From 1990 to 2009, at the Research Institute for OBCs were examined and treated 62 children with testicular germ cell tumors. The average age of our patients was 3.7 years (range 3 months to 15 years). All children performed a study of tumor markers titer, ultrasound. In 14 children identified metastases. Surgical treatment is the first stage in the volume orhifunikulektomii conducted all 62 children. Retroperitoneal limfoadenektomiya made in   4 children and 5 children underwent thoracotomy with removal of metastases in the lung. Drug treatment was performed in 47 children with malignant germ cell tumor. Using a combined method in the treatment of malignant testicular tumors led to 100 % relapse-free and overall survival.

 

The purpose of the study – to estimate the clinical and prognostic values of the pretreatment prostate specific antigen (PSA) doubling time (PSADT) in patients with prostate cancer.

Materials and methods. Pretreatment PSADT and follow-up information was compiled on 912 men who were treated with external beam radiation therapy (RT). PSADT   were compared with the clinical tumor category, Gleason score, PSA level at diagnosis, as well as the age and level of education of patients. The pretreatment PSADT also were compared with survival rates of patients.

Results. In the current study the correlation between the PSADT and the degree of tumor progression was shown. PSADT decreased with the increase of clinical tumor stage, Gleason score and PSA level at diagnosis. Moreover, in the study the prognostic value of PSADT was confirmed. The statistically and clinically significant associations between the PSADT and all-cause mortality in the setting of PSA failure following have been described.

 

Background. Prostate cancer (PC) is one of the most common malignant tumors in men. The total Gleason (Gleason index) scores are one of the most important prognostic factors in patients with PC. The expression of p53 and Ki-67 proteins is also considered as a prognostic factor.

Objective: to estimate the frequency with which the expression of these proteins shows up and to compare the findings with Gleason scores.

Materials and methods. This investigation studied prostatic drugs after radical prostatectomy. The Gleason scale was use to rate the grade of a tumor. The expression of Ki-67 and p53 was an immunohistochemical method. The data were statistically processed using Spearman’s cor-relation test.

Results. Based on the Gleason index, all the tumors were divided into 3 groups: 1) low grade (4–6 scores); 2) intermediate grade (7 scores); 3) high grade (8–10 scores). Group 1 included 5 (16 %) patients; Group 2 and 3 consisted of 19 (64 %) and 6 (20 %) patients, respectively. The expression of p53 and Ki-67 was observed in none of the low-grade tumor samples. There was a statistically significant relationship between higher Ki-67 proliferation and higher Gleason scores.

Conclusion. In accordance with the results of this investigation, the expression of the marker Ki-67 can be used as a prognostic factor in PC. At the same time, a possible relationship between p53 expression and prognosis in PC calls for further investigation.

 

Patients with high-risk prostate cancer (PC) make up a heterogeneous population who has a substantially varying benefit from surgical treatment. The long-term oncological results of radical prostatectomy (RPE) were studied in 446 high D’Amico-risk PC patients. Overall 5- and 10-year relapse-free survival (RFS) rates were 65 and 62 %; overall 10- and 15-year cancer-specific survival (CSS) rates were 92.6 and 82.6 %. Patients with the completely removed tumor located in the histologic specimen (HS) benefited most greatly from RPE. In the HS located and unlocated tumor groups, 5-year RFS rates were 79.6 and 32.7 %; 10-year CSS rates were equal to 100 and 78.6 %. The number of preoperative high risk factors had a significant impact on outcomes. In the 1, 2, and 3 risk factor groups, 5-year RFS rates were 76.7, 39, and 35.3 % and 10-year CSS rates were equal to 97.8, 85.4, and 64.2 %, respectively.

 

Prostate cancer (PC) is the most common cancer among elderly males in the countries of North America and Europe. The mean age of patients with PC is 72–74 years old. A decision on a treatment option for elderly patients must be based on their somatic status and desire. Today radical operations for locally advanced PC are most commonly performed in older age groups (over 70 years). This is associated with the improvement of both medical equipment and surgical techniques. The patients’ good surgery tolerability is combined with satisfactory oncological results. However, because of age, the regenerative capacities of the patients in this group are diminished and postoperative restorative processes are slower and more difficult. Quality of life was assessed in the patients aged over 70 years who had undergone radical surgery in  our clinic for PC in the past 2 years.

 

Prostate cancer (PC) is one of the most burning problems of modern urologic oncology, which is attributable to the fact that the incidence of this pathology remains high. Hormone therapy (HT) is a basic treatment in patients with metastatic PC. Intermittent HT (IHT) is an effective and safe method for hormonal exposure in PC patients, as supported by the results of many trials. IHT may be recommended in the therapy of patients with PC in different clinical situations, including in patients with distant metastases. Eligard is recognized to be an effective and safe medicament to treat this category of patients. Its injection formulation once three or six months is easy-to-use for IHT.

