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Background: To evaluate as the natural history of superficial bladder tumors is modified by intravesical chemotherapy and if the behavior of treated tumors allows to forecast subsequent tumoral evolution., Methods: 125 patients with superficial bladder tumor Ta and T1 were submitted to transurethral resection (TURB) and additional chemotherapy for one year. Mean follow-up was of 92.2 +/- 39.8 months and all patients were observed for four years at least., Results: Efficacy of treatment was according to the literature: the median of recurrence was estimated about the 10th year (increase of free interval); the percentage of patients free from recurrence after 14 years of follow-up was 35 +/- 19.9, instead that of specific survival was 87.1 +/- 11.8 (inefficacy in a long period); the percentage of tumor related deaths was of 10.4 (inefficacy to avoid the progression). Regarding the risk factors present on the beginning, there was a significance for the T1 that relapsed in the 56.6% versus the 30.9% of the Ta (p = 0.012) and for the multiple tumors that relapsed in the 64.4% versus the 38.7% of the single one (p = 0.009). Also the time and the T category of the first recurrence were interesting factors for the subsequent evolution of disease. In fact, in the 47 patients at beginning T1 that relapsed, there was a 43.4% of tumor related deaths if the recurrence occurred in the first year of follow-up, versus the 12.5% if the recurrence occurred after the first year (p = 0.017). Furthermore the 61.9% of patients "non Ta" (T1 or Tis) to the first recurrence died for tumor but no one if the first recurrence was Ta (p = 0.000)., Conclusions: Intravesical chemotherapy is still reliable. It is able to increase the free interval of recurrence after TURB. Moreover it can offer a useful criterion to recognize patients with chemoresistant tumors at higher risk of progression.

The optimal treatment of prostate cancer in clinical stage C is controversial. On the one hand a disease still confined by definition, as stage C is, should require a curative therapy such as surgery or radiotheratherapy. On the other hand the known fact that 50% of stages C are pathological stages D1, should propose a palliative, even thou effective, medical treatment. In fact both choices are questionable. A radical treatment risks being insufficient, whereas a palliative does not allow for giving a chance of a theoretically possible cure. In an attempt to resolve this difficulty, a sort of compromise is proposed. The patients should be initially treated with radical radiotherapy, and only in the case of progression will standard hormonotherapy be given. Thanks to this behaviour a possibility of cure is maintained, and, in addition, when suffering a progression the patients are likely to benefit from hormonotherapy owing to the fact that they are not pretreated. From 1985 to 1991 forty-eight clinical stage C patients were observed. They were given the choice between two treatments after explaining the theoretical benefits and disadvantages of both. Treatment A consisted of cobalt-60 therapy followed by hormonotherapy after progression, treatment B in primary ormonotherapy with LH-RH analogue +/- Flutamide. Twenty patients opted for treatment A and 21 for B.(ABSTRACT TRUNCATED AT 250 WORDS)

The main goal of hormonotherapy in management of locally advanced or metastatic prostate cancer is the control over the progression of the neoplastic disease rather than a possible benefit to the primary lesion. Nevertheless during hormonal treatment an evident decrease of prostatic volume can often be noted even though its clinical meaning has rarely been investigated. In order to evaluate a possible correlation between local modifications and prognosis, a retrospective analysis of a group of patients on hormonotherapy was performed. From March 1987 to March 1991, 98 patients with clinical stage C and D2 prostate cancer were treated. Fifty two of them were considered eligible for assessing local response because they had had neither surgery nor radiotherapy over the prostate; moreover their pre-treatment prostatic volume, as assessed by US scan, exceeded 22 ml. Out of these patients 24 were given Goserelin every 4 weeks and the remaining 28 added Flutamide at the dose of 750 mg per day. The prostatic volume was assessed quarterly and considered as response if decreased more than 35% of pretreatment value or as progression if increased over 25% of immediately previous value. In both cases the result needed to be confirmed three months later, but it was registered when first observed. After a mean follow-up of 32.4 +/- 18.7 months a local response occurred in 44 patients (84.6%) during a period ranging 3 to 18 months. Eight patients did not show a prostatic volume decrease and 4 suffered of local progression. In these latter cases the local progression coincided with distant progression.(ABSTRACT TRUNCATED AT 250 WORDS)

Seventy-three patients with stage C and D prostatic carcinoma were treated with hormonotherapy. During a mean follow-up of 27 +/- 17.8 months, 30 tumour-related deaths were registered. The patients in the G3 subset suffered a 35.7% early death rate versus a 10.1% rate of G1-2 ones. This difference is significant (p = 0.0102). Nevertheless the Authors' opinion is that G3 patients should not be given a more aggressive treatment initially apart from the case of a controlled trial.

The paper describes a case of light-cell carcinoma of the kidney in a patient affected by hairy-cell leukemia. The immunological status is assessed revealing a severe deficit of NK phenotype lymphocytes. Therapy with alpha interferon was proposed in order to stimulate killing and recruitment processes of new NK cells.

The case of a multiple kidney cyst in an adult patient is described. The cyst had caused parenchymal atrophy by blocking the excretory ways. The pathological anatomy of the lesion is described and the aetiopathogenic hypotheses found in the literature are reported.

The therapeutic efficacy of chemotherapy in bladder's carcinoma is today supported by many statistical reports; the response rates are ranging from 35% to 45%. Results of the treatment with adjuvant chemotherapy (M-VEC in 22 patients with or without metastatic tumor are presented. Favourable objective responses were seen in 25% of the patients. The conclusion is drawn that this therapy is very useful in the treatment of metastatic diseases, but it can be used also in non-metastatic (M0) patients to prevent the growth of micrometastasis.