Tumor markers for diagnosis of bladder cancer and defining the prognosis of the disease have been actively studied for past decade. FISH-study demonstrates the highest sensitivity and specificity. Abbot Company has developed a diagnostic test system «UroVision» which includes colored DNA-probes referring to 3, 7, 17 and 9p21 chromosomes. This system use provides clinicians with insights into an early diagnosis, prognosis and monitoring of efficacy of anticancer therapy.

Among 1430 patients with renal tumors who have been treated and followed up in urologic clinic of I.M. Sechenov Moscow Medical Academy from 1973 to 2006, bilateral tumors were found in 117 (8,2%) of whom in 81 (5,7%) bilateral renal cancer was diagnosed: 51 (3,6%) patients had synchronous and 30 (2,1%) — asynchronous cancers. Bilateral renal cancer is an absolute indication for renal-conserving surgery. Side of initial operation is decided individually taking into consideration clinical manifestations of disease and local tumor characteristics. In case of overt clinical manifestations the side of more extensive disease is selected for first stage surgery. Otherwise, surgical treatment should be started from kidney which is more suitable for organ-conserving surgery: the reference points are size, localization and growth direction of tumor and to lesser extent stage of disease. Analysis of morphologic structure of renal cancer revealed similar patterns of tumors on both sides in 92,5% of patients with synchronous and 85,2% with asynchronous bilateral renal cancer. The same grade of tumor differentiation of cancerous tissue of both sides was found in 72,5% patients with synchronous and 48,1% with asynchronous cancers. Among patients with asynchronous bilateral renal cancer of different grades of differentiation of their tumors, second tumors were of higher grade of malignancy in 92,9% of these patients. Molecular genetics revealed mutations of genes VHL and FHIT of 3rd pair of chromosomes in all patients with bilateral renal cancer. Our data demonstrates that bilateral renal cancer is genetically determined pathology which can manifest itself synchronously or asynchronously, quite often in considerable time interval. Overall and adjusted 5-year survival rates were 62,7% and 68,6% for patients with bilateral synchronous renal cancer and 53,3% and 60,0% for patients with asynchronous cancer.

Bilateral nephroblastoma is a rare malignant tumor which is considered to be a hereditary disease. Specific proportion of bilateral nephroblastomas is 5—10% of all renal malignant tumors in children. From 1964 t 2007, 92 children with bilateral nephroblastomas received treatment in the surgical department of thoracoabdominal oncology of Research Institute of Pediatric Oncology and Hematology of N.N. Blokhin Russian Cancer Research Center. Diagnosis was confirmed by morphologic study in all patients. Our study enrolled 83 children, because in remaining 9 patients early dissemination of disease was revealed and they died from disease progression without being treated. Depending upon strategy and tactic of the treatment all patients were subdivided into 2 groups of historic control: first group included patients treated from 1964 to 1979, and second group—from 1980 to 2007. Clinical manifestations of disease and diagnostic algorithm are analyzed. The issues of surgical tactics, pre and post-operative treatment and radiotherapy are discussed. Overall survival rate of children of 2nd group was 79,2%, which is 3 times higher than outcomes in patients who received treatment from 1964 to 1979. Disease free survival rate in patients with bilateral nephroblastoma of 2nd group was 70,2%.

Our goal was statistical assessment of the in vivo cystoscopic optical coherence tomography (OCT) ability to detect early neoplasia in human urinary bladder. We analyzed major reasons of false positive and false negative image recognition results. Optical coherence tomography was performed to image the bladder during cystoscopy. The study enrolled 114 zones with suspicion for bladder cancer. The diagnosis was established by histopathology examination of a biopsied tissue. Each biopsy site was examined by OCT. Two physicians blinded to all clinical data participated in the recognition (malignant, suspicion or benign) of the OCT images. 82% sensitivity and 85% specificity for the OCT recognition of dysplastic/malignant versus benign/reactive conditions of the bladder were demonstrated. The interobserver agreement multi-rater kappa coefficient is 0.56. Good sensitivity and specificity of the OCT method in the diagnostics of bladder neoplasia makes OCT a promising complementary cystoscopic technique for non-invasive evaluation of zones suspicious for early cancer.

