Background. Epidemiological surveillance is crucial for the development and implementation of anticancer programs. According to GLOBOCAN 2019 data, colorectal cancer (CRC) is the third most deadly and fourth most commonly diagnosed cancer worldwide.

Materials and methods. We used the state reporting form No. 7 of the Ministry of Health of the Republic of Uzbekistan “Information on malignant diseases”, as well as data on the average annual population from the State Statistics Committee of the Republic of Uzbekistan.

Results. CRC is the fifth most common malignancy and fourth leading cause of mortality in the Republic of Uzbekistan. The CRC incidence among men and women is 5.3 and 4.3 per 100 000 population, respectively. A total of 5.2 % of all registered cancer cases were CRC cases. The proportion of patients with advanced disease decreased from 21.3 % to 16.5 % over the last 5 years. CRC is the fourth most common cause of cancer mortality with an incidence of 2.9 per 100 000 population.

Conclusion. Our findings suggest that CRC is one of the most common and deadly malignancies in Uzbekistan and its incidence and mortality are constantly growing. Given the high proportion of patients diagnosed at late stages, early diagnosis of CRC is highly relevant.

Background. Colorectal anastomotic leakage (AL) has always been one of major challenges in rectal surgery.

Objective: to perform multivariate analysis of risk factors for AL.

Materials and methods. In this retrospective cohort study, we analyzed patients that had undergone resection of the rectum with anastomosis formation between 2013 and 2020. We included patients with favorable prognostic factors (tumor located >5 cm above the anal verge, no history of chemoradiotherapy). We performed multivariate analysis using logistic regression to assess risk factors for AL.

Results. The use of more than 3 linear stapler firings to suture the rectum significantly increased the risk of AL (risk ratio 3.035; 95 % confidence interval 1.473–6.252; p = 0.003). The univariate analysis demonstrated that reinforcement of the anastomosis was significantly associated with an increased risk of AL (risk ratio 2.35; 95 % confidence interval 1.112–5.762; p = 0.027); however, this association failed to reach statistical significance (risk ratio 1,520; p = 0,066). Pelvic peritoneum suturing had no impact on the AL incidence, but in case of its development, pelvic peritoneum reconstruction prevented peritonitis (p = 0.002).

Conclusion. The number of stapler firings >3 used to suture the rectum, as well as reinforcement of the anastomosis tended to increase the risk of AL; however, these findings did not reach the level of statistical significance. Pelvic peritoneum reconstruction did not affect the incidence of AL, but significantly reduced the risk of peritonitis.

Objective: to identify the main factors associated with an increased risk of urgent complications of colorectal cancer.

Materials and methods. This retrospective cohort study included 214 patients with colorectal cancer who had undergone emergency surgery in Smolensk hospitals between January 2016 and January 2020. Their median age was 66 years. We analyzed patients’ sociodemographic characteristics (sex, age, settings (urban or rural), education, employment, profession, and family status), disease history, clinical characteristics (type of urgent complication, comorbidities), morphological tumor characteristics (histological type, pTNM stage, pattern of tumor growth (exo- or endophytic, mixed), tumor length along the intestine (<4 cm, 4–7 cm, >7 cm), presence of lymph node metastases and distant metastases). Multivariate logistic regression was used to analyze factors that were independently associated with an increased risk of decompensated intestinal obstruction and colon perforation.

Results. The most significant risk factors for decompensated intestinal obstruction included T4 stage (odds ratio (OR) 3.19; 95 % confidence interval (CI) 1.66–7.12; p <0.001), high-grade tumor G3–G4 (OR 2.93; 95 % CI 0.89–3.97; p = 0.008), and presence of competing diseases (OR 2.03; 95 % CI 1.84–2.39; p <0.001). The risk of perforation was higher among patients with T4 tumors (OR 3.74; 95 % CI 2.61–5.48; p <0.001), lymph node involvement (N+) (OR 1.61; 95 % CI 1.33–2.01; p <0.001), high-grade tumors G3–G4 (OR 3.56; 95 % CI 2.08–4.93; p <0.001), and diabetes mellitus requiring insulin therapy (OR 2.11; 95 % CI 1.78–2.42; p <0.001).

Conclusion. Elderly patients with stage III and IV colorectal cancer and high comorbidity are more likely do develop urgent complications, such as decompensated acute intestinal obstruction or tumor perforation.

By the beginning of the 2000s, oncologists have developed a standard algorithm for the management of patients with locally advanced rectal cancer. It includes preoperative chemoradiotherapy followed by surgery 6–8 weeks after chemoradiotherapy completion. However, there was no clear evidence indicating the efficacy of adjuvant chemotherapy in this clinical situation. In recent decades, the concept of neoadjuvant treatment for locally advanced colon cancer changed due to an opportunity to perform hypofractionated radiotherapy and conduct chemotherapy in the preoperative stage. This literature review aims to summarize the results of studies analyzing neoadjuvant therapy for locally advanced colon cancer, as well as to compare the efficacy and tolerability of various therapeutic options currently available for this group of patients.

Promising results of neoadjuvant therapy have encouraged changes in treatment standards for many types of cancer, including triple negative and HER-positive breast cancer, gastric cancer, rectal cancer, etc. Preoperative chemotherapy can decrease the tumor burden, which might reduce the volume of surgery; it also improves the disease prognosis by reducing the number of viable tumor cells and micrometastases in regional lymph nodes; it increases the proportion of patients receiving systemic treatment, which often leads to an improved overall survival of patients; it enables the evaluation of tumor sensitivity to therapy, which also allows the investigation of tumor sensitivity to new pharmacological agents. However, colon cancer seems to stay away from these trends. This literature review focuses on studies analyzing neoadjuvant therapy for resectable colon cancer and analyzes the role of preoperative therapy in this disorder.

Surgery remains the main treatment for non-metastatic colorectal cancer. These patients undergo radical operation (when possible) or cytoreductive surgery with the excision of most tumor tissue. Neoadjuvant radiotherapy is also an important step of treatment in patients with lower and middle rectal tumors. However, randomized clinical trials indicate that combination neoadjuvant treatment that includes polychemotherapy and radiotherapy is more effective.