Summary: we have studied indicators of nitrogen metabolism, water-electrolyte balance and its hormones-regulators in blood and urine serum (plasma) in 49 male patients with transitional cell tumour of the urinary bladder of T2a-T2b stages before and after radical cystectomy with ileocystoplasty. Shifts in nitrogen and water-electrolyte balance aggravating after radical surgery have been identified. Changes have been noted in the concentration of hormones regulating water-salt metabolism as well as biomarkers’ levels in blood and urine serum.

The results of treatment were analyzed in 308 in patients with non-muscle-invasive (NMI) bladder cancer (BC). The incidence of recurrences was studied in patients with NMI BC who had undergone primary and second look (SL) transurethral resection (TUR). SL TUR is used to identify residual Т1G2−G3 tumors and to specify the stage of the disease, owing to which treatment policy for BC is changed. The authors revealed significant differences between the groups in the rate of early and recurrent NMI BC and its occurrence time during 5 years. The findings show the benefit of relapse-free survival after SL TUR in the T1G2-G3 BC group (p = 0.018). The authors also discuss whether it is reasonable to use SL TUR that allows this procedure to be recommended for patients with G2-G3 NMI BC in routine clinical practice.

Tumor cell proliferation and angiogenesis are essential factors for tumor growth, progression, and metastasis.

Objective: to assess the relationship between the values of proliferative activity and the morphometric parameters of intratumoral microvessels in metastatic and localized carcinomas of the kidney.

Materials and methods. Surgical specimens taken from 54 patients (32 men and 22 women) aged 26 to 69 years (mean age 55 ± 1.5 years) with the verified diagnosis of clear-cell renal cell carcinoma (RCC) were studied.

Conclusion. Proliferative activity and angioarchitectonics are an important biological characteristic of a tumor of unequal clinical value in RCC. Metastatic carcinoma has a higher proliferative activity and a low tumor vascularization than those of localized carcinoma.

The investigation deals with the study of the biomechanical properties of renal tissues and the comparison of different hemostatic suture procedures used during resection of the kidney for its tumor. The performed experimental study allows one to recommend that a renal capsule as the organ’s most stable and plastic part must be necessarily inserted into the hemostatic suture on both sides. The elastic modulus (Young’s modulus) serves as an integral indicator of the deformation-strength properties of renal tissues, which enables it to be recommended for the wider use in experimental and clinical studies. The proposed modified suture can minimize the number of postoperative bleedings from the renal parenchyma and reduce the time of surgery, thereby improving the results of organ-saving treatment in patients with kidney cancer.

Sequential targeted therapy is now the standard of treatment for metastatic renal cell carcinoma (mRCC). A switch into a different mechanism of action of mTOR inhibitor after vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKI) in second-line therapy helps to elude cumulative toxicity and cross-resistance, which may occur in the sequential use of different anti-VEGFR agents through the overlapping mechanisms of action. After VEGFR TKI therapy failure, treatment with the mTOR inhibitor everolimus in second-line therapy is recognized to be effective and safe, substantially increasing progression-free survival, without worsening its quality. Everolimus is recommended as second-line targeted treatment for patients with progressive mRCC after primary VEGFR TKI use. Switching to everolimus is warranted especially in patients who have a poor response to or a high toxicity of first-line antiangiogenic therapy.

The early diagnosis and radical treatment of aggressive prostate cancers (PC) is an effective way of improving survival and quality of life in patients. To develop mini-invasive tests is one of the ways of solving the problem. The cells of a peripheral blood mononuclear fraction in the expression patterns of their genetic loci reflect the presence or absence of cancers, including information on therapeutic effectiveness. RT-PRC was used to study the relative expression of 15 genetic loci in a chromosome and one locus of mitochondrial DNA in the cells of the peripheral blood mononuclear fraction in patients with PC or benign prostate hyperplasia and in healthy men. The genetic locus patterns whose change may be of informative value for differential diagnosis in patients with different stages of PC were revealed. The authors studied the relationship and showed the prognostic role and non-relationship of the altered transcriptional activity of loci in the TP53, GSTP1, and IL10 genes in PC to the changes in prostate-specific antigen the level with 90 % specificity and 93 % specificity.

The search of molecular markers of metastasing and prognosis in prostate cancer remains an urgent task. In this study, we investigated the relationship of gene expression heparanase-1 (HPSE1) and D-glucuronil C5-epimerase (GLCE) with early disease relapse and metastasis of a 2,5−3 years after diagnosis. It was shown that the ratio of the expression levels of genes HPSE1/GLCE > 1 may serve as a prognostic relapse marker and trends of the tumour to metastasis. The data obtained suggest to use this option as a molecular marker for the diagnostics of metastatic process and the disease prognosis.

