bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative pharmacoeconomic analysis of biologicals used for metastatic urothelial carcinoma
Authors: Tolkushin A. G. , Luchinin E. A. , Holownia-Voloskova M. E. 
Published: July 2021

Objective: to determine the economic and clinical consequences of using atezolizumab in metastatic urothelial cancer compared with pembrolizumab and nivolumab.Materials and methods. An assessment of the effectiveness and safety of medicines for urothelial cancer was carried out on the basis of a systematic search and review of clinical studies and an analysis of direct medical costs for medicines from public procurement in Moscow in 2019-2020 and information from official instructions for medical use.Results. Systematic search identifies 4, 4 and 7 clinical trials of nivolumab, pembrolizumab and atezolizumab, respectively, as well as 2 meta-analyses. The obtained data on the efficacy and safety did not allow us to identify greater or lesser effective options. Calculation of cost of three months therapy revealed that the cost of atezolizumab (935 thousand rubles) is 7 % lower vs. pembrolizumab (1 million rubles) and 18 % lower vs. nivolumab (1,136 million rubles). Thus, when using atezolizumab instead of pembrolizumab or atezolizumab, budget savings may occur, or allowing additional therapy to be provided to every 14th or every 6th patient, respectively within fixed budget.Conclusion. The use of atezolizumab in metastatic urothelial cancer led to budget savings or the possibility of additional treatment coverage with immuno-oncological therapy.
Retrograde endoscopic assisted percutaneous treatment of urinary fistulas after partial nephrectomy
Authors: Guliev B. G. , Korol E. I. , Avazkhanov Zh. P. , Yakubov Kh. Kh. , Agagyulov M. U. , Talyshinskiy A. E. 
Published: July 2021

Background. Urinary fistulas (UFs) are one of the most significant complications after partial nephrectomy. Placement of an ureteral stent eliminates urine extravasation in the majority of patients. However, some of them have persistent UFs despite upper urinary tract drainage. Such cases require retrograde injection of fibrin glue into the renal cavity through a ureteroscope or via the percutaneous approach. Some authors reported cases of simultaneous use of 2 stents and percutaneous cryoablation of the fistula, but these techniques are rare and, therefore, it is problematic to evaluate their efficacy.Objective: to evaluate the results of the new treatment method for the elimination of persistent UFs using the retrograde endoscopic percutaneous approach.Materials and methods. This study included 5 patients (3 males and 3 females) with UFs developed after kidney resection. Mean age of the patients was 55.8 years. The tumor size was 2.5 to 4.8 cm; mean R.E.N.A.L. score was 7.8. All patients had earlier undergone minimally invasive partial nephrectomy; the time between surgery and UF development varied between 3 and 10 days. Four out of 5 patients had a large amount of discharge from their paranephral drainage system, examination of which confirmed high creatinine level. Patients underwent flexible ureteropyelography in the lithotomy position. During this procedure, we identified the damaged calyx and then performed percutaneous puncture targeting the distal end of the endoscope at this calyx, ensuring that the tip of the needle appeared in the paranephral cavity in front of the injured calyx. Using the flexible ureteroscope, we inserted the needle into the pelvis, dilated the puncture opening along the string, and installed a nephrostomy drainage system (12 Fr). Then the endoscope was removed and the ureter was additionally drained with a stent. The stent was removed after 8-10 days with subsequent antegrade pyelography. If there was no extravasation, the nephrostomy tube was removed and the patient was discharged from hospital to continue treatment in outpatient settings.Results. All patients with UFs resulting from partial nephrectomy was successfully operated on. No complications were registered. The mean surgery time was 45.0 ± 20.5 min (range: 40-65 min). Only two patients had some discharge from the fistula within 1 day after nephrostomy tube removal and it stopped without any additional interventions. Three patients had their fistula healed immediately. The treatment efficacy during the whole follow-up period of 18 ± 4 months (range: 6-26 months) was 100 %.Conclusion. Ureteral stenting ensures elimination of UFs in the majority of patients after partial nephrectomy. In individuals with persistent UFs, retrograde endoscopic percutaneous drainage of the pelvicalyceal system is the method of choice, because it allows rapid and effective treatment of UFs.
The role of targeted biopsy methods in the prostate cancer diagnosis
Authors: Petov V. S. , Sapelko A. V. , Danilov S. P. , Chernov Ya. N. , Taratkin M. S. , Amosov A. V. , Enikeev D. V. , Krupinov G. E. 
Published: July 2021

