Case histories of 91 patients with synchronous urinary tract polyneoplasias were analyzed. There were a total of 183 polyneoplasias, of them 116 and 67 neoplasms were located within and outside the urogenital system, respectively.

During a synchronous polyneoplastic process, urogenital tumors coincide in 26.4±4.6% of the patients. The kidney is most commonly involved (37.9±4.5%), the urinary bladder (33.6±4.4%) and prostate (19.8±3.7%) are less frequently. Synchronous tumors are located more frequently in the digestive system (49.3±6.1%), less frequently in the lung (16.4±4.5%) and skin (14.9±4.4%).

It is difficult to diagnose synchronous urinary tract polyneoplasias due to the fact that the second tumor is asymptomatic. As the result, the second tumor is missed in 28.9±4.5% of the patients on examination. Ultrasound study and endoscopy are the most informative diagnostic techniques.

Treatment of complications due to both early and end-stage urological cancers and those resulting from chemo- or radiotherapy is currently a topical problem.

Anemia in cancer patients is a complex syndrome that is caused by the disease and may be treatment induced with the blood level of hemoglobin being below the normal physiological range (< 12 g/dl).

A great number of causes of anemia are known in urologic cancer patients. These include chemotherapy for disseminated cancer of the testicle, urinary bladder, and prostate; radiotherapy for prostate cancer; concomitant chronic renal failure in renal cancer; metastatic bone marrow involvement in prostate, renal and urinary bladder cancers; hemorrhages in bladder tumors; profuse bleedings from the bladder and rectum in radiation-induced cystitis and rectitis. A reduction in the level of hemoglobin below the normal physiological range affects not only prognosis and quality of life, but also the course of the disease and the efficiency of specific treatment. Detection of anemia in urological cancer patients and its treatment are required to improve the quality of life and the indices of specific treatment.

In a malignant process, anemia is generally chronic and frequent blood transfusions substantially increase the risk for adverse reactions (transmission of viral infections, allergic and immunological reactions). The use of recombinant human erythropoietin is an alternative approach that has been recently widely used to correct and prevent anemia in cancer patients.

In the past 10 years, numerous prospective and retrospective studies dealing with the treatment of cancer-induced and postcytostatic anemia in patients with solid tumors and lymphoproliferative diseases. They have demonstrated the efficacy of erythropoietin alpha (Eprex®) that considerably increases blood hemoglobin levels and improves life quality indices.

Objective: The immediate and long-term results of nephron-sparing treatment for renal-cell carcinoma (RCC) were retrospectively assessed. The impact of several prognostic factors on treatment results was analyzed.

Material and Methods: All cases of partial nephrectomy in RCC performed at the N.N. Alexandrov Research Institute of Oncology and Medical Radiology in 1993 and 2005 were collected. The data on the patients' deaths were selected from the Byelorussian cancer register. Mono- and multivariant analyses were made by using the Kaplan-Meier method and the Cox proportional hazard model.

Results: A total of 298 operations were performed in 292 patients, 271 being in RCC. Complications developed in 5.5% of the patients. The follow-up averaged 30.0±28.2 months. A local relapse was diagnosed in 4 (1.5%) patients. Five- and 10-year crude survival rate was 87.2%. The results of partial nephrectomy in pT3a tumors more than 4 cm were found significantly worse than those in pT1-2 and pT3a 4 cm or less (p = 0.03). The Cox proportional hazard model revealed the significance of pT, size and grade combination (p = 0.03). Three groups of patients were formed by the significantly different 10-year survival rates.

Conclusion: Partial nephrectomy is a safe and effective treatment for localized RCC. Elective operation can be performed in patients with T3a RCC 4 cm or less. It is possible to divide patients into 3 prognostic groups with different survival rates in relation to the treatment results in pT, tumour size and grade.

Multiple antitumor therapy in patients with locally advanced renal cancer leads to a 2.3-fold reduction in the incidence of recurrences during 2 years, as compared to a control group and to a 1.7-fold increase in 5-year survival rates.

Magnetotherapy used as part of multimodality treatment for locally advanced renal cancer can lower the incidence of postoperative complications by 1.9 times and the frequency of side effects during teleradiotherapy by 1.4 times.