Retrospective assessment of preoperative magnetic resonance imaging (MRI) data in 37 patients with prostate cancer, who had undergone radical prostatectomy, established the most diagnostically valuable MRI signs of minimal extracapsular spread (ECS): asymmetry of neurovascular fascicles (72 % accuracy, 93 % sensitivity, 77 % specificity, 73 % positive and 94% negative predictive values) and iron outline deformity/irregularity (66/80/64/60/82 %, respectively); as well as their higher diagnostic efficiency versus the clinical and laboratory predictors of ECS: total Gleason scores (58/87/55/57/86 %, respectively) and serum PSA levels (uninformative), which permits their consideration while choosing a more or less radical prostatectomy modality.

Purpose. To reveal prognostic factors of PSA-failure following radical prostatectomy in patients with localized and locally-advanced prostate cancer.

Materials and methods. Medical data of 386 consecutive patients with localized and locally-advanced prostate cancer who underwent radical prostatectomy from 1997 to 2011 were analyzed. Median age was 61.0 years. Median PSA before surgery – 10.3 ng/ml. Plasma levels of VEGF, VEGFR2, VEGFR3, TGF-β1, CD105, IL-6 were measured using Enzyme Linked-Immuno-Sorbent Assay (ELISA) before radical prostatectomy in 77 patients. Postoperatively the tumours were categorized as pT2 in 288 (59.1 %), pT3 – in 144 (37.3 %), pT4 – in 14 (3.6); pN+ – in 34 (8.8 %) cases. Gleason score < 7 was present in 254 (65.8 %),  7 – in 132 (34.2 %) specimens. Perineural invasion was identified in 188 (48.7 %), angiolymphatic invasion – in 126 (32.6) cases.

Results. Biochemical recurrence occurred in 64 (16.6 %) out of 386 patients at a median follow-up of 30.5 (12−164) months. Independent predictors of biochemical recurrence were PSA (HR 0.161 (95% CI:0.058−0.449); р = 0.001), Gleason sum in surgical specimens (HR 0.496 (95 % CI:0.268−0.917); p = 0.025), pN (HR 0.415 (95 % CI:0.181−0.955); p = 0.039). The patients were divided into 3 prognostic groups: good (0 factor), intermediate (1 factor), poor (2 factors) and very poor (3 factors) (AUC – 0.720 (95% CI: 0.656−0.784)). High preoperative levels VEGF ( 67 pg/ml) (р = 0.005), VEGFR2 ( 3149 pg/ml) (р = 0.036), VEGFR3 ( 2268 pg/ml) (р = 0.001), TGF-β1 ( 14473 pg/ml) (р = 0.052) were identified as unfavorable prognostic factors for survival without PSA-failure.

Conclusion. Independent prognostic factors of biochemical recurrence after prostatectomy were PSA, Gleason sum and pN. Joint effect of the factors allows to predict PSA-relapse with accuracy 0.720. Preoperative serum levels VEGF, VEGFR2, VEGFR3, TGF-β1 potentially are perspective markers for PSA-failure after surgical treatment prostate cancer, further trials are needed.

The prevalence of prostate cancer (PC) is steadily growing every year. In the Russian Federation, its peak morbidity is in the age group of 70 years. Some patients refuse surgery or have contraindications because of comorbidity. Teleradiotherapy in combination with or without hormone therapy is an alternative treatment. The paper analyzes the authors’ results of treating high- and very high-risk patients with PC who received hormone and radiation therapy. The study retrospectively included the data of 132 patients who had been allocated to 3 groups according to the duration of adjuvant hormone therapy. The treatment results were assessed over a 5-year follow-up period according the following parameters: a lower decreased prostate-specific antigen (PSA) score, recurrence rate, and 5-year relapse-free survival determined the by PSA level.

Objective: to evaluate the relationship between serum PSA and other variables to eliminate bone scanning (BS) in patients with biochemical recurrence (BR) after radical prostatectomy (RP) having a low probability of bone metastasis.

Material and methods. The study included 110 patients with BR after RPE between 2008 and 2012. Bone metastasis was studied for its correlation with various clinical and pathological variables in these patients.

Results. According to multivariate regression analysis the trigger PSA level, PSA doubling time and Gleason sum were independent predictors of detecting of bone metastases using scintigraphy. The frequency of bone metastases was 0 % (95% CI 0,0−14,3) in patients with PSA  5 ng/mL, PSA doubling time  6 month and Gleason sum after RP  6.

 Conclusion. For patients with trigger PSA levels of 5 ng/ml or lower, PSA doubling time 6 month or less and Gleason sum 6 or less, BS may be eliminated because of the negligible risk of bone metastases.

Prostate cancer (PC) is one of the urgent problems of modern urological oncology. The incidence of this pathology is steadily growing worldwide. Despite the fact that PSA diagnosis is extensively used and programs for the early detection of this disease are introduced, the rate of dia gnosis of advanced PC forms remains high. Furthermore, a number of aspects of therapy for this disease remain controversial so far. The 7 th Congress of the Russian Society of Urological Oncologists, which dealt with some issues of combination therapy for locally advanced PC, was held in Moscow in October 3 to 5, 2012. The paper covers a number of controversial issues in the management of patients with PC in different clinical situations.