[First experience of Ho:YAG laser urethrotomy in the treatment of strictures in patients with prostate cancer].

Strictures of vesicourethral anastomosis (VUA), urethral strictures, and bladder neck obliteration are frequent complications occurring after treatment for prostate cancer and dramatically reducing the quality of life of the patients. To date, there is no single standard treatment of urethral strictures. One of the promising methods is laser optical urethrotomy using a solid-state Ho:YAG- laser. Since 2012, we treated 12 patients with strictures of VUA, urethral strictures, and bladder neck obliteration. According urethrography, the maximum length of stricture was 4.5 cm. Treatment efficacy was assessed at 6 months after surgery objectively according urethrography, uroflowmetry, and ultrasound of the bladder with the definition of residual urine; and subjectively--by IPSS questionnaire and QoL questionnaire. After removal of the urethral catheter, all patients had recovered independent urination, decreased IPSS scores by 59.5%, IPSS-QoL score by 45.87%, decreased residual urine volume by 89.92%, and increased maximum urinary flow rate by 78.19%. Intraoperative complications and early postoperative complications were not observed. Ho:YAG laser is a minimally invasive and safe tool for urethrotomy of strictures of VUA, urethral strictures, and bladder neck obliteration arising after treatment for prostate cancer. Definitive conclusions about the effectiveness of this method should be based on long-term results of comparative trials.

[Dynamics of prostate-specific antigen concentration--growth kinetics of prostate cancer?].

Current research confirms that the prostate-specific antigen (PSA) is not just a protein required for liquefaction of the ejaculate but it plays biological role in the development of prostate cancer. Assessment of the PSA dynamics offers good opportunities for understanding the kinetics of growth of prostate tumors. The most frequently it is performed calculation of PSA doubling time (PSADT), a parameter that requires a logarithmic analysis and takes into account the exponential nature of tumor growth. The review shows modern clinical applications and evaluation of PSADT at all stages of prostate cancer development.

[First experience of using positron emission tomography with 11C-choline in prostate cancer (PC)].

Introduction into clinical practice of combined positron emission technology and computer tomography (PET/CT) allows in one study to identify structural and functional abnormalities. The study involves 32 patients who underwent PET/CT with "C-choline, including 5 patients with prostate cancer (PC), 3--with chronic prostatitis and 24--with biochemical PC recurrence. PET/CT with 11C-choline has a high diagnostic efficacy in detection of local recurrence and PC metastases in patients with biochemical PC recurrence. The results of visual analysis do not permit to distinguish PC from benign prostate diseases.

[Characteristics of surgical approach using for patients with renal cell carcinoma, complicated by postcava tumor thrombosis].

The postcava tumor thrombosis had about 1/3 of patients with renal cell carcinoma at the initial examination. Reconstructive interventions were performed on the postcava for 38 patients (24 men, 14 women). The postcava thrombectomy was applied in 15 patients. The thrombectomy with postcava resection were carried out in 13 patients and plasty- in 6, prosthetics-in 4. An actuarial 3-year or 5-year survival rate of patients consisted of 59.4% and 42.2%. The performance of reconstructive interventions on postcava with its involvement was justified and provided satisfactory results in patients with renal cell carcinoma.

[The possibilities of surgical and combined treatment of patients with locally-disseminated renal cell carcinoma].

A comparative analysis of surgical and combined treatment of renal carcinoma in 84 patients has shown that preoperative embolization of the renal arteries failed to reduce blood loss and duration of operation, failed to increase recurrence-free period and 3 to 5 years survival of the patients. Specific features of combined interventions are described.

[A method for forming a urinary bladder from the sigmoid after radical cystectomy in patients with bladder cancer].

A procedure was evolved and tested for forming a urinary bladder from the sigmoid in the course of radical cystectomy carried out for invasive bladder cancer (20). A sigmo-sigmoid anastomosis ("end-to-side") was used by means of an apparatus suture.

[Influence of immunological parameters on the effectiveness of systemic and loco-regional immunotherapy in disseminated renal carcinoma].

Survival was assessed among patients with disseminated renal carcinoma from different prognostic groups as established by MSKCC protocol. Multivariate evaluation pointed to prognostic value of IL-6 (spontaneous and induced production), IL-8 (spontaneous and induced production),TNF-alpha (spontaneous production), IFN-gamma (induced production), TNK-cells (CD3+CD16+CD56+), and T-regulatory cells (CD4+CD25+Treg). It was demonstrated that additional criteria may be used to evaluate prognosis.

[Poorly differentiated prostate cancer may be associated with cytomegalovirus infection in prostatic tissue].

Polymerase chain-reaction procedure was used to test archival samples of prostate tissue from 90 cancer patients for cytomegalovirus infection detected in 46.7%. The median Gleason score and G-index (TNM classification) were significantly higher in CMV-positive patients (8 and 4, respectively) than those in CMV-negative ones (6 and 2, respectively). A relationship between cytomegalovirus infection and poor prognosis of prostate cancer is suggested.

[Specific features of hemostasis during radical retropubic prostatectomy].