Recombinant tumor necrosis factor- α activates cellular immunity, as reflected in the immune status as increases in the absolute count of T lymphocytes and their active forms by 44.9 and 33.71%, respectively.

In patients with Bcl-2+/Ki-67⁺ (24%), had the lowest relapse-free survival rates (median 16 months; 95% CI 8—24 months) whereas those (58%) with Bcl-2-/p53⁺ had the highest ones (median not being achieved). The phenotype Bcl-2⁺/Ki-67⁺ characterizes a more aggressive course of renal cancer and has a poor prognosis.

In experimental systems, interference with coagulation can affect tumor biology. Tumor-mediated activation of the hemostatic system has been implicated in both the formation of tumor stroma and the promotion of hematogenous metastasis. We emphasize that hypercoagulation is a frequent symptom in metastatic renal cell carcinoma (MRCC) patients and clinically correlates with progression of the disease. It has been suggested that hypercoagulation is a possible negative predictor for a response to immunotherapy in MRCC patients.

Neoadjuvant chemotherapy (CT) with cisplatin administered intraosseously into the pubic bone in patients with invasive bladder carcinoma (Т2—4N0M0) was most effective in patients with circular involvement of the bladder neck, even in large tumors of 5—7 cm. Out of 4 patients with this site of a tumor, full regression without further treatment was achieved in one patient, transurethral resection was performed in 3 patients with 75% tumor regression. In multiple bladder tumor lesions involving the bladder neck, the degree of regression was not greater than 40%. The therapeutic efficiency of intraosseous CT with cisplatin was 54% with acceptable toxicity.

The authors conducted an immunohistochemical study with antibodies to Her-2/neu and tenascin in urothelial bladder carcinoma. The samples taken from 32 patients with stages Т2b/T3a, N0 and N+ urinary bladder carcinoma were studied. The tumor cells showed hyper-expression of the oncoprotein Her-2/neu in 6 out of 13 patients with metastases to the regional lymph nodes (T3b и T3a) and in 2 out of 7 tumors (Т3а) without lymph node involvement. Quantitative assessment of the reaction with tenascin antibodies revealed that in the metastatic lymph node involvement group, the staining area was much larger than that in metastasis-free group and it averaged 49.83 and 44.21% and 11.27 and 15.7%, respectively. Comparison analysis of Her-2/neu and tenascin expression revealed no clinically significant regularities. The study of the intercellular matrix showed a high correlation between the increase in the share of tenascin-expressing and/or containing structures and the rise in the metastatic activity of a tumor.

Objective: Comparative evaluation of the efficiency of palliative courses of external beam radiation therapy in patients with bladder cancer (BC).

Materials and Method: In 1990-2005, 26 patients with BC received a palliative course of external beam radiation therapy (EBRT) using two regimens: 1) conventional fractionation Group 1 (n=13); 2) accelerated dynamic fractionation Group 2 (n=13).

Results: The immediate efficiency of EBRT was determined at moment of a rapid relief of local symptoms of disease (hematuria, pain, dysuria). A clinically significant response was achieved in 5 (38.5%) patients in Group 1, in 11 (84.6%) patients in Group 2 (p < 0.01). Twelve months after the completion of therapy, disease progression was noted in 8 (61.5%) patients in Group 1, and in 4 (30.8%) patients in Group 2 (p < 0.1). The median survival was 25.7 months in Group 1, and 28.1 months in Group 2. The palliative course of EBRT using the nontraditional technique caused no increase in the rate and severity of radiation reactions and complications.

Conclusion: Accelerated dynamic fractionation was found to reduce therapy time and to improve the results of treatment and life quality in incurable patients with BC. The trial is underway to make further studies of this issue.

Objective: to evaluate the efficiency of various therapeutic modalities in patients with Stages III, IV prostate cancer (PC) concurrent with local hyperthermia (LH).

Materials and methods. The results of treatment were analyzed in 895 PC patients; out of them 743 had Stages III (49.9%) and IV (33.1%). The following treatments were performed: radiation, hormonal, hormonoradiation, and hormonoradiation treatment with thermoradiomodification. Therapeutic efficiency was evaluated by the cumulative cancer-specific survival rates.

