[Chemotherapy of hormone-resistent cancer of the prostate].

A total of 59 patients with hormone-resistent prostatic cancer (HDPC) treated in 1999-2004 entered the trial. Three schemes of first-line chemotherapy were examined for clinical efficacy and toxicity in the above patients. Anticancer combined treatment vinorelbin + cycloplatam was given to 23 patients, mitoxantron + prednisolone--to 23 patients, mitoxantron+cysplatin+prednisolone--to 13 patients. The latter scheme was most effect and toxic. Partial regression of metastases and a 50% decrease in the initial PCA level were seen in 23% cases. Vinorelbin+cycloplatam was less effective and toxic: partial regression of metastases--13%, PSA regression-- 17.4%. The least efficacy and toxicity were observed in the treatment with mitoxantron+prednisolone --.7%. Thus, the above first-line HDPC therapy was most effective but has the highest toxicity in using the scheme mitoxantron+cysplatin+prednisolone.

[The role of preserving therapy of invasive cancer of the urinary bladder].

Cystectomy in the treatment of invasive cancer of the urinary bladder is not the only therapeutic modality in this pathology. In selected patients an alternative exists--transurethral resection of the urinary bladder followed by adjuvant concurrent chemotherapy and radiotherapy. The preserving therapy can be recommended to patients over 60 years of age in the presence of a low-grade solitary tumor of a mobile wall of the urinary bladder respectable with preservation of the organ capacity.

[Treatment of patients with retroperitoneal metastases of nonseminoma tumors of the testis]. / Lechenie bol'nykh s zabriushinnymi metastazami neseminomnykh opukholei iaichka.

PVB or VAB-6 combination chemotherapy was given to 41 funicular orchiectomized cases of unresectable retroperitoneal metastases of nonseminoma testicular tumors. Seven of them also revealed metastases to the lung. Complete regression of retroperitoneal metastases was observed in 7 and greater than 50% regression--in 20 cases. Six patients showed complete regression of pulmonary lesions. Chemotherapy raised an opportunity for retroperitoneal lymphadenectomy in 31 cases. Lung metastasis was also removed in one patient. Following chemotherapy, histological examination failed to detect metastases in 17 cases, differentiated teratoma elements were found in 6, while tumor cells were identified in the remaining patients. Three-year survival rate for radically treated patients was 55.5% (m = 8.9). Long-term results were shown to depend mainly on the effectiveness of chemotherapy.

[Maximal androgen blockade in the treatment of patients with disseminated cancer of the prostate]. / Maksimal'naia androgennaia blokada v lechenii bol'nykh disseminirovannym rakom predstatel'noi zhelezy.

Up-to-date approaches to treatment of disseminated prostatic cancer are discussed, including the experience of the use of maximum androgen blockade in 120 patients. The procedure may be recommended to start hormonal therapy in such patients with.

[Retroperitoneoscopy in diagnosis of lymphogenic metastases of bladder cancer]. / Retroperitoneoskopiia v diagnostike limfogennylh metastazov mochevogo puzyria.

Application of retroperitoneoscopy improved diagnosis of regional metastases urinary bladder cancer because it provided relevant morphological verification. Fifty patients were examined for urinary bladder cancer. Factors influencing the frequency of lymphogenic dissemination were studied. A comparative evaluation of the results of direct contrast lymphography and of retroperitoneoscopy suggests that a complex of procedures including retroperitoneoscopy should be used for diagnosis of regional metastases of urinary bladder cancer (T3-4).

[Wilms' tumor in adults]. / Opukhol' Vil'msa u vzroslykh.

Wilms' tumor occurs extremely rarely in adults. There is no consensus in the literature on the problems of clinical manifestations, diagnosis and treatment of the disease. Ten adult patients (aged 16-29) with Wilms' tumor formed the study group. They made up 0.9 per cent of the total number of kidney tumor patients. The peculiarities of the clinical course that distinguish adult nephroblastoma from renal cancer and Wilms' tumor of the infancy were analysed. The latent period appeared to be long. Problems of diagnosis are discussed. Angiography proved to be of the highest diagnostic value. Complex treatment including transperitoneal nephrectomy, radiation and chemotherapy was carried out in 7 cases, palliative chemotherapy and radiation treatment--in 3. Unlike pediatric nephroblastoma, Wilms' tumor in adults was resistant to radiation. Treatment results still remained unsatisfactory: 6 patients died 7-19 months after the beginning of treatment.

[Treatment of penile cancer]. / Lechenie raka polovogo chlena.

The results of treatment of 252 cases of cancer of the penis were evaluated. Indications for available methods of treatment with regard to patient's age, stage and size of primary tumor were worked out. Conservative treatment should be given to cases of T1 and T2 tumors, combined treatment--T3, and palliative therapy--T4 neoplasms. An experience with cryodestruction of tumor in combination with chemotherapy is discussed. More advantage seems to be offered by application of radiation treatment in such cases. Three- and five-year survival rates for stage 1 tumors were 98.6 and 97.5%, stage II--84.5 and 83.3%, stage III--26.2 and 24.9% irrespective of the procedure. Not a single patient with stage IV tumor survived over one year.

