Bladder cancer (BC) accounts for 5 to 10% of all cancers and ranks fourth in the prevalence of male cancers. In Russia, its morbidity increases with age and amounts to 8.1—9.6 per 100,000 with the annual increase being 3.34%.

Objective: to assess the results of sparing cystectomy (CE) for BC in the presence of urological complications.

Subjects and methods. From February 1999 to December 2007, the study consequently included 196 patients receiving surgical treatment for the aggressive form of BC, of whom 101 patients received surgical treatment for CE with intestinal plastic repair. There were 33 (84.6%) males and 6 (15.4%) females. The patients' mean age was 69.4 (range 35-81) years; the duration of the disease averaged 1.4 years (range 6 months to 5 years). The proportion of the males who has undergone sparing CE was 48.5% of the total number of patients. There were no women who had been operated on.

Results. Examination of 101 patients with invasive CE revealed that 69 patients had the following types of complications: intractable bleeding, hydronephrosis, acute pyelonephritis, chronic renal failure, progressive cancer intoxication, and acute urinary retention. These patients were determined as having undergone sparing CE. Group 2 comprised 127 patients who had received organ-preserving therapy.

Conclusion. Physical examination, instrumental, and X-ray studies established a correlation of the tumor aggression with the severity of urological complications; sparing CE for urological involvement in patients with invasive UBC has an advantage over organ-preserving treatment (33.3% versus 4.7%) in providing 5-year survival. However, the early postoperative mortality from occurring complications was higher in Group 1 than that in Group 2 without radical treatment.

A system of clinical and morphological criteria is currently used to determine the pattern of superficial bladder cancer (SBC). However, this system does not completely reflect the clinical potential of SBC and needs additional markers. The purpose of this study was to search for and evaluate molecular genetic disorders as additional markers of the course of SBC. The diagnostic panel included the deletion of the loci 3р14, 9р21, 9q34, 17р13 (ТР53), mutations of exon 7 of the FGFR3 gene, and hypermethylation of the promoter regions of the RASSF1, RARB, p16, p14, CDH1 genes. The study was made on 108 matched samples (tumor/peripheral blood) obtained from patients with SBC. The deletions of the loci 3р14, 9р21 and anomalous methylation of the RARb and p16 genes are markers of the worse course of SBC while FGFR3 gene mutation is a marker of better prognosis. In the context of estimation of the relapsing potential of a primary tumor, the 9p21 locus deletion is a marker associated with recurrence within the first year after malignancy resection. The group of molecular genetic markers determined by the authors for poor prognosis in combination with classical clinical and morphological criteria will specify the pattern of the course of the disease and its prognosis.

The efficacy and tolerability of temsirolimus are considered in patients with metastatic renal-cell carcinoma. The drug has been found to have a high antitumor activity and a good tolerability in patients with disseminated renal-cell carcinoma with a very poor prognosis and to cause few side effects.

Background: to define interrelation of lymphdissection at radical nephrectomy in surgical treatment of renal cell carcinoma (RCC).

Materials and methods: 221 patients were investigated with RCC. The men — 119, women — 102. Middle age of patients has made 53,3 years. T1 stage in 16 patients (7.3 %), T2 — in 55 patients (24.8 %), T3-133 (60.2%), T4-17(7.7%) patients. N1 occurred in 22 (9.9 %) patients, N2 in 8 (3.6 %), N0 in 191 (86.5 %) patients. Patients were divided into 2 groups depending on volume of lymphdissection, with the period of supervision of 3 years.

Results: Group I. Simple nephrectomy was executed in 130 patients without removal of regional lymph nodes. Metastases during the postoperative period occurred in the remote organs in 25.1 % cases, loco-regional metastasis in lymph nodes in 3.8 % cases was revealed, relapse 3%. Average life expectancy has made 25,6 months (of calculation 3 years). Group II. Nephrectomy with expanded lymphdissection from legs of a diaphragm to bifurcation of illiac arteries by midline approach was performed in 91 patients. On pathogistological research, metastases in regional lymph node was revealed in 15.3 % cases. Metastases during the postoperative period occurred in the remote organs in 6.6 % cases, metastasises in kept away lymph node in 1.08 % cases was revealed, relapse 3,2%. Average life expectancy has made 33,4 months (of calculation 3 years).