Androgen deprivation therapy with luteinizing hormone-releasing hormone (LHRH) antagonists versus therapy with agonists of this hormone ensures a better disease control due to the rapider and persistent suppression of testosterone levels without a flare phenomenon and requires no preventive use of antiandrogens. The third-generation LHRH antagonist degarelix shows a good tolerability and causes no systemic al-lergic reactions inherent in the earlier known drugs of this group. As indicated, the use of degarelix was characterized by the longer response of prostate-specific antigen (PSA) with a lower risk of adverse reactions, namely, serious cardiovascular and osseous complications, urinary tract infections (UTI). Thus, in males with a history of cardiovascular diseases, the risk of serious cardiovascular events or death decreased by 56% just within the first year of degarelix therapy. The findings allow degarelix to be regarded as the drug of choice for first-line hormone therapy in patients with advanced PC, particularly in males with cardiovascular disease or a high risk for UTI and osseous complications.

 

Prostate cancer (PC) is one of the most burning problems of modern urologic oncology because the incidence of this pathology remains high now. Castration-refractory PC (CRPC) is an extremely heterogeneous disease whose prognosis is largely determined by a number of factors, including the number and site of distant metastases. In the patients with CRPC, distant metastases are verified with the highest frequency in the bones, lymph nodes, and lung. Atypical metastatic involvement cases are rarely observed in patients with CRPC. The paper gives a review of literature and describes a clinical case of the atypical site of metastasis in a patient with CRPC.

 

Locally recurrent prostate cancer (PC) in the bladder neck can substantially worsen quality of life in patients and hinder further treatment when castration-resistant PC develops. The paper describes a clinical case of very high-risk PC in a 55-year-old patient in whom radical cystectomy (RCE) with removal of metastases in the bladder neck and the Bricker ileal conduit were performed for a local recurrence after radical retropubic prostatectomy (RPE). It gives the data of preoperative examination, the technical features of the primary operation RPE, the data of postoperative observation, the technical aspects and outcomes of еру surgery for a local recurrence, as well as the results of a 1.5-year follow-up after RCE.

 

Renal cell carcinoma (RCC) is a heterogeneous disease in which the patients survive for months to years. At the present time the prognostic models have no sufficient information or exact prognostic value. Cell proliferation and apoptosis play a key role in cell cycle regulation; and impairment in these processes is commonly detected in different human tumors. The investigation enrolled 76 patients (49 men, 27 women) aged 32 to 73 years (mean age 56 ± 7.6 years) diagnosed with RCC. The follow-up was 8 to 116 months (mean 36.5 months). All the patients underwent nephrectomy; antibodies against р53, Bcl-2, and Ki-67 were investigated by immunohistochemistry. The expression of p53 and none or reduced expression of Bcl-2 are poor prognostic factors and associated with the metastatic potential of a tumor and with low relapse-free survival. High Ki-67 levels are a risk factor for metastases. A combination of p53 expression and high proliferative activity reflects the aggressive potential of a tumor and suggests the high risk of metastases just at the disease diagnosis and early tumor dissemination.

 

Introduction. Recently, Abbasi A. et al. found unpaired variant lumbar vein, which opens in the retrohepatic part of IVC in 38.8 % of cases. The authors believe that variant lumbar veins are a major cause of bleeding from an isolated area of the IVC during thrombectomy.

The purpose of this study was to investigate the sources of bleeding from the lumen of the IVC during the remove of tumor thrombus. We have studied the anatomy of the posterior tributaries of IVC, including adrenal, inferior diaphragmal veins, variant lumbar veins and lumbar veins of infrarenal IVC.

Materials and methods. Material of anatomical study included 35 fresh cadavers (no more than 48 hours after the death). For to study the IVC and its tributaries following procedure was used. After removal of complex of organs the sharp and blunt dissection of back surface of the inferior vena cava was performed. Wherein we was estimated topography and size of the right adrenal, inferior right diaphragmatic veins and lumbar veins of cavorenal and infrarenal IVC segments. Special attention is given to the search of a variant lumbar veins in retrohepatic and subhepatic parts of vena cava. Thereafter we opened IVC longitudinally and estimated the mouth of its main tributaries.

