Objective: to identify independent risk factors affecting survival of patients with renal cell carcinoma (RCC) and tumor venous thrombosis who have undergone nephrectomy and thrombectomy.

Materials and methods. This study included 768 patients with RCC complicated by tumor venous thrombosis who have undergone nephrectomy and thrombectomy. Median age was 58 years (range: 16-82 years); the male to female ratio was 2.3:1. The symptoms of tumor venous thrombosis were identified in 232 patients (30.2 %); laboratory abnormalities at baseline were observed in 456 patients (59.3 %). Grade I and II tumor thrombosis was diagnosed in 456 (59.3 %) and 201 (26.2 %) patients, respectively; grade III and IV thrombosis was found in 171 (22.3 %) and 177 (23.0 %) patients, respectively. One hundred and twenty-nine participants (16.8 %) had infrarenal inferior vena cava thrombosis. Regional metastases were detected in 188 individuals (24.4 %), distant metastases were registered in 274 patients (35.7 %). All patients have undergone surgery: either radical (n = 555; 72.3 %) or cytoreductive (n = 213; 27.7 %). All primary tumors were histologically classified as RCC (G_3-4 in 337 cases; 43.9 %). A total of 719 patients (93.6 %) survived the perioperative period; 183 patients with metastasis (23.8 %) received systemic antitumor therapy.

Results. The median follow-up was 24 months (range: 1-200 months). The 24-month overall and cancer-specific survival of all patients were 96.9 and 99.7 %, respectively; recurrence-free survival of patients after radical surgery reached 92.9 %. Progression-free survival among those patients who underwent cytoreductive surgery and received first-line therapy/follow-up was 41.7 %. Negative predictive factors of overall survival included hepatomegaly (p = 0.024), ascites (p = 0.033), level IV tumor thrombosis (p <0.0001), infrarenal inferior vena cava thrombosis (p = 0.002), regional metastases (p <0.0001), and cytoreductive surgery (p = 0.012). Depending on the number of risk factors, we have identified 3 prognostic groups: favorable (0 factors), intermediate (1-2 factors), and poor (3-6 factors). Median overall survival differed significantly between the groups and was 128.6 ± 11.8; 40.9 ± 6.7 and 12.3 ± 2.2 months, respectively (p <0.0001 for all).

Conclusion. Stratification of patients operated on for RCC and venous tumor thrombosis with their allocation to prognostic groups will ensure the choice of an optimal management strategy.

Background. Patients with signs of tumor lesions in a single kidney or in the only one functioning kidney, with bilateral renal tumors are at high risk of functional failure or insufficiency of the kidney after surgery. Joint discussions with specialists in X-ray endovascular surgeries resulted in the development of a treatment algorithm for patients with localized kidney cancer who require organ-sparing surgery without ischemic kidney resection.

Objective: to evaluation of the immediate results of two-stage surgical treatment of localized kidney cancer in patients with signs of tumor lesions in a single kidney or in the only one functioning kidney, with bilateral renal tumors, including superselective embolization of the artery supplying the tumor at the first stage, and laparoscopic kidney resection without renal ischemia parenchyma at the second stage.

Materials and methods. This study included 5 patients with localized kidney cancer, who underwent two-stage treatment at Moscow Regional Oncology Dispensary between 24.03.2021 and 19.04.2021. The first stage included superselective embolization of the artery supplying the tumor; the second stage implied laparoscopic kidney resection 6-7 days following the first stage.

Results. The median age of the patients was 62 years (range: 42-73 years). Four patients (80%) had unilateral kidney lesions, while 1 patient (20 %) had bilateral (synchronous) kidney cancer. The mean RENAL score was 8 (range: 6-10); patients were distributed as follows: score 4-6 in 40 %, score 7-9 in 40 %, and score >10 in 20 % of patients. At the first stage, patients underwent endovascular embolization of the branches of the renal artery. Patients had superselective embolization of either middle (n = 3; 60 %), upper (n = 1; 20 %), or lower (n = 1; 20 %) segmental arteries supplying the tumor. In one of them (20 %), we identified 3 large arterial branches; in another one (20 %), we identified 2 large arterial branches.