Conclusion: we have come to opinion on inexpediency of performance usual nephrectomy on RCC. Application expanded lymphdissection from from legs of a diaphragm to bifurcation of illiac arteries is improved by the remote results.Напоминаем

The authors determined the detection rates of prostatic intraepithelial neoplasia (PIN) in 2317 patients with benign prostatic hyperplasia (BPH) and prostate cancer (PC); and those of chronic prostatitis and fibrosis in patients with PIN, BPH, or PC. There was no difference in median age between the groups. PC was found to be more concurrent with PIN 2 than with BPH. The severer inflammation or fibrosis is, more likely there is a concomitance with PIN 2 or PC. There is evidence for the theory of inflammation is a factor of carcinogenesis. Prostatic fibrosis may also initiate carcinogenesis.

The authors consider and prove the efficiency of radical prostatectomy used in the treatment of patients with locally advanced prostate cancer as monotherapy and as a component of multimodality therapy.

Object: to evaluate the efficiency of prostate scintigraphy in the prebioptic diagnosis of prostate cancer (PC).

Subjects and methods. Two hundred and two patients with suspected PC underwent comprehensive examination, including 99mTc-technetril prostate scintigraphy and a morphometric study of biopsy material columns. A computer program (official registration certificate No. 2007614475 dated October 24, 2007) was worked out and patented to calculate the intensity of accumulation of radiopharmaceuticals in different portions of the right and left prostate lobes.

Results and discussion. When the division index point «pathological focus/background», 1.5; ≤ 1.5, healthy; > 1.5 suspected prostate cancer was used, the sensitivity of prostate scintigraphy was 81.65%; its specificity was 87.1%; the diagnostic effectiveness was 84.37%.

Conclusion: The application of prostate scintigraphy can improve indicators for early detection of PC, due to the purposeful detection of the points, enhance the effectiveness of biopsy, and, having more grounds than the early ones, to exclude this disease at the prebioptic stage. The method is noninvasive and can be used to monitor patients with suspected PC.

The purpose of the study was to provide a retrospective clinicomorphological assessment of the results of examining 70 patients with occult prostate cancer (PC). The findings show it expedient to identify latent prostate cancer as a special clinicomorphological form having a relatively good prognosis. According to the data, surgical or medical antiandrogen blockade had not caused a significant increase in the survival time up to 9 years in these patients and the cause of death was the development of intercurrent diseases rather than tumor progression. Latent cancer is characterized by the following signs:

— detection of only single foci of malignization among a great deal of study tissue pieces) (a tumor in 1—3 out of 20—30 tissue fragments);

— a Gleason score not more than 4;

— detection of Ki-67 in more than 10% of tumor cells;

— the activity of nucleolar organizers up to 3.8;

— a strong reaction to androgen receptors in the majority of tumor cells;

— no p53 hyperexpression;

— a slight or moderate lymphoid or monocytic cell infiltration of the tissues adjacent to the tumor.

The planning of PC management should involve in-depth morphological and molecular genetic analyses.

Mini-invasive treatments, including radical laparoscopic retropubic prostatectomy, have recently enjoyed more increasing popularity. The precision performance of continuous cystourethral anastomosis under visual control is one of its indisputable advantages.

The efficacy of Zometa has been evaluated in the treatment of patients with disseminated prostate cancer. The use of Zometa as an inhibitor of bone resorption in the presence moderate changes in the activity of bone resorptive processes has shown the highest survival rates.

Objective: to estimate the diagnostic value of octase in patients with prostate cancer (PC) to detect whether they have metastases to the skeleton.

Subjects and methods. To examine the impact of PC on the serum level of octase, the study included 58 PC patients who had received various treatment modalities and 8 control males without PC.

Results. Higher serum octase concentrations in PC patients receiving the maximum androgenic blockade allow one to suspect metastatic progression of a tumor to the skeleton, which necessitates osteoscintigraphy in these patients.

Discussion. The findings lead to the conclusion that octase may be used in the screening of PC patients receiving antiandrogen therapy in order to predict whether there will be bone metastases.

Leuproprelin acetate (Lucrin-depot) is an efficacious and safe luteinizing hormone-releasing hormone analogue, the efficiency of which has been proven in a number of large clinical studies. The agent exhibits a sustained release, is easy-to-use and well-tolerated, and causes minimal side effects. Lucrin-depot may be recommended for use as alone and in combination with other hormonal agents in patients with prostate cancer if androgenic deprivation is indicated.