[Immunochemical study of the alpha-globulins in human kidney tumor tissue]. / Immunokhimicheskoe izuchenie al'fa-globulinov v opukholevoi tkani pochki cheloveka.

Four individual tissue proteins were studied both in normal and tumoral tissue of kidney (hypernephroma, Wilms tumor) using immunochemical analysis. Occurrence of an antigen, which was absent in definitive tissue of homologous origin, as well as a decrease in biosynthesis of some homologous antigens were found in malignant tissue.

[Comparative immunochemical and physicochemical study of 2 alpha-glycoproteins from human kidney tumors]. / Sravnitel'noe immunokhimicheskoe i fiziko-khimicheskoe izuchenie dvukh al'fa-glikoproteidov opukholei pochki cheloveka.

Using immunochemical methods two "divergent" antigens were identified in tumors of kidney; these antigens were not found in normal kidney, but were observed in several other normal tissues. Both antigens were alpha-glycoproteins. Immunochemical analysis was carried out to find these proteins in extracts of normal tissues, in malignant tumors of kidney as well as in blood serum of patients with the kidney tumors. These proteins were-dissimilar in immunochemical properties and also in some physico-chemical characteristics; one of them was a thermostable protein and the other one was able to bind estrogens.

[Possibility of evaluating the degree of dissemination of malignant tumors of the bladder using ultrasonic tomography]. / Vozmozhnosti mestnoi otsenki rasprostraneniia zlokachestvennoi opukholi mochevogo puzyria s pomoshch'iu ul'trazvukovoi tomografii.

The paper discusses the results of an analysis of degree of bladder cancer expansion with the aid of ultrasonic tomography. The results of tomography were compared with surgical and pathohistologic findings. The study group included 94 patients with bladder cancer. Stages A, B, and C were distinguished on the basis of tomographic features, which correspond to T1, T2, T3 and T4 according to TNM system. Application of ultrasonic tomography in conjunction with other diagnostic procedures offers more advantage in selecting an adequate stage-oriented treatment. The tomographic examination findings were confirmed in 80.7% for stage A (T1), 81.9%--stage B (T2) and 93.4% for stage T (T3 and T4).

[Computerized tomography in the complex diagnosis of space-occupying formations in the kidneys]. / Komp'iuternaia tomografiia v kompleksnoi diagnostike ob"emnykh obrazovanii pochek.

A computer tomography study of 10 cases of suspected nodulation in kidneys was carried out. The method proved effective in the identification and differential diagnosis of cysts and tumors in the kidney. Tumors were detected in 40 cases, polycystosis -- in 10 patients. Out of 10 cases, renal polycystosis and clinically -- implicit polycystosis of the liver were revealed in 4 patients. Computer tomography should be carried out at the beginning of examination because it may often save the trouble of using more complicated procedures. Application of computer tomography provides fresh means of differential diagnosis of nodulation in the kidney.

[Morbidity and treatment of penile cancer (based on data from the Moscow Municipal Oncology Dispensary)]. / O zabolevaemosti i lechenii raka polovogo chlena (po materialam Moskovskogo gorodskogo onkologicheskogo dispansera).

Penis carcinoma morbidity in the city of Moscow in 1973-1979 was 0.5 per 100,000 of male population, most of the patients being older than 60 years. On primary application, stage I of the disease was identified in 17.5%; stage II -- 42.9%; stage III -- 34.9% and stage IV in 4.7% of patients. Therefore, advanced tumors were found in 39.6% of patients. Combined treatment was given to 31.6%, radiation alone -- 37.5%, surgery -- 21.3% and symptomatic therapy -- 7.4% of cases. Three patients refused to take therapy.

[Bilateral tumors of the testis]. / Bilateral'nye opukholi iaichka.

Sixteen cases of bilateral tumors of the testicle (1.7% of all patients with tumors of germ origin) were treated at the Clinic of Urology of the Center in 1953-1982. The age of the patients varied 17-54 years (mean age--32.9 years). Cryptorchism was recorded in 2 out of 16 cases. Separate tumor was found to develop in the contralateral testicle in most cases, this factor being of vital importance for the choice of treatment procedure. The results of treatment did not differ from those in cases of unilateral lesions and were chiefly related to stage and microscopic pattern of tumor.

[Is maximal androgenic blockade necessary in the treatment of prostatic cancer?]. / Nuzhna li maksimal'naia androgennaia blokada v lechenii raka predstatel'noi zhelezy?

As the literature data give arguments both pro and contra wide use of maximal androgenic block (MAB) in the treatment of prostatic cancer, the authors studied MAB in 200 patients. They came to the conclusion that MAB can be applied in patients with symptoms of disseminated prostatic cancer as neoadjuvant therapy before prostatectomy and as neoadjuvant and adjuvant therapy in planning radiotherapy.

