Background. Penis cancer is rare malignant tumor with morbidity 0,1−0,9 on 100 000 male in year. Most patients come to a doctor late, when performance of organosparing treatment is impossible. Organosparing operations associate with high frequency of development of local reccurence as compared with penectomy. Combined method is optimal treatment for patients with invasive penile cancer and provides good long-term results and preservation organ's function.

Objectives. to increase of cure effectiveness by performance of organosparing operations into combined treatment.

Subjects and methods. The investigation was included 72 patients with invasive squamouse penile cancer. Patients were divided into two groups subject to kind of treatment: I (42) — organosparing operations, II (30) — combined method. Surgical treatment was performing whole of 72 patients: 51 — resection, 12 — circumcision, 3 — local excision. Beam therapy was carrying out to 30 patients.

Results. The frequency of relapse in I group was 52,4 %, in II — 13,2 % (p < 0,01). Duration of period without relapse was four times higher in group of combined method — 71,3 ± 13,4 monthes as compared with group of surgical treatment — 17 ± 5,7.

Conclusion. The combined method of cure for patients with invasive squamous penile cancer provides good long-term results and preservation of organ's function.

Study investigates the prevalence, diagnosis and treatment in patients with retention disorders upper urinary tract cervical cancer stage IIB III after more than 3 months after combined radiotherapy. In the apartment complex to the diagnosis of renal ultrasound and radioisotope study of renal excretory function added to the study ureteral emissions by color Doppler sonography. Information on ureteral emissions revealed a violation of the early passage of urine in 23.1 % of patients with renal ultrasound revealed no pathology. On the basis of violations ureteral emissions increase in the number of patients, respectively, are assigned to nonoperative treatment (anti-inflammatory, spasmolytic therapy). As a result, decreased by 14.2 % (p = 0.034), female patients, which showed drainage of the upper urinary tract.

Bladder cancer (BC) remains a current problem in oncourology. Despite that bladder cancer risk factors have been studied and described in the literature, new molecular and genetic mechanisms have been identified that predisposes to the disease development. There are numerous cellular processes involve in BC pathogenesis. The less-aggressive, non-invasive slow progressing bladder cancer types are defined by Ras-MAPK system activation. Tumors that are more aggressive and have low cancer-specific survival rate are characterized by changes in retinoblastoma genes and p53. Attempts are made to develop prognostic tests to predict tumor behavior, targeted treatment. perspectively, BC patients will be treated using molecular genetic markers allowing the accurate prediction of the patient’s tumor behavior and fitting the treatment tactics on the individual basis.

The article represents the study of frequency and nature of the recurrence and survival rate (common, oncology-specific, disease-free) after organ-saving surgery of patients with muscle-invasive bladder cancer stages T2b and T3a. Oncology-speсific and disease-free survival rates were much higher if full diagnosis of bladder mucosa, the adjuvant intravesical chemotherapy had been on pre-operative and intra-operative stages than in the absence of these diagnosis and therapy. Recurrentes of bladder cancer which appeared in the absence of diagnosis and combination therapy, statistically reliably occured at another location other than the zone of operation, stage of recurrentes and degree of differentiation of recurrents were less than the original tumor. This information confirms the existence of foci of cancer in situ which have not been identified on the diagnostic stage.

The paper analyzes the data on 34 patients with non-muscle-invasive bladder cancer (NMIBC) who have undergone radical cystectomy (RCE). The patients were divided into 2 groups according to the preoperative period: with delayed and early RCE. Heterotopic and orthotopic reservoirs were the methods of choice for urinary derivation. Five-year overall relapse-free survival was 68.9±12.6%. There were differences in the number of relapses in the delayed and early RCE groups. The timely established indications for RCE make it possible to prevent disease progression and to long maintain a good quality of life in the majority of patients with NMIBC.

Objective: to develop nomogram based on clinical variables, that predicts pathological local extent of the bladder cancer рТ3-рТ4 (рТ3+).

Material and methods: We used data of 511 patients with bladder cancer, that have undergone radical cystectomy between 1999 and 2008 at N.N. Alexandrov National Cancer Centre. For prediction of pT3+ on preoperative data were used mono- and multivariate logistic regression analysis. Coefficients from logistic regression equalization were used to construct nomogram. Nomogram accuracy was evaluated with concordance index (с-index) and by building the calibration plot. Internal validation by bootstrap method with 200 variants of dataset was performed.

Results: We developed nomogram, that include: clinical stage сТ, tumor grade, tumor macroscopic appearance, presence of upper tract dilatation, prostatic urethra and/or prostatic lobe(s) involvement, 3 or more bladder walls involvement, ESR and creatinine level. Bootstrapcorrected prognostic accuracy of nomogram was 81,4%, that 12,6% better than clinical stage accuracy.

Conclusion: developed nomogram can significantly improve pathologic tumor stage prediction accuracy that may be used to select patients for neoadjuvant chemotherapy.

Purpose: To improve the efficacy of palliative radiation therapy for patients with bladder cancer (BC).

Materials and Methods: In the years 1990−2010, 90 patients with BC were treated with palliative external beam radiation therapy (EBRT) using three regimens: conventional fractionation in group 1 (n = 37), hypofractionation in group 2 (n = 22) and accelerated dynamic fractionation in group 3 (n = 31).

