Onkourologiya最新文献

{"title":"Reconstructive plastic surgery for bladder cancer metastasis into urethra (case report)","authors":"M. Tillyashaykhov, E. V. Boyko, N. T. Rakhimov, L. Koren, S. Khasanov, N. T. Abdusamatov, A. K. Ataboev","doi":"10.17650/1726-9776-2019-15-4-135-139","DOIUrl":"https://doi.org/10.17650/1726-9776-2019-15-4-135-139","url":null,"abstract":"Due to few observations, a standard treatment scheme for metastatic cancer into urethra has not been developed yet. However it has become evident, that combined approach using neoadjuvant radiation or chemoradiotherapy together with surgical tumor removal, taking into account its location, size, local prevalence and metastases to regional lymph nodes, is much more effective. The article describes a clinical case of a secondary urethra metastatic lesion from bladder.","PeriodicalId":42924,"journal":{"name":"Onkourologiya","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67754412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic magnetic-resonance cystography in diagnosis of perivesical fat invasion in bladder cancer","authors":"E. Grigoriev, I. Frolova, E. Usynin, N. V. Vasiliev, A. Usova, N. Trukhacheva, S. Velichko","doi":"10.17650/1726-9776-2019-15-4-93-99","DOIUrl":"https://doi.org/10.17650/1726-9776-2019-15-4-93-99","url":null,"abstract":"Objective: to evaluate the diagnostic capabilities of the dynamic magnetic-resonance cystography technique in detecting invasion of perivesical fat in case of bladder cancer.Materials and methods. The study included 125 patients (105 male and 20 females, mean 62.6 Ѓ} 11.0 years) with transitional cell carcinoma of the bladder. To assess the accuracy of the dynamic cystography method, cases with a tumor size of more than 20 mm, affecting the wall outside the bladder triangle, were selected with suspicion of perivesical fat invasion on magnetic-resonance scans. A furacilin solution was fractional injected into the catheterized bladder to obtain repeated series of T2‑haste-FS images until the bladder was completely expanded.Results. In postprocessing, the selection of areas of interest (ROI) was performed along the contour of the affected wall in the cross section through the center of the tumor. Comparison of the displacement of the affected and intact walls by a diagram of the values of the intensity of the magnetic-resonance signal in the dynamics of bladder dilatation was evaluated. The verification method was the morphological study of the surgical material after the operative treatment. The limit of values with a more likely lesion of perivesical fat was found, which is less than 11 % of the intensity change of the magnetic-resonance signal in selected ROIs during bladder wall expansion.Conclusion. The effectiveness of dynamic magnetic-resonance cystography in the differential diagnosis of perivesical fat infiltration in bladder cancer is characterized by a sensitivity of 90.0 %, a specificity of 93.3 %, and an accuracy of 92.0 %. The proposed technique improves the accuracy of the magnetic resonance imaging method with suspected infiltration of perivesical fat and is well tolerated by patients.","PeriodicalId":42924,"journal":{"name":"Onkourologiya","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67755108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Basic characteristics and features of the molecular genetic test systems designed for non-invasive diagnostics and prognosis of prostate cancer and bladder cancer","authors":"D. Mikhaylenko, S. A. Sergienko, B. Alekseev, A. Kaprin, M. Nemtsova","doi":"10.17650/1726-9776-2019-15-4-18-29","DOIUrl":"https://doi.org/10.17650/1726-9776-2019-15-4-18-29","url":null,"abstract":"Improving the laboratory diagnosis of prostate cancer and bladder cancer are still an actual problem in modern urologic oncology. Test systems for DNA or RNA alterations that occurred during carcinogenesis and associated with the malignant tumor and the prognosis of disease have been actively developed in recent years. Here we reviewed the data published mainly in the last 5 years about the molecular genetic kits for diagnosis (Progensa, SelectMDx, ExoDx Prostate Test, Prosta-Test, Confirm MDx) and assessment of prognosis (Prolaris, Decipher, Oncotype DX) in patients with prostate cancer, discussed their sensitivity and specificity. The characteristics of analogous kits and panels for bladder cancer (UroVysion, CertNDx Bladder Cancer Assay, UroSEEK, mutations in the FGFR3 and TERT genes, and the Cxbladder Monitor/Detect/Triage kit's line) were systematized. Particularly we focused on the description of the patient cohorts for whom kits mentioned above have greater diagnostic accuracy, described limitations of these test systems in consequence both a methodological and registration aspects, and their use in combination with other tumor markers. This review is aimed at oncologists, urologists, laboratory