Up to now radical cystectomy remains standard treatment modality for invasive transitional cell bladder cancer. Even reconstruction of bladder using other organs can not substitute patient's own organ. Data from numerous prospective single and multi-center trials which enrolled several thousands patients convincingly showed that survival after three-component combined modality treatment consisting of transurethral bladder resection, radiotherapy and chemotherapy is comparable to survival after cystectomy.

We have assessed the implication of analysis of amydolitic activity of hepsin, which is a trans-membrane serine protease of II type, in the detection of prostate cancer diagnosis. According to literature review over-expression of hepsin is characteristic for prostate cancer whereas prostatic cells do not express this protease in normal states and benign tumors of prostate. Our results have demonstrated the value of screening for hepsin activity in the diagnosis of prostatic pathologies which possibly is an adequate substitution for widely used test of prostate specific antigen determination.

Introduction and objective: the authors compared the results of biopsies performed in 1994 and 2004, respectively.

The analysis of the results of prostate biopsy obtained in 1994 and 2004 was carried out. Prostate cancer is the most common malignant tumor in males; its diagnostic algorithm and therapy were analyzed. The aim of the study was to compare data from the prostate biopsies performed in 1994 with those of 2004. During this decade, 4.5 fold increase of the number of prostate biopsies has been observed. In 1994, 36.2%, while in 2004, 47.5% of the biopsies proved to be a cancer. The mean age of the patients undergoing biopsy decreased from 69.7 to 62.3 years; however, the mean age of patients who were suffering from prostate cancer remained constant (70.8 vs. 71.3 years).

Conclusions: Whereas in 1994 only the total level of PSA was estimated, in 2004 the diagnostic algorithm included additional measurements of free-PSA and PSA-density. Prostate biopsy was performed by a trans-rectal ultrasound guided technique unlike the blind or trans-perineal methods which were only available previously. Although the effectiveness of the prostate biopsy is improved, the diagnosis and identification of prostate cancer at a younger age remains to be a challenge. The Gleason score marking the aggressiveness of the prostate cancers was lower; therefore, more patients were found suitable for curative surgery. However, the increased mean value of PSA level indicated that patients were still rather of a more advanced stage in majority, which could only be treated by palliative therapy.

Radical retropubic prostatectomy is one of the most widely used and highly effective ways of managing of patients with clinically local prostate cancer.

Purpose: The purpose of our study is to evaluate long term results of treatment of patients with clinically local and locally advanced prostate cancer and to define prognostic factors.

Materials and methods: 332 patients with prostate cancer who underwent radical retropubic prostatectomy were followed up. Mean follow up time was 53,85±30,39 months. Local prostate cancer (pT2 disease) was found in 61,0% of patients, locally advanced (pT3) and advanced (pT4) stages of disease was registered in 39,0%. Finally, in 6,0% of patients involvement of regional lymph nodes was diagnosed.

Results: overall 5 and 7-year survival rates after radical retropubic prostatectomy were 89,85±2,02 and 89,1±2,14%, respectively; adjusted survival rates were identical (94,76±1,58%); disease free survivals were 62,38±3,18 and 44,03±3,67%, respectively. Relapses of prostate adenocarcinomas clearly correlate with preoperative serum level of prostate specific antigen and such pathologic signs as tumor differentiation grade and extent of disease (р≤0,05). Correlation of long term outcomes with results of digital rectal investigation of prostate gland, positive resection lines and lymph node involvement is less evident, but nonetheless statistically significant (р≤0,05).

Conclusions: radical retropubic prostatectomy is highly effective treatment modality for patients with local prostate cancer and for selected patients with locally advanced diseases. Determining the prognostic significance of various factors provides a mean to sort out patients at increased risk of disease relapse. This subset of patient needs close follow up to timely diagnose disease recurrence and adjust therapy, therefore improving survival of patients.

