Objective of the study is to conduct a systematic analysis of the data available in current literature on the modern concepts of the role of matrix metalloproteinases and their tissue inhibitors in the clinical course and prognosis of ovarian cancer.
Materials and Methods. The overview comprises the data from foreign and Russian academic articles found in PubMed on the subject published over the past 10 years.
Results. The overview analyzes the publications that focus on the study of the role of various members of matrix metalloproteinase family (MMP) and their tissue inhibitors in differential diagnosis, in prognosis of the clinical course and in the development of novel treatment strategies for ovarian cancer. It was concluded that gelatinases/collagenases of collagen IV — MMP-9 and MMP-2, matrilysine (MMP-7), as well as tissue inhibitor MMP of type 1 (TIMP-1) and membrane-associated MMP-1 (MMP-14) are the most promising markers for differential diagnosis and prognosis of ovarian cancer.
Conclusion. The existing methods of inhibiting MMP activity, including the use of specifi c inhibitors, enable to reduce the invasiveness of ovarian cancer cells in vitro, but these methods require further research and development in order to be integrated into practice.
Keywords: matrix metalloproteinases, tissue inhibitors of matrix metalloproteinases, ovarian cancer, diagnosis, prognosis, molecular targeted therapy.
 Full text (in Russian)

Objective of the study is to conduct a systematic analysis of the data available in literature on side effects of hormonal therapy with tamoxifen.
Materials and Methods. The review includes data from foreign and Russian academic articles found in PubMed on the subject published over the past 20 years.
Results. Hormonal therapy is highly effective and generally well-tolerated treatment of hormone-dependent breast cancer. However, there are a number of adverse effects that can reduce the quality of life of patients and can be a reason for premature discontinuation of the drugs. The article describes the major side effects of tamoxifen, ways of their prevention and correction.
Conclusion. A number of tamoxifen adverse events can be prevented or corrected. To maintain satisfactory quality of life of patients oncologists should pay more attention to those side effects that really deteriorate patients’ quality of life and not to be too anxious and fussy about those which are clinically insignifi cant.
Keywords: hormonal therapy, tamoxifen, side effects.
 Full text (in Russian)

Objective of the study is to conduct a systematic analysis of the data on the possibility of endometriosis malignization and on the risk of development of malignancies of various localizations.
Materials and Methods. The work provides the fi rst-hand observations of ovarian cancer development in patients with endometriosis as well as an overview of current literature data.
Results. The clinical observations introduced in the article demonstrate that endometriosis and ovarian cancer have common etiological risk factors and are determined by inherited factors.
Conclusion. Endometriosis is not always an obligate precancerous process for heterogeneous group of malignant ovarian tumors, and the incidence of malignization of endometrioid lesions is not high. Further research on endometriosis pathogenesis and predictor factors of malignant ovarian neoplasms is required.
Keywords: endometriosis, malignization, ovarian cancer
 Full text (in Russian)

Objective of the study is to analyze the results of surgical treatment of patients with intravenous leiomyomatosis and intracardiac lesions.
Materials and Methods. Surgical tactics and results of the treatment of 12 patients who had undergone surgery for intravenous leiomyomatosis with intracardiac component of the tumor for the period from October 2012 to February 2018 at Federal State Budgetary Institution «N.N. Blokhin National Medical Research Center of Oncology» of the Ministry of Healthcare of the Russian Federation, Moscow and Federal State Budgetary Institution «National Medical Research Center named after Academician E.N. Meshalkin» of the Ministry of Healthcare of the Russian Federation, Novosibirsk were analyzed retrospectively.
Results. The mean age of patients was 46 (38–52) years. The tip of the tumor thrombus reached right atrium (RA) in 6 patients, and in 7 patients — right ventricle (RV), in one patient tumor thrombus spread into pulmonary arteries. 6 (50%) patients underwent R0 surgeries, 6 (50%) patients — R2 surgeries, and in two of them the surgical treatment can be ultimately considered radical after repeat surgeries. The mean duration of surgical procedures was 380 (177–510) minutes. The mean duration of artifi cial blood circulation (AC) was 46,2 (20–80) minutes. The mean blood loss made up 7500,0 (2000,0– 12500,0). Hormonal treatment in post-operative period was prescribed to 7 (58,3%) patients. All patients receive follow-up care and are alive. The mean traceability was 40,1 (3–99) months, median — 27 months. Recurrences and progression of the disease were identifi ed in 4 (25%) patients.
Conclusion. Intravenous leiomyomatosis with intracardiac spread is a rare disease of a challenging localization, that require performing of complicated surgical interventions, excellent technical equipment and technology infrastructure of the operating room and multidisciplinary cooperation, that is possible to provide only in highly specialized (tertiary) multipurpose medical institutions.
Keywords: intracardiac intravenous leiomyomatosis, uterine leiomyoma, smooth muscle tumor of uncertain malignant potential.
 Full text (in Russian)

