ABSTRACT
Urinary tract infectious-inflammatory complications frequently occur after polytrauma. Among many causes of such complications is low resistance to infection. Addition of the immunomodulator cycloferon to combined treatment of polytrauma improves prophylaxis and treatment of acute pyelonephritis in patients with combined trauma.
Subject(s)
Acridines/therapeutic use , Interferon Inducers/therapeutic use , Multiple Trauma/drug therapy , Pyelonephritis/drug therapy , Pyelonephritis/etiology , Acridines/administration & dosage , Acute Disease , Adult , Aged , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/therapeutic use , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/therapeutic use , Drug Administration Schedule , Drug Therapy, Combination , Female , Humans , Interferon Inducers/administration & dosage , Male , Middle Aged , Multiple Trauma/complications , Multiple Trauma/immunology , Pyelonephritis/immunology , Treatment Outcome , Young AdultABSTRACT
Approximately 10.0% of tumors occurs in the lower urinary tract and morbidity and lethality are constantly on the rise. Over 90% of such tumors registered in Europe and the USA is transitional cell carcinoma. Primary bladder cancer morbidity in Russian males rose by 4.0-4.6% in 1990-1997 while the share of patients with superficial bladder cancer (SBC) went up by 1.5% for the same period. According to the National Bladder Cancer Group, the rising incidence of relapsing SBC is associated with urothelial dysplasia, positive test for urinary sediment after therapy and occurrence of four or more tumors larger than 5 cm. Prevention of muscular invasion is vital in management of SBC. Sometimes, such aggressive modalities as early cystectomy or radiotherapy are recommended in cases of high risk for this pathology. Conversely, certain palliative measures, short of transurethral resection of the bladder and adjuvant intravesical therapy, are regarded as sufficient.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Transitional Cell/therapy , Urinary Bladder Neoplasms/therapy , Aged , Carcinoma, Transitional Cell/drug therapy , Carcinoma, Transitional Cell/epidemiology , Carcinoma, Transitional Cell/pathology , Carcinoma, Transitional Cell/surgery , Chemotherapy, Adjuvant , Cystectomy , Drug Administration Schedule , Female , Humans , Incidence , Instillation, Drug , Male , Middle Aged , Risk Assessment , Risk Factors , Russia/epidemiology , Treatment Outcome , Urinary Bladder Neoplasms/drug therapy , Urinary Bladder Neoplasms/epidemiology , Urinary Bladder Neoplasms/pathology , Urinary Bladder Neoplasms/surgeryABSTRACT
A retrospective analysis included 63 patients with urothelial cancer. Untreated tumor tissue sampled in the course of primary surgery was examined by immunostaining procedure. After surgery, superficial tumors were treated with intravesical chemotherapy, invasive cancer--chemoradiotherapy. Overall survival was significantly higher in cases of low expression of antigen Ki-67 and gene-suppressor p53 while relapse-free survival in patients without HER-2 expression was significantly higher than in cases of overexpression.
Subject(s)
Biomarkers, Tumor/analysis , Carcinoma/chemistry , Carcinoma/diagnosis , Ki-67 Antigen/analysis , Receptor, ErbB-2/analysis , Tumor Suppressor Protein p53/analysis , Urinary Bladder Neoplasms/chemistry , Urinary Bladder Neoplasms/diagnosis , Adult , Aged , Carcinoma/therapy , Disease-Free Survival , Down-Regulation , Female , Gene Expression Regulation, Neoplastic , Humans , Immunohistochemistry , Male , Middle Aged , Mutation , Predictive Value of Tests , Prognosis , Retrospective Studies , Survival Analysis , Tumor Suppressor Protein p53/genetics , Up-Regulation , Urinary Bladder Neoplasms/therapy , Urothelium/chemistry , Urothelium/pathologyABSTRACT
Organ preservation has been investigated inmuscle-invasivebladder cancer over the past years as an alternative to standard radical cystectomy. However, the morbidity of radical cystectomy and early reports of good results of radical transuretheral resection of bladder tumors (TURBT) have stimulated interest in combined treatment for muscle-invasive bladder cancer. Organ preservation requires a trimodal schedule, including transuretheral surgery, mega voltage radical external beam radiotherapy (EBRT) and adjuvant chemotherapy (ACT). Our results point to the effectiveness of combined therapy of urinary bladder in old patients with invasive, advanced cancer (stage T2). These results demonstrate the effectness of intra-arterial ACT when used in combination with EBRT.
