The authors provide the proceedings of the 2005 First International Society of Urological Pathology Consensus Conference and the basic provisions that differ the modified Gleason grading system from its original interpretation. In particular, we should do away with Gleason grade 1 (or 1 + 1 = 2) while assessing the needle biopsy specimens. Contrary to the recommendations by Gleason himself, the conference decided to apply stringent criteria for using Gleason grades 3 and 4. This is due to the fact that these grades are of special prognostic value so it is important to have clear criteria in defining each Gleason grade. Notions, such as secondary and tertiary Gleason patterns, are considered; detailed recommendations are given on the lesion extent sufficient to diagnose these components.

Tumor grade and pT stage are significant prognostic factors in non-muscle-invasive papillary urothelial bladder carcinoma (BC) therefore the accurate identification of these indicators are of great importance. The purpose of the investigation was to determine whether molecular biological markers (Ki-67 level, p53, CK20, and c-erbB-2 expression) may specify the grade and invasive potential of papillary urothelial BC. The investigators examined the specimens taken after transurethral resection of the bladder from 57 patients (46 men and 11 women) aged 24 to 75 years (mean age 56 +/- 1.5 years) with non-muscle-invasive papillary urothelial BC referring to as a moderate and poor prognostic group according to the EORTC scoring system, who had received combined treatment at the Medical Radiology Research Center in 1998 to 2005 (the postoperative follow-up was 2 to 9 years).

The diagnosis of superficial papillary bladder tumors remains a serious problem and has 2 aspects: classificational and morphological ones. As of now, 2 classifications of superficial bladder tumors, the basis for which is different principles (the 1973 WHO and the 2004 WHO ones) are equally used. Pathologists and clinicians must know criteria for both classifications and understand their differences, advantages, and disadvantages. If they are unaware of the normal structure of the bladder and the specific features of work with transurethral resection material, they cannot adequately stage non-muscle-invasive tumors.

The authors describe their experience in treating patients with prostate cancer (PC). The data of 68 patients undergoing beam therapy in combination with long-term hormonal therapy are restrospectively analyzed. The patients mainly present with locally advanced tumors. Radiotherapy was performed with a cumulative focal dose of as high as 70 Gy; hormonal therapy involved orchiectomy or long-term adjuvant therapy with luteinizing hormone releasing-hormone analogues for 36 months. Five-year outcomes were estimated; relapse-free and biochemical progression-free survival rates were 88.9 ± 4.9 and 89.4 ± 5.3%, respectively. Early and late radiation damages were also evaluated: the rate of grades 2 and 3 acute radiation-induced urinary tract lesions was 64.3 and 3.6%, respectively; that of grades 1 and 2 gastrointestinal lesions was 26.8 and 7.1%; and that of grade 2 late lesions was not greater than 1.5%.

Renal cell carcinoma (RCC) is a heterogeneous disease in which the patients survive for months to years. At the present time the prognostic models have no sufficient information or exact prognostic value. Cell proliferation and apoptosis play a key role in cell cycle regulation; and impairment in these processes is commonly detected in different human tumors. The investigation enrolled 76 patients (49 men, 27 women) aged 32 to 73 years (mean age 56 ± 7.6 years) diagnosed with RCC. The follow-up was 8 to 116 months (mean 36.5 months). All the patients underwent nephrectomy; antibodies against р53, Bcl-2, and Ki-67 were investigated by immunohistochemistry. The expression of p53 and none or reduced expression of Bcl-2 are poor prognostic factors and associated with the metastatic potential of a tumor and with low relapse-free survival. High Ki-67 levels are a risk factor for metastases. A combination of p53 expression and high proliferative activity reflects the aggressive potential of a tumor and suggests the high risk of metastases just at the disease diagnosis and early tumor dissemination.

Small cell carcinoma of the prostate is a rare and very aggressive tumor. Primary emphasis is laid on the morphological and immunohistochemical characteristics of this type of a tumor, the clinical presentations of the disease, performed treatment, and its response. Three clinical cases of small cell carcinoma of the prostate with their further discussion are described.

Tumor cell proliferation and angiogenesis are essential factors for tumor growth, progression, and metastasis.Objective: to assess the relationship between the values of proliferative activity and the morphometric parameters of intratumoral microvessels in metastatic and localized carcinomas of the kidney.Materials and methods. Surgical specimens taken from 54 patients (32 men and 22 women) aged 26 to 69 years (mean age 55 ± 1.5 years) with the verified diagnosis of clear-cell renal cell carcinoma (RCC) were studied.Conclusion. Proliferative activity and angioarchitectonics are an important biological characteristic of a tumor of unequal clinical value in RCC. Metastatic carcinoma has a higher proliferative activity and a low tumor vascularization than those of localized carcinoma.

The values of the diagnostic efficiency and consistency of preoperative evaluations of locally advanced prostate cancer (PC) by magnetic resonance imaging (MRI) with a matrix coil were estimated in 37 patients with PC who had undergone radical prostatectomy. The accuracy of differentiation of T3 and T2 stages in prospective and retrospective assessments was 59 and 73 %; the sensitivity was 7 and 40 %, and the specificity was 96 and 9 %, respectively; with the moderate consistency of evaluations.

