Weekly docetaxel and prednisolone versus prednisolone alone in androgen-independent prostate cancer: a randomized phase II study.

Background: Due to its palliative effect and prostate-specific antigen (PSA) decrease, many clinicians have considered prednisolone monotherapy to be the standard systemic treatment in patients with androgen-independent prostate cancer (AIPC). This approach should be compared with docetaxel (Taxotere)+prednisolone.

Methods: A total of 109 eligible patients were entered into a randomized phase II study (arm A: Taxotere+prednisolone [30 mg m(-2) weekly during 5 of 6 wk+prednisolone 5 mg x 2 per os daily]; arm B: prednisolone [5 mg x 2 per os daily]).

Perforation of continent urinary reservoirs. Scandinavian experience.

In a questionnaire survey of urological departments in Sweden, Denmark, Finland and Norway, 20 episodes of perforation of continent urinary pouches were found to have occurred in 18 patients, representing an incidence of 1.5%. This complication occurred with ileal as well as colonic segments, without predilection.

Diagnosis and treatment of enterovesical fistula.

The records of 24 patients with enterovesical fistula treated at the urology sections of Telemark and Vestfold Central Hospitals are presented. Most fistulas were due to diverticulitis or a malignant tumor. The part of the intestine most frequently affected was the sigmoid colon in 14 patients, the rectum in 3, the cecum in 2 and the small intestine in 2.

A bladder cancer multi-institutional experience with total cystectomy for muscle-invasive bladder cancer.

Background: The role of total cystectomy was to be assessed in the curative treatment of muscle-invasive bladder cancer.

Methods: Two hundred and fifty-three patients with T2-T4a transitional cell carcinoma of the urinary bladder were referred to precystectomy radiation therapy (46 Gy, 66 patients; 20 Gy, 187 patients). These patients represented approximately 20% of all patients developing muscle-invasive bladder cancer in Southern Norway from 1980-1990.

Clinical significance of DNA ploidy and S-phase fraction and their relation to p53 protein, c-erbB-2 protein and HCG in operable muscle-invasive bladder cancer.

DNA ploidy and S-phase fraction (SPF), determined by flow cytometry were studied in 118 patients with muscle-invasive transitional cell carcinoma (TCC) of the urinary bladder, scheduled for cystectomy after pre-operative radiotherapy (20 Gy/1 week) with or without systemic cisplatin-based neo-adjuvant chemotherapy. The correlation between these parameters and immunohistochemically demonstrated p53, c-erbB-2 and HCG was also investigated. There were 16 DNA diploid and 102 DNA non-diploid tumours.

A randomized study on hormone-resistant prostatic cancer: estramustine phosphate versus low dose epirubicin with or without medroxyprogesterone acetate. A Norwegian multicenter study.

A prospective randomized study has been carried out in order to compare three different treatment modalities for symptomatic metastatic hormone-resistant prostatic cancer. A total of 79 patients were included. One group was treated with estramustine phosphate, another with Epirubicin plus Medroxyprogesterone acetate (MPA), while the third arm consisted of Epirubicin plus placebo.

Pre-cystectomy chemotherapy in patients with muscle infiltrating bladder carcinoma. A multicentre feasibility study.

Fourteen patients with muscle infiltrating bladder cancer in whom total cystectomy was planned, received 3 cycles of cis-platinum (70 mg/m2 Day 1) and Methotrexate (40 mg/m2 Day 1) with 3-week intervals before pelvic radiotherapy (20 Gy). Thirteen patients underwent cystectomy whereas the remaining patient finally was found to be inoperable. The subjective toxicity (nausea, vomiting, decrease of performance status), the hematological side effects and the nephrotoxicity of this pre-cystectomy treatment were acceptable.

Cancer of the penis. Experience at the Norwegian Radium Hospital 1974-1985.

The cancer-related 5-year survival was 80% in 79 patients with penile cancer treated at the Norwegian Radium Hospital from 1974 to 1985 (N0 = 61, N1-2 = 12, N3 = 6). Sentinel node biopsy (SLN) of the inguinal lymph nodes medial to the saphenous vein helps to identify patients with early regional spread. The survival for these N+ patients is favourable if radical lymph node dissection is performed immediately.

Weekly low-dose adriamycin in hormone-resistant metastatic cancer of the prostate.

Weekly intravenous doses of 20 mg Adriamycin were given to 22 patients with hormone-resistant metastatic cancer of the prostate. (Median duration treatment: 8 weeks; range 3-60 weeks.) Of 21 adequately treated patients, 6 achieved a subjective response (Median duration: 4 weeks; range 4-28 weeks).

Flare reaction during the initial treatment period with medroxyprogesterone acetate in patients with hormone-resistant prostatic cancer.

During the initial period of treatment with high-dose medroxyprogesterone acetate (MPA), 4 of 40 patients with metastatic prostatic carcinoma experienced a marked clinical flare reaction, predominantly with bone pain exacerbation. All 4 patients subsequently had excellent subjective responses to MPA treatment, lasting for several months. The reason for this transient flare reaction is poorly understood but most probably represents a temporary androgenic effect of high-dose MPA on the prostatic cancer cell.

Short-term and long-term effect of prophylactic treatment of superficial bladder cancer with intravesical adriamycin.

37 patients with recurrent Ta/T1 bladder cancer were treated with intravesical adriamycin (80 mg monthly) after complete TUR (1977-1979). Within a minimum follow-up of 5 years, 11 of them developed evidence of progression - muscle invasion or distant metastases. 8 of them have died of bladder cancer.

Transurethral resection of bladder tumors under local anesthesia.

More than two thirds of urothelial bladder tumors are of small or intermediate size and of low grade. These lesions are treated mostly with transurethral resection. To reduce trauma to patients and the costs for medical care, we have evaluated if such tumors could be excised using topical anesthesia of the urethra supplemented with infiltration of a local anesthetic into the tumor base and bladder wall.

The effect of patient's delay and doctor's delay in patients with malignant germ cell tumours.

In 103 patients with malignant germ cell tumours the initial clinical diagnosis was incorrect in 45 (44%). The correct diagnosis was established within 2 months in only 31% of the patients, and delayed by more than 6 months in 27%. Stage, distribution and survival were correlated with the histology, but not with the duration of symptoms or the patient's/doctor's delay.

Crossed, non-fused renal ectopia and ipsilateral ureteral carcinoma. A case report.

A man with crossed, non-fused renal ectopia had carcinoma of the distal ureter, leading to hydro-ureter, hydronephrosis and urinary infection. Crossed ectopic kidneys are more disease-prone than are normal kidneys. Complicating disorders are discussed, the value of thorough urologic investigation is stressed and the incidence of tumour of the upper urinary tract in crossed renal ectopia without fusion is reviewed.