Vol 7, No 1 (2011)

During the study, the authors assessed changes in the blood coagulation system and made a spectral analysis of serum and prostate tissue. They revealed immunological changes suggesting occult disseminated intravascular coagulation, an evolving systemic inflammatory response and the latter caused by endothelial damage, microcirculatory disorders, lipid peroxidation, and release of inflammatory factors. The findings permit a tactic for medical prevention of complications to be elaborated.

Fluorescence in situ hybridization (FISH) assay was used to detect tumor cells in the urine sediment of patients diagnosed as having urinary bladder cancer (UBC). For this, the investigators applied a fluorescence DNA probe kit (UroVysion) that could reveal the cytogenetic abnormalities characteristic for UBC, such as hyperploidy for chromosomes 3, 7, and 17 and deletion of the 9p21 locus, in the cast-off cells. Twenty-eight patients with the primary diagnosis of UBC, 12 with its suspected recurrence, 3 subjects without UBC were examined. The findings were compared with cystoscopic data after urine samples were taken. The sensitivity of the UroVysion test totaled 78.5 ± 9.7 % for all stages of primary cancer (pT1-pT4), 87.5 ± 11.6 % for its early stage (рТ1), and 100 % for UBC recurrences. Hyperploidy was a predominant type of cytogenetic abnormalities in the cast-off tumor cells. Among the abnormal cells, the types of hyperploidy (tri-, tetrasomy) were most common for chromosome 3 and less for chromosome 7. Thus, the UroVysion test is a noninvasive highly sensitive tool that may be used in clinical practice to improve the diagnosis of UBC, to detect recurrences, and to monitor the efficiency of treatment.

The paper gives the results of percutaneous electroresection of the renal pelvic wall with a tumor in 4 patients. The operation has been made for absolute indications: 3 patients had a single kidney and the fourth patient had a single functioning left kidney (the right pelvic dystopic kidney failed to function). In all the patients, the primary symptom of the disease was macrohematuria, the examination for which revealed a renal pelvic tumor measuring 1.2 to 2.5 cm in size. There were no complications after percutaneous electroresection of the renal pelvic wall with a tumor. Intrarenal BCG therapy was performed in the postoperative period. Percutaneous electroresection is indicated for tumors of the renal pelvis and the upper third of the ureter of the single kidney.

Data on 435 patients with pT1N0M0 renal cancer (RC) and grade (G)2-4 and pT1–4N0–2M0 RC and G1–4 were retrospectively analyzed. A control group (n = 212) underwent nephrectomy only; in a study group (n = 223), 5-fluorouracil 500 mg/m2 and leucovorin 200 mg/m2 were injected at a 5-hour interval before treatment and once a week at the stages of adjuvant gamma-teletherapy (GTT) with 1.2 Gy + 1.2 Gy to the bed of RC and to the area of lymph nodes. In the study group, five-year survival rates for pT1N0M cancer and G2–4 were 76.5 ± 5.4 % with a median of 58.2 ± 4.7 months; in the control group, these were 57.1 ± 6.6 % and 47.8 ± 2.4 months, respectively (p < 0.05). In pT1–4N0–2M0 and G1–4, without affecting the frequency of distant metastases, adjuvant chemoradiotherapy increased the survival in the first 2 follow-up years by 16 % (p < 0.05).

Chemotherapy with docetaxel (Taxotere) used alone or in combination with other agents is today the standard of treatment for metastatic hormone refractory prostate cancer (HRPC). Nevertheless, there remain many unsolved problems associated with its use. A search for drugs, their combinations, and new therapy regimens for patients with HRPC is being continued to improve the results of treatment.

By evaluating abnormal metabolism, magnetic resonance spectroscopy (MRS) is a highly effective tool for diagnosing prostate cancer (PC). Our study has indicated that the level of citrate (Ci) and the ratio of the content of choline (Cho) and creatine (Cr) to that of citrate ((Cho + Cr)/Ci) are the most sensitive and specific indicators. These may be effectively used separately (to diagnose tumor involvement and to determine the degree of tumor differentiation) and as a part of the authors’ discriminant model.

The findings suggest that it is expedient to use MRS in the comprehensive diagnosis of PC.

The analysis of the performed study has established that zoledronic acid is an effective agent in multimodality therapy for locally advanced prostate cancer (PC) and allows long-term stabilization of bone tissue. In addition, there is evidence for the efficacy of zoledronic acid in preventing bone metastases (BM) and increasing the time to the first BM. The currently accumulated experience with zoledronic acid used in PC permits one to consider its use as standard concomitant therapy.

The paper presents a clinical observation of patient K. who has undergone single left kidney re-resection 5 years after extracorporeal resection for renal cancer recurrence. Active surgical policy as re-resection of the autografted kidney has been found to be sound and to yield satisfactory functional results.

Overall survival is about 100 % in patients with stage I testicular germ cell tumors after orchofuniculectomy, which is achieved, by applying alternative adjuvant approaches. Methods, such as a follow-up, chemotherapy or retroperitoneal lymphadenectomy, may be used to treat nonseminomatous germ cell tumors. The paper shows the main advantages and disadvantages of the above treatment options.