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Введение. В настоящее время существует достаточно данных о благоприятной роли программы раннего восстановления (fast track) на течение послеоперационного периода. Тем не менее роль этих протоколов, уже включенных в стандарты при хирургическом лечении многих онкологических заболеваний, на сегодняшний день в онкоурологии в целом и при раке предстательной железы (РПЖ) в частности не ясна. Цель исследования -определить влияние элементов программы fast track на результаты лечения у пациентов после радикальной простатэктомии. Материалы и методы. В период с мая 2015 г. по февраль 2016 г. в НИИ онкологии им. Н. Н. Петрова проведено 86 радикальных минимально инвазивных (лапароскопических или внебрюшинных эндоскопических) простатэктомий по поводу РПЖ. Больные были разделены на 2 группы: в 1-й группе (n = 44) традиционного хирургического ведения элементы fast track не применяли совсем или использовали частично; во 2-й (n = 42) -в полном объеме. Оценивали влияние выполнения положений fast track на частоту интраоперационных и ранних послеоперационных осложнений, длительность операции, сроки госпитализации и нахождения в отделении реанимации и интенсивной терапии, частоту повторных хирургических вмешательств, а также повторных госпитализаций в течение 30 дней послеоперационного периода. Результаты. Наличие и отсутствие предоперационной подготовки не повлияли на частоту развития интраоперационных осложнений. Интраоперационная кровопотеря не привела к необходимости выполнения гемотрансфузий. Достоверных различий в частоте развития 30-дневных осложнений между группами не наблюдали. При оценке послеоперационных показателей отмечена разница между 1-й и 2-й группами в длительности дренирования таза (3,3 и 0,9 сут соответственно, p = 0,002), средней длительности катетеризации (11,2 и 5,2 сут соответственно, p = 0,0003) и длительности госпитализации (15,1 и 6,5 сут соответственно, p = 0,0008). Заключение. Применение принципов ускоренной программы периоперационного ведения пациентов (fast track) при лечении больных РПЖ не влияет на частоту интра-и послеоперационных осложнений, однако потенциально экономически более целесообразно прежде всего за счет уменьшения срока нахождения больного в стационаре.

Background To our knowledge, there is no clinical data pertaining to COVID-19 outcomes and safety of COVID-19 vaccination in Russian patients with genitourinary (GU) malignancies. Aim of our analysis was to describe the characteristics of the COVID-19 infection course as well as preliminary safety and efficacy of Gam-COVID-Vac vaccine in patients with active GU malignancies. Methods Patients were retrospectively identified at nine cancer centers in different regions. Patients were included if COVID-19 was diagnosed by a polymerase chain reaction. Data from additional patients with GU cancers who had no positive SARS-CoV-2 RT-PCR test before vaccination and who received two doses of Gam-COVID-Vac (Sputnik V) between 11 February and 31 August 2021 were collected for safety assessment. Anonymized data were collected through an online registry covering demographics, treatments, and outcomes. Results The Gam-COVID-Vac vaccine was well tolerated; no grade 3–5 toxicities were reported in 112 vaccinated metastatic GU cancer patients. The most common grade 1 adverse events (81%) were injection site reactions (76%), flu-like illness (68%), and asthenia (49%). Five patients experienced grade 2 chills (4.5%) and 3 patients had grade 2 fever (2.7%). With median follow-up of 6.2 months, two COVID-19 cases were confirmed by RT-PCR test in the vaccine group (of 112 participants; 1.8%). Eighty-eight patients with COVID-19 disease were included in the analysis. The average age as of the study enrollment was 66 (range 39–81) and the majority of patients were male with renal cell carcinoma (RCC). Thirty-six patients (41%) had evidence of metastatic disease, of these 22 patients were receiving systemic therapy. More than half of patients required hospitalization. Fifty-four patients (61%) experienced complications. Sixteen patients who developed COVID-19 pneumonia required mechanical ventilator support. Sixteen patients (18%) died in a median of 23.5 days after the date of COVID-19 diagnosis was established. The 3-month survival rate was 82%. Clinical and/or radiographic progression of cancer during COVID-19 infection or the subsequent 3 months was observed in 10 patients (11.4%). Conclusion Patients with GU malignancies are at increased risk of mortality from COVID-19 infection when compared to the general population. Vaccination could be safe in GU cancer patients. Trial registration: retrospectively registered.

