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Treatment of patients with metastatic castration-resistant prostate cancer in clinical practice is a vital necessity and a challenging task since the causes of castration resistance are not fully understood. Adherence to treatment regimens in accordance with the National Clinical Guidelines allows to achieve an increase in both overall survival and progression-free survival, as well as to reduce the mortality rate in this category of patients. Administration of 1st-line treatment regimens stabilizes the disease in the majority of pancreatic cancer patients; in some cases, the disease becomes aggressive, distant metastases appear, most oſten in bones, lymph nodes, and internal organs, as demonstrated by three clinical observations presented in this article. The administration of enzalutamide (in 2 cases) and abiraterone acetate (in 1 case) at the stage of resistance to castration therapy allowed to obtain a complete “response” from visceral lesions, stabilise bone metastatic foci and increase the life expectancy of patients.

Currently, due to the dynamic development of surgical technologies, indications for organ-sparing treatment of kidney cancer are expanding. Acute kidney injury is a serious complication that leads to chronic kidney disease, increased postoperative mortality, deterioration of long-term functional outcomes, and increased hospitalization. At present, it is known that even a slight damage to kidneys or their impairment, presented by a decreased urine output and change in blood biochemical parameters, entails serious clinical consequences and is associated with a poor prognosis. Damaging factors, when the kidney is exposed, initially induce molecular changes, which entail the production of certain biomarkers, and only after that clinical aspects of kidney damage develop. The causes of acute kidney injury can be different, from specific renal disorders (acute interstitial nephritis, vascular and glomerular lesions, prerenal azotemia, obstructive disorders) to toxic damages, direct trauma and surgical treatment. The development of acute renal injury in the postoperative period is a serious complication of the surgical treatment of kidney disease, and, according to various authors, the frequency of its occurrence varies from 5.5 % to 34 %. An active study of this problem made it possible to find specific biomarkers that give the possibility to predict and diagnose acute renal injury in the early stages, to optimize the treatment strategy, to reduce the incidence of postoperative complications, and to shorten the period of postoperative rehabilitation. Currently, the most studied of acute kidney injury (AKI) biomarkers are cystatin C, neutrophil gelatinase-associated lipocalin‑2 (NGAL), hepatic protein L-FABP, KIM‑1 (Kidney injury molecule‑1), Interleukin – 18. Further study of AKI biomarkers will make it possible to determine the most significant ones for subsequent use in everyday practice

At the present time primary-multiple malignancies are of interest in connection with the frequency of prevalence, which remains at the rather high level and continues to grow up, therefore increasing the relevance of this pathology in clinical oncology and everyday practice. With the exception of the treatment of primary multiple malignancies requiring a multimodal approach, as well as in the case of the use of complex treatment in conjunction with chemotherapists and radiotherapy specialists. In the past three decades, the development of screening tests that prevent and detect some cancers at an early, more treatable stage, and treatment advances have increased the 5‑year relative survival rate for all cancers to 66%. In addition to concerns about cancer recurrence, survivors also worry about their risk of developing a new cancer. Prostate cancer is a leader in terms of morbidity and mortality in the world, just as often are found in combination with other malignant tumors. However, given the high detectability of prostate cancer, primary patients are currently receiving radical treatment, and if metastatic prostate cancer is detected, they are receiving drug treatment, which improves the survival and quality of life of patients. Soft tissue sarcomas are rare malignant tumors that develop in the connective tissues and remain poorly understood due to the fact that they make up less than 1% of all malignant diseases. One of the main methods for treating soft tissue sarcomas is the surgical method. Soft tissue sarcomas are difficult to treat and therefore it is imperative that surgeons and other specialists have experience in treating this disease. Studies show that patients with this pathology show better results if they receive treatment in specialized cancer centers that have experience in treating soft tissue sarcoma. This article demonstrates the clinical case of surgical treatment of a patient with primary multiple retroperitoneal tumors and metastatic prostate cancer.

