The prognostic value of the expression of c-erbB-2 oncoprotein, p53 protein, cytokeratin 20, and Ki-67 was estimated in papillary urothelial non-muscle-invasive bladder carcinoma (BC). The biopsy and surgery samples from 57 patients (46 males and 11 females) aged 24 to 75 years (mean age 56±1.5 years), who received combination treatment for non-muscle-invasive BC, were examined. It has been found that с-erbB-2 and р53 are important prognostic markers of non-muscle-invasive BC. Co-expression of 3 markers is of high statistic significance.

Background. Radical cystectomy (RC) with urinary diversion is one of the most traumatic operations in urologic oncology. This paper estimates the frequency and severity of complications due to successive series of RC and analyzes the predictors of serious events after surgery. Materials and methods. All cases of complications were selected from the medical records of 408 patients who had undergone RC with urinary diversion at the N.N. Alexandrov Research and Practice Center of Oncology and Medical Radiology in 1999 to 2008. The frequency of grades 3 to 5 complications was studied in relation to various variables, by applying the univariate logistic regression analysis. The multivariate analysis of the most important parameters was made. Odds ratios (OR), 95% confidence intervals (CI), and statistical significance (p) were calculated for all parameters. Results. A total of 132 complications were recorded in 91 (22%) patients. According to the severity of the disease, the complications were divided as follows: grades 1 [n=26 (20%)], 2 [n=39 (30%)], 3 [(n=48 (36%)], 4 [(n=5 (4%)], and 5 [(n=14 (10%)] complications. Body mass index > 25 (OR 2,62; 95% CI 1,23-5,55; p=0,012) and a surgeons experience (> 100 cystectomies) (OR 0,48; 95% CI 0,240-0,99; p=0,04) were of prognostic value in the multivariate analysis. Conclusion. A considerable number of complications were noted after RC with urinary diversion. The multivariate analysis has shown that overweight increases the risk of severe complications after surgery and a surgeons rich experience reduces it.

The data of 67 kidney cancer (KC) patients with bone metastases, who had been treated at Moscow City Cancer Hospital Sixty-Two in 2002 to 2009 and had undergone skeletal bone surgery, were retrospectively analyzed. The role of surgical treatment for bone metastases from KC was assessed and the factors influencing the patients survival were determined. Surgical treatment for bone metastases from KC was ascertained to yield satisfactory results in improving the quality of life and increasing survival rates in the patients.

The development of molecular biology led to the discovery of major pathogenetic pathways in the development of renal cell carcinoma (RCC), contributing to the designing of novel drugs to treat metastatic RCC, which belong to a group of target agents or tyrosine kinase inhibitors. Phases II and III clinical trials have proven the efficacy and controlled safety profile of a broad range of drugs for the treatment of metastatic RCC. The developing resistance to drugs and their intolerance determine the need to conduct new clinical studies and to search for novel agents and treatment regimens to improve survival and quality of life in patients. The performed studies of the efficiency and safety of sequential use of antiangiogenic drugs and their combination have supported that it is expedient to apply these treatment policies to patients with metastatic RCC. The expected results from the ongoing large Phase III clinical trials will let one find out how to optimally use target agents, in what combination or in what sequence.

The substantial improvement of treatment results in patients with disseminated forms of renal cell carcinoma (RCC) is associated with the active clinical application of target drugs that affect the molecular genetic mechanisms underlying the development of this disease. Inactivation of the VHL gene and/or the disorders related to other elements of the signaling pathway regulating the processes of proliferation and neoangionesis in tumor tissue (mammalian target of rapamycin; hypoxia-induced factor; vascular endothelial growth factor and its receptor; platelet-derived growth factor receptor; and carboanhydrase IX) are considered to be one of the early and key events in carcinogenesis in clear cell RCC. However, there is presently no consensus of opinion as the prognostic value of these disorders and their impact on the efficiency of drug therapy. The results of the clinical trials assessing potential molecular biological markers are discordant. This is attributable both to the dissimilar clinical characteristics of patients and different methodological approaches to evaluating these or those molecular impairments. There are also other alternative signaling pathways and mechanisms responsible for the formation of primary or secondary drug resistance when target agents are administered. Thus, the quest of potential biomarkers remains an urgent problem as before. This paper analyzes the results of the currently available clinical studies of the role of various biological markers in predicting the efficiency of the present-day medicinal approaches to treating patients with RCC.

Target therapy is a main approach to treating metastatic renal cell carcinoma. Bevacizumab plus interferon alfa-2A is now standard first-line options for patients with previously untreated, good or intermediate prognosis (using the Memorial Sloan-Kettering Cancer Center criteria). We have presented our experience in using bevacisumab plus interferon alfa-2A in patients with metastatic renal cell carcinoma. Median progression-free survival and overall survival were 10 months and 22 months, respectively.