geneticists and specialists in related professions.","PeriodicalId":42924,"journal":{"name":"Onkourologiya","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67754520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current advances in kidney cancer immunotherapy","authors":"A. Korotaeva, N. Apanovich, E. Braga, V. Matveev, A. Karpukhin","doi":"10.17650/1726-9776-2019-15-4-30-38","DOIUrl":"https://doi.org/10.17650/1726-9776-2019-15-4-30-38","url":null,"abstract":"In Russia, among tumors of the genitourinary system, renal cell carcinoma takes the 2nd place after prostate cancer. In 25 % of patients at the time of diagnosis, metastases are detected. Treatment of advanced stages of renal cell carcinoma is often not effective enough. The introduction into clinical practice of modern immunotherapeutic drugs based on inhibition of immune check points has changed the prognosis of the disease for many patients with various malignant neoplasms, including kidney cancer. In this article, we described the results of recent clinical trials on the use of immunotherapy in the treatment of kidney cancer. The most effective is combination of drugs that inhibit different immune check points, and a combination of a check point inhibitor with a targeted drug. This approach is likely to be a major one in the treatment of renal cell carcinoma in the short term. Combinations of control point inhibitors with radiation therapy and immunomodulatory drugs, the role of miRNAs in the regulation of expression of immune control points, the significance and characteristics of the microbiome in connection with the success of immunotherapy for kidney cancer, gene expression profiles as biomarkers of the immune response, and other biomarkers are considered. A better understanding of the mechanisms that limit the effectiveness of immune control point inhibitors will improve future treatment.","PeriodicalId":42924,"journal":{"name":"Onkourologiya","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67754682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic metastases from renal cancer: comparing surgery and pharmacotherapy efficacy","authors":"A. Kotelnikov, A. Kriger, D. Podluzhny, I. S. Proskuryakov, G. Galkin, Y. Patyutko, I. Fainstein","doi":"10.17650/1726-9776-2019-15-4-58-64","DOIUrl":"https://doi.org/10.17650/1726-9776-2019-15-4-58-64","url":null,"abstract":"Background. Today, targeted therapy is a standard treatment in advanced renal cell carcinoma, while the surgical method plays the role of a possible approach in a select category of patients with solitary and single metastases.The study objective to compare the effectiveness of two alternative treatment approaches: the surgical method and modern pharmacotherapy in achieving long-term overall survival of patients with pancreatic metastases of renal cell carcinoma.Materials and methods. A retrospective two-center study was conducted. The cohort of surgical treatment included patients (n = 56) who underwent surgery for pancreatic metastases from renal cell carcinoma at the N.N. Blokhin National Medical Research Center of Oncology and A.V. Vishnevsky National Medical Research Center of Surgery in the period from 1990 to 2019. Operations were performed for all types of pancreatic lesions: synchronous/metachronous, solitary/single and multiple, isolated/combined with lesions of other organs. Postoperative mortality rate was 5 % (3 patients). The pharmacotherapy cohort (n = 28) included patients with potentially resectable pancreatic metastases from clear cell renal cell carcinoma who underwent targeted therapy. Survival was assessed using the Kaplan–Mayer method. The Mantel–Cox test was used to test null hypothesis.Results. The 5-year overall survival rate was 68 % in the surgery group compared to 35 % for the pharmacotherapy group. Median overall survival for surgical and non-surgical patients was 82 months and 43 months, respectively (p = 0.01). The advantage of the surgical method was also found in a subgroup survival analysis of patients with extrapancreatic disease (p = 0.037). In this case, the 5-year overall survival rate was 66 % in the surgery subgroup (n = 25) compared to 35 % for the pharmacotherapy subgroup (n = 24). Conclusion. Radical surgical treatment in comparison with modern pharmacotherapy allows to achieve significantly higher rates of overall survival in patients with pancreatic metastases of renal cell carcinoma and can be considered as a priority.","PeriodicalId":42924,"journal":{"name":"Onkourologiya","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67755132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is technically complicated partial nephrectomy justified in renal cell carcinoma patients with normal contralateral kidney?","authors":"M. Volkova, V. A. Ridin, V. A. Cherniayev, A. Klimov, K. Figurin, A. Kirichek, V. Matveev","doi":"10.17650/1726-9776-2019-15-4-39-49","DOIUrl":"https://doi.org/10.17650/1726-9776-2019-15-4-39-49","url":null,"abstract":"Objective: