Introduction. Recent studies have led to the conclusion that gender is an important factor influencing the prognosis of survival of patients with colorectal cancer.

Aim. To analyze 5-year overall survival rates in patients with colorectal cancer of different sexes and in different age groups.

Materials and methods. The study included 1593 patients, of whom 720 were men (45.2 %) and 873 women (54.8 %). Patients were divided into 3 age groups: under 50 years, 50–70 years and over 70. Overall survival rates were calculated, followed by comparison between groups of patients, taking into account gender and stage of the disease.

Results. Analysis of treatment results taking into account a gender approach showed that the prognosis of the disease was most favorable in women. With approximately the same 5-year survival rate in men and women (54.9 and 52.7 %), this indicator correlated with the age of the patients and was significantly better than in men in the group of patients under 50 years of age.

Conclusion. The identified gender and age characteristics in the development and course of colorectal cancer are relevant for oncologists when choosing diagnostic, treatment and rehabilitation strategies. 

Inroduction. Polymorbidity significantly increases the risk of complications in the early postoperative period, especially in patients with colorectal cancer, taking into account the initial nutritional status disorder. At present, several scales of postoperative complications risk assessment (POSSUM, RCRI, MUST) are used, but they do not fully meet the needs of modern oncosurgery, so we consider it necessary to compare their effectiveness and propose a new integrated scale.

Aim. To establish the most significant factors influencing the outcome of surgical treatment and length of hospitalization in comorbid patients with colon cancer with the development of a surgical risk assessment scale that is most adapted for this group of patients.

Materials and methods. We analyzed the data of hospital charts of patients undergo surgery for colorectal cancer in the oncoproctologic department of the S. P. Botkin State Clinical Hospital of the Moscow Healthcare Department in the period from 2019 to 2022. Inclusion criteria: histologically verified colorectal adenocarcinoma; colorectal cancer in stage cT4, cN0, cM0 or cT1–4, cN1–2, cM0; presence of one or more concomitant diseases in the patient. Exclusion criteria: presence of distant metastases of colorectal cancer; absence of confirmed comorbidities; early forms of colorectal cancer (cT1–2, cN0). All patients were assessed for risk of perioperative complications using ASA, POSSUM, MUST, and RCRI scales. The study endpoints were number of days in intensive care, number of days of hospitalization, and 30-day mortality. An Excel database with POSSUM, RCRI, and MUST scale calculators was created for the study. The evaluation of parameters influencing the outcome of hospitalization was performed using ROC analysis and correlation analysis using Pearson’s criterion. To identify the most sensitive parameters affecting the outcome of hospitalization, commonly used calculators were studied in detail.

Results. 200 patient records were analyzed. The results of treatment were compared with the data obtained using the postoperative risk scales POSSUM, MUST, RCRI. A comparative analysis of the scales presented above with our proposed integral scale of postoperative complications risk assessment was carried out. It was found that the parameters of our proposed integral scale showed the highest sensitivity (Se >70 %) and specificity (Sp >70 %) to the risk of postoperative complications. Our proposed integral scale showed a moderate correlation with the age of patients (r = 0.475, p = 0.01) and preoperative weight loss (r = 0.592, p = 0.01), as well as a high correlation with POSSUM (r = 0.649, p = 0.01; r = 0.852, p = 0.01) and MUST (r = 0.655, p = 0.01).

Conclusion. The developed scale for assessment of surgical risk in comorbid patients with colorectal cancer showed a higher correlation with the outcome of surgical treatment than similar known scales, which indicates its effectiveness and possibility of application in clinical practice after its validation in prospective studies. 

Aim. The choice of optimal method of colorectal anastomosis formation remains a matter of debate. The purpose of this study is to assess safety of an original method of forming a manual colorectal anastomosis.

Materials and methods. The retrospective study included patients having rectal cancer with tumor localization above 5 cm from the anocutaneous line, who underwent anterior resection of the rectum with formation of a manual “side-to-end” anastomosis of own modification. The main parameter evaluated was frequency of anastomotic failure and the additional one was overall incidence of postoperative complications.

Results. The study included 31 patients, among them were 15 (48.4 %) men, 18 (58.1 %) of them were older than 50 years, 9 (29 %) were smokers, 17 (54.8 %) had a body mass index greater than 25 kg/m2 . Anastomosis failure developed n 2 (6.5 %) patients and only 1 (3.2 %) patient required a second surgery.