Results. In the patients with Stage III PC receiving multimodality treatment, 5-year survival was 66.1%. In the group of patients where thermoradiomodification was added the survival reached 76.7%. Patients treated with radiotherapy and hormonotherapy had a survival rate of 60.4 and 55.2%, respectively. By year 10 of a follow-up, the survival rates were 47.9% in the hormonotherapy group and 42.5% in the hormonoradiotherapy group. In patients with locally advanced Stage IV PC, 5-year survival was 68.5, 66.4, and 52.9% after hormonoradiation therapy, radiotherapy, and hormonotherapy, respectively. The patients receiving treatment with thermoradiomodification fail to survive up to 5 years. 10-year cancer-specific survival following hormonoradiotherapy and hormonotherapy was 27.1 and 13.2%, respectively. In the patients with metastatic PC who had hormonotherapy, radiotherapy, complex treatment without and with thermoradiomodification, 5-year survival was 51.0, 45.3, 35.6, and 0%, respectively. As high as 7.7% of the patients, who have received hormonal therapy, survived up to 10 years.

Conclusion. Multimodality treatment is most effective in the management of Stages III and IV PC. Thermoradiomodification significantly improves the results of treatment for Stage III, but it should not be applied to patients with Stage IV. Radiotherapy is more effective in the first years of life, but further its efficiency becomes less. Hormonotherapy is most beneficial in disseminated cancer.

Docetaxel is the most effective chemical agent used in the treatment of hormone-resistant prostate cancer (HRPC). Three different docetaxel-based combinations were tested. The study included 30 patients with HRPC: 10 patients received chemotherapy as intravenous docetaxel, 75 mg/m² once every 21 days with prednisolone, 10 mg/day (DP); other 10 patients had docetaxel, 75 mg/m², estramustin, 300 mg/m² daily, and prednisolone, 10 mg daily (DEP); 10 more patients received a combination of doxorubicin, 20 mg/m² on day 1 of weeks 1, 3, and 5, ketoconazole, 1200 mg/day on days 1—7 of weeks 1, 3, and 5, docetaxel, 20 mg/m² on day 1 of weeks 2, 4, and 6, estramustin, 420 mg/day on days 1—7 of weeks 2, 4, and 6, prednisolone, 10 mg daily (DEKP). The study revealed that all these three combinations have about the same efficacy; with their use, the clinical improvement rate was 70—80%. Thus, the use of docetaxel in different combinations is an effective treatment for HRPC.

Objective: To study the clinical capacities of the radiopharmaceutical samarium oxabifore (¹⁵³Sm) in palliative therapy in prostate cancer patients with bone metastases and pain syndrome.

Subjects and methods: 53 patients with prostate cancer and multiple bone metastases and pain syndrome in whom ¹⁵³SM was intravenously injected once (n = 34), twice (n = 14), thrice (n = 5). The activities were used in the range of 1.0 to 1.5 mKu/kg body weight.

Results: The disposition of the radiopharmaceutical and its accumulation in the involved osseous tissue foci were studied. The agent was shown to be highly effective in palliative therapy for prostate cancer. There was a reduction in the intensity of patients in 40 (75.4%) patients for 3 months or more. Life quality improved (after the Karnovsky method). The side effects of radionuclide therapy were evaluated.

The RTOG 85-31 study has indicated that adjuvant hormonotherapy is particularly effective in prostate cancer (PC) patients with a high Glisson score. Long-term adjuvant hormonotherapy is not warranted in patients with a total Glisson score of 2-6. Exception is patients with disseminated locally advanced tumors, in whom neoadjuvant androgenic suppression (RTOG 86-10 protocol) considerably improves the results of treatment. Long-term adjuvant hormonotherapy may be the method of choice in treating PC patients with a poor prognosis.

Human interleukin-6 (IL-6) is of considerable importance in the pathogenesis of prostate cancer (PC). Prostatic cells are also known to be a reservoir for human herpesvirus 8 type (HHV-8). Due to the findings that HHV-8 had a homologue of human IL-6, viral IL-6, it seemed interesting to study the expression of these two cytokines in the tumor tissue of patients with PC. The expression of IL-6 mRNA was found in 70% of the patients. That of viral IL-6 was not detected in this disease. Nevertheless, a genetic HHV-8 material was ascertained in the tumor tissue of 2 patients with PC.