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The effect of preoperative irradiation on the survival of patients with renal adenocarcinoma was studied in a clinical trial. 88 patients with verified renal carcinoma entered the trial during 1968-1972, of whom 38, selected in a randomized fashion, received preoperative irradiation to a total dose of 3 300 rads in 3 weeks, followed by extrafascial nephrectomy after a 3 week interval; in the remainder an extrafascial nephrectomy was performed immediately. Actuarial 5-year survival was 47% in the "preoperative irradiation" group and 63% in the "nephrectomy-only" group, i.e. preoperative irradiation did not improve the 5-year prognosis. Survival was also studied in P-categories of the U.I.C.C. as well as in high and low grade malignancies. In none of these groups could we find a clear tendency to a more favourable prognosis with preoperative irradiation; no statistically significant differences were found. Because no improvement in prognosis after preoperative irradiation was found in our series or any of the sub-groups, we consider preoperative irradiation not routinely indicated as an adjuvant therapy. It may be useful in some selected cases, but selecting these cases will be difficult.

Fifty-four female patients were treated for interstitial cystitis. The age range was 16 to 80 and the mean age 59 years. The average duration of symptoms before diagnosis was six years.Antinuclear antibodies were demonstrated in 85 per cent of the patients. Allergy of reagin type was present in 13 per cent and hypersensitivity reactions to drugs had occurred in 35 per cent. The series included a pair of monozygotic twins. These observations suggest that interstitial cystitis closely resembles connective tissue disease. The diagnosis must be based on the history in the case together with urinalysis, cystoscopy, biopsy and the response to treatment. The demonstration of antinuclear antibodies is an important diagnostic aid. The biopsy specimens in this series showed that interstitial cystitis always involves the whole of the bladder, though the macroscopic changes often are local.The patients were classified in three groups according to the severity of the symptoms, the capacity of the bladder and the response to treatment. Dilatation of the bladder sufficed in the mild cases and was combined with intramural injections of prednisolone in the moderately severe cases. Subtotal cystectomy and colocystoplasty seemed to give the best results in severe cases. Neurosurgical procedures also seemed to be helpful.As a result of the apparent similarity between interstitial cystitis and connective tissue disease, therapeutic trials with antimalarial agents and salicylates have been begun. MATERIAL, METHODS AND RESULTSThe series consisted of 54 women; 36 were treated at this Urology Unit between 1963 and Scand J Urol Nephrol4 Scand J Urol Nephrol Downloaded from informahealthcare.com by Cornell University on 12/27/14 For personal use only. Scand J Urol Nephrol Downloaded from informahealthcare.com by Cornell University on 12/27/14 For personal use only. Scand J Urol Nephrol Downloaded from informahealthcare.com by Cornell University on 12/27/14 For personal use only. J Urol 67, 903-915. . Cibert, J., Garbit, J. L. & Massoumi, R. 1968. L'ileOcystoplastie dans le traitement de la cystite chronique d'ttiologie non tuberculeuse, non neoplastique, non bilharzienne, de la cystalgie et de la pollakiurie sans cystite. Rtflexions sur les pollakiuries rebelles A l'agrandissement intestinal dans les cystites chroniques. J Urol Nephrol (Paris) 74, 159-171. Darget, R. & Ballanger, R. 1954. Cystires invdtCries el algies pelviennes. Masson & Cie, Paris. Scand J Urol Nephrol4 Scand J Urol Nephrol Downloaded from informahealthcare.com by Cornell University on 12/27/14 For personal use only. 72, 332-341. 377-383.Scand J Urol Nephrol Downloaded from informahealthcare.com by Cornell University on 12/27/14For personal use only.

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