КЛИНИЧЕСКИЕ РЕКОМЕНДАЦИИ. ДИАГНОСТИКА И ЛЕЧЕНИЕ РАКА РОТОГЛОТКИ

Клинические рекомендации подготовлены на основании материалов научно-практической конференции Проблемной комиссии «Опухоли головы и шеи» Научного совета по злокачественным новообразованиям Отделения медицинских наук Российской академии наук и Министерства здравоохранения РФ, посвященной памяти профессора Александра Ильича Пачеса, «Актуальные вопросы диагностики и лечения рака ротоглотки» (25 июня 2015 г., г. Архангельск).Клинические рекомендации подготовлены на основании материалов научно-практической конференции Проблемной комиссии «Опухоли головы и шеи» Научного совета по злокачественным новообразованиям Отделения медицинских наук Российской академии наук и Министерства здравоохранения РФ, посвященной памяти профессора Александра Ильича Пачеса, «Актуальные вопросы диагностики и лечения рака ротоглотки» (25 июня 2015 г., г. Архангельск)

COMBINED SURGERY OF SPREAD THYROID CANCER

Results of treating of 99 patients with differentiated thyroid cancer spreading beyond the capsule of the organ were analysed. In most cases with spreading the tumor to the tracheal rings performing of organ-preserving operations (from “window-like” tracheal resections to circular tracheal resection with intertracheal anastomosis) is possible. Choosing of type of operation to be performed depends on localisation and spread of tumor invasion of trachea, pharynx and esophagus. Using of combined operations in patients with locally-spread thyroid cancer allows to achieve long and stable remission in most of the cases

USE OF PREDICTORS TO CHOOSE TREATMENT POLICY FOR THYROID CANCER

The paper analyzes the results of treatment in patients with papillary thyroid cancer, by applying a great deal of clinical material. Different prognostic factors have been studied for their influence on the survival of the patients after surgical treatment. The most optimal treatment policy is proposed to be defined for patients with this form of cancer on the basis of the association between the above factors

THE DIAGNOSIS AND TREATMENT OF MEDULLARY THYROID CANCER

The paper presents many years’ international experience in treating medullary thyroid cancer (TC). Two hundred and forty-two patients with different stages of the disease were followed up. The morphological and genetic features of this tumor are given. The results of used treatment options for medullary cancer, such as surgical, radiation, multimodality, and drug therapies, are analyzed. Surgery is a leading treatment option for this disease. The volume of surgery on a primary tumor focus depends on both the shape of a (sporadic or hereditary) tumor and its sizes. Removal of pre- and paratracheal fat is indicated for any volume of surgery for TC due to the high risk of its metastases to lymph nodes at this site. For radiotherapy there are three main indications: 1) the dubious, macroscopically and microscopically evaluated efficiency of an operation; 2) inoperable cancer; 3) distant bone metastases for palliative and symptomatic care. The now chemicals available at an oncologist’s disposal exert no significant effect on increased survival in a patient with medullary TC

A RARE CASE OF THYROID CANCER METASTASIS TO PARAPHARYNGEAL LYMPH NODES

The paper presents the specific features of the diagnosis and treatment of thyroid cancer metastases to parapharyngeal lymph nodes

SURGICAL TREATMENT FOR GENERALIZED SKIN CANCER OF THE FOREHEAD (2 CLINICAL CASES)

The paper outlines the possibilities of surgical treatment in patients with generalized skin cancer of the head and neck. The use of different types of free revascularized flaps can yield acceptable functional and cosmetic results

THE USE OF THE SUBMENTAL FLAP IN RECONSTRUCTION OF HEAD AND NECK DEFECTS

Reconstruction of head and neck defects after surgery for cancer remains challenging. The choice of the reconstruction technique  depends on the tumor size and localization, type of the defect,  patient’s age, concomitant diseases, and disease prognosis.  Surgeons have currently a broad range of material for reconstructive surgery, from free flaps to revascularized flaps. Microsurgical  reconstruction has made a revolution in treatment of patients with  complex head and neck defects. However, the use of this technique may not be advisable for some patients. The search for  new techniques is needed to improve functional and aesthetic results and reduce traumatism without compromising oncologic outcomes.  Thirty-six patients underwent surgery with reconstruction using the  submental island flap, a new alternative in the reconstruction of  various head and neck defects. The graft was taken after making a  neck incision for neck lymph node dissection. A few patients develop  total and marginal necrosis of the graft. Short- and long-term results showed no worsening of oncologic outcomes in the selected group of patients

DIAGNOSIS AND TREATMENT OF OROPHARYNGEAL CANCER. CLINICAL RECOMMENDATIONS

Клинические рекомендации подготовлены на основании материалов научно-практической конференции Проблемной комиссии «Опухоли головы и шеи» Научного совета по злокачественным новообразованиям Отделения медицинских наук Российской академии наук и Министерства здравоохранения РФ, посвященной памяти профессора Александра Ильича Пачеса, «Актуальные вопросы диагностики и лечения рака ротоглотки» (25 июня 2015 г., г. Архангельск)