Introduction. According to the literature, the detection rate of laterally spreading tumors has increased in recent years due to the constant development of endoscopic diagnosis and treatment technologies. It is reported that these neoplasms account for about 15 % of all colorectal neoplasias. According to the literature, laterally spreading tumors are characterized by a more frequent presence of areas of malignancy compared to polypoid formations. Since such neoplasms are closely correlated with colorectal cancer, it is very important to fully understand the clinical presentation and morphological characteristics to select the optimal treatment strategy.

Aim. The development of mapping of samples during morphological examination with subsequent correlation with endoscopic data and search for the most suitable areas for taking a biopsy.

Materials and methods. To solve the problem described above, a mapping technology was developed for the morphological study of samples of laterally spreading colon neoplasia, which consists in creating an algorithm of actions, described in more detail in the work.

Results. The first step of gross is the correct orientation of the resected specimen. The macroscopic integrity of the removed specimen is described. When describing microscopic data, the first question that the morphologist must answer is whether the process is benign or malignant. In case of malignant processes, the morphologist must answer according to the questionnaire: histological type, degree of differentiation / dysplasia, size (mm), depth of invasion, assessment of resection margins, lymphovascular and perineural invasion, tumor kidneys.

Conclusion. The presented technique, when used in everyday pathological practice for neoplastic neoplasms of the colon, can allow a reliable assessment of all prognostic factors and the development of an objective interdisciplinary consensus for further treatment.

The article presents information on the most popular methods of culturing human malignant neoplasms to implement the obtained fundamental knowledge into the basis of translational research in oncology. A brief description of each of them allows you to decide on the possibility of including the technique in experimental work. The first approximation to the formation of the logic of the mathematical justification of the design of an experiment on modeling human malignant neoplasms is given.

Also, using the example of a brief description of the original design of the experiment of scientists from the Khanty-Mansiysk State Medical Academy and the Tyumen State Medical University, the logic of constructing the design of such an experiment as part of the research work is demonstrated. An idea is formed about the need to include fundamental and translational stages in clinical experimental work as part of a unified strategy for responding to the great challenges of personalized medicine. An idea is formed about the need to include fundamental and translational stages in clinical experimental work as part of a unified strategy for responding to the great challenges of personalized medicine.

This article presents changes to clinical guidelines for the treatment of metastatic colon cancer in 2024. The new provisions in the clinical guidelines are complemented by a brief overview of the research results that underlie them. The changes considered concern not only systemic antitumor treatment, but also surgery and molecular genetic diagnostics. The differences between the recommendations of RUSSCO and the Ministry of Health of Russia are given. The introduction of information to determine the clinical benefit of expensive therapeutic options in relation to the use of the ESMO-MCBS and RUSSCO-MCBS scales is discussed.

Aim. Bringing information to a wide range of readers on planned changes in clinical guidelines.

Patients with tumor involvement of lateral pelvic sidewall represent a peculiar category and were not assessed as the candidates for curative surgery up until recent years. The aim of the current review of literature is to display the working results of the most experienced surgical oncologists in pelvic surgery. We have analyzed issue-related articles, which were published from 1967 till 2023, considering the free margin status as a key prognostic factor. It is elucidated that R0 resection could be achieved in more than a half cases, 5 year overall survival ran up to 50 %, and postoperative mortality was less than 7 %. The majority of authors described high morbidity though (up to 82 %). Exenteration with laterally extended endopelvic resection could improve overall survival rate in patients with locally advanced pelvic malignancies granting sensible patient selection in expert medical care unit.

