Peritoneal Canceromatosis in Malignant Tumors of Various Localizations. Achievements and Prospects

Peritoneal carcinomatosis is viewed by many experts as a terminal illness with an unfavourable course and prognosis. Existing therapies are controversial and exhibit ambiguous efficacy. We review the current state of the art in therapy for peritoneal metastases of various origin and its historical background. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy compound the treatment of choice as achieving the highest survival rates. Palliative surgery and systemic chemotherapy are an alternative that proved even more aggressive and ineffective in comparative survival evaluations. Manifold studies and expert opinions exist on the efficacy and expedience of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in treatment of peritoneal carcinomatosis. Today, however, their routine use in everyday practice is hotly debated. Despite an evident progress in managing peritoneal metastases, a series of questions remain unsolved. Contentious research data, late diagnosis, low treatment efficacy in severe peritoneal dissemination, a limited applicability of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, all highlight the importance of inventing and developing novel methods for early high-accuracy diagnosis and careful selection of the treatment strategy. Fundamental knowledge of malignant metastasis underlies the choice of patient management and the innovative toolkit for prevention and treatment of peritoneal carcinomatosis

Peritoneal Carcinomatosis: Current State of the Art and Schools of Thought

Peritoneal carcinomatosis (PC) is a global challenge of modern oncology representing the most unfavourable scenario in diverse-locality tumourisation. Despite certain attention by the oncological community, the management of PC patients is currently palliative, which weakly promotes research into the basic principles of this morbidity. This literature review attempts to comprehensively cover the PC problematic from a global perspective and presents a key evidence on the world schools of thought in this area. Briefly taking, peritoneal carcinomatosis is viewed today as a local process in the conventional implantation theory, which imposes a locoregional character on all current or emerging therapies, such as cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Their inadequate efficacy is largely due to pronounced gaps in our understanding of PC logistics and signalling. PSOGI is a key organisation for centralising the specialty effort in peritoneal carcinomatosis. Despite its global geography and approach to PC discussion, a multitude of scientific questions remain unanswered impeding the establishment of novel effective therapies. The seven countries that nurtured distinguished schools of thought in PC studies are the USA, UK, Japan, China, Italy, France and Germany. Taking peritoneal carcinomatosis in a global perspective, an insufficient attention to its problematic in Russia should be addressed. The founding and fostering of national PC institutions will benefit cancer patients and progress in oncological science

Кафедра онкологии Башкирского государственного медицинского университета: от становления к новым горизонтам

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Новый учебник по онкологии

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Новый учебник по онкологии издательства «ГЭОТАР»

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Перспективы ингибирования NF-kappa B внутрибрюшинным введением DHMEQ

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Neuroendocrine Breast Cancer. Clinical Observation. Personalized Approach

Introduction. Neuroendocrine breast tumors represent a rare subtype of breast cancer, accounting for less than 1 % of all neuroendocrine neoplasms. Starting from their pathology definition, and going through their prevalence, prognosis and treatment, our knowledge is still really uncertain.Materials and methods. The article presents a rare clinical observation of a neuroendocrine breast tumor. A breast fibroadenoma was diagnosed at the initial diagnosis stage in a private clinic; after a surgical treatment and further morphological study, it was estimated: a diagnosis of Cancer in situ of the left breast T1N0M0, stage I. Next, 3D-conformal remote radiation therapy was performed on the area of the left breast.Results and discussion. After conducting positron emission tomography, multiple metastases were detected in the lymph nodes, bones, and liver. Additionally, micropreparations were consulted at the Federal Reference Center in St. Petersburg and at an independent third-party molecular biological laboratory in Germany (Munich). Given all the instrumental, molecular biological, histological and immunohistochemical studies of the patient, an individual regimen of drug therapy was selected.Conclusion. After 18 months of personalized drug therapy, we observed a positive trend and a significant decrease in metabolic activity according to positron emission tomography

Possibilities of Surgical Treatment of Vulva Cancer in the Context of the COVID-19 Pandemic

Background. At the end of 2019, a new coronavirus infection emerged in the People’s Republic of China. On March 11, 2020, the World Health Organization announced the start of the COVID­19 pandemic. During 2018, 2068 patients with malignant neoplasms of the vulva were identified, with the majority of patients aged 75–79 years. Surgical treatment is currently the main treatment method for vulva cancer (VC) patients. According to most authors, surgical treatment is the only method providing good long­term results. One of the approaches to reducing the volume of surgical treatment in such patients is the selective biopsy of the sentinel lymph node (SLN).Aim. To apply the method of SLN biopsy in VC patients with the purpose of reducing the amount of surgical treatment and surgical complications, as well as shortening hospital stay in the context of the COVID­19 pandemic.Materials and methods. This paper presents the results of surgical treatment of 19 patients with malignant neoplasms of the vulva. All the patients were at risk for a complicated course of COVID­19 due to age and concomitant pathologies. In 13 cases, vulvectomy with SLN biopsy was performed. SLN biopsy was performed by radioisotope lymphoscintigraphy.Results and discussion.A decrease in the duration of hospital stay and the absence of surgical complications characteristic of lymphadenectomies were noted.Conclusion. Reducing the duration of hospital stay in the context of the COVID­19 pandemic is an urgent task. The method of SLN biopsy in patients with invasive squamous cell carcinoma of the vulva with T1A — T2 was found to be effective, allowing the amount of surgical treatment to be reduced. Vulvectomy accompanied by SLN biopsy is the surgical treatment of choice in the context of strict anti­epidemiological measures in the COVID­19 pandemic

Нейроэндокринный рак молочной железы. Клиническое наблюдение. Индивидуальный подход

