In patients with a renal tumor, the non-oncologic diseases of the contrary organ occur in 17,7% of observations. Among them are: concrements – 5,3%, cysts – in 9,7%, hydronephrosis – in 1,6%, renal artery stenosis – in 1,1% of observations. In patients with a renal tumor and the nononcologic disease of the contrary counterpart, the one first of all should determine a sequence of the therapeutic actions, whereupon the one should solve a question on the type of surgery on the kidney affected by tumor. In all the cases, the one executes surgery on the neoplasm after ensuring an adequate urine outflow from the contrary side. The indications for the organ-sparing surgery on the tumor are the dynamic state of the contrary kidney and the degree of manifestation of the chronic renal failure: in latent state – relative, in intermittent – absolute. 5-year general survival in patients with renal tumor and non-oncologic disease of the contrary organ amounted 76,3%, corrected – 83,3%.

The problem of forecasting of a kidney cancer and a choice of a method of adjuvant treatment the advanced forms of this disease remains actual. In the given research the estimation of prognostic importance of apoptotic and proliferative markers in 66 patients with local advanсed and metastatic renal cell carcinoma has been led. Results of the work allow to conclude that the estimation of expression of these markers allows to allocate groups of patients of the high risk requiring careful supervision and treatment.

Great attention paid to renal cell carcinoma (RCC) is due to increase in its prevalence. This paper is devoted to comparison of classic clinical and pathological prognostic factors and expression character of proliferation marker Ki-67 in this cancer. Proliferative activity was analyzed in 101 cases of RCC by immunohistochemical assays using antibodies to the Ki-67. High index Ki-67 was diagnosed more often in an aggressive variants RCC and Fuhrman grade 3–4 tumors. Besides, RCC with high proliferative activity had significantly lower time of appearance of distant metastases and poor survival in coparison with RCC with low proliferative activity.

Research purpose: investigation of the features of the ultrasonography and computed tomography (CT) image of the uncharacteristic renal angiomyolipomata (AML) and the analysis of the diagnostic efficacy of these radiologic means.
Materials and methods: the data of the radiologic checkup of 12 patients with verified AML were investigated. For all the patients, multihelical computed tomography (MHCT) and ultrasonography (US) including perioperative in 5 observations were performed. A comparative evaluation of the opportunities of the given radiomethods in diagnosing atypical AML is executed.
Results: when in preoperative observation, CT image of tumor of the all patients was not characteristic of AML. All the tumors were solid, roundish formations, mainly extrarenal, with a density conforming to soft tissues, and in the native phase of the study didn't practically differ from unaffected renal parenchyma. In intravenous contrast enhancement, the uneven accumulation of the contrast medium occurred, at that their heterogeneity became more apparent. Thus, according to CT data all the patients were diagnosed with renal cancer. At that, the US image of the 11 patients was typical of AML. According to histology of the operational material, a change in ratio of the structural components of the AML, favoring significant predominance of the smooth muscle component, was revealed in all the tumors.
Conclusions: If the smooth muscle component predominated in the structure of the renal AML, the atypical CT image may be a cause of diagnostic errors, specifically, renal cancer hyperdiagnostics. In these cases especially when planning organ-sparing surgeries, the one should consider that sonographic signs of the majority of such tumors remain characteristic of AML.

Purpose. Investigate prognostic solemnity of the clinical and laboratory values of the II stage bladder cancer patients and develop a nomogram allowing to predict a clinical outcome of this patient category.
Materials and methods. Data of 299 BC patients, being treated in oncology center named after N.N. Aleksandrov since 1995 to 2002 were analysed retrospectively. The patients with transitional cell BC T2N0M0 (UICC classification 2002) treated according to a radical program with the use of organ-sparing or organ-removal method were included in the study. The organ-sparing treatment was undergone by approximately 250 patients (83,6%), cystectomy — 49 (16,4%). Observation period median amounted 62 months. Risk ratio (HR) and confidence interval (CI) were calculated. The calculations were performed by program complex STATISTICA 6.0. The obtained values of the risk ratio were used to develop a nomogram.
Results. Main 5-year probability of survival of the II stage bladder cancer patients included in the study mounted 70,9 ± 2,8%. On basis of ratios obtained by multiple classification using multivariate regression model of the proportional risks of Kox, a nomogram of the prediction of the treatment results of the II stage bladder cancer patients was developed. A classification scale in what integer values in scores were awarded to gradations of the prognostic factors, is made. According to the given nomogram, a criterion can possess the value from 0 to 19 scores. The investigated body of 299 patients are distributed to 2 classes with the statistically significant discriminating long-term results of the treatment. 88 (29,4%) patients with the general 5-year probability of survival are attributed to unfavorable class, 211 (70,6%) patients with the probability of survival 82,1±2,8% — to the favorable counterpart.