This literature review describes various surgical techniques that reduce the urinary incontinence chance after orthotopic plastic surgery of the bladder by Studer. Satisfactory retention of urine is possible in case of maintaining the maximum length of the urethra, consistency of vesico-urethral anastomosis, sufficient volume of neocystis with low pressure, as well as functional and morphological adaptation of the intestinal wall. The techniques that help to reduce tension in the region of the vesico-urethral anastomosis and pressure in a short mesentery, preservation of functional urethral length by "secondary sphincter" using, attention is paid to some exposure characteristics of the ileum segment of sufficient length for the formation of neocities a satisfactory amount of, performing neotestamentaria during robot-assisted of cystoplasty, comparing the surgical techniques, as well as possible the feasibility of using suture V‑loc. A modified method for forming a robot-assisted anastomosis for laparoscopic operations is described. The results of clinical studies are presented, in one of which the results of modification of the "non-hole" technique are considered, and in the other — the method of temporary tension of the anastomosis zone. The article describes the experience of forming a vesico-urethral anastomosis using a CAPIO cross-linking device, as well as the experience of reconstructing The denonvillier fascia intraoperatively. An artificial device to achieve urinary retention: the artificial urinary sphincter (AUS).

Prostate cancer (PC) is one of the most urgent problems of modern oncourology because of the continuing high incidence of this pathology. The main methods of radical treatment of patients with localized and locally advanced prostate cancer are radical prostatectomy (RP) and radiotherapy – remote (RRT) or brachytherapy. However, the frequency of biochemical markers of disease progression after curative treatment is high and reaches up to 27–53%. It is extremely important to find the tumor lesion that leads to the increase of the marker. The palliative hormone therapy (PHT) was the only accepted method in patients with occurrence of distant metastases in recent time. However, a significant number of patients relapse marker may be associated with the so-called oligo-metastatic disease progression, in which the number of detected metastatic lesions is minimal. As the results of the research, the use of surgical or radiological treatment in selected patients of this cohort can significantly increase the length of time prior to the appointment of HT, and in some cases completely abandon its holding.Purpose. To evaluate the results of the saving pelvic lymphadenectomy in patients with prostate cancer with disease progression after radical therapies.Patients and methods. The article summarizes the results of surgical treatment of patients who have undergone life-saving lymphadenectomy about oligo-nodal metastatic progression of prostate cancer after treatment in 3 centers – P. Hertsen MORI, the branch of NMRRC; N. Petrov Research Institute of Oncology and Russian scientific center of radiology and surgical technologies. In this multicenter study they evaluated the immediate and remote results of surgical treatment of 57 patients.Results. The results performed the high efficiency of the method of the saving pelvic lymphadenectomy in patients with prostate cancer with disease progression after radical treatment. So, response to therapy and reduction in the marker level was observed in 47 (82.5%) patients. The decline in PSA level ≥50% from initial level in a month after the operation was in 38 (66,7%) patients. A complete answer in the form of lower marker ≤0.2 ng/ml was observed in 13 (22,8%) patients. For the entire median follow-up period of 12 months, patients with complete response to therapy had received any hormonal treatment.Conclusion. The saving pelvic lymphadenectomy is an effective method for the treatment of patients with the presence of lymphogenic progression of prostate cancer after a radical treatment with satisfactory oncological results. A significant contingent of patients, SLE is associated with good response to therapy and reduction in PSA levels and long disease-free period. In some patients the removal of nodal metastases allows to postpone or to abandon the HT and hope to increase overall survival of patients.

Renal cell carcinoma (RCC) is one of the most urgent problems of modern urology, due to the steady increase in the incidence of this disease worldwide. Horseshoe kidney is a rare observation, the frequency of detection of this disease in the population is 2.8% of all malformations. RCC horseshoe kidney are rare, less than 2% of all cases of horseshoe kidney. Surgical treatment remains the golden standard of therapy of patients with RCC. The article presents a clinical case of resection of horseshoe kidney in a patient with RCC.

Prostate cancer (PC) is one of the most actual problems of modern oncourology. Hormone therapy (HT) using medical castration is the main method of treatment of patients with metastatic PC. HT with usage of the new class of drugs that block the receptors for luteinizing hormone releasing hormone (LHRH) is a promising and effective method of castration therapy that has a number of significant advantages over the use of analogues LHRH. This article presents areview of studies that compared the effectiveness and side effects of HT using antagonists and analogues LHRH.

A solitary fibrous tumor (SFT) are rare mesenchymal neoplasms and due to the fact of their low occurrence, there are no large-scale researches of this nosology today. The article describes the report of 37‑year old woman with the case of solitary fibrous tumor of the kidney. A laparoscopic radical right nephrectomy was performed. Histological and immunological studies revealed a solitary fibrous tumor of the kidney. The patient did well postoperatively and remains disease-free at the present time.