Objective: to compare the efficacy and toxicity of aflibercept and bevacizumab in combination with fOLfIRI in secondline therapy for patients with metastatic colon cancer.
Materials and methods. we performed a retrospective analysis of data on patients with metastatic colon cancer treated in 9 clinics in the Russian federation. The inclusion criteria were as follows: metastatic or locally advanced colon cancer; treatment with bevacizumab or aflibercept plus fOLfIRI in the second-line therapy. The primary outcome measure was progression-free survival (PfS). Secondary outcome measures included objective response rate and incidence of adverse events.
Results. A total of 271 patients with metastatic colon cancer who received second-line therapy with bevacizumab (n = 81) or aflibercept (n = 190) between 2014 and 2018 were selected for this study. Study groups were matched for main prognostic signs. The objective response rate was 18.1 % in the bevacizumab group and 20.5 % in the aflibercept group (p = 0.7). The median PfS was 5 months (95 % confidence interval 3.8–6.1) in the aflibercept group and 7 months (95 % confidence interval 0.81–2.1) in the bevacizumab group (hazard ratio 1.4; 95 % confidence interval 0.99–2.1; p = 0.04). multivariate regression analysis demonstrated that the type of the targeted drug independently had no effect on PfS (hazard ratio 1.3; 95 % confidence interval 0.9–1.9; p = 0.2). we observed no statistically significant differences in the incidence of complications of any grades between the groups (58 % vs 72 %, p = 0.1). Patients receiving aflibercept were more likely to develop grade III–Iv arterial hypertension (2 % vs 9.5 %) and diarrhea (0 % vs 5.4 %), whereas thrombotic complications were more common in the bevacizumab group (10 % vs 1.8 %).
Conclusion. we observed no significant differences in objective response rate and PfS between patients with metastatic colon cancer receiving bevacizumab or aflibercept in combination with fOLfIRI as second-line therapy. The toxicity profiles were different. Our findings can be used for choosing an optimal targeted drug for second-line treatment.

Objective: to compare short-term and long-term postoperative complications between patients who have undergone central pancreatectomy (CP) and distal pancreatectomy (DP).
Materials and methods. This retrospective study included patients who had CP for benign pancreatic tumors and tumors of low malignant potential (cases) and patients who had DP for similar reasons (controls). The controls were randomly selected and matched cases for tumor size, presence of diabetes mellitus (Dm), and ASA physical status. we evaluated the incidence of grade ≥III complications (Clavien–Dindo classification), clinically significant pancreatic fistulas, Dm, and impaired exocrine pancreatic function in the late postoperative period.
Results. There were 25 cases and 25 controls. Both groups were matched for the main clinical characteristics. Surgeries were significantly longer in the CP groups compared to the DP group (230 min vs 180 min, р < 0.0001). There was no difference in the overall incidence of postoperative complications (9 (36 %) vs 14 (56 %), р = 0.26); there was a trend towards a higher incidence of postoperative complications in the CP group. Two patients after CP (8 %) required repeated surgeries. none of the study participants died. Clinically significant (B and C) pancreatic fistulas were registered in 8 (32 %) and 11 (44 %) patients, respectively (p = 0.56). Two patients in the DP group (8 %) developed impairments of exocrine pancreatic function that required pharmacotherapy. none of the patients developed Dm postoperatively.
Conclusion. Despite the fact that CP and DP outcomes were comparable in terms of the main parameters evaluated, severe post-CP complications indicate that there is a need for careful selection of patients for such interventions and further accumulation of experience. Our findings can be used in the subsequent analysis of the experience of different clinics.

Background. Colorectal anastomotic leakage remains on of the most significant challenges in rectal surgery.
Objective: to assess the impact of pelvic peritoneal floor reconstruction on the incidence of postoperative complications associated with colorectal anastomosis.
Materials and methods. In this retrospective cohort study, we analyzed medical records of rectal cancer patients who had undergone rectal resection with anastomosis formation between 2013 and 2020. we compared patients who had no pelvic peritoneal floor reconstruction (from 2013 to 2017) and those who had it (2018–2020). Only patients with favorable prognosis (tumor located at least 5 cm above the transitional anal fold and no history of chemoradiotherapy) were included. The primary outcome measure was the incidence of peritonitis and colorectal anastomosis leakage. Secondary outcome measures included overall incidence of complications (Clavien–Dindo), mortality rate, blood loss, and duration of surgery.
Results. A total of 120 patients were included into the experimental group, while the control group was composed of 125 patients. Ten patients from the control group developed peritonitis (8.0 %), whereas in the experimental group, there were no cases of peritonitis (p = 0.002). Anastomotic leakage was registered in 12 individuals from the experimental group (12.5 %) and 14 controls (11.2 %) (p = 0.753). The overall incidence of postoperative complications was 23.3 % (n = 28) among patients who had pelvic peritoneal floor reconstruction and 18.4 % (n = 23) among those who did not have it (p = 0.342). Colostomy was required in 92 patients from the experimental group (76.7 %) and 78 patients from the control group (62.4 %) (p = 0.018). The postoperative mortality was 0.8 % in the control group (n = 1) and 0 % in the experimental group (p = 1).
Conclusion. Pelvic peritoneal floor reconstruction reduces the risk of peritonitis, but does not affect the overall risk of anastomotic leakage. This method is effective for the prevention of severe postoperative complications.

The aim of this study was to analyze currently available information on the risks of fistulas in patients with cervical cancer after radiation therapy and possible treatment options.
This review includes data from Russian and foreign articles devoted to this problem. It covers the frequency of fistulas of after radiation therapy in cervical cancer patients, as well as some treatment methods.
Attempts to change the approaches to radiation therapy for advanced cervical cancer were unsuccessful; therefore, patients with cervical cancer will be at high risk of developing fistulas in the next few years. Different treatments for fistulas demonstrate contradictory results and dictate the need for a tailored-approach in such cases. The development of new surgical methods for the correction of vesicovaginal and rectovaginal fistulas is still highly relevant.

Targeted therapy for colorectal cancer usually includes anti-vEgf and anti-EgfR antibodies. The initiation of first-line therapy for metastatic colorectal cancer depends on the baseline patient’s characteristics, tumor spread, and its mutational status. Despite the wide range of possible combinations of these factors, an oncologist should choose between standard platinum-based chemotherapy regimens and combination of similar chemotherapeutic agents with bevacizumab or cetuximab. Disease progression after first-line therapy poses a dilemma to an oncologist, since the range of potentially beneficial targeted drugs or immunotherapeutic agents is much wider along with the lack of sufficient evidence. This article focuses on the efficacy of aflibercept as a second-line treatment for colorectal cancer, indications for its use, and outlooks.

Primary pancreatic leiomyosarcoma belongs to a rare group of malignant soft tissue tumors. we present a clinical case of a 61-year-old patient who underwent hemipancreatectomy with splenectomy for a pancreatic tumor in 2018. Histological and immunohistochemical studies confirmed the diagnosis of leiomyosarcoma. for three years, the patient has been observed at the N.N. Blokhin National Medical Research Center of Oncology of ministry of Health of Russia without signs of progression.