Malignant neoplasias are one of the most complicated medical and social problems. According to WHO data, about 3% of the all malignant neoplasias are comprised of bladder cancer (BC). According to numerous epidemiological studies, up to 90% of the all malignant neoplasias arise due to hostilities impacts and accumulation of genotoxic substances as well as carcinogens and mutagens. The main genetic factors are considered and their impact on the bladder malignant neoplasias formation is analysed in the article. The given data testify to the important role of the xenobiotics detoxication enzymes, gene methylation state, cytokines activity in the development of the tumor processes and specifically BC.

To determine features of the bone metabolism, 65 patients with prostate cancer (PC) were examined. Locally advanced process is determined in 41 patients, disseminated counterpart – in 24 patients. To specify the level of bone metabolism, the level of the osteoporosis markers – osteocalcin and â-cross-laps was measured. The markers level determines activity of the bone metabolism: osteocalcin shows the level of synthesis, â-cross-laps – resorbtion intensity.
In locally advanced PC, a significant positive correlation between resorbtion marker and the patients age is observed.
An increase in the value of the marker of bone synthesis and time of treatment after surgical castration in patients with locally advanced process is observed.
Thus, increase of the bone metabolism is revealed, reliably associated with the age changes and the treatment features in patients with locally advanced PC. The same changes accompany metastatic cancer progression. Based on these observations, the one can conclude, that the bone metabolism alterations in patients with locally advanced and disseminated PC are pathologic and can be measured fairly.
Bisphosphonates use, especially those of the last generation (zoledronic acid) is not only justified but is indicated in the locally advanced cancer to prevent progression of the pathologic bone metabolism caused by age and intense hormonal therapy. It will redice a probability of the expansion of the tumor process into the bones and disease progression.
In disseminated PC, decrease in the pathologic bone metabolism will also allow to hamper disease progession and reduce the probability of the pathologic manifestations of the skeleton lesion.

The purpose of our research was to estimate condition of microcirculatory bed of the prostate in its benign and malignant neoplasias via laser Doppler flowmetry. Based on the obtained results, decrease in blood circulation and stasis in capillary part of the prostate tissue affected by malignant neoplasm is reveled, in comparison with the tissues of the benign prostate hyperplasia (BPH). By mathematical simulation, a formula allowing to distinguish 2 diseases: BPH and prostate cancer, is deduced. Sensitivity and specifity of the given method amounted 93 and 88%, respectively.

Objective. To improve prediction accuracy of non-organ confined prostate cancer before radical prostatectomy.
Material and methods. Diagnostic efficacy of clinical staging, pretreatment PSA, Gleason score in prostate biopsy and combination of aforementioned factors in prediction or capsular penetration or seminal vesicle invasion were assessed in 272 pts. undergone radical prostatectomy in RIOMR between 1996 and 2007. Sensitivity, specificity and diagnostic accuracy of these factors were compared. Receiver-OperatingCharacteristic (ROC) curves were constructed and areas under curves were calculated.
Results. Sensitivity, specificity and diagnostic accuracy for clinical staging were 39,3%, 88,1% and 68,0%; for Gleason score 7—10 — 41,1%, 80,6%—64,3%; for pretreatment PSA≥20 ng/ml — 45,5%, 80,6%—66,2% accordingly; for only 1 aforementioned factor — 78,6%, 58,1% and 66,5%; for combination of 2 factors — 39,3%, 92,5% and 70,6%; for 3 — 5,4%, 98,2% and 42,7% accordingly. Areas under ROC curves for clinical stage, Gleason score, pretreatment PSA and combination of aforementioned factors were 0,66 (95%CI 0,60 — 0,73); 0,64 (95%CI 0,57 — 0,71); 0,69 (95%CI 0,63 — 0,76) and 0,74 (95%CI 0,68 — 0,80).
Conclusion. Diagnostic accuracy for combination of clinical stage, Gleason score and pretreatment PSA was highest comparing to use of these single variables. Presence of 0 to 1 unfavorable factors may be used as an indication for radical prostatectomy according to our data.

