Immunobiology of genitourinary tumors

Adjuvant immunotherapy with bacillus Calmette-Guérin in prostatic cancer

Ninety-two patients with histologically proved prostatic cancer were studied. Forty-six patients were treated with bacillus Calmette-Guérin (BCG) adjuvant immunotherapy, and 46 other patients, matched for stage and hormone therapy, served as controls. Survival from the time of histologic diagnosis was sixteen and one-half months longer (thirty-seven and one-half versus twenty-one months) in the BCG-treated patients. There was no mortality and only minimal morbidity. Changes in some immunologic parameters (white blood cell count, skin tests) suggest an immune response.

Evaluation of renal masses including retrograde renal brushing

1. The evaluation of renal masses has become an increasingly important topic because of the increasing incidence of kidney cancer, the improved cure rate of renal carcinoma with the proper preoperative diagnosis, and the proliferation in renal mass diagnostic methodology. 2. A variety of benign entities can produce an abnormal renal mass with attendant difficulties in being distinguished from malignant neoplasms. Among these benign lesions are: simple renal cysts, polycystic kidneys, congenital variations in renal size and shape, segmental renal hypertrophy, renal infarcts, intrarenal hematomas, renal hamartomas, renal leiomyomas, renal adenomas, renal angiomas, renal fibrolipomatosis, hydronephrosis of a duplicated collecting system, renal abscesses, and xanthogranulomatous pyelonephritis. 3. Nephrotomography, nephrosonography (ultrasound), adrenalin renal arteriography, selective magnification renal arteriography, renal venography and cavography, lymphangiography, renal scintillation scanning, abnormal levels of enzymes in blood and urine, immunologic studies (circulating antibodies and tumor-associated antigens), percutaneous needle aspirations, and retrograde renal brushing have all increased the diagnostic accuracy of determining the etiology of renal masses. None of these diagnostic procedures is infallible. A judicious combination of procedures gives the most reliable diagnostic results. 4. A search continues for (a) chemical agent(s) or a chemical profile in the blood or urine which is (are) specific for renal carcinoma, but as yet this is an investigational area and not a practical clinical reality.