Retrospective assessment of preoperative magnetic resonance imaging (MRI) data in 37 patients with prostate cancer, who had undergone radical prostatectomy, established the most diagnostically valuable MRI signs of minimal extracapsular spread (ECS): asymmetry of neuro vascular fascicles (72 % accuracy, 93 % sensitivity, 77 % specificity, 73 % positive and 94% negative predictive values) and iron outline de formity/irregularity (66/80/64/60/82 %, respectively); as well as their higher diagnostic efficiency versus the clinical and laboratory predic tors of ECS: total Gleason scores (58/87/55/57/86 %, respectively) and serum PSA levels (uninformative), which permits their consideration while choosing a more or less radical prostatectomy modality.

Rhabdomyosarcoma is the most common soft tissue tumor in children aged less than 19 years. In the represented case report, polychemotherapy at Stage 1 of treatment resulted in a complete regression of metastases in the lung and pleura, normalization of the patients health status within 18 months. Consolidation radiotherapy directed to the prostate and femoral bones could achieve a local control over these foci. The emerged recurrence was located in the lung and pleura. The effect of second-line chemotherapy did not exceed 3 months. Despite primary disease dissemination and poor prognosis, disease stabilization and better quality of life (improved general condition, recovery of spontaneous urination, relief and complete disappearance of pain) could be achieved at therapy month 27.

Rhabdomyosarcoma is the most common soft tissue tumor in children aged less than 19 years. In the represented case report, polychemotherapy at Stage 1 of treatment resulted in a complete regression of metastases in the lung and pleura, normalization of the patients health status within 18 months. Consolidation radiotherapy directed to the prostate and femoral bones could achieve a local control over these foci. The emerged recurrence was located in the lung and pleura. The effect of second-line chemotherapy did not exceed 3 months. Despite primary disease dissemination and poor prognosis, disease stabilization and better quality of life (improved general condition, recovery of spontaneous urination, relief and complete disappearance of pain) could be achieved at therapy month 27.

The nested variant of urothelial cell carcinoma is a relatively rare neoplasm of the urinary bladder, which has in turn an aggressive behavior and a poor prognosis. This report discusses the clinical pathological characteristics of this disease and its possible treatment options.

Prostate cancer is most common and its heterogenicity is presently apparent. There is a continuous search for the factors allowing the prediction of the poor course and biological difference of tumors. The College of American Pathologists classifies the currently known prognostic factors into 3 categories: 1) the factors whose prognostic importance and successful use have been proven in practice; 2) those that have been widely studied biologically and clinically, but the significance of which needs to be proven in extensive statistical studies; 3) all other factors that have been inadequately studied to demonstrate their prognostic value. Category 1 prognostic factors, such as prostate-specific antigen levels, TNM stage, Gleason grading, and the status of surgical margins, enjoy wide application. Category 2 factors are not used IN clinical practice so extensively. The value of some Category 3 factors (the biomarkers p53, Ki-67, Bcl-2, receptors of androgens) is indubitably and they claim to be widely applied in clinical practice with time. The clinical significance of molecular biological markers calls for further investigation.

The prognostic value of the expression of c-erbB-2 oncoprotein, p53 protein, cytokeratin 20, and Ki-67 was estimated in papillary urothelial non-muscle-invasive bladder carcinoma (BC). The biopsy and surgery samples from 57 patients (46 males and 11 females) aged 24 to 75 years (mean age 56 +/- 1.5 years), who received combination treatment for non-muscle-invasive BC, were examined. It has been found that c-erbB-2 and.53 are important prognostic markers of non-muscle-invasive BC. Co-expression of 3 markers is of high statistic significance.

Target therapy is a main approach to treating metastatic renal cell carcinoma. Bevacizumab plus interferon alfa-2A is now standard first-line options for patients with previously untreated, good or intermediate prognosis (using the Memorial Sloan-Kettering Cancer Center criteria). We have presented our experience in using bevacisumab plus interferon alfa-2A in patients with metastatic renal cell carcinoma. Median progression-free survival and overall survival were 10 months and 22 months, respectively.

Rhabdomyosarcoma is the most common soft tissue tumor in children aged less than 19 years. In the represented case report, polychemo-therapy at Stage 1 of treatment resulted in a complete regression of metastases in the lung and pleura, normalization of the patient's health status within 18 months. Consolidation radiotherapy directed to the prostate and femoral bones could achieve a local control over these foci. The emerged recurrence was located in the lung and pleura. The effect of second-line chemotherapy did not exceed 3 months. Despite primary disease dissemination and poor prognosis, disease stabilization and better quality of life (improved general condition, recovery of spontaneous urination, relief and complete disappearance of pain) could be achieved at therapy month 27.

Patients with primary diagnosis of bladder cancer (42 persons) were studied. FISH analysis performed in all patients showed the following results: 39 (93%) patients were FISH positive and 3 (7%) were FISH negative. The molecular cytogenetic criterion for determining the grade of differentiation of Ta and T1 tumors chromosomal hyperploidy in morphologically abnormal cells, was suggested. All patients demonstrating increased amount (more than 26%) of abnormal cell with hyperploidy of chromosomes 3, 7 and 17 were found to have high grade malignancies.

Patients with primary diagnosis of bladder cancer (42 persons) were studied. FISH analysis performed in all patients showed the following results: 39 (93%) patients were FISH positive and 3 (7%) were FISH negative. The molecular cytogenetic criterion for determining the grade of differentiation of Ta and T1 tumors — chromosomal hyperploidy in morphologically abnormal cells, was suggested. All patients demonstrating increased amount (more than 26%) of abnormal cell with hyperploidy of chromosomes 3, 7 and 17 were found to have high grade malignancies.