The current prostate cancer screening program results in unnecessary biopsies in a quarter of patients, overdiagnosis of clinically insignificant prostate cancer (ISUP 1) and overtreatment. Intoducing multiparametric magnetic resonance imaging into routine practice before biopsy allows to decrease the number of biopsies, thereby reducing the burden on clinicians and increasing the likelihood of detecting clinically significant forms of prostate cancer (ISUP >2). The objective of this literature review is to compare targeted biopsy techniques and to determine their current role in the prostate cancer diagnosis.
Review of the article “Laparoscopic single port radical nephrectomy challenges: a case presentation”
Authors: Перлин Д. В. 
Published: July 2021

Радикальная нефрэктомия продолжает оставаться «золотым стандартом» лечения злокачественных новообразований почки больших размеров [1]. Многими исследованиями показаны одинаковые онкологические результаты лапароскопических операций с открытыми вмешательствами, при гораздо лучшем косметическом эффекте и меньшем количестве осложнений [2]. В течение трех десятилетий, прошедших после выполнения Ральфом Клейманом первой лапароскопической радикальной нефрэктомии [3], продолжались поиски наименее инвазивных и наиболее эффективных методов этой эндоскопической операции. Ряд исследований посвящен сравнительнению трансперитонеального и ретроперитонеального доступа, оценке методик hand-assistance, NOTES и даже роботической нефрэктомии [4].Разработка целого ряда специальных эндоскопических инструментов и портов для их введения привели к концу первой декады двухтысячных к достаточно бурному развитию, так называемой, однопортовой (single‑port) хирургии [5]. Наша клиника, как и многие коллеги, тоже активно внедряли в этот период однопортовые операции, включая нефрэктомию. Поэтому я не только хорошо понимаю трудности, которые подробно описывают авторы при выполнении основных этапов операции, но и пути их разрешения, такие как перемещение камеры между портами или смена оптики с другим углом зрения. Кроме того, возможно дополнительно использовать отдельный 3-5 мм порт [6], что, впрочем, делает вмешательство «не совсем однопортовым».
Renal cell carcinoma with metastases to the external genitalia. Literature review and case report
Authors: Menshikov K. V. , Sultanbaev A. V. , Musin Sh. I. , Izmaylov A. A. , Muginov R. R. , Menshikova I. A. , Sharifgaleev I. A. , Lipatov D. O. , Sultanbaeva N. I. 
Published: July 2021

Annually, up to 300 thousand new cases of kidney cancer and more than 134 thousand deaths associated with this disease are registered in the world. In the Russian Federation in 2019, 20,758 patients with a newly diagnosed renal cell carcinoma were registered; it should be noted that at the end of 2019, 177,755 patients with this diagnosis were registered. The issue of renal cell carcinoma metastasis seems to be quite relevant. The most common organs for metastatic renal cell carcinoma are lungs (up to 55 %), lymph nodes (up to 34 %), liver (up to 32 %), bones (up to 32 %), adrenal glands (up to 19 %), contralateral kidney (up to 11 %) and the brain (up to 5.7 %). The incidence of skin metastases in renal cell carcinoma ranges from 2.8 to 6.8 %, according to various authors.Our publication presents a case of treatment of a patient with a rare localization of renal cell carcinoma metastases in the external genital organs. The patient underwent palliative nephrectomy and vulvectomy. Taking into account the data on the prevalence of the disease, therapy with cabozantinib is carried out. Cabosantinib is an inhibitor of the tyrosine kinase domains of a number of growth factors, angiogenesis, abnormal bone remodeling, metastasis, and drug resistance.
The state of oncology care in Russia. Kidney cancer (morbidity, mortality, index of accuracy, one-year and year-by-year mortality, histological structure). Part 1
Authors: Merabishvili V. M. , Poltorackiy A. N. , Nosov A. K. , Artem'eva A. S. , Merabishvili E. N. 
Published: July 2021