At the second stage, we performed laparoscopic kidney resection. None of the patients required renal artery clamping, because there was an excellent visualization of the demarcation zone and no significant blood loss. The resection area was sutured in 1 case (20 %). In 2 individuals (40 %), a hemostatic sponge was installed in the removed tumor bed. In the remaining 2 cases (40 %), hemostasis was ensured by coagulation. The median blood loss was 100 mL (range: 50-200 mL). The postoperative period was uneventful in all patients. None of the patients developed symptoms of acute renal failure.

Conclusion. Thus, superselective embolization of arteries supplying a kidney tumor has undeniable advantages in organ-sparing surgeries for patients with localized kidney cancer and some additional kidney problems, when organ preservation is crucial for patient's life.

Objective: to analyze factors affecting relapse-free and overall survival of patients with non-metastatic non-clear cell renal cell carcinoma (nccRCC) after surgical treatment.

Materials and methods. This study included 279 (13.62 %) nccRCC patients from the database containing information on 2049 patients with localized and locally advanced renal cell carcinoma (RCC) without distant metastases who underwent surgical treatment in the Department of Urologic Oncology, P.A. Herzen Moscow Oncology Research Institute between 2002 and 2018. Gender ratio was 1.36:1 (161 men (57.7 %) and 118 women (42.3 %)). Median follow-up time was 34.5 months (range: 1-141 months). Patients had undergone either radical nephrectomy (n = 117; 41.9 %) or kidney resection (n = 160; 57.4 %) or radiofrequency thermal ablation (n = 2; 0.7 %). Standard (open) transperitoneal approach was used in 135 patients (48.4 %) patients, whereas 144 (51.6 %) patients were operated on via laparoscopic approach. Postoperative histological examination demonstrated that 110 participants (39.4 %) had chromophobe RCC, while 79 (28.3 %) and 63 (22.6 %) individuals had type 1 and type 2 papillary RCC, respectively. Twenty-seven patients were found to have rare or mixed variants of nccRCC (they were excluded from the analysis due to their relatively small number). Patients were diagnosed with the following stages of cancer: рТ1а (n = 129; 46.2 %), pT1b (n = 72; 25.8 %), рТ2а (n = 18; 6.5 %), pT2b (n = 8; 2.9 %), рТ3а (n = 31; 11.1 %), pT3b (n = 4; 1.4 %), рТ4 (n = 1; 0,4 %), and pN+ (n = 16; 5.7 %).

Results and conclusion. 13 patients (4.7 %) were diagnosed progressive disease; 9 patients (3.2 %) died due to nccRCC progression. The highest relapse-free and overall survival rates were registered in the patients with type 1 papillary RCC and chromophobe RCC.

Spearman's correlation analysis showed a significant correlation between the risk of disease progression and tumor size (R = 0.23; p <0.0001), pT stage (R = 0.24; p = 0.0001), vascular invasion (R = 0.36; p <0.0001), pN+ stage (R = 0.4; p <0.0001), surgical resection margin (R = 0.5; p <0.0001), histological variant (R = 0.14; p = 0.02), and Furman differentiation grade (R = 0.16; p = 0.02). The following factors were found to have an impact on relapse-free survival according to multivariate Cox regression: presence of necrosis (p = 0.04), pT stage (p = 0.03), and vascular invasion (p = 0.08), although the last variable failed to reach statistical significance. Cancer-specific survival was significantly affected by pT stage (p = 0.01) and Furman differentiation grade (p = 0.04). None of the factors demonstrated significant associations with overall survival. Thus, the most significant prognostic factor affecting relapse-free, overall, and cancer-specific survival in nccRCC patients was the pT stage (p <0.05).

The study objective is to evaluate effectiveness and tolerability of 1st line combination immuno-oncological therapy with nivolumab and ipilimumab in patients with metastatic renal cell carcinoma (mRCC) in clinical practice.

Materials and methods. The study included 38 patients with mRCC who received combination immunotherapy between July of 2019 and September of 2021. Median follow-up duration was 8 (2-25) months. Mean age of the patients was 58.3 (20-85) years. Previously 22 (57.9 %) patients underwent surgical treatment. Unfavorable physical status 2-3 per the ECOG scale was observed in 10 (26.3 %) patients. Clear-cell type of renal cell carcinoma was diagnosed in 34 (89.6 %) patients, non-clear-cell types in 4 (10.4 %). Sarcomatoid component in the tumor was detected in 8 (21.0 %) patients. G3-4 mRCC variant was verified in 16 (42.1 %) patients. Poor prognosis per the IMDC (International Metastatic Renal Cell Carcinoma Database Consortium) scale was identified in 16 (42.1 %) patients, intermediate -in 20 (52.6 %) patients. All 4 administrations of combination immunotherapy were received by 29 (76.3 %) patients.

