Vol 2, No 3 (2006)

Radiotherapy alone ranks below radical cystectomy in results; but the latter of multimodality organ-preserving therapy are comparable with those of radical cystectomy in patients with the same stage of the disease and of the same age. The development of current radiotherapy technologies, the advent of new effective chemotherapy regimens, and the integration of these methods with organ-preserving surgery offer hope to longer survival and urinary bladder preservation in patients with invasive bladder cancer.

Aim. To study chromosomal abnormalities in bilateral renal cell carcinoma (RCC).

Materials and methods. Paraffin-embedded specimens from 8 patients with bilateral RCC were examined by comparative genomic hybridization.

Results. 1 to 6 chromosomal aberrations were found in each sample. The same chromosomal aberrations in both tumors in 7 (87.5%) cases chromosomal changes were different in one (12.5%) case.

Conclusion. Further genetic studies of bilateral RCC may give a better insight into the biology, diagnosis, and treatment of bilateral RCC.

Notwithstanding the fact that advances have been made in various urine derivations, the assessment of life quality in patients who have undergone this type of surgical treatment is still not only a medical problem, but, to a greater extent, a social one. Eighty-seven patients who had undergone radical cystectomy and urine derivation for invasive bladder cancer were examined. According to the type of urine derivation, the patients were divided into groups. Then early and late complications, survival rates, and quality of life were estimated. The latter was assessed by three components: physical, psychological, and urological health. Emphasis is laid on physical health component in assessing the quality of life. The special questionnaire applied to the assessment of life quality in patients undergoing urine derivation may be useful for this purpose in those after other urological operations.

Materials and Methods. The results of examination and treatment of 163 males who had undergone radical retropubic prostatectomy (RRP) with bilateral pelvic lymphadenectomy for clinically locally advanced prostate cancer (PC) (T1aN0M0-to-cT2bN0M0) were studied. The patients’ mean age was 63.5 years and ranged from 41 to 74 years. After RRP, the duration of a follow-up averaged 46.6±2.7 months and ranged from 24 to 81 months. Digital rectal study, determination of serum prostate-specific antigen (PSA) and its density, transrectal multifocal prostate biopsy under ultrasound guidance, and, if required (PSA more than 20 ng/ml or a total of above 7 Glisson scores), computed tomography and scintigraphy of skeletal bones were performed in all the patients. The postoperative examination involved postmortem examination and measurement of serum PSA levels over time.

Results. The study has revealed that there is an clear tendency for an increase in the frequency of other poor signs with elevated preoperative PSA levels.

Conclusion. The findings have indicated that there is a direct and statistically significant correlation between the preoperative values of total PSA, its density, and the possible outcomes of RRP.

Clinical course of primary urethral cancer is characterized in detail in 31 patients. Specific features in the disease course with consideration for tumor stage and patient's sex are analyzed. Urethral cancer is diagnosed only at stages III—IV in the majority (74.2%) of cases. The disease is more incident in women aged over 60 years with a history of chronic cystitis, urethritis, and urethral leukoplakia. The main clinical manifestations of primary urethral cancer are bloody discharge from the urethra, painful difficult urination, and palpated tumor. The symptoms persist for 12.06 months on average. The treatment efficiency depends on the stage of the process: complete effect is attained in 100% patients with stage I, in 75% with stage II, in 54.55% with stage III, and in 41.67% with stage IV. Local relapses are significantly more incident in men (50% vs. only 5.26% in women), 5-year uneventful survival is significantly better in women: 59.6%, vs. 31.2% in men. The median total survival of patients with primary urethral cancer is 61.3 months, total 5-year survival 53±11.6%. Evaluation of the results of different treatments for primary urethral cancer demonstrated the advantages of surgical and combined treatment vs. radiotherapy as a monotreatment. Radiotherapy should be carried out only when surgical removal of the tumor is impossible.