The article presents an overview of the clinical trials on the use of letrozole in the treatment of advanced hormone receptorpositive breast cancer. The article outlines the recommendations on its use.
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Objective: to assess the capabilities of cytomorphological method in the diagnosis of benign breast conditions based on the analysis of own data.
Materials and Methods: 406 cytomorphological investigations were conducted in the study of benign breast diseases: 311 cytograms, obtained using fi ne-needle aspiration biopsy, 95 — nipple discharge.
Results: accuracy of cytomorphological investigation of benign breast disease, irrespective of sample gathering technique, was high and made up 94,6%. The accuracy of cytological analysis of nipple discharge in benign breast disease was 89,2%, in intraductal papilloma — 91%.
Conclusions: high level of accuracy of cytomorphological method in the diagnosis of benign breast diseases allows to confi rm the clinical diagnosis before the treatment, to choose the right treatment technique, to determine the optimal extent of surgical intervention, and to predict the outcome of the disease.
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Objective. The study of the infl uence of informing pregnant women with CIN3/CIS and microinvasive cervical cancer about the peculiarities of cervical cancer clinical course on their making the decision to take the pregnancy to full-term and the consideration of the course of the disease during gestation with determining of progression risks and effect on a fetus.
Materials and Methods. An outpatient examination, dynamic observation of patients with continuing gestation and the consequent treatment of 59 pregnant patients, including 48 patients with CIN3/CIS, 11 patients with microinvasive cervical cancer without lymphovascular invasion (stage 1a1 — 9 patients, stage 1a2 — 2 patients) were conducted. The patients were diagnosed on the basis of the results of cervical smear examination when they came to a maternity welfare clinic for routine control at the term of 6–14 weeks, no visible tumor was detected.
Results. 58 patients of 59 women who had CIN3/CIS and microinvasive cervical cancer decided to continue with the pregnancy following the conversation with a doctor. 56 patients of them successfully continued their pregnancy to full term, 3 patients with CIN3/CIS had spontaneous miscarriage. The deliveries were at term, 50 women delivered vaginally, 13 — had cesarean sections. The disease progression was not observed.
Conclusions. It is important to underline that in cases when severe epithelial lesions are detected and cervical cancer is suspected in the absence of visible signs of tumor the decision to continue the pregnancy to full-term or terminate pregnancy must be made not by a physician, but by a patient on condition of patient full awareness of all possible risks associated.
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Extrinsically-controlled organizational factors for the decrease in mortality rates for cervical cancer, differentiated for medical oncology service and the primary healthcare institutions are substantiated.
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Ewing's sarcomas/PNET – are rare tumors, which comprise about 1% of all sarcomas. All histological variants of PNET tumor family possess the apparent ability to hematogeneously disseminate. Prior to the introduction of cytostatic agents into clinical practice (doxorubicin, cyclophosphamide, vincristine, actinomycin D) nearly half of the patients didn't survive a 12-month period after their cancer diagnosis. An integrative approach involving surgery, chemotherapy and radiation therapy provided an opportunity to increase 5-year survival rates of patients who have Ewing's sarcomas/PNET up to 60- 70%. In this article we present an extremely rarely observed case of indolent course of locally-advanced uterine Ewing's sarcoma/PNET in 26-year old woman.
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Objective. To analyze the long-term results of adjuvant radiation therapy in patients with stage I-II endometrial cancer.
Materials and Methods. The study involved 560 patients with stage I-II endometrial cancer who underwent surgery or surgical treatment combined with adjuvant radiation therapy.
Results. It was shown that adjuvant remote and combined radiation therapy don’t improve the overall and recurrence-free survival rates for the patients who have stage I endometrial cancer.
Conclusions. In the presence of risk factors pelvic and when required - lumbar lymph node dissection should be performed for the patients with endometrial cancer and further treatment must be planned on the basis of regional lymph node status. Special attention should be given to the treatment of 58-year-old or younger patients with stage I endometrial cancer. Prescription of remote radiation therapy should be avoided for the patients of this age group and the indications for regional lymph node dissection should be expanded.
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The article considers the modern aspects of pathogenesis, diagnosis and treatment of borderline ovarian tumors. It analyzes the worldwide data related to the incidence of recurrence and fertility indicators after using different strategies of conservative surgery, it provides an overview of the evaluation of the relevance of prognostic factors for the diseases of this particular nosological group. The article also presents the experience of performing ultra-conservative surgeries in patients with bilateral borderline ovarian tumors in the Gynecologic Oncology Clinic of Moscow P.A.Gertsen Research Oncology Institute.
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The absence of multicenter, randomized research studies, having to rely upon singular numbers of cohort and prospective trials with a short period of observations related to both the infl uence of pregnancy on the clinical course of cancer disease and on the health condition of a newborn when carrying out chemotherapy pose signifi cant challenges for cancer specialists when choosing the optimal methods of diagnosis and treatment and all these issues require further investigations and methodological advancement in the management of pregnancy complicated by cancer.
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The article gives an overview of the modern approaches to the process of the formation of postoperative adhesions in gynecologic patients. It discusses the effect of surgical access on the risk of adhesion formation and the incidence of adhesions in women according to the results of the repeated laparoscopic surgeries. The article also presents the data of multicenter studies on the effi ciency and safety of the modern adhesion barriers and discusses the possibility of their use in endoscopic surgery. The article details the results of a 5-year study of the effectiveness of the use of adhesion barriers in gynecologic patients based on the repeated «Second look» laparoscopic surgeries.
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