Objective of the study is to identify indications for adjuvant treatment and to develop its technique for stage IA G1 endometrial cancer (EC) with myometrial invasion based on the results of retrospective and prospective randomized studies.
Materials and Methods. The results of two studies constituted the core of this work. The fi rst one was a retrospective study of the survival rate of all patients with stage IA G1 endometrial cancer (EC) with myometrial invasion of up to one-half of the myometrial thickness for the period 2006–2010, who had undergone treatment in Belarus (n = 1191, patient age — from 32 to 89 years old, the mean age — 59,8 ± 0,3 years, median — 59 years). Surgical treatment (ST) was performed in the extent of simple hysterectomy with bilateral salpingo — oophorectomy (SH-BSO). In combination treatment (CT) the same surgery was supplemented with preoperative brachytherapy (PB) and/or postoperative remote radiation therapy (RRT). The second one was a prospective monocentric randomized research of long-term results of the treatment of patients for the period 2011–2015, carried out at Republican Scientifi c and Practical Center of Oncology and Medical Radiology named after N.N. Aleksandrov (n = 154, patient age — from 31 to 80 years old, mean age — 58,4 ± 0,7 years, median age — 58 years.) Patients were randomized into three groups: a group of patients who had undergone surgical treatment (ST) performed in the extent of simple hysterectomy with bilateral salpingo — oophorectomy (SH-BSO), a group who had undergone preoperative brachytherapy (PB) and simple hysterectomy with bilateral salpingo — oophorectomy (SH-BSO) and a group who had undergone simple hysterectomy with bilateral salpingo — oophorectomy (SH-BSO) and adjuvant endovaginal brachytherapy (EVBT).
Results and Discussion. Based on the data of retrospective trial, 5-year overall- (OS), improved- (IS) and relapse-free (RFS) survival rate were 86,9% (95% confi dence interval (CI), 84,9–88,8%), 93,5% (95% confi dence interval (CI), 91,9–94,8%) and 92,4% (95% confi dence interval (CI) 90,7–93,8%) respectively. Upon the research results of prospective randomized study 5-year overall-(OS), improved-(IS) and relapse-free (RFS) survival rate made up 95,6% (95% confi dence interval (CI) 90,9–98,2%), 97,1% (95% confi dence interval (CI) 92,6–98,9%) and 95,3% (95% confi dence interval 90,9–98,2%) respectively. In the retrospective study statistically signifi cant differences (p = 0,0005) between combination treatment (CT) and surgical treatment (ST) were obtained for the indicator of overall survival (OS), but not for the indicators of improved survival (IS) (p = 0,541) and relapse-free survival (RFS) (p = 0,260). It was also established that adjuvant remote radiation therapy (ARRT) hadn’t improved the outcomes of combination treatment (CT) as compared to other techniques of radiation therapy. In the prospective study there were no statistically signifi cant results obtained for the indicators of overall (OS), improved (IS) and relapse-free survival (RFS) between all the three groups. Yet statistically signifi cant differences were observed between the tumors with lymphovascular invasion and without it for the factors of overall survival (OS) (p = 0,0005) and relapse-free survival (RFS) (p = 0,030).
Conclusion. The treatment of patients with stage IA G1 endometrioid endometrial cancer (EC) with myometrial invasion can be limited to simple hysterectomy with bilateral salpingo — oophorectomy (SH-BSO) in the absence of lymphovascular invasion. In cases when lymphovascular invasion occurs the surgery of the same extent should preferably be supplemented with adjuvant endovaginal brachytherapy.
Keywords: endometrial cancer, low risk, surgical treatment, adjuvant radiation therapy.
 Full text (in Russian)

Objective of the study is to evaluate the effectiveness and safety of the use of nadroparin calcium in patients with gynecologic cancer.
Materials and Methods. The hemostatic system and incidence of thrombotic complications in 200 patients with gynecologic cancer who had undergone surgical treatment was investigated. 120 patients (group I) received nadroparin calcium (fraxiparin) before surgery and for 7–15 days in post-operative period , group II (80 women) consisted of patients who didn’t receive any medications for the prevention of thrombotic complications (control group). Also 120 patients with gynecologic cancer who received antitumor treatment were under examination. Group I patients (70 people) got low-molecular- weight heparins for the prevention of thrombotic complications during each cycle of chemotherapy, a minimum of 3 days, a maximum of 30 days, group II (50 people) were patients who didn’t receive any medications for the prevention of thrombotic complications (control group).
Results. The use of nadroparin calcium in patients with gynecologic cancer before surgery and in postoperative period and in patients receiving antitumor drug therapy reduces the intensity of intravascular coagulation, decreases the incidence of deep vein thrombosis and prevents fatal venous thromboembolism and that holds great promise of anti-cancer treatment and improves the quality of life of cancer patients.
Conclusion. Nadroparin calcium is an effective and safe agent for the prevention of thrombotic complications in cancer patients.
Keywords: patients with gynecologic cancer, hemostatic system, thrombotic complications, fraxiparin.
 Full text (in Russian)

Objective of the study is to conduct a systematic analysis of the most signifi cant indicators of cancer statistics for such localizations as malignant neoplasms of the organs of female reproductive system.
Materials and Methods. An analysis of the data on the state of cancer care provided for patients with female reproductive cancers in Russia and its regions, CIS countries, as well as of the data of world statistics is carried out.
Results. The article examines the incidence, mortality patterns, the quality of cancer care in Russia and its regions, in CIS countries, as well as the data of world statistics. Age groups with signifi cant prevalence of the disease were determined in order to detect this pathology in women. The trends in standardized indicators of incidence, prevalence proportion and mortality were assessed. The analysis and evaluation of similar data in the system of medical institutions of the Central Medical Department of the Administration of the President of the Russian Federation for the period from 2000 till 2017 were performed.
Conclusion. Despite the growth of female reproductive cancer incidence rates, the fall of mortality rate appears to be the principal trend in the targeted population group, and in this respect, the main line of activity of cancer care services aimed at increasing the survival rate of patients is an early and active diagnosis.
Keywords: incidence, mortality, contingents, cancer care, malignant neoplasms, survival.
 Full text (in Russian)