Treatment policy for small renal tumors, up to 4 cm (T1a) varies from a follow-up to organ-removing operations. Renal resection is currently the standard of treatment. The basic principle of organ-preserving treatment is a maximally sparing attitude towards to the renal parenchyma. Mini-invasive treatments for locally advanced renal cancer in small neoplastic sizes have recently found clinical application. These include cryodestruction and radio-frequency ablation. The well-known advantages of mini-invasive treatments are preservation of the renal parenchyma, low traumaticity, and short-term hospitalization, as well as a rapid recovery of the patient’s working capacity after intervention. This paper considers the theoretical and practical aspects of use of current thermodestruction methods in the treatment of renal tumors.

Quality of life (QL) is a highly informative health index that is based on the self-assessment of general well-being and used in clinical practice to evaluate and enhance the efficiency of health care delivered to patients. The present review gives data on various QL studies mainly based on the principles of the psychometric test theory that provided data collection, by applying self-questionnaires or by interviewing patients. Studies of QL in cancer patients use a diversity of specialized test systems considering not only the specificity of various diseases, but also the nature of impact of various treatment modalities on the followed-up patients.

Currently available treatments for prostate cancer adversely affect LQ in patients very frequently. The preponderance of these or those abnormalities depends on a treatment option; therefore its selection for a specific patient should be determined, by taking into account their possible impact on quality of life in patients with prostate cancer.

There is no standard care for metastatic renal cell carcinoma (MRCC). High and intermediate IL-2 regimens are difficult to recommend due to their high toxicity. A combination of low-dose cytokines is assumed to be effective and safe in MRCC patients. A prospective randomized study was started in 2003.

Methods: The eligibility criteria included histopathologically confirmed MRCC, ECOG PS 0—2, no autoimmune diseases, no brain metastases, and normal organ function. All patients were randomized in three arms: IL-2 alone, 1.5 MIU, iv, t.i.w., weeks 1—3 or IL-2 1.0 MIU, iv, t.i.w., weeks 1—3 plus IFN 5 MIU, sc, t.i.w, weeks 1—3 or biochemotherapy group 5-FU, 500 mg/m 2 , iv, once a week, weeks 1—3 plus IL-2 1.0 MIU, iv, t.i.w., weeks 1—3 plus IFN 5 MIU, sc, t.i.w., weeks 1—3. Cycles were repeated every three weeks. A response was evaluated according to RECIST every 2 cycles.

Results: 64 patients were enrolled of whom 63 were analyzed. The patients’ median age was 55.4 years (range 16—74). 55.6% of the patients had a poor prognosis (as described by Motzer et al., 2002). Bone metastases were present in 52.4%. Sixteen patients treated with IL-2 alone showed no CR, no PRs, 2 SDs, and 14 PDs. Of the 23 patients in IL-2+IFN group, 5 PRs, 8 SDs, and 10 PDs were observed, with a response rate of 21.7%. Amongst the 24 patients in 5-FU+IL-2+IFN group, 1 CR, 3 PRs, 10 SDs, and 10 PDs were shown, with a response rate of 16.7%. One-year survival was 20.0%, 81.3% and 81.0%, respectively. Flu-like syndrome was the most common side effect in the patients receiving IFN (89.1%, grade 1, CTC). Hypotension associated with IL-2 (all groups) was seen in 56.3% (grade 1 in 50% and grade 2 in 6.3%). The other toxicities were 12.7% grade 1 neutropenia and vomiting in 4.7% (group 3).

Conclusions: Small-dose IL-2 in combination with IFN and 5-FU in MRCC is feasible, tolerable, with the efficacy comparable to other more toxic therapeutic modalities.

This retrospective study assessed the prognostic value of different clinical and morphological factors of renal-cell carcinoma (RCC) in patients undergoing radical surgery. The paper describes a clinical study of 149 patients operated on in 1997 to 2003. The patients were divided into two groups: a) those with incidental carcinoma and b) those with symptomatic carcinoma. Cancer-specific survival determined by the Kaplan-Meier method. Patients with incidental RCC show a higher cancer-specific survival than those with symptomatic RCC. The asymptomatic course of renal tumor (incidental RCC) has a better prognosis of cancer-specific and relapse-free survival rate.