[Results of organ-preserving therapy for invasive bladder cancer]. / Rezul'taty organosokhraniaiushchei terapii invazivnogo raka mochevogo puzyria.

87 patients with urinary bladder cancer (UBC) stage T2-3aN0M0 have received an organ-saving treatment which combined neoadjuvant chemotherapy (methotrexate, adriamycin, vinblastin, cysplatinum) followed by transurethral or open resection of the bladder. The patients were followed up for 3 to 60 months. Recurrent tumors arose in 49(56.3%) patients, at the primary site in 94%. Recurrence-free 5-year survival made up 32.8 +/- 14.1 and 24.2 +/- 15.2% after transurethral and open resections of the bladder, respectively. In patients with a complete response to the neoadjuvant chemotherapy 5-year overall and recurrence-free survival reached 89.0 +/- 11.1 and 68.5 +/- 18.9%, respectively. It is thought valid to consider planning organ-saving treatment only in relation to patients with a complete regression of the tumor after neoadjuvant chemotherapy.

[Regional metastases of penile cancer: optimal treatment policy]. / Regionarnye metastazy raka polovogo chlena - optimal'naia taktika lecheniia.

Emergence of regional penile cancer (PC) metastases reduces late survival of PC patients from 94.4 to 83.9%. PC stage can hardly be diagnosed by clinical data significantly. Bilateral inguinal lymphadenectomy is indicated for all PC patients with enlarged and clinically negative regional lymph nodes in poorly differentiated primary tumor (G3) and stages T2-3. Follow-up can be recommended for patients with stage Tis-T1, low and moderate anaplasia (G1-2) of the primary tumor. Metastases to the iliac lymph nodes are an indication to pelvic lymphadenectomy. Preventive removal of the iliac lymph nodes in intact inguinal ones is not justified. Unremovable fixed regional lymph nodes should be exposed to radiotherapy.

[Role of fluorescent control in raising radicality of surgical treatment for superficial bladder cancer]. / Rol' fliuorestsentnogo kontrolia v povyshenii radikalizma operativnogo lecheniia poverkhnostnogo raka mochevogo puzyria.

Solution of 5-aminolevulinic acid (5-ALA) and D-Light unit (Karl Storz GmbH & Co) were used for fluorescent control over radicality of transurethral resection (TUR) of the urinary bladder. TUR with the fluorescent control was performed in 85 patients. The new procedure allowed to remove tumors undetectable at standard TUR in 46(54.1%) patients. Sensitivity and specificity of the method was 98.7 and 76.3%, respectively. 5-ALA-induced fluorescence used to control radicality of bladder TUR reduced the number of recurrences within 12 postoperative months 2-fold.

[Liver resection in locally-spread and metastatic kidney cancer]. / Rezektsii pecheni pri mestno-rasprostranennom i metastaticheskom rake pochki.

The postoperative outcome and survival were studied in patients operated for renal cancer with involvement of the liver. 9 patients have undergone radical nephrectomy and 12 patients--hepatic resections for direct hepatic involvement (2), synchronous (2) and metachronous (8) metastases of renal cell carcinoma. Right hemihepatectomy was performed in 2 and wedge resection in 10 cases. A complete resection was performed in 8 of 9 patients while one patient with direct hepatic invasion was found to have positive surgical margins. Postoperative lethality was absent but complications occurred in 6 patients: pancreatitis (1), pneumonia (3), hepatic abscess (1), hepatic and renal failure followed by GI bleeding (1). At follow-up, two patients died of progressive disease 4 and 68 months after the surgery and one was lost for follow-up. One patient with positive surgical margins is alive with pulmonary and liver metastases 16 months after surgery. Five patients are alive with no evidence of relapse 6, 10, 12, 19 and 56 months after the operation. Thus, the aggressive surgical approach is justified and should be considered in patients with renal cancer and hepatic involvement.

[Results of a 5-year screening for prostatic cancer]. / Itogi 5-letnego skrininga raka predstatel'noi zhelezy.

The results of 5-year screening (1996-2000) for prostatic cancer in 1129 males 40 to 80 years of age are presented. The examination included: measurement of blood levels of prostate-specific antigen (PSA), finger rectal examination, transrectal ultrasonic examination (TRUE) and, on demand, biopsy of the prostatic gland. Prostatic cancer was diagnosed in 1.5, 2.2 and 16% patients having PSA levels of 0-4.0, 4.0-10.0 and 10.0-30.0% ng/ml, respectively. At finger rectal examination prostatic cancer was suspected in 8% examinees, only in 33% of them the diagnosis was verified morphologically. By TRUE evidence 7% examinees were suspected and in 44.3% of them prostatic cancer was confirmed. Thus, biopsy proved necessary in 172 cases of 1129 examinees. In 64 (5.7%) males prostatic cancer was diagnosed and confirmed. Early prostatic cancer in the screened men and those consulted in the outpatient department of the National Cancer Research Center was detected in 77.7 and 22% men, respectively. The conclusion is made that men over 50 years of age should undergo prophylactic examination of the prostatic gland once a year.