Vol 5, No 2 (2009)

Прогностические молекулярно-генетические маркеры рака мочевого пузыря (обзор литературы)

The purpose of the study was to reveal the independent anatomic, histological, and clinical factors of cancer-specific survival in patients with renal-cell carcinoma (RCC). For this, the authors retrospectively analyzed their experience with radical surgical treatments in 73 RCC patients operated on at the Department of Urology and Surgical Andrology, Russian Medical Academy of Postgraduate Education, from January 1, 1999 to December 31, 2004; their outcomes have become known by the present time. There was a statistically significant correlation of cancer-specific survival with its parameters, such as pathological stage of a tumor, its maximum pathological size, differentiation grade, involvement of regional lymph nodes, venous tumor thrombosis, level of thrombocytosis, and degree of the clinical symptoms of the disease. Multivariate analysis of survival in RCC in relation to the prognostic factors could reveal odd ratios for the limit values of significant prognostic factors. The statistically significant prognostic values established in the present study, as well as the molecular factors the implication of which is being now investigated can become in future an effective addition to the TNM staging system to define indications for certain treatments and to predict survival in RCC  

The immediate and late results of treating patients with renal metastases with a new intermittent interferon-α (IFN-α) use regimen are presented.

Subjects and methods. The study included 131 patients receiving IFN-α as 3106 IU subcutaneously, days 1—10 at a further 2-week inter- val.

Results. Complete and partial effects were achieved in 11 (8.4%) and 18 (13.7%) patients, respectively; stable disease (≥6 months) was observed in 35 (26.7%). The median time to progression was 23.3 months. The sizes and number of lung metastases were found to have a great impact on survival: with metastases sizing ≤2 cm and their number of ≤10, the median overall survival was 29.9 months. These patients are the most promising candidates for the effective first-line IFN-α therapy.

The results of cystectomy (CE) in bladder cancer, performed in the standard and modified modes, were compared. The case histories of 153 patients operated on, by completely or partially preserving the prostate, were analyzed. With the extent ≤ T2N0, the rates of local and distant dissemination after standard and modified CE was 4%/2.1% and 9.5%/10.9%, respectively; i.e. the values did not differ greatly. The data of the performed analysis suggest that the compared values after modified CE are not worse than those after standard CE with orthotopic cystoplasty and do not allow one to doubt the oncological appropriateness in reducing the volume of an operation in specially selected patients.

Objective: to determine the rate of prostate cancer (PC) development after repeated transrectal saturation prostate biopsy (RTRSPB), to study the characteristics of diagnosed tumors, and to estimate their clinical significance from the data of radical retropubic prostatectomy (RRP).

Materials and methods. The results of RTRSPB were analyzed in 226 patients with a later evaluation of a tumor from the results of RRP. All the patients underwent at least 2 prostate biopsies (mean 2.4). The average number of biopsy cores was 26.7 (range 24—30). The average value of total prostate-specific antigen before saturation biopsy was 7.5 (range 7.5 to 28.6) ng/ml. The mean age of patients was 62 years (range 53 to 70).  

Results. PC was diagnosed in 14.6% of cases (33/226). An isolated lesion of the prostatic transition zone was in 12.1% of cases. If this zone had been excluded from the biopsy scheme, the detection rate of PC during saturation biopsy should be reduced by 13.8%. Better PC detectability during repeated saturation biopsy generally occurred due to the localized forms of the disease (93.3%). The agreement of Gleason tumor grading in the biopsy and prostatectomy specimens was noted in 66.7% of cases.

Conclusion. Saturation biopsy allows prediction of a pathological stage of PC, Gleason grade of a tumor and its site localization with a greater probability. Most tumors detectable by saturation biopsy were clinically significant, which makes it possible to recommend RTRSPB to some cohort of high PC-risk patients 

Заключительный метаанализ исследования ЕРС (Early Prostate Cancer)

The authors describe a new technology for controlling blood loss during an oncourological operation, which allows expansion of indications for radical surgical treatment in elderly patients with severe comorbidity.

Отчет о 6-м Конгрессе Европейского общества онкоурологов

The prognostic value of the Fuhrman renal-cell carcinoma (RCC) gradation system has been supported by numerous studies. The high RCC  grade after Fuhrman is a sign of the high risk of recurrence even in patients with the early stages of the disease, in clear-cell tumor in par-  ticular. The anticancer vaccine Oncophage is recommended to prevent a recurrence and/or to increase a relapse-free period in patients with  early stages of RCC. While using this vaccine, one should follow the Fuhrman histological gradation system and use a coordinated multi-  disciplinary approach to treating this group of patients. This paper describes the Fuhrman histological gradation system, indications for the  use of Oncophage in patients with the early stages of ECC and a moderate risk of a recurrence. The role of urological surgeons, oncologists,  and pathomorphologists in the treatment of patients with early stages of ECC is also considered.