The landscape of cancer treatment has evolved significantly with the integration of multimodal approaches, wherein surgery plays a pivotal role. This comprehensive review examines the dynamic role of surgical interventions within the framework of multimodal cancer therapy, highlighting historical advancements, innovative surgical techniques, and their synergistic effects with other treatment modalities. We explore preoperative, intraoperative, and postoperative considerations, emphasizing patient selection, technological innovations, and multidisciplinary collaboration. Through case studies and clinical trials, we illustrate the efficacy and challenges of combining surgery with chemotherapy, radiotherapy, and emerging therapies. Addressing controversies and future trends, this review underscores the necessity of personalized and precision medicine in enhancing patient outcomes. The insights provided aim to guide clinicians and researchers in optimizing surgical strategies within the multifaceted landscape of cancer care.

Introduction. Today, resection margins are assessed in different ways, but in clinical practice, preference is given to the histological method with macro- and microscopic examination of the margins. Assessment of resection margins can be carried out not only during planned histological examination, but also during intraoperative examination.

Aim. To evaluate the feasibility of intraoperative assessment of resection margins when performing organ-preserving operations in patients with primary resectable breast cancer.

Materials and methods. A retrospective study analyzed data from patients with early breast cancer who underwent surgical treatment at the Blokhin National Medical Research Center of Oncology of the Ministry of Health of Russia from June 2020 to May 2022. All patients underwent mammary gland resection with or without intraoperative marginal GI of resection, with sentinel lymph node determination or regional lymphadenectomy at the first stage. Patients included in the final analysis were divided into 2 groups: the study group consisted of patients who underwent intraoperative marginal GI of resection, and the control group consisted of patients who did not undergo intraoperative marginal GI of resection. Marginal GI of resection is performed by a pathologist by measuring the distance from the tumor node to the resection margins on a macropreparation. Frozen sections were always stained with hematoxylin and eosin.

Results. The 451 patients with early forms of breast cancer included in the final analysis and subjected to breast resection at the first stage were divided into 2 main groups: the study group consisted of patients (n = 310) who underwent intraoperative microscopic histological assessment of resection margins, and the control group included patients (n = 141) who did not undergo intraoperative assessment of resection margins. During intraoperative histological assessment of resection margins, patients with positive resection margins were most often observed with invasive cancer – 20.3 versus 3.9 % with intraductal cancer.

Conclusion. Further research is needed to determine the factors influencing the increase in the incidence of positive resection margins and their impact on patient survival rates.

Introduction. Microsatellite instability, PD-L1 CPS expression, high tumor mutational burden (TMB), and the presence of Epstein-Barr virus are the main tumor predictors of the response to immunotherapy in patients with metastatic gastric cancer (mGC). However, selecting patients for immunotherapy in mGC seems challenging due the lack of an optimal cut-off for PD-L1 CPS expression in microsatellite-stable gastric adenocarcinomas, significant benefit from anti-PD-L1 inhibitors in late-line treatment, and inaccessibility of Epstein-Barr virus and TMB determination in real clinical practice.

Aim. The aim of our study is to determine prognostic and predictive biomarkers of patients, who received ICIs for mGC.

Materials and methods. Our study included patients with mGC treated with anti-PD1 antibodies between 2018 and 2023 in five oncology centers in Moscow. Variables with p <0.05 obtained from a univariate analysis, were selected to perform multivariate analysis. According to the number of prognostic factors, patients were stratified into two groups with favorable and unfavorable prognosis. The optimal cut-off of the neutrophil-lymphocyte ratio (NLR) to predict of the efficacy of immunotherapy was determined using ROC analysis. The Kaplan–Meier method was performed to analyze survival curves of patients according to prognostic groups and NLR levels and the log-rank-test was used to compare the differences. Statistics was performed using the IBM SPSS v. 22 and PRISM 10.