The results of surgical treatment of 79 patients with invasive bladder cancer treated with radical cystectomy with continent urinary diversion (ileal neobladder) between 1997 and 2005 were analyzed. The incidence of early and late complications was 12.7 and 15.5%, respectively; postoperative mortality was 2.5%. The reservoir volume was 250—300, 400—450, and 500—600 ml 3, 6, and 12 months after surgery, respectively. Spontaneous urination and day time continence was restored in 100%; partial nocturnal incontinence was noted in 11.7% of the patients. In the vast majority of cases, renal function was not impaired or improved. Thus, radical cystectomy with bladder substitution with low-pressure ileal reservoirs with anti-reflux ureteric implantation is the method of choice in treating invasive bladder cancer.

The study was undertaken to compare the levels of p53, bcl-2, and Ki-67 in 40 patients who had undergone radical mastectomy for bladder cancer and to evaluate their possible effect on survival. Only the level of p53 affected survival (p = 0.052). An immunohistochemical study, determination of p53 expression in particular, will enhance the accuracy of prognosis and will probably allow correcting the treatment.

Radiation-induced lower urinary tract events are currently a topical problem despite technological progress and improvement of small pelvic radiotherapy procedures. New preventive treatments for this pathology are constantly developed. The present investigation dealt with ozone therapy used in this nosological entity. It was based on the study of the pathogenesis and morphological changes in the urinary bladder wall during small pelvic radiotherapy in combination with intravesicular ozonized solution. Based on the results of use of this procedure in 40 patients receiving teleradiotherapy applied to the small pelvis, the authors developed an ozone therapy regimen. A pronounced beneficial effect of intravesicular ozone therapy was achieved in a high proportion of patients. The findings were compared with those of the control group of patients receiving no ozone therapy. They were based on a follow-up diagnostic monitoring. The findings give grounds to recommend ozone therapy for the treatment of radiation therapy-induced lower urinary tract events as one of the components of combined therapy for radiation complications.

Androcur is one of basic drugs for the hormonal treatment of patients with prostate cancer. A great number of randomized studies showing the efficacy of androcur alone and in combination with other hormonal treatments have been completed. When orally or intramuscularly administered, the drug is well tolerated, showing the equal efficacy. Androcur used before treatment with luteinizing hormone-realizing hormone agonists is effective in inhibiting the «flash» syndrome. A combination of the agent with surgical or medical castration enhances the efficiency of therapy and improves the quality of life, by reducing the incidence of adverse reactions, such as hot flashes and hyperhidrosis. Androcur therapy prior to radical prostatectomy decreases the frequency of positive surgical edge while neoadjuvant therapy used before radiotherapy enhances the efficiency of radiation and reduces the number of local recurrences.

By using the routine studies, the authors have analyzed clinical and morphological data of 129 prostate cancer (PC) patients, 48-92 years old with different clinical stages. PC turned out to be initially heterogenic in the composition of tumor cells (cytotypic and immunophenotypic heterogenicity). Therefore combined PC treatment should take into account the presence of hormone-resistant tumor cells even when a neoplasm looks at the light microscopy as a usual low- or moderate-grade adenocarcinoma with a great number of adrenoceptors in the tumor cells.

Intratissue radiotherapy with Co60 sources in combination with gamma-teletherapy was used in 11 patients with penile carcinoma as organpreserving treatment. In this group of patients, 5-year relapse-free survival was 91.6%. Along with high survival rates, this treatment modality assured a high quality of life. Combined radiotherapy is most effective and advisable in patients with T1-T2.

Germinomas of the testis are most commonly presented in early (I-II) stages. In Stage T, choice of adjuvant therapy is based on the type of a tumor, the presence of risk factors, and a patient’s wishes. Seminoma requires monitoring, radiotherapy (20 Gy paraaortically) or chemotherapy (a course pf carboplatin therapy), non-seminomic testicular tumors call for monitoring, nerve-preserving retroperitoneal lymphadenectomy (NPRLAE) or chemotherapy (2 courses of ВЕР). All treatment modalities ensure recovery in above 95% of patients. In Stage II, the similar results can be achieved by radiotherapy or chemotherapy (3 courses of ВЕР) in patients with seminoma, by NPRLAE or chemotherapy (3 courses of ВЕР) in patients with non-seminomic tumors of the testis. The equal efficiency of all approaches generates a need for discussing all possible treatment modalities with the patient, by taking into account toxicity and convenience.