Shudo Takai

Treatment of bladder cancer with a combination of hyperthermia, radiation and bleomycin.

The treatment of urinary bladder cancer with hyperthermia in combination with radiation and bleomycin was investigated. Immediately following a daily course of external bladder irradiation (150–200 rad; total 4 week exposure of 3500–4000 rad), patients diagnosed with transitional cell carcinoma of the bladder were irrigated with a solution of warmed saline (intravesical temperature, 42°C−43°C), containing 30 μg/ml bleomycin. Of a total of 33 patients, complete responses were observed in 14 patients, and partial responses were observed in 10. The side effects of the combined treatment were limited to local symptoms of bladder and urethral irritation. These preliminary results suggest that the combined use of hyperthermia, radiation, and bleomycin may represent an effective conservative therapy for the management of bladder cancer in humans.

Postoperative prophylactic use of progesterone in renal cell carcinoma.

Medroxyprogesterone acetate has been used prophylactically in 35 patients with stages I and IIIA renal cell carcinoma who had undergone radical nephrectomy. Metastasis was noted in 26 per cent (9 of 35) of the patients who had received the drug and in 44 per cent (20 of 45) of those who had not (controls). The incidence of metastasis in patients who had undergone nephrectomy more than 3 years previously was 10 per cent (3 of 31) for patients who received medroxyprogesterone acetate and 35 per cent (15 of 43) for the control group, the difference being statistically significant. Prognosis tended to be better in patients who had received medroxyprogesterone acetate than in the controls, and relative 3 and 5-year survival rates being 99.3 and 87.2 per cent, respectively, in the former group, and 86.8 and 75.0 per cent, respectively, in the latter group. There was no significant difference between these 2 groups. However, it may be concluded that prophylactic medroxyprogesterone acetate seems to be beneficial in the prevention of postoperative metastasis of renal cell carcinoma.

Idiopathic ureteroduodenal fistula.

AbstractA case of ureteroduodenal fistula corrected by fistulectomy is described. The possible causes of its formation are discussed and the likelihood of a primary duodenal origin is postulated.