From September 1999 through March 2008 radical retropubic prostatectomy (RRP) with bilateral pelvic lymphadenectomy was fulfilled in 148 male patients aged from 48 to 77 years, mean age 61 +/- 5.3 years. The patients were divided into 2 groups: the first group (63 patients) was subjected to RRP without using apparatus "LigaSure" and using either antegrade or retrograde technique RRP. In the second group patients hemostasis was achieved by using apparatus "LigaSure" in addition to other methods. Mean duration of surgery in the first group was 154 minute when using the antegrade technique, and 161 minutes when using the retrograde technique. In the second group mean time of operative intervention was 123 min when using the antegrade technique and 128 min with the retrograde (p < 0.01). The volume of blood loss in the 1st group varied on average from 1624 with the antegrade technique to 1587 ml with the retrograde technique, while in the 2nd group 1028 with the antegrade technique and 1138 ml with the retrograde technique (p < 0.01). Blood transfusion in the 1st group was required for 42 patients, in the 2nd group for 19 patients (< 0.01). The data obtained show that individual approach to every patient when using RRP as well as wide use of modem instruments allow dangerous complications to be avoided or minimized.

[Positron emission tomography with 18-fluorine deoxyglucose in the diagnosis and assessment of prostate cancer].

Results of PET studies using 18-fluorine deoxyglucose (18-FDG) in patients with large-size masses (51) are discussed. Histologically-confirmed prostate cancer was diagnosed in 36 (70.5%), benign hyperplasia--12 (23.5%) and chronic prostatitis--3(6%). 18FDG PET was conducted as whole body irradiation. Our results established its high predictive significance in identifying the scope of tumor involvement. However, the latter's potential is limited in diagnosis of primary tumor node due to low rate of glycolysis in it.

[Application of radiofrequency ablation for treatment of localized renal carcinoma].

An evaluation of the results of radiofrequency ablation of renal clear-cell carcinoma (pT1aN0M0) in 7 patients is presented. The longest follow-up was 26 months, the shortest--4 months. No complication was reported. A review of the literature and our own experience point to radiofrequency ablation being an effective procedure of thermotherapy for small-size peripheral renal neoplasms.

[Capacities of complex ultrasound study in the diagnosis of prostate cancer].

Prostate cancer (PC) constitutes the bulk of male small pelvic abnormalities. The early diagnosis of PC is the most topical problem in oncourology. At present, ultrasound imaging is common in the diagnosis of prostatic diseases. With the advent of ultrasonic angiography, the diagnosis of PC has gone to a new level. The high-accuracy diagnosis of early PC has been made by complex ultrasound study that yields images of prostatic tissue and vascular structures. The sensitivity and specificity of transrectal ultrasound study of the prostate in the detection of PC and in the estimation of the extent of a local neoplastic process.

[The frequency and diagnostic value of microscopic signs of minimal prostate adenocarcinoma].

Prostate biopsy specimens from 64 patients were studied. In most cases with minimal prostate adenocarcinoma, the tumor was limited by the organ and of moderate malignancy.

[Positron emission tomography in oncourology].

The authors present the results of the examination of 61 patients with genitourinary space-occupying lesions, using 18F- fluorodeoxyglucose positron emission tomography (PET) in whole body mode. In all cases the diagnosis was verified morphologically. The results demonstrated high diagnostic accuracy of PET, including possibility to determine the extent of oncourological cancer. However, the method displays poor efficacy in cases of hypernephroid cancer due to low level of glycolysis in this type of tumor.

[Technical improvement of the prostate thick-needle biopsy].

The method is proposed for minimizing loss of material of needle biopsy of the prostate by means of a container during fixation. This allous (1) saving all the fragments, (2) to increase the surface of the material in the micropreparation and (3) to put into one paraffin block several columns and thus to decrease the cost of histological study.

[Gene expression profiles of protein kinases and phosphatases obtained by hybridization with cDNA arrays: molecular portrait of human prostate carcinoma]. / Profili ékspressii proteinkinaz i fosfataz, poluchennye metodom gibridizatsii s uporiadochennymi naborami kDNK (cDNA arrays): molekuliarnyi portret raka predstatel'noi zhelezy cheloveka.

Hybridization with cDNA arrays was used to obtain expression profiles of 263 protein-tyrosine kinase (PTK), protein-tyrosine phosphatase (PTP), dual-specific phosphatase (DuSP), and other genes for the normal prostate tissue, primary prostate carcinomas (PC) of 84 patients, 7 xenografts, and 5 carcinoma cell lines. Analysis of 96 profiles revealed eight clusters of genes coexpressed in PC (coefficient of correlation r > 0.7). According to the known functions of their genes, the clusters were designated as proliferating-cell (CDC42, TOP2A, FGFR3, MYC, etc.), neoangiogenesis and blood-cell (LCK, VAV1, KDR, VEGF, MMP9, SYK, PTPRS, and FLT4), invasion-1 and invasion-2 (ADAM17, TRPM2, DUSP6, VIM, CAV1, CAV2, JAK1, PTPNS1, FYN, and PDGFB), HER2, and PSA/PSM/HER3. Basing on expression profiles of 66 genes, a molecular classification of PC was constructed and allowed discrimination between PC and cell lines or xenografts at 98.9% probability. The results suggested that, along with PSA, PSM (FOLH1), kallikrein-2, and a-2-macroglobulin, cell signaling genes EGFR, HER2, HER3, TOP2, KRT8, KRT18, VEGF, CD44, VIM, CAV1, and CAV2 may serve as diagnostic and prognostic markers in PC. The HER2, VEGF, and CD44 genes and the MMP and ADAM families were assumed to be promising targets for inhibitors of PC cell proliferation and metastasis.