder and cervical cancer (BC and CC) (Т4N0—1М0) who underwent small pelvic evisceration with different types of urine derivation. The heterotopic urinary reservoir, ureterocutaneostomy, and Bricker’s operation were the derivation methods of choice. Three-year survival rates for BC and CC were 81.8 and 77.5 %, respectively. Evisceration is today the only procedure to preserve and prolong the life of patients with locally advanced and complicated BC and CC.

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.

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.

The specific features of tumor angiogenesis were studied in cancer-adjacent kidney tissues. The activity of neoangionesis in the peritumor area (PA) was shown to depend on the biological properties of a tumor and to be highest in high-grade tumors. The density of the PA microcirculatory bed correlated with the most important prognostic parameters for renal cell carcinoma and therefore it might be used as an additional prognostic factor in kidney cancer.

Objective: to study the prognostic value of alterations in the VHL gene and the plasma markers hVEGF, hVEGFR2, and hVEGFR3 in patients with metastatic kidney cancer (KC) who receive targeted therapy.

Subjects and methods. Paraffin blocks from 22 patients with metastatic KC who received targeted therapy were analyzed for VHL gene mutation/methylation. Polymerase chain reaction (PCR) products were sequenced using a BigDye® Terminator v 3.1, a Cycle Sequencing Kit, and an ABI3100 genetic analyzer in accordance with the Applied Biosystems protocols. VHL gene methylation was determined by methyl-sensitive PCR. The markers hVEGF, hVEGFR2, and hVEGFR3 were measured in the plasma of 43 patients before, during, and after targeted therapy, by applying the commercial DuoSet® ELISA kits (RnDSystems, USA). The results obtained were analyzed by known statistical methods, by using the package of statistical programs SPSS 13.0 for Windows. Survival was estimated by the Kaplan-Meier method. Survival differences were found by the log-rank test in the patient groups. Cox uni- and multi-factorial regression analyses were used to identify factors that were prognostically significant for survival.

Results. Out of 22 patients, 10 (45.5 %) and 1 (4.5 %) were found to have VHL gene mutations or methylation, respectively. VHL gene inactivation did not affect prognosis in patients and the results of antiangiogenic therapy. Correlation analysis revealed no relationship between the concentrations of hVEGF and hVEGFR2 before and during therapy or absolute increases in hVEGF and hVEGFR2 concentrations during treatment with the frequency of progression during targeted therapy, with progression-free survival, and total life expectancy. No correlation was either found between the hVEGFR3 concentration and its changes and the results of antiangiogenic therapy. There was an inverse correlation between the pretreatment plasma hVEGFR3 level and lifetime without progression during antiangiogenic therapy (r = – 0.477, p = 0.039).

Conclusion. VHL gene alterations and plasma hVEGF and hVEGFR2 levels are not predictors of a response to antiangiogenic therapy. The pretreatment plasma hVEGFR3 level correlates with progression-free survival in KC patients receiving targeted therapy.

The review covers the state-of-the-art of proteomic studies to seek and identify potential markers for kidney cancer. It considers the markers found in biological fluids and tumor tissues and those detected using the models of cultured kidney cancer cells.

Fluorescence in situ hybridization is a current technique to detect chromosomal specific genetic disorders specific to urinary bladder cancer (UBC). This technique may be used to diagnose UBC, to follow up patients after surgical treatment, to evaluate the efficiency of adjuvant therapy in these patients, and to predict the development of disease recurrence.

The values of the diagnostic efficiency and consistency of preoperative evaluations of locally advanced prostate cancer (PC) by magnetic resonance imaging (MRI) with a matrix coil were estimated in 37 patients with PC who had undergone radical prostatectomy. The accuracy of differentiation of T3 and T2 stages in prospective and retrospective assessments was 59 and 73 %; the sensitivity was 7 and 40 %, and the specificity was 96 and 9 %, respectively; with the moderate consistency of evaluations.

