Background. Important task is determining the long-term consequences of colorectal anastomotic leakage. Leakage with clinical manifestations leads to a higher frequency of local recurrences of rectal cancer and increases the severity of manifestations of low anterior resection syndrome. How does the leakage of colorectal anastomosis affect the period before the closure of loop stoma?

Aim. To determine the influence of anastomotic leakage on the term before closing the ileostomy.

Methods. In this retrospective incomparable study were included 618 patients with rectal cancer who had been underwent anterior or low anterior resection with formation colorectal anastomosis and loop stoma.

Results. Colorectal anastomotic leakage was detected in 86 from 618 patients (13.9 %). The loop stoma was closed in 513 from 618 (83 %) patients. The time to the preventive stoma closure in patients with anastomotic leakage was significantly higher than in patients without anastomotic leakage, p = 0.001. Reconstructive surgery in patients without anastomotic leakage was performed in 9 months after anterior resection. The median time before the stoma closure of patients with X – ray anastomosis leakage was 11 months, with clinical leakage – 17 months, p <0.001.

Conclusion. Colorectal anastomotic leakage statistically increases the term before ileostomy closure.

Aim. To evaluate the clinical significance of survivin (BIRC5) mRnA expression in circulating tumor cells (CTCs) and tumor material from colorectal cancer (CRC).

Materials and methods. The study was organized according to the principle of a continuous prospective non-randomized study. The expression of survivin (BIRC5) mRnA in CTCs and tumor material was determined using RT-pCR.

Results. The study included 130 patients (study group – 109 patients with colorectal cancer and observation group – 21 patients with colon adenomas). All patients underwent complete tumor removal (radical surgery – 93.6 %), cytoreductive – 6.4 %).

A high level of survivin (BIRC5) mRnA expression was detected in colorectal adenocarcinoma in comparison with adenomas (p_{Mann–whitney} < 0.001) M ± SD (1.678 ± 2.45 and 0.023 ± 0.07). In the study and observation group, the expression of survivin mRnA (BIRC5) in CTCs both before surgery M ± SD (1.175 ± 1.33 and 0.052 ± 0.11) and after 3 months M ± SD (1.015 ± 0.93 and 0.018 ± 0.002) was significantly different (p_{Mann–whitney} <0.001).

During adjuvant chemotherapy, a decrease in the level of survivin expression in CTCs was observed (p 9 months after surgery, CTCs remain in the bloodstream even despite adjuvant chemotherapy (p = 0.015 and p = 0.012). Overexpression of survivin in CTCs before surgery correlates with damage to regional lymph nodes (p = 0.03, r = 0.21), stage of the tumor process (p = 0.01, r = 0.25), degree of tumor differentiation (p = 0.03, r = 0.21). Overexpression of survivin in CTCs 9 months after surgery significantly affects relapse-free survival HR (95 % CI HR) = 3.1 (95 % CI 1.56–6,08, p = 0.0012) and overall survival of patients HR (95 % CI HR) =6.8 (95 % CI 2.65–17.33, p = 0.0001).

Conclusions. Overexpression of survivin mRnA in colorectal cancer is a negative prognosis factor for the disease and directly depends on the tumor involvement of regional lymph nodes, the stage of the disease, degree of tumor differentiation, promoting the development of disease relapse, and can be used to diagnose minimal residual disease (MRD) and assess the prognosis of overall patient survival.

Introduction. Despite the wide introduction of the principles of total mesorectumectomy and effective schemes of neoadjuvant chemoradiotherapy, the development of local recurrences of tumors of the rectum and female reproductive system remains a complex and unsolved surgical problem. The lack of a unified classification and algorithms for choosing the optimal volume of surgery are one of the reasons for unsatisfactory results of treatment of this group of diseases.

The aim. To standardize the choice of surgery volume based on the proposed unified classification.

