Objective of the study is to conduct a systematic analysis of the data available in the current literature on the prognostic signifi cance of the use of multi-gene analysis in the treatment of patients with breast cancer.
Materials and Methods. The review comprises the data on the subject obtained from Russian and foreign sources that have been published over the past 10 years.
Results. The creation of microchips based on the achievements of molecular genetics and oncology signifi cantly contributed to more extensive analysis of the tumor and to the identifi cation of parameters that have wide application in clinical practice. Analyses based on gene expression of breast cancer are of signifi cant importance in the estimation of recurrence risk and of life expectancy which is refl ected in the planning of antitumor treatment and of dynamic follow-up of certain categories of patients.
Conclusion. The use of various microchips is promising and is becoming more popular in world oncology which is confi rmed in the literature data. However, it is necessary to conduct further research in the fi eld of multi — gene analysis and its implementation into clinical practice.
Key words: microchips, gene analysis, breast cancer.
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Objective of the study. To conduct a systematic analysis of the current literature data concerning possibility of breast-conserving surgery in multicentric (MC) and multifocal (MF) breast cancer.
Material and Methods. The review includes the data of national and foreign literature, found in Web of Science, Pubmed and e-Library having been published.
Results. There are presented the frequency of multicentric (MC) and multifocal (MF) breast cancer, frequency of regional lymph node involvement, indications and contraindications for breast-conserving surgery in multicentric breast cancer, long-term results after breast-conserving operations in comparison with mastectomies. It is shown the principal possibility of breast-conserving operations in MC/MF breast cancer.
Conclusion. Conservative surgery in MF/MC breast cancer treatment is acceptable and reasonable in compliance with certain conditions: age 50 — 69 years, multifocal growth, size of the largest lesion < 1 cm. absence of DCIS, value of Kindex < 0.1%. Preoperative evaluation of all tumor foci is a must. The question of possibility of breast-conserving surgery must be discussed with the participation of surgeons, chemotherapeutist and radiologist.
Keywords: breast cancer, multicentricity, multifocality, conservative surgery, breast-preserving operations.
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Objective of the study: is to conduct an analysis of the data, available in current literature concerning different approaches to surgical treatment of a rare morphological form of breast cancer — Paget’s disease of the breast, as well as to defi ne the most optimal extent of surgical interventions to the breast and to the zones of regional lymphatic drainage in this disease.
Materials and Methods. The review presents the research carried out in this fi eld by Russian and foreign authors, found in PubMed published over the past 20 years.
Results. The most optimal surgical approaches to combined treatment of Paget’s disease of the breast of different stages are outlined. The possibilities of the use of organ — preserving surgery for early stages of this disease are indicated, and key prognostic factors, signifi cantly affecting the course of the disease in different treatment strategies are revealed.
Conclusion. It is necessary to continue further research on wider implementation of a biopsy procedure of signal lymph nodes for early stages of Paget’s breast cancer and on advancement and development of techniques of adjuvant radiation therapy for these categories of patients.
Keywords: breast, Paget’s disease of the breast, surgery.
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Objective of the study: is to carry out an overview of literature data focused on early diagnosis of ovarian cancer. Materials and Methods. The review incorporates Russian and foreign academic publications predominantly from the last 5 years.
Results. The work presents an algorithm developed for early diagnosis of ovarian cancer as well as the results of large randomized studies on screening (Americal PLCO and British UKCTOCS).
Conclusion. Algorithms of early diagnosis of ovarian cancer are yet imperfect and fl awed, and contrary to the expectations of medical community, effectiveness of screening remains in dispute.
Keywords: ovarian cancer, screening, early diagnosis.
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Objective of the study. Review of studies of surgical treatment for recurrent ovarian cancer. Materials and Methods. The results of the most signifi cant publications over the past 30 years are analyzed.
Results. The article discusses indications for secondary cytoreductive surgery and its results, and prognostic models, assessing the possibility of complete secondary cytoreduction.
Conclusion. According to the retrospective data, secondary cytoreductive surgery increases overall survival in selected patients with recurrent ovarian cancer. Selection criteria include platinum-sensitive recurrence, the prospects for further chemotherapy, the presence of one or several recurrent tumors. Secondary cytoreductive surgery is rational when all macroscopic tumor is removed.