to compare the results of partial (PN) and radical nephrectomy (RN) in patients with renal parenchymal tumors with nephrometric PADUA index ≥8 and/or RENAL index ≥7 and functioning contralateral kidney.Materials and methods. Medical data of 114 consecutive patients with renal cell carcinoma (RCC) cT1–3aN0M0 and functioning contralateral kidney were included into the study: 57 (50.0 %) persons undergone PN for tumors with nephrometric PADUA index ≥8 and/or RENAL index ≥7 (the main group), and 57 (50.0 %) patients undergone RN (the control group). The groups were comparable with regards to demographic characteristics, nephrometric parameters, morphological tumor features, and baseline glomerular filtration rate (р >0.05 for all). Median follow-up – 52.0 ± 23.6 (9.1–138.5) months.Results. Technically complicated PNs were associated with an increase of median surgery time (by 39 min, р = 0.06), blood loss (by 319 ml, p within the groups. Chronic kidney disease (CKD) progression rate was significantly higher in RN than in PN group (40 % vs 31.6 % respectively, р = 0.050), including more frequent development of CKD stages III–IV (31.6 % vs 26.3 % respectively; р = 0.034). There was no difference of long-term survival between PN and RN groups, and that included survival results stratified according to gender, age, baseline CKD stage, PADUA and RENAL indexes. Five-year recurrence-free survival was 94.1 % vs 92.2 % (р = 0.223), cancer-specific survival – 92.3 % vs 90.8 % (р = 0.443), cardio-specific survival – 91.6 % vs 77.9 % (р = 0.549), overall survival – 89.8 % vs 70.7 % respectively (р = 0.858).Conclusion. PN is effective and safe method of treatment in patients with renal parenchymal tumors with PADUA index ≥8 and/or RENAL index ≥7 and functioning contralateral kidney, providing significant functional benefit without survival compromising when compared with RN.","PeriodicalId":42924,"journal":{"name":"Onkourologiya","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67754701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PET / CT in the early and differential diagnosis of adrenocortical cancer","authors":"I. Aboyan, K. V. Berezin, A. Hasigov, S. Pakus, E. V. Prilepina, N. B. Volkonskaya, V. Chernousov","doi":"10.17650/1726-9776-2019-15-4-113-119","DOIUrl":"https://doi.org/10.17650/1726-9776-2019-15-4-113-119","url":null,"abstract":"The objective of the study was to develop criteria for the early diagnosis and differential diagnosis of adrenocortical cancer (ACC) during positron emission tomography combined with computed tomography (PET / CT) with 18F-fluorodeoxyglucose (18F-FDG). Materials and methods. Diagnostic tests were performed on a General Electric the Discovery PET / CT 610. After scanning 60–90 minutes after the administration of the radiopharmaceutical, PET-grams were formed showing the distribution of the radiopharmaceutical throughout the body in both physiological and pathological areas. Using software, automatic \"fusion\" of images obtained on PET and CT scanners was carried out. Initially, a radiologist performed an analysis of structural pathological changes in organs, followed by an assessment of the level of accumulation and determination of CT densitometry of pathological adrenal formations. Subsequently, metabolic activity was determined by the level of SUV (standart uptake value). Results. A retrospective analysis of PET / CT data with 18F-FDG was performed in 50 patients with adrenal tumor formations. Based on the data studied, all patients were divided into 2 groups: 1st group (n = 21) with a subsequent diagnosis of ACC, 2nd group (n = 29) with benign adrenal neoplasms. The age of the patients was 68 (32–76) years and did not statistically differ in both groups (p ˃0.05). After check up tumor parameters the following results were obtained: the average tumor size in patients of the 1st group was 4.5 Ѓ} 0.75 cm, of the 2nd group – 4.9 Ѓ} 1.1 cm, no significant difference was found (p ˃0.05). The diagnostic model obtained by constructing and subsequent analysis of the ROC curve of the SUV level in patients with malignant and benign neoplasms of the adrenal glands showed a high quality model with a sesitivity of 90 %, specificity of 95 % (area under the ROC curve (AUC) 0.93 at p <0.0001 (z = 27.37)) and a cut-off point of 3. When studying CT densitometric parameters of a tumor in patients of the 1st and 2nd groups, a direct correlation relationship between these parameters and the diagnosis of malignant lesions was also obtained (Rs = 0.67; coefficient τ Kendall 0.64; p = 0.001). Interpretation of the results of the ROC analysis of the tumor density level (CT density in Hounsfield units (HU)) in patients of the 1st and 2nd groups showed 80 % sensitivity and 90 % specificity (AUC 0.89; p <0.0001) with