The study objective: estimation of two group patients, treated in N.N. Petrov National Medical Research Center of Oncology with renal cell carcinoma.Materials and methods. The 1st group include patients with standard postsurgical care management after open renal resection with lumbotomy access and warm renal ischemia. The 2nd group include the same treated patients with minimally invasive surgeries and fast track elements under induced hypotension. We analysed preparation of patient for surgery, differences in after treatment care management, frequencies and pain severity, after treatment complications, blood loss severity.Results and conclusion. Research suggests that the system of enhanced recovery after renal resection ensure early patients rehabilitation with two-time less hospitalization period.

Злокачественные опухоли яичка составляют около 1-2 % всех новообразований у мужчин и 5 % опухолей мочевыделительной системы и мужских гениталий. На ранних стадиях злокачественные новообразования яичка не проявляются клинически. Постепенно увеличиваясь в размерах, они меняют форму и плотность яичка. Мужчинам, обратившимся за консультацией по поводу бесплодия в браке, рекомендуется проводить ультразвуковое исследование органов мошонки. В результате выявляется больше больных, у которых при нормальном уровне онкомаркеров и отсутствии симптомов выявлены небольшие (<1 см в диаметре) новообразования яичка (инциденталомы яичка) и тестикулярный микролитиаз. В последнее время появляется все больше публикаций, свидетельствующих о возможности расширения показаний к проведению органосохраняющего лечения, в частности при инциденталомах яичка. Представляем обзор данных литературы на эту тему и собственные наблюдения.

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TPS4696^ Background: Docetaxel (D) in combination with prednisone (P) as first-line (1L) chemotherapy in patients (pts) with mCRPC is the current standard of care. However, treatment is not curative and D-resistant disease typically develops. Cabazitaxel (Cbz) is a novel taxane active in D-sensitive and -resistant tumor models. Clinical activity of Cbz plus P (CbzP) was demonstrated in the Phase III TROPIC study in mCRPC pts previously treated with a D-containing regimen; CbzP showed a significant overall survival (OS) benefit vs mitoxantrone plus prednisone (median OS 15.1 vs 12.7 months; HR 0.70; P < 0.0001). Therefore, it is of interest to determine if CbzP provides an OS advantage vs DP in 1L mCRPC pts. Methods: The phase III FIRSTANA study (NCT01308567) is a randomized, open-label, multinational trial in 1L mCRPC pts, designed to compare the efficacy of Cbz 25 mg/m² IV Q3W (Arm A) and Cbz 20 mg/m² IV Q3W (Arm B) vs D 75 mg/m2 IV Q3W (Arm C). P 10 mg PO QD is to be given concomitantly. Pts are stratified by ECOG PS (0–1 vs 2), measurable disease (yes/no) and region (depending on availability of Cbz as 2L). Pts with ECOG PS ≤ 2, histologically/cytologically confirmed metastatic prostate adenocarcinoma, with no prior chemotherapy and with disease progression following medical or surgical castration are eligible. The primary endpoint is OS. Secondary endpoints include progression-free survival (PFS) (PCWG2 criteria), radiologic PFS, tumor response in measurable disease (RECIST 1.1), PSA response and PSA PFS, pain response and pain PFS, time to occurrence of any skeletal-related events, safety profile and health-related quality of life. Cbz pharmacokinetics and pharmacogenomics will be assessed in pt subgroups. Pts will be treated until progression, unacceptable toxicity or pt request. Planned enrollment is 1,170 pts; study size was calculated to achieve 90% power for OS. Study start was in May 2011; at January 2012, 219 pts were enrolled. The first DMC meeting recommended continuing the study without change.

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