Conclusion. Preliminary analysis data indicate safety of the proposed method of colorectal anastomosis formation. It is necessary to conduct comparative studies to evaluate possibility of wider implementation of this technique in clinical practice. 

Aim. To evaluate the frequency and clinical characteristics of positional neuropathies in patients with cancer who underwent surgery.

Materials and methods. A retrospective study of medical records of patients undergoing surgical treatment in 2023, who showed signs of secondary neuropathy of the upper and/or lower extremities in the postoperative period. The main analyzed parameter was the frequency of postoperative neuropathies among patients who underwent surgery; additional parameters were the degree of neurological deficit according to the neurological deficit assessment scale, the median regression of neurological deficit.

Results. The study included 29 patients who underwent surgery at the National Medical Research Center of Oncology named after N. N. Blokhin in 2023, who developed a clinical picture of positional neuropathy in the postoperative period. The overall incidence of positional neuropathies was 0.28 %. Neuropathies of the brachial plexus were predominant (96 %). A severe degree of neurological deficit was noted in 35 %, medium – in 45 %, mild – in 20 % of patients. 27.5 % of patients continued to have varying degrees of neurological deficit over a 10-month period.

Conclusion. Positional neuropathies can persist for a long time; it is necessary to develop methods for their prevention.

Aim. To evaluate the effectiveness and tolerability of systemic chemotherapy in elderly patients with metastatic pancreatic cancer (mPC) in real clinical practice.

Materials and methods. The study included patients with mPC over 65 years of age who received first-line chemotherapy at the N. N. Blokhin National Medical Research Center of Oncology for the period from 2004 to 2023. Any previous antitumor chemotherapy for mPC was an exclusion criterion. The primary endpoint was 1-year overall survival (OS), and the secondary endpoints were ORR, median progression-free survival, median OS, chemotherapy tolerability.

Results. The study included 148 patients aged 65 to 86 years with mPC who received first-line chemotherapy. Median progression-free survival among the entire population was 5.2 months. One-year OS among all patients was 32 %. The 1-year OS in mFOLFIRINOX group was 43.4 % and in gemcitabine group – 19.6 %. In a subgroup analysis, median OS with combination treatment was higher than in the gemcitabine monotherapy group (median OS 8.4 months vs. 6.8 months, p = 0.009). Patients with ECOG 2–3 also benefited from combination chemotherapy. Median OS was 8.9 months versus 3.9 months in gemcitabine (p = 0.008). The frequency of an objective response with triple chemotherapy was 66.1 %. In 30.8 % of cases, grade 3–4 neutropenia developed with mFOLFIRINOX, but febrile neutropenia developed only in three patients (5.8 %). The incidence of grade 3–4 adverse events was low, and these chemotherapy regimens were well tolerated.

Conclusion. Conducting a triple chemotherapy regimen in elderly patients with mPC is an effective treatment option with an acceptable range of toxicity. 

Introduction. The standard of treatment of rectal cancer is a combined or complex technique in the form of neoadjuvant chemoradiotherapy (CRT) followed by surgery or observation, with proven radicalization of CRT. Currently, the most adequate methods of evaluating the results of CRT are endoscopic diagnostics. The most reliable visual criteria for endoscopic examination of absence or presence of residual tumor are: complete response (flat white scar, telangiectasia), partially complete response (uneven mucosa, small nodules on mucosa, superficial ulceration, slight persistent erythema of scar) and incomplete response (visible tumor).

Aim. The study is to assess sensitivity and specificity of endoscopic method in assessment of radicality of neoadjuvant CRT in patients with rectal cancer.

Materials and methods. A retrospective study of 75 patients with verified rectal cancer after CRT was carried out. Inclusion criteria: histologically verified rectal cancer (adenocarcinoma); endoscopic picture of clinical response of rectal cancer to CRT; absence of established distant metastases at the moment of examination. Exclusion criteria: morphological types of tumors other than adenocarcinoma of the colorectal type; patients with primary-multiple diseases.

Results. A retrospective study was conducted in 75 patients with a verified diagnosis of rectal cancer who underwent CRT at the first stage of treatment. All patients underwent endoscopic examination with evaluation of the degree of tumor regression, taking material for cytological and histological examination. In 57 (76,4 %) out of 75 patients on the basis of visual endoscopic picture the absence of residual tumor was stated, in 18 patients visual endoscopic signs were considered as presence of residual tumor. The results of morphological study in the first group of patients confirmed the absence of tumor in 51 cases (92.7 %). In the second group, in the presence of visual signs of residual tumor, morphological confirmation was obtained in 14 out of 18 patients (77.8 %). Morphological verification of residual tumor was obtained in 26.6 % of patients in the total group.

