Combination of surgical treatment and neoadjuvant chemoradiotherapy is the main treatment tactics for cT3 or cN+ rectal cancer patients. Integration of chemoradiotherapy in clinical practice reduced recurrence rate but had impact on overall survival only in patients with R0 resection. Disease progression in most rectal cancer patients occurs mainly by distant metastases development, which dictates the necessity of systemic treatment improvement. Yet till today there was no clinical evidence to support adjuvant chemotherapy after preoperative chemoradiation in rectal cancer patients. This review article focuses on prospective and retrospective data on adjuvant chemotherapy efficacy in rectal cancer patients, who received previous chemoradiation.

The article discusses the quality of life and the necessity of optimization of medical therapy in patients with cancer receiving palliative care. The mechanisms of action and efficacy of the use of hydrazine sulfate in cancer patients.

High-efficiency inhibitors of EGFR (panitumumab and cetuximab) in combination with chemotherapy in patients with advanced colorectal cancer is the result of the targeting special group of the patients based on studies of genes. Previously it was shown that the presence of mutation in exon 2 of KRAS gene (40 % of patients) determines the effectivity of this group of drugs. However, the search for additional indicators was continued. The result is that the presence of mutations in exons 3 and 4 of KRAS gene and in exons 2, 3 and 4 of NRAS gene also predict EGFR inhibitors efficacy. These mutations are defined in 10 % of patients. Analysis showed that the efficiency of panitumumab and cetuximab in combination with chemotherapy significantly increased in patients with wild-type KRAS and NRAS.

Objective: to improve the results of treatment in patients with squamous cell carcinoma of the anal canal, by creating a new combination treatment option, and to increase the rate of organ-sparing treatment.

Subjects and methods. A new combination treatment option for squamous cell carcinoma of the anal canal was created, which involved a combination of radiotherapy and a multiple radio modification program (ultrahigh-frequency (UHF) hyperthermia and local metronidazole (MZ) injection and systemic polychemotherapy) (RF patent No. 2427399 “A treatment option for squamous cell carcinoma of the anal canal” registered on 27 August 2011). To evaluate the created treatment option, the latter was analyzed in 157 patients with Т1–4N0–3M0 squamous cell carcinoma of the anal canal, who had been treated in 1990 to 2012. In 22 patients, radiotherapy was performed in combination with 3–5 sessions of local UHF hyperthermia (thermoradiotherapy (TRT)); 88 patients received the latter in combination with polychemotherapy (thermoradiochemotherapy (TRCT)); in addition to TRCT, 47 patients used MZ (TRCT + MZ).

Results. In the TRT, TRCT, and TRCT + MZ groups, organ-sparing treatment was performed in 11 (50 %), 71 (80.7 %), and 44 (93.6 %) patients, respectively. In these groups, the median follow-up was 18.6; 51.7, and 15.5 months, respectively. In the 3 groups, the three-year overall survival rates were 71.4; 90.0, and 96.3 % and the three-year relapse free survival rates were 46.7; 60.6, and 75.0 %, respectively.

Conclusion. The created combination thermochemoradiotherapy involving a polymer combination with MZ (TRCT + MZ) makes it possible to achieve organ-sparing treatment in 93.6 % of the patients and to slightly improve 3-year overall and relapse-free survival rates in patients with squamous cell carcinoma of the anal canal who have received organ-sparing treatment although there is only a tendency for statistical survival difference in this patient group.

Aim: to investigate treatment results of locally advanced right colon cancer patients with pancreas or duodenum invasion.

Materials and methods. Short-term treatment results of 14 locally advanced right colon cancer patients who underwent right hemicolectomy (or resection of ileotransversal anastomosis) with pancreaticoduodenectomy were analyzed.

Results. Median operative time was 285 (240–420) min. Median intraoperative blood loss was 1800 (600–3300) ml. 6 (42.9 %) patients developed postoperative complications, no postoperative mortality was observed. Overall survival (OS) was: 1-year – 100 %, 3-year – 62.4 %, 5-year – 41.5 %. Median OS was not reached (median follow-up was 23 months).

Conclusions. Surgical treatment of locally advanced right colon cancer patients with pancreas or duodenum invasion allows to achieve significant overall survival with acceptable morbidity and no postoperative mortality.

New prognostic factors for disseminated colorectal cancer (dCRC) are being investigated in this article.

Subjects and methods. In this study we have analyzed three clinical groups. First group – 60 patients with dCRC had not specifical therapy. Second group – 200 patients had specifical therapy, but without identification of prognostic and predictive markers. And third group – 93 patients had individual therapy which was based on prognostic and predictive markers of each patient.

Results. Definition of prognostic factors (TS, TP, DPD, Ercc-1, СОХ-2, MSI, KRAS) in patients with dCRC allowed to prescribe optimal specific therapy and improve results of treatment.

Conclusion. Investigation of prognostic markers allowed to differentiate prognostic groups among dCRC patients. Investigation of prognostic factors in patients with intermediate prognosis allows to improve treatment outcome and improve number of liver surgery.

The case report describes successful treatment of synchronous low rectal and sigmoid cancers with mini-invasive technologies. Transanal endoscopic microsurgery allowed to perform sphincter-saving treatment. Treatment tactics for described tumor localizations are discussed. This case represents individualized approach to colorectal cancer patient, use of modern technologies in oncological surgery.