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Environmental, nutritional and hereditary factors are known to influence the epidemiology and the course of transitional cell carcinoma of the bladder (TCCB) and hence attribute to major ethnic and national differences. The focus of this study was on the characteristics of TCCB among Israeli Arabs who form a particular ethnic group in the Israeli population and were treated in our medical centers.All the Arab patients who presented with TCCB between 1993-2003 to 3 medical centers (Meir, Kfar Saba; Soroka, Beer Sheba and Hillel Yaffe, Hadera) were included in this study. Data was collected retrospectively, with special attention given to epidemiological parameters, risk factors, and treated history of TCCB among these patients.Of 1638 patients who presented with TCCB between 1993 and 2004 at those 3 medical centers, 100 (6.1%) were Israeli Arabs. Male to female ratio among Arabs was 13.4:1 (93 males, 7 females). The prevalence of smoking was 91% and 14% among Arab men and women respectively. The mean age at presentation was 64 (22-93). Arab women were older than men at the time of presentation (mean age 75.7 and 63.1 respectively). Eighty-three percent of patients presented with superficial TCCB and 17% were diagnosed with invasive disease: 80% of patients who presented with superficial TCCB did not progress during the follow-up. In 15% of the patients with stage Ta TCCB progressed to stage T1, while 20% of the patients with superficial TCCB progressed to an invasive stage. The distribution of tumor grades at presentation was 21%, 47% and 32% for grades 1, 2 and 3 respectively.This study demonstrates some major differences in the epidemiology of TCCB among Israeli Arabs in comparison to the general Jewish population. The male to female ratio is significantly skewed towards male predominance. The mean age of the Arab men at presentation with TCCB is younger in comparison to Jewish men as well as to Arab women. The prevalence of smoking among Arab men who present with TCCB is especially high. On the other hand, the treated history and course of TCCB among Arabs seems to follow the known figures of TCCB. Environmental, life style, nutritional and hereditary factors characteristic to the Israeli Arab population may be associated with these ethnic epidemiological differences.

BACKGROUND The current study evaluated the efficacy and toxicity of interleukin-2 (IL-2), interferon-α (IFN-α), 5-fluorouracil (5-FU), and vinblastine (VBL) in the treatment of metastatic renal cell carcinoma (MRCC). METHODS Sixty-two MRCC patients, median age 63 years, received immunochemotherapy. Eastern Cooperative Oncology Group performance status was 1 for 45 patients and 2 for 17 patients. Fifty-four patients underwent nephrectomy prior to treatment. Sites of disease were lungs, lymph nodes, bone, kidney, and liver. Treatment consisted of IL-2 10 MIU/m2 subcutaneous (SC), three times per week, Weeks 1-4; IFN-α 6 MIU/m2 SC, once per week, Weeks 1-4 and 9 MIU/m2, three times per week, Weeks 5-7; 5-FU 600 mg/m2 and VBL 6 mg/m2, intravenous bolus, Day 1 of Weeks 5 and 7. RESULTS In a median followup of 34 months, 62 patients were evaluated for tumor response. Four patients achieved complete response for 26+, 34+, 51+, and 56+ months, respectively; 14 patients achieved partial response for a median of 14 months; and 20 patients achieved stable disease for a median of 9 months. Seven patients (5 partial response, 2 stable disease) underwent complete resection of residual tumor. Five patients remained alive with no evidence of disease for 27, 32, 36, 42, and 48 months, respectively. Nine patients achieved long-term complete response for a median of 36 months. Three-year survival rate for the entire group and for 11 complete responders was 88%. Common side effects were flu-like symptoms, nausea, headache, and depression. Four patients were excluded because of treatment intolerance, and one patient died after nephrectomy. CONCLUSIONS Immunochemotherapy is effective and well-tolerated by patients with MRCC. Surgical intervention for resection of residual disease is justified. Cancer 2002;95:1644–9. © 2002 American Cancer Society. DOI 10.1002/cncr.10842

Purpose: Creating a reliable continence mechanism for a continent reservoir is a great challenge. We describe an easily formed mechanism for allowing complete continence in such patients.Materials and Methods: The native appendix attached to a detubularized right colonic reservoir was used as the catheterizable efferent limb. The continence mechanism was created by crossing 2 nondetached right rectus muscle strips around the appendix.Results: At a mean followup of 32 months (range 4 to 52) in 17 patients complete continence was obtained between 2 to 4-hour self-catheterizations in all positions and even during straining.Conclusions: This continence mechanism is easy to construct and creates a reliable continent stoma in all patients who are not candidates for orthotopic bladder replacement and who retain the native appendix. In patients who have undergone appendectomy an alternate method is to create a small caliber efferent limb from a tailored terminal ileum and build the continence mechanism around it.