Results. For median follow-up duration of 8 (2-25) months, 23 (60.5 %) patients continue treatment, 15 (39.5 %) completed therapy with nivolumab and ipilimumab due to various reasons including progression in 11 (28.9 %), death in 2 (5.3 %), intolerable toxicity in 2 (5.3 %) cases. Median duration of combination immunotherapy was 9 (2-24) months. Subsequent antitumor therapy was administered to 3 (7.9 %) patients. During induction course immune-mediated adverse event (grade III-IV hepatitis) developed in 3 (7.9 %) patients. Adverse events were observed in 81.6 % of patients, including grade III-IV in 23.7 % of patients. Objective response was observed in 44.8 % of cases, complete response in 5.3 % of cases, partial response in 39.5 % of cases; controlled disease was achieved in 84.3 % of patients. Median progression-free survival and overall survival were 8 months.

Conclusion. In our study despite large number of patients with poor prognosis and poorly differentiated tumors, 64.0 % of patients are alive and 60.5 % of patients continue treatment without disease progression after 18 months of combination immunotherapy. Progression-free survival was significantly affected by sarcomatoid component in the tumor, number of unfavorable factors per the IMDC scale, best response per RECIST 1.1; overall survival was significantly affected by sarcomatoid component in the tumor, sum of measurable lesions, number of unfavorable factors per the IMDC scale, best response per RECIST 1.1, and presence of symptomatic metastases in the brain.

The basic principles of the treatment of prostate cancer patients have underwent significant revisions in recent years. Modern radiotherapy techniques, which have demonstrated high efficacy and safety in long-term randomized trials, are beginning to take a leading position in the treatment of prostate cancer in an overwhelming number of clinical scenarios (National Comprehensive Cancer Network, 2021). Despite the obvious successes of radiation oncology, a number of important problems remain unresolved, first of all - the need to reduce the rates of radiation complications. The topographical anatomy of the prostate gland determines the main profiles of post-radiation damage: rectal and genitourinary radiation toxicity. The previous five years have been marked by a significant intensification of research work abroad aimed at clinical testing of a number of biopolymer compositions and products for use as spacers between irradiated structures and normal tissues. The experience has made it possible for the first time to consider the possibility of using spacers in radiotherapy treatment of prostate cancer in the modern recommendations of the European Association of Urology (2021). The analysis of the national literature shows a complete lack of publications on the possibilities of optimizing the radiation treatment of prostate cancer through the use of specers. The purpose of this work was the need to highlight this important and perspective clinical problem.

Prostate cancer is an important disease in current oncological urology. Radical treatment of patients with localized and locally advanced prostate cancer, including surgical and radiological treatments, often does not cure patients from this pathology, especially in the group with high risk of disease progression; the risk of biochemical recurrence in this patient group can be up to 40-60 %. Widespread application of radical treatment allowed to significantly increase survival of patients from this group. However, in case of biochemical recurrence, the majority of patients require longterm androgen-depriving therapy for suppression of natural testosterone level. In some of these patients during longterm castration therapy, non-metastatic castration-resistant prostate cancer develops (CRPC) in the absence of signs of radiological disease progression. Results of large randomized trials show the necessity of stratification of these patients in the group with high risk of progression considering short doubling period of prostate-specific antigen and realization of distant metastases. The main therapy concept for this patient group is use of new-generation inhibitors of androgen signal to increase time to CRPC metastases and overall life expectancy. The article presents results of large trials performed in patients with non-metastatic CRPC and characterizes the role of one of the most effective drugs, darolutamide, used for treatment in this patient cohort.