Background. About 25,000 (2018 - 24,291) new cases of kidney cancer (KC) are registered in Russia annually, in the Northwestern Federal District of Russia in 2018 - 2504.Kidney cancer refers to localizations with a relatively low mortality rate. Mortality in the first year of observation is about 20 %. At the same time, an unfavorable trend in the dynamics of morbidity should be noted. Over the past 10 years, the annual growth rate for both sexes was 3.18%, mortality practically did not change, which indicates certain success in the treatment of patients.Materials and methods. The materials of the research were the monographs of IARC “Cancer on five continents”, reference books of the P.A. Herzen Moscow Oncology Research Institute and the database of the population cancer register of the Northwestern Federal District of the Russia own materials. Standard methods of statistical analysis were used.Results. The study revealed positive trends in the quality of registration of patients with kidney cancer, dynamics of mortality and survival of patients.Conclusion. The positive dynamics of the incidence rate of the population of Russia with kidney cancer has been established, and its place in the world community has been determined. Age-specific levels are close to those in the United States.Particular attention is paid to the need to use the Russian population cancer register database to obtain reliable data for an objective assessment of the activities of the oncological service in relation to kidney cancer.
Maria Sklodowska-Curie, Pierre Curie
Authors: Karyakin O. B. 
Published: July 2021

On July 26, 1895, Pierre Curie and Maria Sklodowska were married. On June 23, 1903, Maria presented her doctoral dissertation “Investigation of radioactive substances” at the Sorbonne, which described the results of hard work in previous years, including the isolation of new elements - polonium and radium. In the same 1903, Marie and Pierre Curie were awarded the Nobel Prize in Physics “in recognition of the exceptional services they rendered to science through the joint research of radiation phenomena discovered by Professor Henri Becquerel”. She became the first female - laureate and remained the only one until 1935, when her daughter Irene was awarded the Nobel Prize. In 1911, Marie Curie received the Nobel Prize in Chemistry “for outstanding achievements in the development of chemistry: the discovery of the elements radium and polonium, the isolation of radium and the study of the nature and compounds of this remarkable element”. Marie Curie became the first and to date the only woman in the world -twice the Nobel Prize winner. After many years, the proposal of Marie and Pierre Curie on the use of radium in medicine has been implemented at the present time. Studied and proved its effectiveness in the treatment of bone metastases of prostate cancer. The merits of these scientists before the whole world can hardly be overestimated. Humanity gratefully keeps a good memory for great discoveries for the benefit of people.
Review of the article “The first experience of transperineal prostate biopsy without antibiotic prophylaxis”
Authors: Зырянов А. В. 
Published: July 2021

Целью проспективного исследования, результаты которого опубликованы в данной статье, явилось изучение возможности сокращения использования антибактериальных препаратов для проведения трансперинеальной биопсии предстательной железы в амбулаторных условиях. В последнее время специалистами активно обсуждается необходимость поиска и изучения оптимальных режимов антибиотикопрофилактики перед биопсией ПЖ в связи со стремительно растущей резистентностью флоры кишки к фторхинолонам и запретом их использования для антибиотикопрофилактики. Первые публикации по профилактике инфекционных осложнений при биопсии простаты относятся к в 1982 году, когда Thompson и соавторы выявили 100% бактериемию после ТР биопсии простаты. В 87% случаев авторы констатировали развитие инфекции мочевой системы, отметив наличие широкого спектра микроорганизмов от аэробной грам-позитивной и грам-негативной до анаэробной флоры в крови и моче после ТР биопсии простаты. В этом же 1982 году Crawford и соавторы опубликовали данные рандомизированного двойного слепого исследования у 63 пациентов, посвященного эффективности антибиотикопрофилактики инфекции мочевого тракта и сепсиса. Двухдневная терапия карбенициллином позволила снизить бактериурию с 36% до 9% по сравнению с контрольной группой без антибиотиков.В последующие годы проводилось довольно много исследований, посвященных антибактериальной профилактике осложнений ТР биопсии простаты. Результаты этих исследований как правило автоматически распространялись и на перинеальную методику. Не могу не согласиться с логическим рассуждением авторов статьи о том, что промежностный доступ при выполнении биопсии простаты менее опасен в отношении инфекционных осложнений по сравнению с трансректальным. Также интересны полученные данные об отсутствии достоверных различий в частоте возникновения инфекционных осложнений (инфекция мочевых путей, инфекция мягких тканей промежности, простатит, лихорадка, сепсис) между группами. Однако, ряд ограничений в отборе пациентов в исследование (наличие уретрального катетера или цистостомического дренажа, патология кожи промежности, контаминация мочи микроорганизмами) не позволяют пока совсем отказаться от антибактериальной профилактики при перинеальной биопсии и требуют продолжения изучения данной очень актуальной темы.
Comparison of treatment results for patients with high-risk prostate cancer according to the EAU and NCCN criteria
Authors: Reva S. A. , Nosov A. K. , Korol V. D. , Arnautov A. V. , Zyatchin I. V. , Berkut M. V. , Petrov S. B. , Belyaev A. M. 
Published: July 2021