Results. Between January 1, 2018 and February 28, 2023, 122 patients with mGC who received ICIs were included. NLR was analyzed in 71 (58 %) patients out of 122. The median NLR was 2.36 (0.41–10.00). The cut-off of NLR for predicting mortality was 1.8 (AUC 0.81, p <0.001). The median of PFS and OS in patients with high NLR (NLR ≥1.8) were 2 and 4 months, respectively; mOS and mPFS in the low NLR group were not achieved (p <0.001). Eight factors were statistically significant in univariate analysis of patients with MSS: ECOG status (0–1 and 2–3), signet-ring cell histology, primary tumor, the number of organs with metastases (1–2 and 3 or more), ascites, pain, the line of immunotherapy (I–II and III–IV) and N LR level. Multivariate analyses revealed the presence of ascites (p = 0.001), immunotherapy administration in III– IV lines (p = 0.02), and NLR≥1.8 (p = 0.004) were independent prognostic factors for OS. Each factor was assigned with a score from 1 to 2, depending on its significance: presence of ascites – 2 points, high NLR – 2 points, III–IV line of immunotherapy – 1 point. Patients were stratified into two prognostic groups according to the number of prognostic factors – the group with favorable prognosis (0–2 points, n = 20) and unfavorable prognosis (3–5 points, n = 22). The mOS of patients with favorable and unfavorable prognosis was 6 months and 3 months, respectively (p = 0.048).

Conclusion. Ascites, NLR level of ≥1.8 and administration of ICIs in late setting are associated with low efficacy of immunotherapy in patients with MSS mGC. Further research should be planned including more patients and those who did not receive ICIs to determine the prognostic significance of our model.

Introduction. Despite advances in the diagnosis and drug therapy of some cancers over the past decade, solid tumors, particularly gastric cancer, still have a poor prognosis and remain a leading cause of death worldwide. Therefore, the development of methods for timely diagnosis, identification of new targets for therapy and biochemical prognosis factors is an urgent problem in clinical oncology. In recent years, the focus of clinical attention has been on immune checkpoint receptors and ligands that can identify patients for immunotherapy. The clinical and prognostic significance of the levels of soluble forms of the programmed cell death receptor PD-1 and its ligand PD-L1 in the blood of patients with gastric cancer is currently not fully determined.

Aim. Comparative study of the levels of sPD-1 and sPD-L1 in the blood plasma of healthy donors and patients with gastric cancer, taking into account the prevalence of the tumor process and the prognosis of overall survival.

Materials and methods. The study included 100 patients with stomach cancer aged from 25 to 81 years (57 men, 43 women), who underwent examination and treatment at the N. N. Blokhin National Medical Research Center for Oncology. The concentration of sPD-L1 and sPD-1 was determined in blood plasma obtained according to standard methods before the start of specific treatment, using reagent kits for enzyme-linked immunosorbent assay “Human PD-L1 Platinum ELISA” and “Human PD-1 ELISA kit” (Affimetrix, eBioscience, USA) in accordance with the manufacturer’s instructions. The content of markers was expressed in picograms (pg) per 1 ml of blood plasma. To compare indicators and analyze their relationships, the nonparametric Mann–Whitney test was used. Overall survival analysis was performed using the Kaplan–Meier method. For all statistical tests, p values <0.05 were considered statistically significant.

Results. The analysis did not reveal a connection at a threshold level of sPD-1 of 8.0 pg / ml in the blood plasma of patients with gastric cancer with overall survival rates (p = 0.59). However, an additional analysis conducted in a group of patients with gastric cancer with stages I–II demonstrated that a marker level ≥8.0 pg / ml is a favorable prognostic factor (p = 0.0039), while in advanced stages III–IV the disease it has no prognostic significance. There was no significant correlation between sPD-L1 concentrations in the blood plasma of patients with gastric cancer and overall survival rates (p = 0.35), however, the best long-term results were found at a threshold level of marker concentrations in blood plasma <35 pg / ml.

Conclusion. An sPD-1 level ≥8.0 pg / ml can serve as a favorable prognostic factor in stages I–II of gastric cancer, while in advanced stages III–IV of the disease it has no prognostic significance. The prognostic role of sPD-L1 in patients with gastric cancer has not been identified. The study needs to be continued in combination with additional predictive biomarkers for gastric cancer.