Complete androgen blockade versus chemical castration in advanced prostatic cancer: analysis of an Italian multicentre study. Italian Leuprorelin Group.

OBJECTIVES: In spite of a great amount of data, the hormonal treatment of advanced prostatic carcinoma (CaP) still remains controversial. As a relevant amount of dihydrotestosterone is present within the prostate tissue after castration, complete androgen blockade (CAB), with inhibition of the activity of both testicular and adrenal androgens, has been advocated as up-front treatment of advanced CaP. However, many controlled studies have failed to demonstrate a benefit for CAB in comparison with simple surgical or chemical castration. The present study was performed to bring additional data for a worldwide meta-analysis of all phase III trials comparing castration and CAB. METHODS: This is a centrally controlled phase III study in which chemical castration with leuprorelin acetate depot was compared with leuprorelin plus flutamide in stage C and D CaP. Two hundred and forty-one eligible and evaluable patients with histologically proven CaP were recruited for the study (120 treated with castration and 121 with CAB). The diagnostic and staging workup consisted of blood chemistry, general condition assessment, prostate-specific antigen (PSA), abdominal sonography and computed tomography scan, and whole-body isotopic bone scan. End points of the study were survival, time to treatment failure, and time to progression. The patients were followed every 6 months with PSA and sonography. RESULTS: At a cut-off analysis performed in December 1996, when the mean follow-up period was 43.7 +/- (SD) 24.1 months, no statistical differences in terms of time to treatment failure, time to progression, and death rate could be detected. Also considering the common risk factors, such as basal PSA, haemoglobin, alkaline phosphatase, and Gleason score, the outcome did not show any clear advantage for CAB. CONCLUSIONS: This study appears to confirm that the advantages of first-line CAB in CaP are at best marginal. The final analysis will be performed when the follow-up period has reached 5-years, but it seems unlikely that the present results will change.

Percutaneous renal biopsy utilizing ultrasonic guidance and a semiautomated device.

Percutaneous renal biopsy is a fundamental diagnostic technique in urology and nephrology, recently refined by real-time ultrasonic guidance. The technique described in this article is a biopsy method employing real-time ultrasonic guidance and a semiautomated device. The new device has been constructed to improve percutaneous biopsy technique and to obtain more perfect specimens. This technique was successfully performed in 20 patients undergoing renal biopsy. Diagnostically satisfactory material containing an average of ten glomeruli per specimen was obtained. The results obtained with the new device Biopty Bard have been compared with the results obtained from the same number of biopsies performed with the traditional technique.

Recombinant alpha interferon in metastatic renal cell carcinoma. A cooperative phase II study.

A total of 61 evaluable patients with advanced renal cell carcinoma have been treated with 3 x 10(6) IU per square meter of body surface with recombinant alpha 2b interferon three times a week within a Cooperative Phase II Study. Toxic death for terminal renal failure occurred in 1 patient (1.63%), and toxicities greater than WHO grade 2 were present in 10 cases (16%). The overall response rate after six months of treatment was 13.1% (partial response 4, minor response 4). Two complete responses were obtained at nine and fifteen months (3.3%). Long-lasting stabilization of disease was 13.1 percent.

[Performance of echo-guided renal biopsy using a new semi-automatic instrument]. / Esecuzione di biopsia renale ecoguidata mediante utilizzo di un nuovo strumento semiautomatico.

Percutaneous renal biopsy is a fundamental diagnostic technique in clinical nephrology, recently refined by real-time ultrasonic guidance. The technique described in this paper is a biopsy method employing real-time ultrasonic guidance and a semi-automated device. This technique has been successfully performed in 10 patients undergoing renal biopsy. Diagnostically satisfactory material containing an average of 9 glomeruli for specimen was obtained.

[2 cases of fibroepithelial polyp of the ureter]. / Due casi di polipo fibroepiteliale dell'uretere.

Fibroepithelial polyps of the ureter, a mesodermal benign tumor, are rare. The first case of a fibroepithelial ureteral polyp associated with bilateral complete ureteral duplication and another case associated with bilateral hydronephrosis are reported. The first case suggested a malformative congenital etiology. The two fibroepithelial polyps were treated by conservative surgery.

[Intraoperative anterograde spermatic phlebography: its usefulness in the treatment of varicocele]. / La flebografia spermatica anterograda intraoperatoria: sua utilità nel trattamento del varicocele.

The value of intraoperative anterograde spermatic phlebography in the treatment of varicocele is maintained. The knowledge of the vascular anatomy making it possible to adapt surgical tactics to the needs of the particular patient. Use of this technique significantly reduced the risk of postoperative recurrences.

[Evaluation of vesico-ureteral reflux in children with computerized isotopic cystography in association with urodynamic tests]. / Valutazione del reflusso vescico ureterale in età pediatrica con cistografia isotopica computerizzata in associazione ad esame urodinamico.

Method and results are presented for the cystoscintigraphic detection with 99mTc-DTPA, associated with urodynamic examination for the evaluation of the vesicoureteral reflux, involving a relatively simple execution. The use of this method is advised in Pediatrics because of its low gonadal dose, thorough examination and least aggressiveness.