Background. Colorectal cancer (CRC) is the 4th most frequent cause of death among patients with malignant tumors worldwide. In 2012, approximately 1.3 million people were diagnosed with CRC, nearly 690 000 patients died.
Objective: to assess the impact of various chemotherapeutic drugs and monoclonal antibodies penetration on the dynamics of CRC-associated mortality in patients with metastatic CRC in Russia.
Materials and methods. We analyzed the mortality data for 2014 obtained from the National Cancer Register and the data from the Register of Chemotherapy Drugs (oxaliplatin, irinotecan, capecitabine) and Monoclonal Antibodies (bevacizumab, cetuximab, panitumumab) Procurement for cancer centers from 82 regions of Russia. We performed correlation and regression analysis to estimate the impact of various chemotherapeutic drugs and monoclonal antibodies penetration on the CRC-associated mortality, as well as the mortality from colon cancer and rectal cancer.
Results. We observed a correlation between the mortality reduction in patients with metastatic CRC and penetration of irinotecan (k = –0.324, р = 0.003), capecitabine (k = –0.223, p = 0.04), bevacizumab (k = –0.229, p = 0.04), panitumumab (k = –0.232, p = 0.04), any anti-EGFR monoclonal antibody (k = –0.201, p = 0.07) and all monoclonal antibodies (k = –0.256, p = 0.02). Regression analysis demonstrated a decreased mortality rates in patients receiving irinotecan (β = –0.26, р = 0.02), anti-EGFR monoclonal antibodies (β = –0.19, р = 0.09) and oxaliplatin or irinotecan (β = –0.2, р = 0.06).
Conclusion. Our results suggest a correlation between the administration of irinotecan and monoclonal antibodies and mortality reduction in patients with metastatic CRC.

Objective: to compare short-term and long-term results of laparoscopic and robotic mesorectal excisions.
Material and methods. Our multi-center cohort study based on prospectively collected data included patients with rectal cancer (RC) who underwent laparoscopic and robotic surgeries between 2010 and 2016. Study participants were divided into 3 groups: laparoscopic surgery group (L), 1st robotic surgery group (R1, surgeries were performed during the 1st year after the implementation of the equipment) and 2nd robotic surgery group (R2, surgeries were performed later). We evaluated the quality of mesorectal excision conducted using laparoscopic and robotic surgical techniques on different stages of their implementation. Additionally, we estimated intra- and postoperative complications, duration of surgery, intraoperative blood loss, overall survival and relapse-free survival.
Results. Our groups consisted of 101 (L), 31 (R1) and 82 (R2) patients. Median surgery duration was 235 (110–465), 270 (130–420) and 193 (105–365) min in groups L, R1 and R2 respectively. The frequency of complications in these groups was 12 (11.9 %), 8 (25.8 %) and 9 (11.0 %) respectively. The frequency of R0-resections was 95.0 % (L), 90.3 % (R1) and 98.8 % (R2). The G2–3 mesorectal excision was performed in 87.9 % (L), 96.9 % (R1) and 96.1 % (R2) patients. Relapses were registered in 8 (8.6 %), 2 (6.5 %), and 2 (2.6 %) patients from groups L, R1 and R2 respectively. We observed no differences in relapse-free survival across the groups R1 and R2 (р = 0.131), L and R1 (р = 0.088), L and R2 (р = 0.794).
Conclusions. Robotic surgery can safely be used in patients with RC; however, it should be implemented into routine practice under the supervision of an expert within special training programs. The use of a robotic surgical system with an optimized docking system controlled by an experienced specialist allows reducing the duration of rectal surgery, does not increase the risk of postoperative complications and ensures a higher quality of mesorectal excision.

Objective: comparative evaluation of perioperative clinicopathologic characteristics and short-term outcomes of robotic and laparoscopic surgeries for colorectal cancer (CRC), depending on the phases of the learning curve.
Materials and methods. Patients who underwent robotic or laparoscopic surgeries were compared retrospectively (n = 77 and n = 123 respectively).
Cumulative sum (CUSUM) was used to evaluate the learning curve.
Results. Robotic operations were comparable with laparoscopic in the average blood loss and conversion rate, but differed in the longer duration (237.5 ± 74.9 min versus 213.5 ± 73.1 min, p = 0.024). The short-term outcomes and pathomorphological characteristics were not significantly different in both procedures. According to CUSUM, the learning curve of robotic surgery was the 46 cases and of laparoscopic surgery was the 54 cases. Comparison between 1st phase and 2nd phase in the robotic group showed significant difference in the total operation time and in docking and surgeon console time. Other perioperative characteristics did not differ significantly between the phases of the learning curve. For the laparoscopic group, there was also a decrease in the operation time after the 1st phase of the learning curve, as well as a statistically significant decrease in intraoperative blood loss (140.9 ± 68.8 ml for 1st phase versus 108.1 ± 67.8 ml for 2nd phase, p = 0.009). All cases of conversion in the laparoscopic group were in the 1st phase of the learning curve (p = 0.047). Comparison between 1st phase and 2nd phase for laparoscopic surgery showed no significant difference for the short-term outcomes. Pathologic outcomes were not significantly different in both procedures and phases.
Conclusions. The learning curve for robotic surgery was shorter than for laparoscopic surgery. There were no significant differences in perioperative clinicopathologic characteristics and short-term outcomes in both procedures and phases of the learning curve.

Colon cancer is a heterogenous disease with each subtype having a distinct clinical picture and, consequently, different prognosis. Therefore, the tumors can be classified according to their localization: as emerging from the left or right side of the colon. The proximal and distal colon have different embryogenesis which determines the boundary between the right and left colon at the level of the distal margin of the middle third of the colon. In literature, there’s enough data to consider other differences apart from embryogenesis. Right- and left-side colon tumors differ epidemiologically, clinically and pathomorphologically, molecularly and genetically. This, presumably, explains differences in screening, prevention, and treatment of these tumors. The objective of this review is to analyze differences between colon tumors with different localizations and to determine if such subdivision of colon cancer in clinical practice affects treatment and prevention approaches.

The article is devoted to the surgery standards for colorectal cancer, specific features of colon mobilization in patients with locally advanced colon cancer and the use of germ cell layers as anatomical landmarks. We describe the features and the volume of lymph node dissection during surgeries for left and right colon, the level of central vessels ligation during intervention and the criteria for assessing the quality of mesocolic excision. We studied the impact of these factors on overall and relapse-free survival, highlighted some aspects of mobilization of the right and left colon. The objective of this article was to contribute to the development of methodological guidelines for colon cancer surgery in compliance with the principles of complete mesocolic excision with central vessels ligation.

A rare observation of heterotopic ossification in the metastasis of cecal cancer after surgical treatment and polychemotherapy is presented in this article. This version of the metastatic process of colorectal cancer is not usual, and correct diagnosis in this case can be difficult.