Metastatic castration-resistant prostate cancer is a difficult problem for a clinical oncologist. In addition, mutations in genes of homologous DNA recombination, including BRCA1/2, suggest an aggressive behavior and therapy resistance. Treatment options for such patients were significantly limited until new drugs - PARP inhibitors have been registered. Nevertheless, there is evidence that BRCA1/2 gene mutations are associated with increased mutational load, neoepitopes formation, increased number of tumor-infiltrating lymphocytes and a response to the immune response checkpoints blockade. Studies have shown that BRCA2-mutated prostate cancer demonstrates high level of immune cells infiltration compared to tumors without mutation, in particular with respect to CD4⁺, CD8⁺ and FOXP3⁺ T-lymphocytes. It should be noted that studies have shown a tendency of CD8+ T-lymphocytes/FOXP3⁺ T-cells ratio decreasing in BRCA2-mutated tumors. Thus, the mutational status of BRCA2 presumably forms the immune phenotype of prostate cancer with an increase of intratumoral immune cells, but with immunosuppressive properties. At the same time, the use of immune checkpoint blockers in advanced prostate cancer has been unsuccessful in terms of overall survival. Despite the fact that immune checkpoint blocker's efficacy is often associated with a high intracellular CD4⁺ and CD8⁺ T lymphocytes, their presence is clearly insufficient for response. Studies showed that PARP inhibitors effect tumor microenvironment significantly. Anti-PD-1/PD-L1 combination with PARP inhibitors is being actively studied due to their properties of modulating the tumor microenvironment. Thus, future immunooncological strategies for primary prostate cancer therapy may include not only an increase in mutational load, but also an impact on the immunosuppressive microenvironment. The article presents clinical cases of 3 brothers, carriers of the germinal BRCA2 c.9371A>T mutation, suffering from prostate cancer with a burdened family history. The disease development under standard therapies was studied and markers of the tumor microenvironment were immunohistochemically evaluated. PARP inhibitor Olaparib efficacy in prostate cancer of older brother in late-line therapy for metastatic castration-resistant disease was analyzed.

Background. Surgical morbidities of radical cystectomy, which are, as a rule, complicated intraabdominal infections, appear to be the main causes of repeated surgeries and fatal outcomes. The elimination of the infection Indus and an-timicrobic therapy are the currently accepted standard of treatment for postoperative peritonitis in cancer urology, as well as in general surgery hospital.

Objective: defining the most reasonable option of surgical aid for peritonitis developing after cystectomy.

Materials and methods. In the time period from 2000 through 2014, 58 cancer patients with postoperative peritonitis developing after cystectomy received indoor treatment at N.N. Alexandrov Republican Research and Practical Center for Oncology and Medical Radiology. Their mean age was 64.9 years, the range 44-90 years, 53 (91.4 %) of them being male. Primary urinary bladder cancer was present in 51 (87.9 %) patients. Peritoneal infection was microbiologically verified in 57 (98.3 %) patients. Each case of fatal outcome was associated with ineffective treatment of peritonitis. Depending on the intraoperative findings (presence or absence of a hollow organ defect) and the surgical approach undertaken (obstructive resection or operation maintaining the continuity of the intestinal and/or urinary tract), the patients were stratified into three groups: group 1 (n = 28), group 2 (n = 20) and group 3 (n = 10). There were no significant differences in the basic parameters specifying peritoneal infection severity between the patients of groups 1 and 2 vs group 3 (p >0.05).

Results. Overall mortality amounted to 25.9 %, 15 patients died. Among the 28 (48.3 %) patients (group 1) who underwent obstructive elimination of the peritonitis focus by means of urointestinal reservoir ablation, resection of small or large intestine with ileo- or colostomy, 6 patients died, mortality 21.4 %. In the 10 (17.2 %) patients (group 3) who succeeded in preserving the urinary conduit or continuity of the bowels by anastomosis defect closure, resection of enteroentero-anastomosis or urointestinal reservoir with repeated anastomosing or defect closure, mortality was higher (60 %) (p = 0.045); 6 patients died.

Conclusion. The most effective option of surgical treatment of postoperative peritonitis developing after cystectomy is obstructive reoperation on the bowels and urinary tracts: compared with the intervention consisting in preserving the urinary conduit and/or continuity of the intestinal tract, this type of surgery caused a 2.8-fold lower mortality.

Background. Data on the overall survival (OS) of patients with metastatic bladder cancer (BCa) is rarely published.

The objective of the URRU register study is to assess OS and collect information on the administration of different treatments in patients with metastatic BCa in routine clinical practice in Russia.

Materials and methods. Patients were retrospectively identified in 9 oncology centers in different regions of Russia and included in the study if they were diagnosed with metastatic BCa between January 2017 and January 2018. We collected anonymized data online, including demographic characteristics of patients, details of their therapy, and outcomes.

