Purpose: to evaluate results of treatment of local recurrences of renal cell carcinoma (RCC).
Material and methods: a retrospective analysis of 119 consecutive patients with local recurrence of RCC after nephrectomy treated from 1975 to 2007 at Cancer Research Center was performed. Mean age of the patients was 52.2 (19—75) years. A male to female ratio was 1.3:1. Local recurrences were localized in the renal fossa in 49 (41.2%), in retroperitoneal lymph nodes - in 46 (38.7%), in both renal fossa and retroperitoneal lymph nodes — in 24 (20.1%) cases. The tumor invaded neighboring organs in 59 (49.6%) of 119 patients. Metastases in the postoperative scar were diagnosed in 27 (22.7%), distant secondaries — in 38 (31.9%) cases. Surgery was performed in 78 (65.5%) cases (complete — 60 (76.9%), incomplete — 13 (16.7%), exploratory — 5 (6.4%)), 41 (34.5%) patients received conservative treatment. Neoadjuvant and/or adjuvant immunotherapy and/or chemotherapy were used in 14 (17.9%) of 78 patients treated with surgery. Of 41 (34.5%) patients receiving conservative treatment immunotherapy was administered in 25 (61.0%), chemotherapy — in 1 (2.4%), immunochemotherapy - in 11 (26.8%), hormonotherapy — in 4 (9.8%) (tamoxifen). Median follow-up was 23.3 (1—126) months.
Results: Local recurrences were diagnosed a median of 33.0 (1-151) months after nephrectomy. Progression was registered in 33 (55.0%) of 60 patients following a complete removal of the relapse a median of 23.7 months after surgery (local — 10, distant metastases — 13, both local and distant metastases — 10). Four (12.1%) patients underwent repeat removal of the recurrent tumors, 29 (87.8%) received conservative treatment with no response. One-, 3- and 5 -year disease-specific survival of 119 patients was 72.6%, 41.4% and 30.5% respectively (median — 25.7±5.9 months). In the univariate analysis survival was affected by complete removal of the relapse (p=0.001), number of recurrent nodes (p=0.006), distant metastases (p=0.013) and presence of clinical symptoms (p=0.004). In the multivariate analysis the only factors affected survival significantly were radical surgery (p 0.005) and clinical symptoms of the relapse (p 0.024).
Conclusion: Surgery is the only effective method of treatment in isolated recurrence of RCC following nephrectomy.

The research purpose was a study of the quantitative indices of the vascularization of different histological variants of renal cell carcinoma by multislice computed tomography (MSCT).
Materials and methods. MSCT data of 46 patients (20 women, 26 men at the age of 48—64 years) with different variants of the renal cell carcinoma (RCC) over a period of 2003—2006 were analysed retrospectively. Depending on the RCC histologic type the patients were divided into 2 groups. Patients with clear cell variant of RCC were included in the first group (n=31), the patients with other histological types of RCC formed the second one (n=15). A comparison of the quantitative indices of the vascularization of tumors in the chosen groups of patients on the basis of estimation of contrasting medication accumulation in the arterial and parenchymatous phases of MSCT was made. To investigate a degree of accumulation of the contrasting medication in the tumor («gain constant» — GC) a method of the standardized measuring of the contrasting medication accumulation was used. (A J. Ruppert-Kohlmayr et al, 2004).
Results. In the first group of patients the GC averaged 4,8 (2,1—13,1) in the arterial phase of the study whereas in the second group of patients the given index amounted 2,4 (1,0—2,8). In the parenchymatous phase of CT-study the mean «gain constants» for the first and second groups mounted, accordingly 3,0 and 2,2. Under the statistic analysis of the obtained data, the reliable differences between the chosen groups of patients according to the values of the «gain constant» in 2 phases of CT-study were revealed.
Conclusion. The use of the method of quantitative measuring of the contrasting medication accumulation in the kidney tumors when realizing CT-examination allows avoiding errors in determination of the densitometric indices of the tumor node caused by an incorrect choice of the time administration of the contrasting medication and by individual features of the patient. «Gain constant» may be used as a criterion of the differential diagnosis between clear cell variant of RCC and other histological variants of kidney cancer.

