Background: Because incidental detection of small renal cell cancers (RCC) has recently become increasingly common, nephron-sparing surgery for these cases has been more widely performed.Renal cell cancer was investigated by means of step-sectioning in order to determine which cases were suitable for nephron-sparing surgery and how it should be performed. Methods: Pathology specimens obtained from 90 cases of radical nephrectomy were examined in 5 mm sections. We excluded large and invasive tumors from the present study. Particular attention was given to satellite tumor nodules (STN), pseudocapsules of the main tumor and vascular invasion.Results: Satellite tumor nodules of cancer (STN-Ca) were found in seven of 90 cases (7.8%). Tumor size and grade was not correlated with the existence of STN-Ca. The distance between the main tumor and STN-Ca varied, with the pathology of the STN-Ca mostly resembling that of the main tumor. Pseudocapsules of the main tumor were incomplete in 53 cases (58.9%), but extracapsular invasion of more than 1 mm was not seen in tumors less than 50 mm in diameter. Through step-sectioning, a further six cases with microscopic vascular invasion were found. Vascular invasion within the main tumor was confirmed in 16 of 17 cases (94.1%) and within normal renal tissue in only one case. Conclusions:The incidence of existing STN-Ca was not high (7.8%) in the present study, we had not any characteristics in the cases with STN-Ca. As STN-Ca were rarely near the main tumor, we could not expect to resect STN-Ca with main tumor, resection to more than 1 mm outside the pseudocapsule was needed for complete resection of main tumor less than 50 mm in diameter. Normal renal tissue between the tumor and pelvis is a requirement for selecting appropriate cases in nephron-sparing surgery, but we could not remove the risk of leaving STN-Ca completely.

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A purpose of mucosal random biopsy of urinary bladder is to get informations about the extent of cancerous lesion and the existence of rest of cancer. For the purpose of determining the care range of the operation and postoperative treatments by getting these informations during the operation, we drew up stamp cytological preparations for mucosal random biopsy of urinary bladder performed during TUR-Bt, and examined potency of application of this method to quick diagnostics. First of all, 15 times of transurethral resections of bladder cancers were performed on 14 cases, and 19 of imprint preparations were made from the excised tumor materials during operation. Then the accuracy rate of the rapid cytology was evaluated based on permanent preparations that were made simultaneously. The accuracy rate of the intraoperative rapid cytology was 84.2%. Next, a similar procedure was performed on 68 materials of random biopsy during the above-mentioned operation. The accuracy rate of imprint cytology was 73.5%. The relatively low accuracy rate of rapid cytology must be attributed to diagnostic difficulty noted when dealing with Papanicoloau class 3. For all above, it was suggested that rapid implant cytology during operation must be applicable to quick diagnostics.

The incidence and mortality rate of urogenital cancers in Japan are both low compared to those in western countries. However, the incidence and mortality patterns of cancer in Japan are currently becoming closer to those of western countries, and the importance of urogenital cancers is increasing. We conducted an analysis of urogenital cancers in Gunma Prefecture. The subjects were newly detected urogenital cancer patients living in Gunma Prefecture diagnosed between 1985 and 1992. Details were as follows: prostate cancer 1411, bladder cancer 1253 (male 937, female 316), renal cell carcinoma 411 (male 287, female 124), renal pelvic and ureter cancer 187 (male 127, female 60) and testicular cancer 162. Incidence rate was calculated by year, district and age, and was expressed per 100,000/year and was adjusted to world population. Regarding the incidence rate per year for males, that of prostate cancer and renal cell carcinoma increased dramatically from 8.3 to 13.6 and from 1.1 to 3.2, respectively. Incidence rate of other cancers in males showed a slight increase or remained almost stable. Incidence rate by year for females showed a slight increase or remained almost stable as a whole. Gunma Prefecture was divided into 10 districts by the range of daily life of people and the incidence rates of prostate cancer, bladder cancer and renal cell carcinoma for each district were calculated. Incidence rate of prostate cancer tended to be higher in the northern parts of the prefecture, while that of bladder cancer showed no detectable trend.(ABSTRACT TRUNCATED AT 250 WORDS)