Conclusion. Endoscopic and histologic data can be decisive in the evaluation of the degree of radicality of neoadjuvant CRT.

Aim. To investigate the species composition and frequency of opportunistic pathogens in cancer patients diagnosed with non-small cell lung cancer (NSCLC) receiving chemotherapeutic treatment at the Federal State Budgetary Institution National Medical Research Center of Oncology named after N. N. Blokhin of the Russian Ministry of Health.

Materials and methods. A prospective open single-center study included a cohort of patients with locally advanced or metastatic NSCLC receiving drug antitumor therapy, aged 18 years and older. The study was observational in nature. The endpoint of this phase of the study was to determine the relative number of NSCLC patients with chronic infection (pneumocystis, herpes simplex virus (HSV) 1, HSV-2, cytomegalovirus (CMV), Epstein–Barr virus (EBV), human herpes virus type 6 (HHV-6) and their combinations).

Results. Antibodies to herpes viruses and/or pneumocystis were detected in patients (n = 18) diagnosed with NSCLC in 100 % of cases. Antibody titers corresponding to active infection were more characteristic for EBV and CMV, with CMV infection markers more often registered in titers corresponding to the acute stage of the disease, and EBV – in the reactivation stage without obvious clinical manifestations. In most cases, mixed infection with different pathogens was determined: combination of HSV-1 + EBV + CMV was found in 55.5 % (n = 10) of NSCLC patients; HSV-1 + EBV + CMV + HHV-6 – in 33.3 % (n = 6) of cases, HSV-1 + HSV-2 + EBV + CMV – in 5.5 % (n = 1), HSV-1 + HSV-2 + EBV + CMV + HHV-6 also in 5.5 % (n = 1) of patients. During bronchoalveolar lavage examination, pneumocystis were detected in 3 (42.8 %) out of 7 examined patients.

Conclusion. Based on the results of studies of a relatively small cohort of patients in the absence of clinical symptoms of infection in NSCLC patients, a high percentage of IgM and IgG antibodies, which are markers of opportunistic infections and their combinations, were detected. Pneumocystis was isolated from bronchoalveolar lavage in 42.8 % of cases. It is necessary to evaluate the results obtained in a larger number of patients to determine approaches to the prevention and treatment of opportunistic infections.

Introduction. Gastric cancer is a high burden on the healthcare system due to 1 million new cases every year. Most of these cases are diagnosed at a late stage.

Aim. The aim of this research is to perform epidemiological analysis about gastric signet ring cell carcinoma in the Tyumen region.

Materials and methods. Used data was taken from the regional cancer – registers of the medical center “Medical City”, Tyumen, Russia, which includes the data from 2012 to 2021. The histological tumor develops in accordance with the international histological classification of stomach tumors. The article examines such indicators as: morbidity, proportion of patients with stages I–IV, mortality, one-year mortality. Survival calculations were performed using TIBCO Statistica 13.5.0.17.

Results. 512 cases of gastric signet ring cell carcinoma were detected in the Tyumen region from 2012 to 2021: 51.9 % of them were men, 48.1 % were women. Morbidity over this period has slightly decreased. Average growth rate was – 2.05 %. Mortality increased in the same period. Average growth rate was 8.16 %. The average 1-year mortality over 10 years of the disease was 47.84 %, the average growth rate was negative (–1.19 %). Late diagnosis is still actual for this type of cancer 70.5 % of diagnoses were on the III or IV stages.

Conclusion. The performed epidemiological analysis of signet ring cell gastric cancer allows us to conclude that this problem is relevant for the Tyumen region. In the period from 2012 to 2021, the incidence of gastric signet ring cell cancer in the population has decreased slightly, but high mortality and one-year mortality remain due to detection at late stages. The average rate of increase in mortality is 8.16 %. Average one-year mortality rate from 2012 to 2021 was 47.84 %, and the average growth rate was – 1.19 %. The problem of early diagnosis also remains relevant; the proportion of patients whose diagnosis was made at stages III and IV was 70.5 %. This once again emphasizes the need for early and timely diagnosis. It is quite obvious that the effectiveness of the oncology service is closely related to how successfully the system of early detection of cancer patients is organized.