Results. Variant lumbar veins were detected in 34,3 % patients. The diameter of these vessels ranged from 1 to 2 mm and averaged 1.5 mm. The distance from the top edge of the mouth of the right renal vein to the mouth of the variant veins varied from 0 to 75 mm and averaged  19.6 mm. In 66,7 % of cases the variant veins go into the subhepatic IVC, in 25.0 % drained near at the top of the mouth of the renal veins (cavorenal segment) and only 8.3 % of cases – in the retrohepatic IVC. Considering the problem of bleeding from the lumbar veins during thrombectomy, we have identified a conditional «risk zone» of the lumbar veins of the infrarenal IVC standing in the area of vascular thrombus isolation. This «risk zone» included a section of 10 mm length below the mouth of the ipsilateral renal vein. Lumbar veins drainage in the «at risk» on the right side recorded in 57.6 % patients, on the left side in 15,2 %. The average distance from the right renal vein to the right upper lumbar vein did not exceed 8.3 mm, for left veins – 7,2 mm. The average diameter for right lumbar veins reached 4.6 mm, for left veins – 4,0 mm

Conclusion. Variant lumbar veins rarely are the main sources of bleeding during thrombectomy. From our point of view, leading role played in this matter superior right lumbar vein of infrarenal segment of the IVC, which drained into the inferior vena cava beside the mouth of the renal veins. These veins have an average diameter greater than 4.0 mm and occur in 57.6 % of cases. Before the operation a surgeon must be carefully planned of all steps of vascular thrombus isolation and evaluate the anatomy of the lumbar veins with data visual diagnostic methods.

 

Objective: to assess the advisability and safety of transperitoneal laparoscopic nephrectomy for renal parenchymal tumors.

Subjects and methods. The investigation enrolled 163 patents with clinically localized renal parenchymal tumors that had been resected through laparoscopic (n = 81 (49.7 %)) and open (n = 82 (50.3 %) accesses). The groups of patients operated on via laparoscopic and laparotomic accesses were matched for demographic characteristics, somatic status, baseline renal function, and nephrometric signs of tumor nodules, except the involved side (7 patients in the laparoscopic group had bilateral renal tumors). Renal resection was carried out in all the patients; a contralateral kidney tumor was also removed in 7 patients with a bilateral lesion (nephrectomy and kidney resection were done in 3 and 4 patients, respectively). Histological examination verified benign tumors in 15 (9.2 %) cases, renal cell carcinoma in 148 (90.8 %), including all bilateral renal tumors [рТ1а (n = 135 (91.2 %) cases; рТ1b (n = 4 (2.7 %); рТ3а (n = 9 (6.1 %)]; according to the pT category, the distribution of patients in the laparoscopic and open resection groups was even (p = 0.586). No additional treatment was performed in any case. The median follow-up was 48.2 ± 11.8 months.

Results. The use of the laparoscopic access significantly increased the frequency of intraoperative complications (6.1 and 16.0 %; p = 0.037), but failed to affect that of postoperative complications (13.0 and 18.3 %, respectively; p = 0.291) versus the open access. Laparoscopic versus conventional techniques did not cause any reduction in 5-year overall, specific, and relapse-free survival rates (93.3, 100.0, 80.0 % and 97.1, 100.0, 98.5 %, respectively; р > 0.05 for all). The rate of acute renal dysfunction and its distribution by the RIFLE classes, the rate and level of a decrease in glomerular filtration rate in the late postoperative period did not depend on the surgical access (p > 0.05) for all). Questioning has shown that the laparoscopic versus laparotomic access significantly improves quality of life within one month after renal resection.

Conclusion. Transperitoneal laparoscopic nephrectomy is a safe alternative to open surgery, which can improve quality of life in the patients with clinically localized kidney tumors within one month after surgical intervention.

The data of medical records of 101 patients with urothelial bladder cancer (BC) were compared with the results of laboratory detection of human papillomaviruses (HPV) in the tumor tissue samples taken from these patients during transurethral resection. DNA of HPV 16, the major type of the virus responsible for the occurrence of cervical cancer, was previously detected in 38 samples; and oncogenes E6 and E7 mRNA and HPV 16 E7 oncoprotein were found in 13 of these samples. Comparison of HPV-positive and HPV-negative groups revealed that HPV-positive BC showed higher cell anaplasia than HPV-negative one; moreover, primary cancer was HPV-positive more frequently than recurrent cancer. Sex, age, muscular layer invasion did not correlate with the HPV positivity of BC.

 

Analyzed the surgical treatment of 154 patients with locally advanced pelvic tumors that required resection of the bladder or its complete removal. 67 (43.5 %) patients had colorectal cancer. In 53 (34.4 %) cases of cervical cancer in 21 (13.7 %) – ovarian cancer, 8 (5.2 %) – uterine cancer, in 5 (3.2 %) – a cancer of the vagina. In 41 (26.6 %) patients operation was accompanied by resection of the bladder, 113 (73.4 %) cases, the volume of surgery was pelvic exenteration.

Proposed surgical classification of locally advanced pelvic tumors and secondary destruction of the bladder with locally advanced tumors. Describes the criteria of choosing the optimal amount of intervention at different propagation of the tumor and the degree of involvement of the bladder. The perspective of large interventions to improve the results of treatment of patients with tumors of the pelvic localization.