Brachytherapy is a standard treatment for localized advanced prostate cancer (PC). Complications due to interstitial radiotherapy using permanent sources were analyzed in 149 patients. The incidence of early grade 3 radiation urethritis was 7.4 % and that of rectitis was 3.4%. Late radiation urethritis and rectitis were recorded in 3.4 and 0.7 %, respectively. Sexual function 12 months later was preserved in 86.6 % of the patients. Studies established no statistically significant factors that influenced the frequency of complications. The patients with a prostate volume of > 50 cm3, a preoperative international prostate symptom score of > 15, a urine flow rate of < 15 ml/min, and urethral and
rectal radiation doses of > 210 and > 180 Gy, respectively, tended to have more common radiation reactions. Thus, brachytherapy is a reasonably safe treatment for PC.

Purpose. To evaluate influence of clinical, biochemical and histological factors to detection rate of local recurrence following radical prostatectomy (RPE) using multifocal TRUS-guided vesicourethral anastomosis (VUA) biopsy.

Material and methods. 59 patients with newly diagnosed biochemical recurrence (BR) after RPE were included into prospective study. All of them underwent multifocal TRUS-guided VUA biopsy. Сlinical variables (serum prostate-specifi c antigen [PSA] level and PSA kinetics, time RPE-BR, Gleason grade, stage after RPE and clinical findings) were evaluated. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed.

Results. The detection rate of local prostate recurrence with TRUS-guided VUA biopsy was 45,8 % (95 % CI 33,7–58,3). At multivariate analysis only PSA level at the moment of biopsy (≤ 1,5 ng/ml vs > 1,5 ng/ml) and time RPE-BR (≤ 15 months vs > 15 months) were significantly associated with positive results of multifocal TRUS-guided VUA biopsy (p < 0,05).

Conclusion The detection rate of local prostate recurrence with TRUS-guided VUA biopsy depends on combination of independent predictors (PSA level at the moment of biopsy and time RPE—BR).

Prostate cancer (PC) is the most common malignancy in men. A screening system identifies a tumor process at clinical stages. Current technologies allow one to create nomograms — neural network systems that determine 5-year survival, extracapsular extension, and seminal vesicle lesions and actively monitor patients undergoing radical prostatectomy. Based on neural network simulation, the Department of Urology, Russian Medical Academy of Postgraduate Education, has developed an accounting prognostic system to monitor the postoperative course of PC, which is being actively introduced into the work of the urological units of the Botkin City Clinical Hospital.

Fifteen patients with castration refractory prostate cancer have been treated with sustained-release octreotide in combination with dexamethasone at the Altai Territory Oncology Dispensary since 2008. Control PSA test revealed that 9 (60 %) patients had positive changes; tumor process stabilization was noted in 4 (26.7 %) and only 2 (13.3 %) were found to have disease progression. Thus, more than 86 % of patients responded to combination treatment with sustained-release octreotide + dexamethasone. Octreotide treatment caused no serious specific adverse toxic reactions.

The paper describes a clinical case of pubic chondrosarcoma invading the bladder. Radical cystectomy has been performed with resection of the pubic symphysis and a part of the left ischium.

The paper describes 2 clinical cases of successful treatment for renal cell carcinoma, which confirm its use expediency if there are certain renal cell cancer, metastases, nephrectomyindications.

Prostate cancer (PC) is a topical problem of oncourology because of the steady rise in morbidity worldwide. Despite the introduction of a diagnostic technique using prostate-specific antigen, the detection rate of the disease in its late stages remains high. Hormone therapy (HT) is considered to be a basic treatment in patients with metastatic PC. At the same time continuous HT is associated with the risk of developing side effects and can lower quality of life in the patients. Intermittent HT makes it possible to substantially reduce the cost of the performed therapy and to improve quality of life, without decreasing the efficiency of HT. The paper presents a review of clinical trials demonstrating the efficiency of intermittent HT, including the use of luteinizing hormone-releasing hormone analogues, in patients with PC.