Intravesical hyperthermia and mitomycin-C for carcinoma in situ of the urinary bladder: experience of the European Synergo working party.

OBJECTIVES: To study the results of chemotherapy combined with intravesical hyperthermia in patients with mainly BCG-failing carcinoma in situ (CIS). METHODS: Patients with histologically confirmed CIS were included retrospectively. Outpatient thermochemotherapy treatment was done with mitomycin-C (MMC) and the Synergo system SB-TS 101 (temperature range between 41 and 44 degrees C), weekly for 6-8 weeks, followed by 4-6 sessions every 6-8 weeks. RESULTS: Fifty-one patients were treated between 1997 and 2005 from 15 European centers. Thirty-four were pre-treated with BCG. Mean age was 69.9 years. Twenty-four patients had concomitant papillary tumors. The mean number of hyperthermia/MMC treatments per patient was 10.0. Of the 49 evaluable patients 45 had a biopsy and cytology proven complete response. In two patients CIS disappeared, but they had persistent papillary tumors. Follow-up of 45 complete responders showed 22 recurrences after a mean of 27 months (median 22): T2 (4), T1 (4), T1/CIS (1), CIS (5), Ta/CIS (2), Ta (5) and Tx (1). Side effects (bladder complaints) were generally mild and transient. CONCLUSIONS: In patients with primary or BCG-failing CIS, treatment with intravesical hyperthermia and MMC appears a safe and effective treatment. The initial complete response rate is 92%, which remains approximately 50% after 2 years.

[Treatment of genital condylomatous diseases with electric fulguration and interferon]. / Trattamento della condilomatosi dei genitali con elettrofolgorazione ed interferon.

The therapeutical effectiveness of beta-interferon and the possibility of reducing the incidence of relapses were evaluated by submitting two groups of 10 patients each to various treatment. The first group has been treated only by electro-fulguration and the second also by parenteral administration of beta-interferon. We obtained 60% of relapse (good result in 4 cases) in the first group and 20% (good result in 8 cases) in the second group. No side effects have been reported by patients treated by interferon. We conclude that systemic beta-interferon can be active in treating patients with condylomata acuminata in association with electro-fulguration.

[Role of ultrasonography in the differential diagnosis of acute scrotum]. / Ruolo della ecografia nella diagnosi differenziale dello scroto acuto.

Forty-five patients with acute scrotal disorders underwent gray-scale and color-Doppler ultrasonography. The aim of the study was to evaluate the role of the US in order to distinguish inflammatory diseases from testicular torsion. Gray-scale with color-Doppler US allows for evaluation of morphologic findings and perfusion and enables accurate diagnosis of most scrotal disorders especially in the earlier clinical observations.

Rare secondary carcinoma from colon to testis. Review of literature and report of a new case.

A 65 year old man who underwent a right hemicolectomy for mucus secreting adenocarcinoma of the caecum in 1986 developed a secondary localisation in the right testis one year later. A review of the international literature shows only 14 previously described cases of spread of a colonic tumour into the testis. The Authors discuss the possible mechanisms of this form of dissemination.

[Doppler color echography in varicocele]. / El ecocolordoppler en el varicocele.

The authors report their experience with the color Doppler ultrasound in the diagnosis and follow-up of patients with varicocele. The features and advantages afforded by this technique are described and attention is focussed to the contribution of technological advancement to the urological armamentarium. We report on 18 cases of varicocele, 2 of which were grade I (preclinical), that had been diagnosed by this technique and confirmed at surgery. In this series the scrotal scintiscan proved to be less specific and was falsely negative in one of the two grade I varicoceles.

Secondary tumors of testis: two rare cases and review of the literature.

Secondary testicular tumor is a rare event. Approximately 200 cases have been documented in the international literature since 1935. The most common primary tumor sites have been the prostate, lung and kidney with other sites being reported less frequently. Our literature review discovered only 7 cases originating from primary tumors of the stomach and 14 cases from primary tumors of the colon. We want to add 2 more cases and discuss the possible mechanism of this neoplastic dissemination.

High-dose epirubicin in the prophylactic treatment of T1G2 superficial bladder tumors.

OBJECTIVES: To evaluate the activity and safety of intravesical instillations of 80 mg epirubicin in a selected patient population with T1G2 primary and multiple superficial bladder tumors. To assess the completeness of the transurethral resection (TUR) at 4 weeks (second look) and to compare the histology of local and review pathology. METHODS: One hundred and sixty-nine patients have been histologically assessed both locally and extramurally for T1G2 superficial bladder tumors. Epirubicin (80 mg/instillation) started within 20 days after TUR was administered weekly during the first month and then monthly for another 11 months. Assessments for relapse were carried out according to the standard methods. RESULTS: Histological consistency for T1G2 between local and extramural assessments was found in 85.2% of cases. At the median follow-up time of 38 months, the overall relapse rate was 43.3%. Treatment was very well tolerated: no systemic adverse events were reported and local adverse events were confined to chemical cystitis which in 3% required treatment discontinuation. CONCLUSIONS: Epirubicin (80 mg/instillation) appeared effective in the prophylaxis of relapse in primary and multiple T1G2 superficial bladder tumors. A second TUR at 3-4 weeks is necessary in T1 tumors. Excellent concordance between local and review pathology was found.