Materials and Methods. The experience of surgical treatment of 108 patients with pelvic organ tumor recurrence (pOTR) is summarized in the article. Inclusion criteria: age 18 years and older, confirmation of the diagnosis of tumor recurrence of rectum, uterine body, cervix, ovaries by radiation methods of examination and histologically if the tumor was available for biopsy, the primary tumor was surgically removed with achievement of negative peripheral resection margin (R0), signed informed consent. Inclusion criteria: health status according to the Eastern Cooperative Oncology group (ECOg) 2 or more; distant visceral metastases and/or carcinomatosis of the peritoneum and pleura were diagnosed; complicated course of the tumor process was detected, which did not allow performing a planned surgical intervention.

Results. According to the location of the primary tumor, the distribution was as follows: 66 patients with rectal cancer, 12 with cervical, 9 with uterine body and 21 with ovarian cancer. The sex distribution was as follows: 38 (35.1 %) – males and 70 (64.8 %) females. The median age was 63.0 (53.0; 70.0) years. The ECOg overall status was: 0 points in 44 (66.7 %) patients and 1 point in 64 (59.3 %) patients. The median duration of relapse-free period was 15.25 (6.2; 19.6) months. On the basis of the analysis of the nature and type of local tumor spreading, a classification was developed, distinguishing 8 types of recurrence: anterior-upper, anterior-lower, central, lower, posterior-upper, posterior-lower, lateral-left and lateral-right. The characteristics of the entire cohort of patients were analyzed to determine the extent of surgery appropriate for a particular type of recurrence or their combinations.

A review of the literature concerning the issue of changing the phenotype of breast cancer during treatment is presented. In the Russian Federation, breast cancer (breast cancer) occupies a leading position in the structure of morbidity and mortality of female oncological diseases. Many retrospective studies have reported changes in the expression of bio-markers in surgical samples after neoadjuvant therapy. The study of changes in biological subtypes can change approaches to therapy and contribute to an increase in survival rates in such patients. Based on these data, we can talk about the need for repeated assessments of the tumor biotype during treatment, which contributes to an optimal and personalized approach to breast cancer therapy.

Colorectal cancer remains an urgent problem of oncological proctology and requires active efforts to study risk factors, mechanisms for the formulation and search for genetic components that play a key role in determining the prognosis of the disease. This article analyzes the molecular mechanisms of colorectal cancer formation, factors of transformation of adenoma formation, pathogenesis and molecular nature of CRC. Subtypes based on transcription signatures allow for better refinement and provide insight into the development of subtype-specific treatment methods, which, in turn, can contribute to more effective treatment of this disease.

Clinical case. The article presents a clinical case of malignant retroperitoneal schwannoma, which was a diagnostic finding. The clinical picture of the disease was dominated by pain in the lower abdomen and lower back, frequent urination. After a diagnostic examination and preliminary preparation, the patient was operated on in a hospital at the oncogynecology department of the Tashkent City branch of the Republican Specialized Scientific and practical Medical Center of Oncology and Radiology with a preliminary diagnosis of an ovarian tumor. Interrooperatively, a tumor of the retroperitoneal space with lesions of the obturator nerve was revealed. Subsequently, immunohistochemical analysis clarified the histological type of the tumor, which turned out to be a malignant schwannoma of the retroperitoneal space.

Conclusion. These data may help in the management of patients with this pathology and improve the diagnosis of patients with small pelvic tumors.

Background. Over the past 30 years, with the development of endoscopic technologies and the advent endoscopic ultrasound-guided fine-needle aspiration (EuS-FnA) it has become possible to diagnose with preliminary verification of cardiac tumors, which in turn is an undoubted advantage in detecting cardiac pathology. A rare clinical case is presented: the detection of a tumor of the left atrium using high-tech endoscopic techniques, in particular a EuS-FnA. when studying the surgical material using immunohistochemistry and FISH hybridization, the final diagnosis sounded like intimal sarcoma. Diagnosis of intimal sarcoma is a complex clinical task, and difficulties in making a diagnosis delay the duration of treatment. Our experience demonstrates the modern role of endoscopy as a minimally invasive method of diagnosing intracardiac tumors.