Results. This study included 246 patients. Their mean age upon the diagnosis of metastatic BCa was 72 years with 60.6 % of patients over 70 years of age. The proportion of males was 74.8 %. The histological subtype of BCa (urothelial carcinoma, etc.) was identified in 70.3 % of cases. Ninety-two patients (37.4 %) received pharmacotherapy. The most common treatment option was chemotherapy (76 %); the most common drug combination was gemcitabine and cisplatin (41.3 %). Immunotherapy was used in 19.6 % of patients; 13.6 % of participants received more than two lines of therapy. Three-year OS rate was 10.6 %; median OS was 7 months (95 % confidence interval (CI) 5.4-8.6). Patients receiving systemic therapy demonstrated significantly longer survival than those receiving no therapy (21 months; 95 % CI 17.38-24.62 vs 3 months; 95 % CI 1.79-4.22; p <0.0001). Patients receiving immunotherapy had better survival than individuals receiving chemotherapy (median OS 34.5 months vs 18 months; p = 0.003).

Conclusion. The survival rates in the URRU study were relatively low, which can be attributed to the fact that only one-third of patients received pharmacotherapy and very few patients received immunotherapy. Second and subsequent lines of therapy were rarely used in patients with progressive disease. The implementation of novel treatments, including immune checkpoint inhibitors, will increase the survival of BCa patients.

Background. Prostate cancer (PCa) is well-known as the 2nd leading cause of death from malignant neoplasms among the males from developed countries. One of the variants of the disease - neuroendocrine carcinoma of the prostate (NECP) -manifests itself as the form of castration-resistant PCa. Distinctive manifestations of NECP include a low level of serum prostate specific antigen (PSA), a high potential rate of metastasis, and resistance to hormone replacement therapy. There are very few medical publications on the possibilities of diagnosis and therapy of this type of tumor.

The objective of the study is to review the current foundations of pathogenesis, methods of diagnosis and treatment of patients with NECP.

Materials and methods. The data of modern medical literature from the PubMed/Crossref archives, from the Elsevier and Scopus databases for 1991-2020 were studied. The materials on the epidemiology and pathogenesis of NECP, as well as the methods of diagnosis and treatment of patients with this pathology are summarized. A comparative analysis of the levels of neuroendocrine markers in castration-resistant and localized forms of PCa was carried out. The schemes of combination therapy of NECP with the use of somatostatin analogs are considered.

Results. The detection rate of NECP is reduced due to the blurred clinical picture and morphological characteristics similar to poorly differentiated carcinoma. The basis for the diagnosis of NECP is the determination of the levels of neuronal markers - chromogranin A, neuron-specific enolase, and a number of potentially mitogenic hormones, including PTHrP, NT, serotonin, bombesin, calcitonin, and thyroid-stimulating hormone. The worst prognosis was observed in patients with initially high levels of chromogranin A, which emphasizes the high significance of this indicator for monitoring NECP. The drug of choice in the treatment of patients with this pathology is the somatostatin analogue octreotide-depot, the use of which in combination with hormone replacement therapy leads to stabilization of PCa in 50 % of cases. During therapy with an analogue of somatostatin alone or in cases of tumor progression against the background of chemotherapy, a decrease in PSA level is noted in 50-60 % of cases, and PSA level stabilization - in 41.7-53.3 %.

Conclusion. We founded an insufficient number of randomized clinical trials of NECP, therefore, the prognosis of the development of this pathology remains completely unclear. The use of somatostatin analogues, along with targeted therapy, is the main choice of therapy for NECP, but requires further study in the program of randomized trials. If a positive result is obtained, it will be possible to use somatostatin analogs more widely to improve the quality and increase the life expectancy of patients with NECP.