Objective. Prostate cancer incidence have been increasing over past decade and was estimated to be 17,8 per 100000 male in 2005. That year prostate cancer was the third most common male malignancy in Saint-Petersburg. The instrument «LigaSure» manufactured by WalleyLab, is widely used in hepatosurgery, during cystectomies and surgical removal of huge peritoneal tumors to achieve adequate and prompt hemostasis. Thus, «LigaSure» allows reducing the duration of surgery and diminishing the volume of hemorrhage.

Material and methods. From 1999 to 2006, 118 patients underwent radical prostatectomy with bilateral pelvic lymphadenectomy in CRIRR, Saint-Petersburg. The median age of patients was 63±5,9 years (varies since 49 to 77 years). The diagnosis was confirmed by fine-needle ultrasound-guided biopsy of prostate. All patients were divided into 2 groups. The group 1 included 56 patients who underwent prostatectomy without using the «LigaSure», the group 2 consisted of 62 patients operated on with «LigaSure» use. All patients had I or II stages of prostate cancer. There were 14 patients with T1, 41 — T2a, 33 — T2b; the remaining 30 patients had T2c disease. Patients of both groups were age and stage matched. The PSA level varied from 1,1 to 20,6 ng/ml (mean value 9,8±4,8) and 1,0-17,7 ng/ml (mean value 7,8±3,3) in group 1 and 2, respectively. The prostate’s volume ranged from 10 to 95 sm³ (mean value 40,6±21,2 sm³ ) in group 1 and from 13 to 117 sm3 (mean value 40,6±21,2 sm³ ) in group 2. Since 2003 year we have been using the «LigaSure» during some stages of prostatectomy and in contrast to D.E. Crawford we applied «LigaSure» during separation prostate tissue from bladder and seminal vesicles. After that we put sutures (usually 2 — 5) on the dorsal venous complex by using Vicril 3,0.

Results. All operations were performed by single surgical team. The operation time ranged from 130 to 370 minutes (mean value 210,3±49,1) in group 1 and from 100 to 185 (135,9± 19,3) minutes (p<0,01) in group 2. The volume of hemorrhage in group 1 varied from 300 to 4700 ml (mean value: 1520±1007,8 ml), whereas in comparison group it was 200-2100 ml (1075±517,6 ml) (p<0,05). Substitutive transfusion was required in 13 patients of group 1 and 7 patients of group 2. The volume of transfusion components was 230-580 ml. Hospital stay duration was reduced from 21 days in group 1 to 15 days in group 2.

Discussion. Recently radical prostatectomies have been performed with increasing frequency. Today the number of surgeons, performing such interventions increases every year. However, every doctor knows the seriousness of different complications which can be encountered after such operations. There are various ways of increasing the surgeon’s performance to decrease the incidence of complications. The most dangerous one was perioperative loss of blood. Having accumulated the experience, surgeons try to avoid such complications. One of the ways of achieving this goal is introduction into clinical practice of modern surgical and electrosurgical facilities for securing stable and prompt hemostasis.

Conclusions. Our findings allow recommending the use of «LigaSure» in surgical management of prostate cancer.

Actual level of prostate cancer incidence taking into account the cumulative ecological risk and the quality of diagnosis in the Chelyabinsk region has been established. The authors state that available prostate cancer incidence data is misleading and significantly lower than the real occurrence of disease due to inadequate diagnosis. Besides, the data does not clearly correlate with cumulative ecological risk. The necessity to introduce screening and prophylactic programs for improving the quality of diagnosis is underlined.

Incidence of renal cancer for time period from 1989 to 2004 is analyzed. Three fold upsurge of bladder cancer incidence among whole population, in various age groups and in male and female patients are found. Component analysis showed that increased morbidity correlates with unfavorable environmental factors in which population resides.