Introduction. Neuroendocrine breast tumors represent a rare subtype of breast cancer, accounting for less than 1 % of all neuroendocrine neoplasms. Starting from their pathology definition, and going through their prevalence, prognosis and treatment, our knowledge is still really uncertain.Materials and methods. The article presents a rare clinical observation of a neuroendocrine breast tumor. A breast fibroadenoma was diagnosed at the initial diagnosis stage in a private clinic; after a surgical treatment and further morphological study, it was estimated: a diagnosis of Cancer in situ of the left breast T1N0M0, stage I. Next, 3D-conformal remote radiation therapy was performed on the area of the left breast.Results and discussion. After conducting positron emission tomography, multiple metastases were detected in the lymph nodes, bones, and liver. Additionally, micropreparations were consulted at the Federal Reference Center in St. Petersburg and at an independent third-party molecular biological laboratory in Germany (Munich). Given all the instrumental, molecular biological, histological and immunohistochemical studies of the patient, an individual regimen of drug therapy was selected.Conclusion. After 18 months of personalized drug therapy, we observed a positive trend and a significant decrease in metabolic activity according to positron emission tomography.Введение. Нейроэндокринные опухоли молочной железы представляют собой редкий подтип рака молочной железы, составляя менее 1 % всех нейроэндокринных новообразований. Исходя из определения патологии, распространенности, прогноза и лечения, наши знания все еще остаются неоформленными.Материалы и методы. В статье представлено редкое клиническое наблюдение нейроэндокринной опухоли молочной железы. Фиброаденома молочной железы диагностирована на начальном этапе в частной клинике. После хирургического лечения и дальнейшего морфологического исследования было оценено: диагноз «Рак in situ» левой груди T1N0M0, I стадия. Затем была проведена 3D-конформная дистанционная лучевая терапия в области левой груди.Результаты и обсуждение. После проведения позитронно-эмиссионной томографии обнаружены множественные метастазы в лимфатических узлах, костях и печени. Кроме того, по микропрепаратам консультировались в Федеральном справочном центре в Санкт-Петербурге и в независимой сторонней молекулярно-биологической лаборатории в Германии (Мюнхен). Учитывая все инструментальные, молекулярно-биологические, гистологические и иммуногистохимические исследования пациента, была подобрана индивидуальная схема медикаментозной терапии.Заключение. После 18 месяцев индивидуальной лекарственной терапии мы наблюдали положительную динамику и значительное снижение метаболической активности по данным позитронно-эмиссионной томографии

РЕЗУЛЬТАТЫ РЕНTГЕНЭНДОВАСКУЛЯРНЫХ МЕТОДОВ ЛЕЧЕНИЯ ОПУХОЛЕВЫХ ПОРАЖЕНИЙ ПЕЧЕНИ В ЮЖНОМ КАЗАХСТАНЕ

In clause results endovascular methods of treatment of 70 patients with tumoral defeats of a liver of men 47 (67,1 %), women 23 (32,9 %), from them are presented: a primary cancer of a liver 42 (60 %) cases, metastatic defeats of a liver 28 (40 %). Chemo-infusions a hepatic artery it is executed at 50 patients, from them at a primary cancer of a liver at 32 (45,7 %) by patients, at metastatic defeats of a liver at 18 (25,7 %) patients. At 20 patients it is lead chemo-embolisations a hepatic artery, from them at a primary cancer of a liver 10 (17,1 %) by patients, at metastatic defeats of a liver 8 (11,4 %) patients. Data obtained by us have shown efficiency chemo-infusions a hepatic artery at a primary cancer of a liver at 19 (45,2 %) to patients with high quality of a life that enables wider application of a technique for rendering special treatment of this complex category of patients. Results chemo-embolisations a hepatic artery at a primary cancer of a liver also encourage, as after 1 procedure gives stabilization of process and improves quality of a life of patients. Цель: изучить непосредственные результаты химиоинфузии в печеночную артерию и химиоэмболизации печеночной артерии при опухолевых поражениях печени, выполненных за период 2004-2008 гг. по данным Южно-Казахстанского областного онкологического диспансера. Проанализированы результаты эндоваскулярных методов лечения 70 больных с опухолевыми поражениями печени, из них мужчин 47 (67,1%), женщин 23 (32,9%), первичный рак печени в 42 (60%) случаях, метастатические поражения печени в 28 (40%) случаях. Химиоинфузия печеночной артерии выполнена у 50 больных, из них при первичном раке печени у 32 (45,7%) больных, при метастатических поражениях печени у 18 (25,7%) больных. У 20 больных проведена химиоэмболизация печеночной артерии, из них при первичном раке печени 10 (17,1%) больным, при метастатических поражениях печени 8 (11,4%) больным. При первичном раке печени значительная регрессия отмечена у 2 (4,76%) больных, они наблюдаются в течение 3-х лет без признаков прогрессирования процесса, частичная регрессия отмечена у 6 (14,3%) больных, стабилизация процесса у 16 (38%) и прогрессирование процесса у 8 (19%) больных. После лечения до года со стабилизацией процесса живут 14 (33,3%) больных, 1,5 года живут 3 (7,14%) больных, в сроки от 4 до 8 месяцев после лечения умерло 13 (30,9%) больных. После химиоэмболизации печеночной артерии (ХЭПА) у 8 из 10 больных отмечена частичная регрессия процесса, которая наблюдается в течение 3-5 месяцев, в настоящее время этим больным в плановом порядке проводится 2 и 3 сеансы ХЭПА. Отмечена эффективность ХИПА при первичном раке печени у 19 (45,2%) больных с хорошим качеством жизни, что дает возможность более широкого применения методики для оказания специального лечения этой сложной категории пациентов. Результаты ХЭПА при первичном раке печени также обнадеживают, так как после одной процедуры наступает стабилизация процесса и улучшается качество жизни пациентов