Background: Treatment of localized and locally advanced renal cancer is still of current importance.
Subjects and methods: 100 cases of pT2, pT3a renal cell carcinoma were compared in 2 groups according to the treatment strategy: 1) patients who had received complex treatment (renal artery embolization and surgical treatment) (a study group) and 2) those who had been surgically treated (a control group). The criterion for efficiency was the median duration of relapse- free survival.
Results: the median duration of relapse-free survival was 37 months in study group patients with pT2 disease and 39.5 months in the control group. The relapse-free survival varies greatly: 30.5 months in patients with pT3a in the study group and 16.5 months in the control group.
Conclusion: The findings have led to the conclusion that it is necessary to make preoperative renal artery embolization in the complex treatment of patients with pT3a renal cell carcinoma.

Renal cell carcinoma belongs to a category of chemoresistant tumors. An overall life span of the patients with the disseminated form of disease amounts 10—12 months. Molecular biology development has brought to appearance of the novel kind of systemic treatment — «target» therapy. Use of the given group drugs allows improving the efficacy of the treatment of disseminated renal cancer. According to the guidelines of the European association of urology (EAU), sunitinib is approved as the first line therapy in patients with the favorable and doubtful prognosis.

Objective. Radical cystectomy is the gold standart in the treatment of muscle invasive bladder cancer. We report our initial experience with laparoscopic cystectomy with low-invasive laparotomy and formation of the neobladder by Studer. Results were compared with traditional cystectomy.
Materials and Methods. Since 2003 five patients (1) underwent a laparoscopic cystectomy at our hospital. All patients were male (with a mean age of 57(51—67) and had T2N0M0 stage bladder cancer (G1-2). The procedure consists of two parts: 1 — laparoscopic mobilization of the bladder, ureters, prostate glang and vesicles; 2 — low invasive laparotomy (length 4—5 cm) with special tools and illumination, extraction of the bladder and formation of the neobladder by Studer. Traditional cystectomy (2) with orthotopic neobladder has been applied to 49 patients. There were 45 males and 4 females. Mean age was 62,7 (39—74).
Results. In the first group (1) the mean time of procedure was 505 (430—570) min. Blood loss was between 150—300 ml. There were not serious postoperative complications. Function of intestines was restored in 4 days. The ureteral drainages were removed on 14 day, urethral catheters — on 16 postoperative day. Urodynamic studies after procedure revealed Q max — 18,4 (17—19) ml/sec. In the second group (2) the mean time of procedure was 306 (246—350) min. Blood loss was between 615 (300—1200) ml. Function of intestines was restored in 7 days.
Conclusions. Our initial results indicate, that a laparoscopic cystectomy is an effective surgical method, which is less invasive and deleterious in comparison with open cystectomy.

An immunohistochemical research with antibodies to the mutant p53 protein and a revelation of the human papilloma virus DNA 16 and 18 types via in situ hybridization at the histological sections of the urothelial carcinoma are realized. The material of 44 patients with the superficial bladder cancer (Ta and T1 stages) and with a presence of the indirect signs of the viral infection was studied. 16 patients were included in the group of high risk recurrence, 13 patients were included in the group of the mean risk, 15 patients were included in the group of the low risk. HPV DNA was revealed in 12 of 44 cases only in patients of the mean and high risk groups (5 and 7 cases, respectively); all the positive results in the high risk group were with the HPV 16 type probe. Evaluation of the p53 protein showed a significant increase of its expression in the mean and high risk groups. p53 protein expression mean value was 23,67% in the low risk group, 36,53% in the mean risk group, 53,43% in the high risk group. Presence of HPV DNA was associated with the high p53 expression in the vast majority of cases.

The results of measurings of the local radiation doses of the most irradiated staff bodies regions - operator finger and palm skin, as well as breast region are given. The measurings are carried out via a method of thermoluminescent dosimetry with the use of highly sensitive detectors TLD-500K (Al2O3:C). It is ascertained that even in the biggest total activity of the sources (1221 MBq) and the largest duration of work of the staff with them without using X-ray shielding gauntlets, an absorbed dose (minus dose of the natural background radiation and taking into account an energy dependence of the detector sensitivity) equals 0,18±0,01 mGray (right hand thumb — the highest radiation level) and 0,01±0,0004 mGray (external surface of the left arm palm - the lowest radiation level) that doesn't pose radiohazard even in repeated working with sources (according to radiation standards 99). The normalized values of the absorbed doses (per unit time of the operator work and the sources activity unit) are represented, that allows using the obtained data for the other operating conditions of operator.