Keywords: ovarian cancer, recurrence, surgical treatment, secondary cytoreductive surgery.
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Objective of the study: is to carry out a systematic analysis of the data available in current literature, on the present possibilities of the therapy of recurrent ovarian cancer.
Materials and Methods. The review comprises the data from Russian and foreign articles, found in PubMed on the subject that have been published over the past 10 years.
Results. Despite decisive progress made in recent years in the therapy of recurrent ovarian cancer, practically all patients die from the progression of tumor process. Every new line of chemotherapy for recurrent ovarian cancer provides a shorter remission period in comparison with previous chemotherapy regimen.
Acquired resistance to chemotherapy challenge to seek ways to overcome it and one of such ways is to give maintenance therapy.
Introduction of inhibitors of the enzyme PARP contributes to the maintenance therapy for recurrent ovarian cancer. The article presents the mechanism of action of PARP inhibitors, the results of their clinical trials, indications for their prescription in Russia and other countries, as well as the prospects for expansion of these indications.
Conclusion. Introduction of PARP inhibitors increased the effectiveness of therapy in a separate group of patients with recurrent ovarian cancer. One of the objectives of further research is the development of new biomarkers, that allow to enrich a population of patients who could benefi t from the therapy with the preparations of this group.
Keywords: Olaparib, ovarian cancer, BRCA.
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Objective of the study: is to carry out an analysis of literature data on the investigation of sentinel lymph nodes in surgical treatment of cervical cancer.
Materials and Methods. The review comprises the data of foreign and Russian academic articles found in PubMed on the subject published over the past 10 years.
Results. Currently broader issues regarding the therapeutic role of sentinel lymph node biopsy and clinical signifi cance of metastases, which could not be detected using traditional methods and techniques, have been brought to the forefront. This biopsy procedure provides a unique opportunity, which is common for all localizations, to obtain a small amount of tissue material with high prognostic value. The concept of sentinel lymph nodes is particularly valuable for the cases when lymph node status is the most signifi cant factor to be assessed for feasibility of performing organ-preservation or adjuvant treatment.
Conclusion. It is necessary to conduct further research on «sentinel» lymph nodes aimed at solving of technical and diagnostic problems of sentinel lymph node identifi cation and on studying of particular properties of lymphatic outfl ow in malignant neoplasms of the cervix.
Keywords: cervical cancer, sentinel lymph nodes, radiopharmaceutical agent.
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Objective of the study: is to conduct a systematic analysis of data available in current literature on the problem of injury to ureters during the course of gynecologic and gynecologic oncology operations.
Materials and Methods. The review includes the data obtained from Russian and foreign articles found in PubMed on the subject that have been published over the past 10 years.
Results. Specifi c features of circulation of the ureters, mechanisms of their injury are considered. Current options of the correction for these complications and the basic methods of their prevention are examined.
Conclusion. It is necessary to carry out preventive measures that will contribute to reducing complications arising after surgical interventions for gynecologic oncology diseases.
Keywords: ureteral injury, gynecologic oncology operations, complications.
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Objective of the study — is to conduct a systematic analysis of the data available in current literature on the infl uence of low-molecular-weight heparins on the effectiveness and safety of antitumor treatment in oncology.
Materials and Methods. The review includes the data from foreign and Russian articles found on the subject in Pubmed and in Russian Science Citation Index which have been published over the past 10 years.
Results. The article describes the possible mechanisms of the participation of low-molecular-weight heparins in the prevention and treatment of thromboembolic complications in oncology considering pathogenesis of hypercoagulation, their principal advantages in comparison with unfractionated heparins, as well as the prospects of the use of low-molecular-weight heparins in palliative care. International guidelines on the prevention and treatment of thromboembolic complications in this category of patients are outlined.
Conclusion. Low-molecular-weight heparins proved to be safe and effective when used in surgical treatment, drug therapy and radiation antitumor treatment. Their application in palliative oncology requires further research.
Keywords: low-molecular-weight heparins, oncology, effectiveness.
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