Background. High-risk prostate cancer (PCa) occurs in 15-25 % of newly diagnosed cases and is a life-threatening condition that requires active treatment. In recent years, the percentage of high-risk PCa has significantly increased, as well as the number of prostatectomies performed in patients with unfavorable morphologic features. However, the high-risk group criteria are not fully defined yet. According to various medical associations, a locally advanced or localized disease may have a high risk of progression. Study objective: to evaluate early and long-term results of treatment of patients with high-risk PCa depending on the high-risk group criteria. Materials and methods. The analysis includes results of radical surgical treatment of 832 patients with localized or locally advanced high-risk PCa treated in three medical institutions in St. Petersburg in the period from 2001 to 2019. Clinically high-risk group included patients with one of the following criteria: prostate specific antigen level >20 ng/ml, Gleason score >8, stage (cT); according to the last criterion two groups of patients were identified: HR-EAU (≥cT2c; n = 408) and HR-NCCN (≥cT3a; n = 282). Results. The average prostate specific antigen level was 21.09 and 26.63 ng/ml, respectively, in HR-EAU and HR-NCCN groups (p< 0.0001). The incidence of positive surgical margin, positive lymph nodes (pN+), five-year recurrence-free, cancer-specific, and overall survival did not differ significantly between the clinically high-risk groups. When evaluated according to the criteria obtained from pathomorphological examination of the removed prostate, the HR-NCCN group showed higher frequency of positive surgical margin (24.8 % vs. 19.2 %) and frequency of pN+ (22.4 % vs. 10.4 %). Analysis of long-term outcomes showed less favorable 5-year results in the HR-NCCN group (recurrence-free, cancerspecific, overall survival - 54.8, 87.0, 83.7 %) compared to the HR-EAU group (recurrence-free, cancer-specific, overall survival - 71.0, 92.1, 88.2 %) (p <0.02 for all). Conclusion. Differences in the high-risk group criteria by clinical indicators between associations do not affect early (frequency of positive surgical margin, pN+) and long-term (recurrence-free, cancer-specific, overall survival) outcomes. Pathomorphological indicators are less favorable when evaluated according to NCCN. According to our results, any of the proposed models can be used before radical prostatectomy to determine the prognosis of high-risk PCa patients. However, the NCCN morphological prognostic factors allow better prediction of outcomes and, in accordance with them, prescribe treatment that corresponds to the aggressiveness of the disease.
First experiment study in cytoreductive prostatectomy in patients with oligo-metastatic prostate cancer following neoadjuvant chemohormonotherapy
Authors: Mager V. O. , Orlov A. S. , Gilmutdinov T. R. , Veshkina A. A. , Kovalenko D. A. , Zamyatin A. V. 
Published: July 2021

Background. Nowadays there is no consensus on application of cytoreductive prostatectomy in a complex therapy in patients with oligo-metastatic prostate cancer.Study objective: assessment of short-term results of neoadjuvant chemohormonotherapy followed by cytoreductive prostatectomy in patients with oligo-metastatic prostate cancer.Materials and methods. Cytoreductive prostatectomy was performed in 7 patients with oligometastatic prostate cancer.Results. Postoperative complications in 3 (42.9 %) out of 7 treated patients were classified as grade IIIb according to Clavien-Dindo scale. Post-surgical analysis of prostate tissue samples showed therapeutic pathomorphism of grade II in 3 patients (42.9 %), grade III in 1 patient (14.3 %) and grade IV in another patient (14.3 %). Urinary continence regained in all the patients. Average postoperative supervision period took 12 months. Disease progression was diagnosed in 1 patient (14.3 %).Conclusion. Combined application of neoadjuvant chemohormonotherapy followed by cytoreductive prostatectomy can be considered as an alternative method of treatment in a properly selected group of patients with oligo-metastatic prostate cancer.
Low and high-dose-rate brachytherapy in combination with external beam radiotherapy for high risk prostate cancer
Authors: Solodkiy V. A. , Pavlov A. Yu. , Tsibulskii A. D. , Panshin G. A. , Dzidzaria A. G. , Mirzahanov R. I. 
Published: July 2021