The diagnosis and treatment of testicular tumors in children are customarily associated with the difficulties caused by the rarity of the disease, the necessity of choosing a correct tactic for its diagnosis, adequate surgical intervention, and further treatment. Childhood testicular tumors are globally described as sporadic cases; the fact that there is no unique diagnosis and treatment program is noteworthy. In the past decades, testicular tumors in children have become a model of curability of malignancy, the major factor of which is its high susceptibility to various chemotherapeutic agents, cisplatin in particular. It is difficult to choose the optimal treatment particularly at the early stages of the disease and in disseminated processes and recurrences. That is why the patients do not always receive optimal medical care.

Prostate cancer is most common and its heterogenicity is presently apparent. There is a continuous search for the factors allowing the prediction of the poor course and biological difference of tumors. The College of American Pathologists classifies the currently known prognostic factors into 3 categories: 1) the factors whose prognostic importance and successful use have been proven in practice; 2) those that have been widely studied biologically and clinically, but the significance of which needs to be proven in extensive statistical studies; 3) all other factors that have been inadequately studied to demonstrate their prognostic value. Category 1 prognostic factors, such as prostate-specific antigen levels, TNM stage, Gleason grading, and the status of surgical margins, enjoy wide application. Category 2 factors are not used IN clinical practice so extensively. The value of some Category 3 factors (the biomarkers p53, Ki-67, Bcl-2, receptors of androgens) is indubitably and they claim to be widely applied in clinical practice with time. The clinical significance of molecular biological markers calls for further investigation.

Second-line hormonal therapy, chemo- and glucocorticosteroid therapy, treatment with aminog-lutetimides, ketoconazole, suramin, target agents, and vaccines may be singled out among the basic treatments for hormone refractory prostate cancer (HRPC). There is a search for a new ef-fective therapy for HRPC, which is associated with the development of new regimens based on docetaxel in combination with target therapy and new classes of antitumor drugs, which shows promise of improving the results of treatment for this disease.

The TANDEM multicenter open-label prospective postregistration study was initiated in 2007 to describe the Russian experience with Taxotere used to treat hormone refractory prostate cancer (HRPC) in routine practice. It enrolled a total of 149 patients; therapeutic effectiveness was analyzed in 135 of them. The mean age of the patients was 61,9±7,9 years; their mean prostate-specific antigen (PSA) level was 273,3 ng/ ml. The patients received a total of 807 chemotherapy cycles; ?d 6 cycles were made in most (73,8%) cases. A ?d 50% reduction was recorded in 47,5% of patients; an effect against pain was noted in 13,3%; an objective effect was observed in 47% of patients with measurable foci. The median time to progression was 10 months (95% confidence interval 9,3 to 15,7). Out of the severe (grade III-IV) and serious adverse reactions, there was grade III neutropenia in 5 (3,4%) cases, grade IV agranulocytosis in 1 (0,7%), and infection (herpes zoster) in 1. One patient died because of bleeding occurring in the lower urinary tract. The presented data support the efficiency of using Taxotere in first-line chemotherapy for metastatic HRPC. However, as compared with the data obtained in the TAX 327 study, there were much fewer adverse events, reflecting the real situation with the recording of the side effects of therapy in routine practice.

The earlier diagnosis of cancers, the improvement of a surgical technique, and advances in chemo- and hormonal therapy have increased survival rates. In this connection, some studies of quality of life have been recently under way after radical cyst- and prostatectomy. These mainly concern modifications of lifestyle, restoration of spontaneous urination and erectile function in males.

Eligard (leupropelin acetate, Atrigel delivery system) is a synthetic analogue of luteinizing-hormone-realizing hormone (LHRH), which causes a rapid reduction in the level of testosterone to the concentration comparable with that after surgical castration. Eligard demonstrated a considerable advantage over other LHRH analogues in the depth of androgenic suppression and in the frequency of transient increases in testosterone levels at the beginning and during therapy. Eligard is available as 1-, 3-, and 6-month depot formulations, which allows a flexible approach to be applied to individually making up a therapy regimen. Eligard is as effective as castration therapy techniques. Treatment with this drug shows the low frequency of side effects and is well tolerated by patients.

The paper presents a case of surgical treatment for disseminated horseshoe kidney tumor, by applying extracorporeal resection with further autotransplantation into the iliac region. It also describes surgical techniques and gives a brief review of literature on this matter.

The paper describes a case of metastatic involvement of the thyroid by renal carcinoma. The specific features of this observation are diagnostic difficulties in assessing the pattern and extent of a process and in choosing surgical treatment tactics.

The paper reviews the data available in the literature on the possible involvement of human papillomavirus in the induction of bladder cancer (BC). The results of the authors studies in this area are summarized. The data obtained in clinical and experimental studies in vivo and in vitro count in favor of the idea that human papillomavirus may be implicated in the genesis of BC.