Research purpose. Investigate possibilities of the transrectal ultrasonography (TRUS) in early diagnostics of the local recurrence of the prostate cancer (PC) following radical prostatectomy (RPE).
Materials and methods. 50 PC patients at the age of 52–73 years (mean age – 62,5 years) that have undergone RPE in different clinics were under our observation. Preoperational prostate-specific antigen (PSA) value mounted 1,7–30 ng/ml. The following stages were determined clinically: Т1N0M0 – 8 patients, Т2N0M0 – 42 patients (Т2а – 38, Т2b – 2, T2c – 2). Following RPE, a positive surgical edge was revealed in 7 patients, tumor invasion to the seminal vesicles – in 3. After performed RPE, PSA level was determined 1 time per 3 months and TRUS in B-mode using energetic mapping (EM) was performed in all the patients. For this, MEDISON company SonoAce 8800 device with convex intracavitary sensor with a frequency 7,5 MHz was used.
Results. In 1,5 years after RPE, PSA level increase more then 0,2 ng/ml (0,58–28 ng/ml) was observed. Patients have been examined, including: digital rectal investigation (DRI), TRUS of the prostate bed, helical computed tomography (HCT) of the minor pelvis organs, skeleton scintigraphy. DRI revealed a hardening part in 1 patient, bone metastatic lesion in 2 patients. Via HCT of the minor pelvis organs, a pathologic structure in the prostate bed region with invasion of the posterior bladder wall was revealed. By B-mode TRUS using EM, the areas of solid structure in the region of vesico-urethral anastomosis or behind the posterior bladder wall were revealed in 9 patients, including hypoechogenic with deformed coiled vessels – in 6, isoechogenic with solitary signals by EM – in 2, mixed echogenicity with the posterior bladder wall invasion – in 1 patients. By histological examination of the biopsy materials from the doubtful regions, the PC recurrence is diagnosed in 8 patients, in 1 – histologically local PC recurrence has not been confirmed.
Conclusions. TRUS with using EM – is a higly informative, economically and clinically significant method of early diagnostics of the local PC recurrence following RPE.

In view of necessity to execute the complex estimation of the methods of the prostate cancer (PC) treatment within the near terms, an integral value of the treatment efficacy is suggested – coefficient of the treatment efficacy. To calculate it the one needs to know a value of increase of the prostate specific antigen level, prostate volume, residual urine amount and the value of the scale of estimation of disturbances of urination IPSS for a fixed time. Coefficient of the treatment efficacy is calculated by calculating of the quotient of the product of the values increases by the sum of the valued increases. To standardize estimation of the treatment efficacy, the calculation of scale of the efficacy with evaluating low, medium and high levels of efficacy is performed.
Estimation of the different variants of treatment of PC depending on advance of the pathologic process in 468 patients is executed.

Purpose. Evaluate efficacy and portability of the combination of the drugs Tautax (docetaxel) with a dose of 75mg/m2 1 time per 21 days and prednisolone — 10 mg per 24 h in hormone-refractory prostate cancer (HRPC) patients.
Methods. Patients with verified HRPC were included in the study. Patients without being performed orchofuniculectomy were given LHRH analogues during the entire study. The treatment scheme was: tautax 75 mg/m2 1 time per 21 days as 1,5 h infusion + prednisolone — 10 mg per 24 h per os. Dexamethasone 8 mg was introduced intramuscularly as a premedication before tautax infusion prior to 12, 6 and 1 h. Patients with the revealed bone metastases were given zoledronic acid 4 mg 1 time per 28 days. The therapy was has been being performed for 6 months or till disease progression revelation. In case of regression or stabilization of the disease, up to 10 chemotherapy courses were performed.
Results. 29 HRPC patients are examined. 178 chemotherapy courses are performed. Partial regression is noted in 8 (28%) patients, stabilization — in 9 (31%), progression - in 8 (28%) patients. PSA level decrease >50% has been observed in 19 (65,5%) patients. Improvement of the life quality was reached in 11 (38%) patients. The decrease in hyperfixation of radiopharmaceutical by osteoscintigraphy ocurred in 14 (48%) patients.
Conclusion. Combination of Tautax and prednisolone is an effective treatment regimen of the HRPC patients.