As in other recently published studies that used 5-FU, IL-2, and IFN-alpha, the multicenter SCAPP II trial in patients with metastatic renal cell carcinoma generated severe toxicity. This sequential trial failed to confirm the favorable results previously obtained by Atzpodien and Sella with this combination of three drugs. Its efficacy, assessed on the response and survival rates, is near to the results observed in programs that used IL-2 alone given subcutaneously.

A prospective study of type IV collagen in urothelial tissues was undertaken using an immunoperoxidase method on 125 ethanol fixed specimens. In normal and non cancerous urothelium, the basement membrane was continuously stained and the same pattern was seen in the 27 superficial carcinomas. In the 48 invasive bladder carcinomas, we observed two patterns of staining for collagen IV: in the first one, the staining line was conserved or partially fragmented (28 tumours), while in the second one the staining line was widely fragmented or absent in more than 5% of the tumour area (20 tumours). We found a highly significant statistical correlation between the pattern of staining and short term prognosis. Twenty-nine patients had an assessable follow-up of three years at least. All 16 patients with pattern I staining were alive at two years while only two out of 13 patients with pattern II staining survived two years (P less than 0.0001). At three years, all the patients with pattern II staining died while 11 patients with pattern I were still alive (P less than 0.001). These data provisionally indicate that the type IV collagen staining pattern may be of prognostic value in assessing the short term behaviour of invasive bladder carcinomas. It is thus logical to envisage that the treatment decisions may be influenced by the results of collagen IV staining. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10

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A group of 44 rats underwent the equivalent of a ureterosigmoidostomy (US), while a second group of 18 rats underwent a pediculated graft (PG) of urothelial tissue in the sigmoid wall. Histological lesions were observed in the colon near the bladder colon junction in US rats exclusively. These lesions included dysplasias (5/23), cystic glands (4/23) and 10 neoplasms (9/23), three of which were adenomas, showing elements of juvenile polyp and tubular adenoma in one case. The seven other tumors showed typical histological features of colonic adenocarcinomas, but no frank evidence of parietal tumoral invasion was observed and their cancerous nature was questionable. It is probably a true carcinogenesis since we induced the same histological changes as those in the mucosae adjacent to colonic adenocarcinomas after human US surgery. Moreover, by immunoperoxidase using antibodies against mucus associated antigens (M1 and M3C antigens) we demonstrated that US rat carcinogenesis differs from dimethylhydrazine (DMH) rat carcinogenesis. Furthermore, our results suggest that urine may be an important factor in inducing this type of US carcinogenesis.

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