Objective: to assess a role of immunomonitoring in patients with disseminated renal-cell carcinoma.  

Subjects and methods. One hundred and seventy-five patients treated in 1998 to 2008 were followed up. The patients received various immunochemotherapy regimens including interleukin-2 (IL-2), interferon-α (IFN-α), Xeloda, cyclophosphamide. The immune status, including lymphocytes and their subpopulations, cytokine components (IL-1, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12; IFN-α, IFN-γ; tumor necrosis factor-α (TNF-α)), immunoglobulins (IgA, IgG, IgM), complement components (C1q, C3, C3a, C4, C5a), was evaluated before treatment and at therapy-free intervals.

 Results.  The time course of changes in cytokines (IL-6, IL-8, IL-10; TNF-α and IFN-γ) and some lymphocyte subpopulations (CD4+CD8+, CD3-CD16+CD56+, CD3+CD16+CD56+, CD4+CD25+Foxp3) greatly differs in patients who belong to different prognostic groups according to the Memorial Sloan-Kettering Cancer Center (MSKCC) inclusion criteria. Multivariate analysis has shown that the levels of IL-6 (spontaneous and induced production), IL-8 (spontaneous and induced production), TNF-α (spontaneous production), IFN-γ (induced production), NK T cells (CD3+CD16+CD56+), regulatory T cells (CD4+CD25+Foxp3) affect survival. Integration of the above indices into the MSKCC scale revealed that the groups were prognostically heterogeneous. The median survival in patients with good prognosis was 36.2 months (50.3, 38.3, and 24.5 months in those with 0—1, 2—3, and more than 3 immunological factors, respectively) and in those with relatively good and poor prognosis it was 15.3 (29.1, 15.3, and 18.1 months) and 8.5 (12.1, 9.3, and 6.3 months) months, respectively.

Conclusion. The cytokine status reflects the aggressiveness of a tumor process. The cytokine level changes may be used to predict the out- come of the disease.

Some nontumor processes can resemble renal tumors both clinically and morphologically. Malformations in the kidneys can lead to that the latter preserve primitive renal tissue elements that can be mistaken for nephroblastic tumors. In their clinical practice, pediatric oncologists most frequently come across, among the tumor-like processes simulating nephroblastoma (NB), a massive renal blastema that is also known as nephroblastomatosis (NBM). The paper demonstrates that there is no unified notion of NBM in children and that of a need and options for treatment. It presents data on 37 patients with bilateral NB, the development of which NBM is responsible for. The morphological and radiological signs of NBM are given. The results of treatment in the patients are provided in relation to the extent of a tumor process and the concomitance of NBM and Wilms’ tumor. NBM is shown to be a self-limiting pretumor proliferative process that is characterized by a high NB risk. When the diagnosis of NBM is verified, the patient needs antitumor treatment.   

Objective: to provide a systematic review of the adverse reactions of sorafenib, sunitinib, and temsirolimus and to outline actions for their prevention and correction.

Materials and methods. To provide a description of the main methods to decrease the toxicity of these drugs, the authors made a systemat- ic review of their adverse reactions, by using the publications available in the PubMed database, monographs on the medicines, and instruc- tions for their medical use.

 Results. The frequency of their adverse reactions varied from < 1 to 72%. Grades III—IV side effects are noted more rarely; their incidence is < 1 to 13% for sorafenib, < 1 to 16% for sunitinib, and 1 to 20% for temsirolimus. Sinitinib causes most grades III—IV adverse reactions and sofafenib does the least. However, close comparative studies of the safety of these kinase inhibitors are still lacking. Virtually all side effects can be effectively prevented and treated.  

Conclusion. The prevention, timely recognition, and treatment of the adverse reactions of these agents are of great importance, which allows avoidance of the unneeded dosage reduction that may result in worse therapeutic efficiency.   

Objective: to assess the results of surgical treatment of patients with the intestinal urinary bladder, to characterize its early and late postoperative complications, and to develop their correction tactics.  

Subjects and methods. The results of treatment in 198 patients who had undergone ileocystoplasty were analyzed.  

Results. The developed diagnostic approach and the determined examination periods could reduce the number of late postoperative complications of ileocystoplasty: acute and chronic pyelonephritis from 19.4 to 7.6%, urolithiasis from 17.2 to 1.9%, bladder dysfunction from 25.8 to 7.6%, and metabolic acidosis from 4.3 to 1.9%, and prevent the development of ureterovesical anastomosis stricture.  

