Objective: to evaluate the impact of cytoreductive surgery on treatment results in patients with colorectal cancer and synchronous lung metastases.

Materials and methods. This retrospective investigation analyzed the results of therapy in patients with colorectal cancer and synchronous lung metastases who had been treated in the period 2000 to 2012. The investigators studied the following indicators: the impact of cytoreductive surgery on the survival of patients with this condition, the clinical characteristics of a group of patients with isolated lung involvement, the dissimilarity of this group from a group of patients with extrapulmonary metastases, the possibility of performing complete cytoreductive surgery in patients with varying degrees of a metastatic process, and the number of patients with complications in primary tumor.

Results. The investigations included the data of 112 patients with colorectal cancer and synchronous lung metastases. Out of them, 38 (33.9 %) patients had isolated lung involvement and the latter was associated with extrapulmonary metastases in 74 (64.1 %). In 16 of the 38 patients, isolated lung metastases were regarded as resectable and complete cytoreductive surgeries were performed. The median follow-up in the examined group was 15.2 months. One- and two-year overall survival rates were 63 and 45 %, respectively. The patients with isolated lung metastases were observed to have higher 2-year overall survival rates than those with multiple metastases (63.0 and 37.5 %, respectively; p = 0.055) and there were significantly higher 2-year overall survival rates in patients after removal of primary tumors than in those who had not undergone cytoreductive surgery (21.0 and 52.5 %, respectively; p = 0.004). Two-year overall survival rates were 72.5 % in the complete cytoreductive treatment group.

Conclusion. The prognosis in the patients with colorectal cancer and synchronous lung metastases was better than that in those with isolated lung involvement and in those whose primary tumor had been removed. Complete cytoreductive surgical treatment can provide long-term survival in this category of patients.

Objective: to assess the parameters characterizing a relationship between the histological and growth patterns and grade of a malignant tumor, the nature of regional and distant metastases, patient gender and age, and the type of urgent complications in colorectal cancer.

Subjects and methods. Information on 1098 patients with urgent colonic cancer types treated in Smolensk and its region in the period 2001 to 2013 was studied. This information was given from the records of the Clinical Emergency Medical Care Hospital, City Clinical Hospital One, the Smolensk Regional Clinical Hospital, Smolensk Regional Oncology Clinical Dispensary, and the central district hospitals of the Smolensk Region. Morphological examinations were made at the Smolensk Regional Institute of Pathology.

Results. Among the examinees, the proportion of women and men was 54.4% (n = 597) and 45.6 % (n = 501), respectively. The investigation recorded exophytic, endophytic, and mixed tumor growth patterns in 46.5, 52.3, and 1.2 %, respectively. The endophytic cancer growth pattern was most commonly complicated by acute intestinal obstruction, perifocal inflammation, tumor perforation, and concomitant complications. At the same time, the exophytic growth pattern was characterized by enteric bleeding in 89 % of cases. Complications, such as tumor perforation and enteric bleeding, are more commonly attended with tumor ulceration that was usually detected on the left side (in as high as 80.2 % of cases). A malignant tumor was most frequently recorded to grow into the retroperitoneal fat, small bowel, mesentery, and other colonic segments (15.0, 15.3, and 14.5 %, respectively). The most common complications in moderate-grade adenocarcinoma were enteric bleeding and tumor perforation (80.8 and 76.5 %, respectively; p < 0.05). Regional colorectal cancer metastases were generally usually recorded in patients aged less than 60 years (64 %). Higher distant metastasis rates were noted in those aged over 80 years (44.7 %).

Conclusion. Colon cancer is most commonly complicated by ileus, perforation, and concomitant complications and mainly characterized by the left-sided location, obvious local extent, and poor survival prognosis of the endophytic growth pattern, ulceration, moderate and highgrade of cancer.

Background. The aim of the work was to study the effect of combined surgical treatment of locally advanced rectal cancer (RC) with the invasion of the organs of the female reproductive system on the quality of life of patients.

Materials and methods. Presents the diagnosis and treatment of 134 patients with the RC in age from 21 to 70 years, with the invasion of the organs of the female reproductive system. All patients carried the standard clinical and laboratory tests.

Results. Half of the patients (50.7 % of cases) T4N1M0 stage of the disease has been diagnosed. In 75 (56.0 %) patients with tumor spread into the vagina, and in 16 (11.9 %) patients – just a few of the reproductive system. In the study group of 64 patients with the RC, along with surgery on the rectum, combined organ-performed surgery reproductive organs. In the control group all 70 patients was performed hysterectomy with appendages.

Conclusions. Quality of life according to the questionnaire MENQOL, was significantly higher in patients with organ-treatment, which showed a decrease in vasomotor and psychological symptoms, as well as smoothing of irregularities in the physical and sexual spheres. Studies have show the validity of the widespread introduction in the oncological practice combined simultaneous operations that preserve the reproductive organs in women with invasive RC, which is especially important for women of reproductive age.

Metronomic chemotherapy implies the regular use of cytotoxic agents in doses much smaller than the maximum tolerable doses for a long time. Preclinical experiments show that this treatment option has a many-sided (antiangiogenic, immunostimulating, and direct cytotoxic) effect on tumor. Moreover, this approach has gained the widest acceptance in treating patients with metastatic breast cancer in clinical practice. By taking into account the high activity of angiogenesis in colon cancer progression, it is interesting to study the impact of metronomic chemotherapy regimens for this nosological entity as well. This literature review considers not only the history of metronomic chemotherapy, the mechanisms of action, and a range of drugs having an antitumor effect in the metronomic regimens, but also analyzes clinical trials of metronomic chemotherapy regimens in patients with metastatic colon cancer.

In last two decades, transanal endoscopic microsurgery (TEM) in treatment of both benign and malignant tumor of rectum is actively developing. The aim of this review was to describe the current status of transanal interventions. Due to the low level of recurrens (mean about 6 %) TEM has become the method of choice for removal of rectal adenomas. Several studies have demonstrated the benefits of treatment TEM in cases of early T1 cancer compared to conventional resection. However, for more invasive adenocarcinomas performing TEM remains controversial, but it’s very promising method for the complex treatment. Just as transanal mesorectal exision in treatment of mid- and low rectal cancer as a new strategy – natural orifice transluminal surgery. However, it lack of evidence base and international experience in small series presented, so large randomized trials is needed.

The paper reviews the data available in modern Russian and foreign literature on the existing minimally invasive methods of local exposure of colorectal cancer liver metastases, which include ablation procedures (radiofrequency ablation, laser thermal ablation, and cryoablation), stereotactic radiotherapy and radiosurgery, as well as X-ray endovascular procedures (chemoinfusion, chemoembolization, and radioembolization). The characteristics of some treatment options and a surgical procedure, as well as those of each other were compared.

The paper describes a clinical case of successful treatment in a female patient with disseminated rectal cancer by minimally invasive technologies that could perform one-stage simultaneous intervention into the rectum and lung, which promoted rapid patient rehabilitation and reduced systemic chemotherapy initiation time.