The long-term outcomes of treatment of 117 patients with prostate cancer revealed during adenomectomy were studied. Histological analysis of the adenomatous tissue showed that patients had stage T1a-bNoM0 in 62(52,9%), T2N0M0 in 33(28,2%), T3N0-1M0 in 22(18,8%) cases. G1 adenocarcinoma was identified in 85(72,6%) patients, G2 and G3 adenocarcinoma - in 32(27,4%) patients. Three methods of treatment were used: hormonal therapy, active surveillance and hormonal therapy with radiotherapy. Our results indicate that significant prognostic factors in incidental prostate carcinoma are: age, pT stage , histological grade as well as adjuvant xR- therapy.

Purpose: To assess the effectiveness and safety of testosterone replacement therapy (TRT) in a cohort of hypogonadal patients treated withradical retropubic prostatectomy (RRP) for localized prostate cancer.
Materials and Methods: the results of treatment of sixteen patients that underwent RRP for organ confined prostate cancer from 2001 to 2005 are analyzed. Before and after realization of TRT the content of the total testosterone in the blood serum, level of prostate specific antigen (PSA) in blood as well as intensity of the symptomatology according to the Aging Male Symptoms (AMS) Scale.
Results: At a mean duration of TRT for 15 months the TT raised from 6.5±1.98 nmol/l to 19.2±5.1 nmol/l (р < 0.01), the AMS score decreased from 40.4±5.4 to 20.8±3.8. No biochemical or clinical evidence of prostate cancer was found in any of the patients.
Conclusions: Based on the clinical experience with this group of 16 patients and the data of the literature, we conclude that highly selected hypogonadal patients surgically cured of prostate cancer can be treated with TRT safely with beneficial results, although to formulate the clinical guidelines on TRT use in patients surgically cured of prostate cancer, the large prospective multicenter studies with a big amount of patients are essential.

Objective. Monotherapy with nonsteroid antiandrogens may be used in a number of patients with advanced prostate cancer (PC). We present the results of analysis of survival and safety of treatment in patients with nonmetastatic (M0) locally advanced PC treated with bicalutamide, 150 mg, or castrated in two studies.
Materials and methods: These were pooled data of two open-labeled multicenter studies of the identical design. The patients with PC (T3— 4) were randomized to treatment with bicalutamide, 150 mg/day or castration (bilateral orchiectomy or goserelin acetate, 3.6 mg, once every 28 days) in a ratio of 2:1.
Results: 480 patients with locally advanced PC were randomized. During a median follow-up of 6.3 years, mortality was 56%. There were significant differences in overall survival (relative risk 1.05; the upper 95% CI 1.31; p=0.70) and in interval before progression (1.20; 1.45; p=0.11) between both groups. Bicalutamide therapy was ascertained to have an advantage in two life quality indices: sexual function (p=0.029) and physical capacities (p=0.046). The most common adverse reactions were hot flushes in the castration group and breast pain and gynecomastia in the bicalutamide group. The frequency of other side effects of the therapy was low. Bicalutamide was well tolerated. The drug used during the study had to be discontinued due to adverse reactions only in several cases. There were no new problems associated with the safety of bicalutamide therapy during a long-term follow-up.
Conclusion: Monotherapy with bicalutamide in a dose of 150 mg is an attractive alternative to castration in patients with locally advanced PC in whom hormonal treatment is indicated.

Comparative analysis of morbidity of prostate cancer, kidney cancer, bladder cancer in Russia and Omsk region for period since 1998 up to 2005 showed, that prostate adenocarcinoma is dominating among all urological cancers. Morbidity increase of prostate cancer for this period amounted to 103,6%. Kidney cancer took a second place (16%). Morbidity of bladder cancer reduced and (-6,2%) — negative dynamics was revealed. As a whole year-on-year increase of morbidity of cancer in Omsk region constituted 2,5%.