Background. Prostate cancer (PCa) in the Russian Federation takes the leading place in the prevalence of cancer among the male population.Objective: to investigate the effect of increasing a single focal dose in high-dose-rate brachytherapy (HDR-BT) in combination with external beam radiotherapy on biochemical failure-free survival and local control in patients with high-risk PCa. Materials and methods. The study included 350 men with PCa in the group of high and extremely high risk of progression. All patients included in the study were divided into 4 groups. Groups 1, 2 and 3 included 276 patients who received HDR-BT with a 192Ir source with a single dose per fraction: 10 Gy (n = 83), 12 Gy (n = 46) and 15 Gy (n = 147). Group 4 included 74 patients who received low-dose-rate brachytherapy with 125I sources up to a total focal dose of 110 Gy. At the 2 stage, external beam radiotherapy was a conventional fractionation (single dose of 2 Gy, total - 44-46 Gy).Results. Of 350 patients over a 5-year follow-up period, PCa recurrence was noted in 65 (18.6 %). The 3- and 5-year biochemical failure-free survival rates in the general cohort of patients were 87.4 and 81.4 %. 5-year biochemical failure-free survival was significantly higher in group 3 relative to group 4 and amounted to 89.8 and 74.2 % (p = 0.03). Increasing the dose for HDR-BT from 10 to 12 Gy per fraction significantly reduced the frequency of local relapses from 15.7 % (in group 1) to 2.2 % (in group 2) (p = 0.0001) while maintaining the level of genitourinary and gastrointestinal toxicity. Conclusion. The use of a combination of brachytherapy and external beam radiotherapy in patients with high risk PCa is highly effective in achieving local control of the tumor. The optimal fractionation regime for HDR-BT remains a matter of debate. The use of 15 Gy per fraction for HDR-BT in combination with external beam radiotherapy is the most optimal fractionation regimen in patients with high-risk PCa.
Comparison of clips and electrosurgical instruments in sealing of lymphatic vessels during pelvic lymph node dissection at the time of radical cystectomy
Authors: Kotov S. V. , Prostomolotov A. О. , Nemenov A. A. , Klimenko A. A. , Pavlov I. S. 
Published: July 2021

Background. Bladder cancer is very common and real problem in oncourology. The main treatment for muscle invasive bladder cancer is radical cystectomy (RC). RC with pelvic lymph node dissection (PLND) may be associated with an increased risk of developing lymphatic complications such as lymphedema, prolonged lymphorrhea, and the formation of lymphocele.Objective: to compare the efficiency of clips and surgical instruments for preventing the development of lymphatic complications during PLND at the time of RC.Materials and methods. From January 2016 to October 2020 at the N.I. Pirogov Russian National Research Medical University on the basis of N.I. Pirogov City Clinical Hospital No. 1 were performed 60 RC with PLND. All patients were divided into two groups. The 1st group included patients who underwent the sealing of lymphatic vessels using titanium/polymer clips (n = 30). In the 2nd group the sealing was performed using ultrasonic/bipolar instruments (n = 30). All operations were performed by one surgeon. The study used univariate and multivariate logistic regression analysis.Results. The overall percentage of lymphatic complications was 29 (48.3 %) out of 60 patients. Out of them 7 (11.7 %) patients developed symptomatic lymphocele, and 3 (5.0 %) developed asymptomatic lymphocele, prolonged lymphorrhea was observed in 17 (28.3 %) patients, lymphedema of the lower extremities or genitals in 2 (3.3 %). The percentage of lymphatic complications in the 1st group was 66.7 % (n = 20), and in the 2nd group - 30.0 % (n = 9) (p = 0.004). In multivariate analysis the statistical significance was (p = 0.014), a high odds ratio (6.83; 95 % confidence interval 1.48-31.49) was observed with sealing of lymphatic vessels with clips, while a low odds ratio (0.14; 95 % confidence interval 0.03-0.67) was found with electrosurgical instruments.Conclusion. The use of ultrasonic or bipolar electrosurgical instruments can be an effective method for preventing the development of lymphatic complications during PLND at the time of RC.