Conclusion. Radical cystectomy with the ileoplasty using an isolated segment of the ileum in patients with invasive urinary bladder carcinoma has been the operation of choice no longer; it has become an essential surgical adjunct. This method permits overall 5-year survival to be achieved in 69.7% of patients.

A comprehensive fluorescence technique has been developed to study the urinary bladder mucosa in patients with superficial bladder cancer (BC), by using alasense, white light cystoscopy, fluorescence cytoscopy, and local fluorescence spectroscopy in vivo. Quantification of urothelium fluorescence in the red emission foci of 5-ALA-induced protophorphyrin, with the local autofluorescence intensity being borne in mind, has been shown to increase the specificity of photodynamic diagnosis of superficial BC from 70 to 85% (p ≤ 0.05) and the total accuracy of the technique from 80 to 86%.

Purpose.  The primary end-points of the study were overall response rate, progressive-free and overall survival in patients received Gemcytabin (Cytogem®) and Cisplatin as first-line therapy for transitional-cell bladder cancer. Secondary end-points were toxicity and safty of the regimen.

 Material. From February 2005 to March 2007 25 patients with morphologically verified inoperable locally advanced and metastatic transitional-cell bladder cancer were recruited. Men-to-women ratio was 3:1. Median age of the patients was 66,5±6,8 years. All the patients received Cytogem® 1000 mg/m2 days 1, 8, 15, cisplatin 70 mg/m2 on day 2; every 28 days. No more than 6 cycles were allowed if the evidence of disease progression and unacceptable toxicity were not registered. Median follow-up was 36,2±12,1 months.  

Results. Complete response was observed in 2 (8%), partial — in 11 (44%), stabilization — in 10 (40%), progression — in 2 (8%) of 25 patients. Twelve- and 24-month overall survival was — 51,3% and 22,4% (median 13,4±3,5 (95% CI: 6,6—20,4) months), progressive- free survival — 26% and 13% respectively (median 8,8±1 (95% CI: 6,6—10,6) months). Toxicity was evaluated in 24 patients and occurred in all cases (grade I—II — 16 (67%), grade III—IV — 8 (33%)). The main regimen-related toxicity was hematological (neutropenia — 16 (67%) (grade I—II — 8 (33%), grade III—IV — 8 (33%)), thrombocytopenia — 14 (58%) (grade I—II — 10 (41,5%), grade III—IV — 4 (16,5%)), anemia — 7 (29%) (grade I—II — 5 (21%), grade III—IV — 2 (8%))). Hematological toxicity was not associated with com- plications in any case. Non-hematological side-effects were nausea and vomiting in 21 (88%) (grade I—II — 67%, grade III — 21%), alopecia — in 11 (44%) patients. The regimen-related toxicity was considerable and reversible. No side-effect demanded blood transfusion, antibiotic and/or growth factors administration, and hospital admission.  

Conclusion. Gemcytabin (Cytogem®) and Cisplatin as first-line therapy for advanced transitional-cell bladder cancer have demonstrated satisfactory efficacy and acceptable toxicity. The regimen can be recommended for the clinical practice.

Objective: to define the optimal time and technique of repeated transrectal prostate biopsy (RTPB) in patients with atypical small acinar proliferation (ASAP).

Subjects and methods: RTPB was performed in 210 patients with first diagnosed ASAP. The study was conducted on an average 8 (range 1 to 12) months after the first biopsy and involved 12, 14, 16, and 18 biopsy cores.  

Results: According to the results of repeated biopsy, prostate adenocarcinoma was verified in 64.8% (136/210) of cases. The highest detection rate was found with biopsy schemes including 16 and 18 cores 1 and 3 months after the first biopsy (p < 0.05).  

Conclusions: ASAP is a precursor of prostate cancer and its presence in the morphological specimen during the first biopsy requires RTBT in the early periods irrespective of PSA levels.

Brachytherapy is a high-tech, mini-invasive, and effective treatment modality for prostate cancer (PC). Interstitial radiation therapy is presently one of the standard treatments for PC. A constantly increasing interest in brachytherapy is attributable to higher morbidity and to a need for local therapy modalities. Preoperative prostatic specific antigen levels allow one to predict whether the disease can progress.

Intermittent hormone therapy (IHT) is an effective and safe hormonal method in patients with prostate cancer (PC), which is as efficacious as continuous hormone therapy. IHT substantially improves quality of life at a therapy-free interval and reduces the cost of the performed therapy. IHT