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From 1987 to 1993, 26 patients with superficial urothelial bladder carcinoma pT1G3 were observed consecutively at the Dept. of Urology of Pordenone City Hospital and the Division of Pathology of the Centro di Riferimento Oncologico di Aviano (Italy). All patients were treated with TUR and then with a course of BCG-intravesical instillations. The complete immunoprophylaxis treatment consisted of a weekly instillation of BCG for 6 weeks; then cystoscopy and urinary cytologies or random biopsies were performed. An additional 1-monthly BCG treatment for 3 months was administered to 10 disease-free patients. In 6 cases of pT1G3 recurrences, a new complete cycle of BCG was performed whereas in 10 patients with local progression, defined as muscular infiltration, a cystoprostatectomy or RT therapy was advised. Follow-up examinations, planned every 3 months for 2 years and then every 6 months for 3 years, included cystoscopy and urinary cytologies in 19 patients and cystoscopy with randomized biopsies and washing in the remaining 7 patients. Ten patients were disease-free at a mean of 34 months follow-up (range 13-65 months); 6 patients experienced recurrence at a mean of 7 months follow-up (range 3-40 months) and 10 patients local progression at a mean of 13 months follow-up (range 3-44 months). The morphometric study demonstrated that cases with average nuclear area, in the deepest part of the histological section, more or equal to 40 μm2have a threefold progression rate, compared to cases with average nuclear area less than 40 μm2(p = 0.10). Our results would indicate the possible role of morphometric evaluation of prognostically important parameters, in the clinical management of patients with pT1G3 tumours.

We report the results on 47 patients treated for staghorn renal calculi (partial and complete) by PCN-monotherapy and PCN-debulking. According to Rocco's classification the renal stones were 34 C4 and 13 C5. The PCN-monotherapy was used for 34 C4 and 6 C5, and showed itself to be resolutive in 83.4%. We resorted to the PCN-debulking in 7 cases, all C5: subsequent treatment with Extracorporeal Shock Wave Lithotripsy (ESWL) was performed or planned in other Centres. We emphasize the feasibility of PCN in staghorn renal calculi for the low incidence of major complications and for sometimes reducing the wait, both before and after treatment of complex renal lithiasis.