clipping point equal to 10 HU. Conclusion. Obtaining integral information on the SUV level together with the measurement of CT density during PET / CT with 18F-FDG is one of the most modern diagnostic methods that allow both diagnostics and differential diagnosis of ACC in the early stages of the pathological process. The above factors currently indicate the high diagnostic value of PET / CT with 18F-FDG and the priority nature of this study in cases of suspected ACC in patients with adrenal neoplasms of 1–5 cm in size.","PeriodicalId":42924,"journal":{"name":"Onkourologiya","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67753641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alpha-therapy using radium-223 chloride in patients with castration-resistant prostate cancer. From clinical researches to routine practice","authors":"K. Nyushko, B. Alekseev, V. Krylov, A. Kaprin","doi":"10.17650/1726-9776-2019-15-4-84-92","DOIUrl":"https://doi.org/10.17650/1726-9776-2019-15-4-84-92","url":null,"abstract":"Castration-resistant prostate cancer (CRPC) has a very negative prognosis. The average life expectancy even using modern treatment methods is 1.5–2 years. When the majority of CRPC patients show signs of resistance to therapy aimed at lowering testosterone levels, distant metastases are often determined in the bones. Bone metastases in CRPC patients often worsen life quality due to pain and risk of bone complications, such as pathological fractures and spinal cord compression. Not all treatment regimens to increase their life expectancy patients are effective. Radiopharmacy using alpha-emitting radium-223 chloride is not only one of the methods of palliative treatment, but also one of the most promising therapies that increase life expectancy of these heavy patients. Results of large randomized trials showed that alpha-therapy with radium-223 chloride leads to a significant increase of the overall life expectancy, and significantly improve the patients’ life quality. The article presents literature review as well as the analysis of the results of large randomized trials, which assess the effectiveness of the therapy in CGRG patients, and a clinical case of its use in real clinical practice.","PeriodicalId":42924,"journal":{"name":"Onkourologiya","volume":"15 1","pages":"84-92"},"PeriodicalIF":0.1,"publicationDate":"2020-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67755056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bladder cancer: what’s new in 2018–2019","authors":"О. В. Karyakin","doi":"10.17650/1726-9776-2019-15-4-126-134","DOIUrl":"https://doi.org/10.17650/1726-9776-2019-15-4-126-134","url":null,"abstract":"The review presents the results of the most important and interesting studies on diagnosis, epidemiology and treatment of bladder cancer within 2018–2019. Some regulations are based on the recommendations of the European Association of Urology, while others – on the results of mutual studies. As for treating non-muscle-invasive bladder cancer, data of particular interest pertain to intravesical chemotherapy in case of to BCG resistance (Calmet–Guerin Bacillus) for therapeutic and prophylactic purposes. Response rate and number of adverse reactions are satisfactory and allow to hope for better results in future. The results of epidemiological studies on large populations showed that considering the disease pathogenesis it is necessary to take into account the presence of human hepatitis HBAb, as well as human papillomavirus type 6. As immunotherapeutic drugs are widely used in patients with oncological and urological diseases, their action is studied in patients with nonmuscleinvasive, locally advanced bladder cancer. The results showed the effectiveness of pembrolizumab when administered intravesically in BCG refractory cancer. The same drugs used in the neoadjuvant mode showed an increase of pT0 number after radical cystectomy. A comparative study of pembrolizumab and atesolizumab versus traditional chemotherapy showed their advantage in the frequency of complete regressions and survival rates to progression.","PeriodicalId":42924,"journal":{"name":"Onkourologiya","volume":"15 1","pages":"126-134"},"PeriodicalIF":0.1,"publicationDate":"2020-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48828636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal cell carcinoma: what’s new in 2019","authors":"О. Evsyukova, V. Matveev","doi":"10.17650/1726-9776-2019-15-4-120-125","DOIUrl":"https://doi.org/10.17650/1726-9776-2019-15-4-120-125","url":null,"abstract":"This review of renal cell carcinoma describes new diagnostics and treatment standards, new guidelines from international professional organizations and key studies, published in 2019.","PeriodicalId":42924,"journal":{"name":"Onkourologiya","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67753769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}