Prostate cancer (РСа), being one of the leading causes of cancer mortality in men in Russia and in a number of other countries of the world, remains an urgent problem for modern oncourology, and the choice of surgical method is an important task for a surgeon. Such a pronounced interest in robot-assisted radical prostatectomy (RARP) in patients is driven by good tolerance and effectiveness of these surgical interventions, despite the fact that radical prostatectomy is considered to be the "gold standard" for treatment of patients with clinically localized РСа with regard to European Association of Urology data. The long-term oncological and functional results and the quality of life of patients after RARP deserve close attention and thorough study. According to the data presented in this article, it is obvious that RARP is the preferred method for surgical treatment of РСа, since oncological and functional results in the long-term follow-up are comparable to the results after radical prostatectomy, and according to some authors, these results are superior to the results of radical prostatectomy. The results of the study will allow to continue further introduction of RARP into clinical practice and its popularization as a method of surgical treatment of patients with localized PCa, which will reduce the length of hospital stay of patients, accelerate their medical and social rehabilitation, and improve the quality of medical care.

The amount of data on the study of distant oncological and functional results of RARP as well as its superiority over other treatment methods is limited in medical literature, which prompted us to conduct our own research. Currently the urological clinic of the A.I. Evdokimov Moscow State University of Medicine and Dentistry continues work aimed at studying the longterm results of RARP in the first patients in Russia.

Background. Urothelial carcinoma (UTC) is an aggressive disease with a known propensity for frequent recurrence. It is difficult to predict the velocity of the development of UTC recur using modern means of clinical diagnostics. Therefore, the development of the capabilities of histo-morphological study of tumor tissues is of particular relevance.

Materials and methods. The materials of publications (PubMed, CrossRef) for 1990-2021, devoted to the choice of biomarkers for the diagnosis of UTC, the analysis of molecular pathways, progression and metastasis, were studied. The search was carried out for the key phrases "urothelial carcinoma", "recurrent UTK", "stem cells", "biomarkers of bladder cancer", "genetic changes in urothelium", "circulating tumor DNA".

Results. Cancer stem cells serve as a source of UTC recurrence after removal from the primary focus, localizing in any areas of the urothelium, as well as outside the main tumor focus and are characterized by a common genotype, but different phenotypic manifestations. To predict the recurrence of the tumour is advisable to use gene expression signatures, since the subtypes of UTC are characterized by clear gene expression profiles. A larger sample and independent dataset is needed to confirm the clinical significance of the findings. Combined biomarkers predict UTC behavior, and FGFR3 and TP53 mutations can be components for a panel for predicting UTC recurrence. The use of the liquid biopsy method with the determination of the level of circulating tumor DNA is a promising diagnostic method that needs to evaluate the results of an initiated randomized trial.

Conclusion. The accumulation of knowledge base about the molecular patterns of UTC will help bridge the gap between the results of molecular genetic and clinical diagnostics. Molecular changes in the transitional cell UTC demonstrates a high potential for determining the timing of tumor recurrence, assessing disease-free survival of patients and for planning the resource base of the healthcare system.

Renal tumors account for 2 to 3 % of all malignant tumors in adults. Of all patients with renal cell carcinoma, 30 to 40 % have advanced forms of the disease. In the literature, the term "giant renal tumor" is used for tumors larger than 20 cm. In this article, we report a case of surgical treatment for a giant malignant kidney tumor.

Patient N., female, 54 years old, referred to an outpatient clinic with complaints of a change in the shape of the abdomen on the left with a palpable large tumor, abdominal pain, shortness of breath, weakness, constipation, episodes of blood in the urine and increased blood pressure. Body mass index 30.2 kg/m². Ultrasound examination revealed a large tumor in the left retroperitoneal space. Laboratory testing of blood, urine was performed, findings were unremarkable. According to the data of magnetic resonance imaging, the left kidney was transformed into a large cystic solid formation, measuring 30.5 х 17.5 х 17.0 cm, heterogeneously accumulating a contrast agent with a solid component. Patient was admitted to the urology department for surgical treatment. We performed radical nephrectomy on the left with thoracolumbar laparotomy access on the left with resection of the 10th rib, resecting the renal tumor with the adrenal gland, total weight of the complex was 10.7 kg. The histological structure was determined as poorly differentiated renal carcinoma with invasion of the perinephric tissue. In the adrenal gland, fields of fresh erythrocytes with an admixture of tumor tissue were noted. Examined lymph node tissue was completely replaced by tumor cells. Postoperative period was characterized by episodes of dynamic intestinal obstruction. The patient was discharged from the department in a satisfactory condition on the 13^th day after the operation, but died 1.5 months after discharge, the cause of death has not been established, as no autopsy was performed. Thus, the size of the tumor is not a contraindication to surgical treatment, which improves the survival rate of patients with malignant renal tumors.