Results: The immediate efficacy of EBRT was evaluated taking into account rapid relief of local symptoms of disease. In group 1, a clinically significant response (hematuria relief) was achieved in 63,0 % cases, in group 2 — in 62,5 %, in group 3 — in 91,7 % cases. The 10-year follow-up showed that in group 1, the median survival was 21,8 ± 3,3 months; in groups 2 and 3, the median survival was 27,0 ± 7,8 and 32,6 ± 9,8 months, respectively. In group 2, an increase in the rate of acute radiation reactions was noted, whereas in group 3, palliative EBRT did not produce higher rates and severity of acute radiation reactions and complications.

Conclusion: Accelerated dynamic fractionation was found to shorten treatment times and to improve outcomes and quality of life for incurable patients with BC.

Results of treatment of 143 patients who underwent cystprostatectomy or anterior pelvic exenteration. A comparative analysis of two groups of patients whose operation ended with the traditional drainage through the anterior abdominal wall (n = 71), and bilateral perineal drainage (n = 72). Bilateral perineal drainage after operations on the pelvic organs, accompanied by cystectomy and extended lymphadenectomy in conjunction with the restoration of the peritoneum lateral pelvic walls, improves postoperative recovery of intestinal peristalsis, promotes an earlier reduction in the intensity of pain and morbidity in the early postoperative period. Installation is simple perineal drainage performed and safe procedure. We recommend bilateral perineal drainage after operations on the pelvic organs, accompanied by cystectomy and extended lymphadenectomy.

The incidence of recurrences was analyzed in patients with non-muscle-invasive bladder cancer who had undergone primary or secondary transurethral resection (TUR). The 5-year incidence of recurrences was studied. The authors also discuss whether it is reasonable to use second-look (restaging) TUR, which allows this procedure to be recommended for routine clinical practice.

The wide use of current diagnostic techniques, such as ultrasound study, computed tomography, and magnetic resonance imaging, has led to significantly increased detection rates for disease in its early stages. This gave rise to a change in the standards for the treatment of locally advanced renal cell carcinoma (RCC). Laparoscopic nephrectomy (LN) has recently become the standard treatment of locally advanced RCC in the clinics having much experience with laparoscopic surgery. The chief drawback of LN is difficulties in maintaining intraoperative hemostasis and a need for creating renal tissue ischemia. The paper gives the intermediate results of application of the new procedure of LN using radiofrequency thermal ablation in patients with non-ischemic early-stage RCC.

The new potentialities of 3D transrectal ultrasound study were realized in a HistoScanning diagnostic unit. It has been used at the R.M. Fronshtein Urology Clinic, Research Institute of Uronephrology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, since September 2011. A study of the sensitivity and specificity of the technique enrolled patients undergoing high-intensity focused ultrasound (HIFU) ablation of the prostate of for its (PC) in the period 1 to 7 years. Prostate biopsy study with subsequent histology was made to confirm the results of histoscanning. Statistical processing of the obtained data showed that the sensitivity and specificity of histoscanning were 96 −100 and 87.5 −100%, respectively. These results allow one to appreciate histoscanning as a highly sensitive technique that advantageously differs in its significance level and informative value from now routinely used methods. The study on the possibility of planning and monitoring patients after focal treatments for PC opens up great prospects in achieving a balance between the radicality of performed surgery and the maintenance of quality of life in patients.

Small cell carcinoma of the prostate is a rare and very aggressive tumor. Primary emphasis is laid on the morphological and immunohistochemical characteristics of this type of a tumor, the clinical presentations of the disease, performed treatment, and its response. Three clinical cases of small cell carcinoma of the prostate with their further discussion are described.

The treatment of prostate cancer (PC) is one of the most urgent problems of modern urology. Its higher morbidity rates, the actuality of quality of life maintenance, and a large number of treatment procedures determine interest in this problem. Radical prostatectomy (RPE) is the gold standard for treatment of locally advanced PC. Extraperitoneoscopic RPE (ERPE) is a current low-trauma treatment for locally advanced RPE. The complexity of adopting this intervention interferes with the wide introduction of this procedure. The authors of the paper propose a standardized approach to adopting ERPE. In their mind, this approach will contribute to the wide promotion of a video-assisted treatment procedure for patients with locally advanced PC, which will be able to enhance the efficiency of therapy in patients of the above group.

Mechanisms of development of hormone refractory prostate cancer currently not fully understood.

Materials and methods: treatment results of 135 prostate cancer patients underwent subcapsular orchiectomy.

Results: hormone resistance registered at 38 (28.15%) patients, were sensitive to anti-androgenic therapy 97 (71.85%) patients. There are reliable differences between the probability of development of hormone refractory and the patient's age, disease stage and degree of tumor cell differentiation.

Conclusion: сlinical developed, laboratory and pathomorphological criteria, the use of which may reliably predict the likelihood of hormone refractory patients with prostate cancer on the background of antiandrogenic treatment.

Renal cryoablation is an alternative minimally-invasive method of treatment for localized renal cell carcinoma. The main advantages of this methodology include visualization of the tumor and the forming of "ice ball" in real time, fewer complications compared with other methods of treatment of renal cell carcinoma, as well as the possibility of conducting cryotherapy in patients with concomitant pathology. Compared with other ablative technologies cryoablation has a low rate of repeat sessions and good intermediate oncological results. The studies of long-term oncological and functional results of renal cryoablation are presently under way.