Centrally Located renal tumor poses a diagnostic challenge to differentiate between renal cell carcinoma and transitional cell carcinoma. Imaging alone is not sufficient to make the diagnosis, some invasive diagnostic investigations are required to ascertain the diagnosis. We present a 60 years old gentleman, who presented dyspepsia and further investigation by contrasted CT kidney revealed a centrally located right renal tumor. Before making a management decision, we performed the right renal biopsy of the tumor which turns out to be a renal cell carcinoma. Henceforth, we performed a robotic-assisted laparoscopic right nephrectomy. A renal biopsy, in this case, assisted to decide only radical nephrectomy instead of radical nephroureterectomy which has higher associated morbidity. Thus, it is important to make confirm by tissue biopsy before deciding on surgery in case of the central renal tumor as this prevents subjecting a patient to under-or overtreatment.

A clinical case of treatment of a 32-year-old patient with an adrenocortical tumor of the right adrenal gland is described. When applying to the clinic, the patient was complaining about moderate pain in the right lumbar region, the general condition of the patient was estimated as satisfactory. The patient was of normosthenic constitution, had no bad habits, preoperative general and biochemical blood counts, including the levels of adrenocorticotropic hormone, cortisol, aldosterone, direct renin, metanephrine, normetanephrine were within normal parameters. The patient underwent laparoscopic lateral transperitoneal adrenalectomy on the right in the position on the left side using 4 trocars. The condition of the patient was satisfactory, he was released from the hospital on the 3rd day after surgery.

Background. The growing number of patients with prostate cancer (PCa) imposes additional requirements on the quality control system in healthcare, including ensuring the widespread availability of innovative algorithms for early diagnosis and treatment. One illustrative example of quality management initiatives is national PCa audit in the UK. Objective. Highlighting the approaches to quality assessments within audit of PCa care in the UK.

Materials and methods. The relevant scientific data have been retrieved from Google and PubMed. The search horizon covered the last 10 years. The queries included such wording as: "prostate cancer" AND "audit" OR/AND "Great Britain" AND "quality assurance", etc.

Results. At least four basic parameters were used as signal indicators to check the consistency and overall quality of the collected data on PCa patients in England and Wales. The fundamental arrangement of clinical quality indicators for PCa care comprised not less than fourteen measures. The outliers for some indicators were allocated into two groups using such criteria as: 1) more than three standard deviations from the national average (definition of an alarm); 2) more than two but below three standard deviations from the national average (definition of an alert). The outlier policy is usually applied for three treatment outcome performance indicators.

Conclusion. The multidisciplinary teams must actively collaborate to provide the best standards of cancer care to the community. The introduction of multicriterial assessments to monitor the performance of highly specialized professional groups would bring a great benefit for cancer patients, particularly, through increasing the affordability of state-of-the-art medical algorithms across the counties.

Irene Joliot-Curie is the daughter of Marie Curie, a double Nobel Prize-winner. In 1925, Irene Curie became Doctor of Science.

In 1926, Irene married her colleague Frederic Joliot, an assistant at the Radium Institute. With him, she continued experiments with various chemical elements. In some of these experiments, Irene and Frederic performed bombardment of boron, and aluminium with alpha particles, thereby producing new chemical elements. These new elements were radioactive: aluminum became radioactive phosphorus, while boron became a radioactive isotope of nitrogen. Within a short time, Joliot-Curie created many new radioactive elements. In 1935, Irene and Frederic Joliot-Curie were jointly awarded the Nobel Prize for Chemistry for their artificial creation of new radioactive elements Working with uranium in the late 1930s, Irene Joliot-Curie made several important discoveries and came close to the discovery of uranium decay, when bombarded with neutrons.

Jean Frederic Joliot was born in Paris, in the family of a prosperous merchant Henri Joliot and Emilia (Roederer) Joliot, who came from a wealthy Protestant family from Alsace.

Frederic obtained his Doctor of Science degree in 1930 for a thesis on the electrochemistry of radioactive polonium. Having received the Nobel Prize in 1935 together with his wife, 35-year-old Frederick still remains the youngest Nobel Laureate in Chemistry.

The discoveries and achievements of the Joliot-Curie family laid the foundation for further research in nuclear physics, chemistry, and nuclear medicine. Without their discoveries, it is impossible to imagine modern science and everyday life.