Panitumumab has been shown to increase progression free and overall survival in patients with metastatic colorectal cancer.

Our purpose was to evaluate whether panitumumab is effective and safe in patients with potentially resectable colorectal liver metastases (CRLM).

Methods. Consecutive analysis of data from 11 patients (KRAS wild) receiving oxaliplatin-based chemotherapy and panitumumab as converse preoperative treatment for potentially resectable CRLM. At the moment of presentation R0-liver resection was not possible due to technical reasons (small remnant volume, large liver vessels involvement etc.). We studied objective response rate, surgical characteristics, skin toxicity profile, and perioperative course. Also expression of EGFR-ligands (transforming growth factor-α and amphiregulin) and   expression of E-cadherin were studied.

Results. After median 6 courses of treatment, metastatic liver tumors were reduced considerably (PR) in 8 pts (73 %). Radical liver resection (R0) with 3 median number of removed segments was done in 6 (55 %) patients. Two pts underwent successfully the two-stage surgery (1 – portal vein embolization and 1 – portal vein ligation with partial left resection). Two patients progressed on chemotherapy (18 %). There was no correlation between skin toxicity and response. Mean blood loss was 250 ml. Preoperative administration of panitumumab was associated with higher risk of postoperative infection complication (57.1 %).

Conclusions. To the best of our knowledge this is the first report about using panitumumab as conversion therapy before liver resection. The panitumumab and oxaliplatine-based regimen may increase the resection rate of liver metastases and influence on adhesive and proliferative activity of cancer cells. It is necessary to focus on postoperative infection complications.

The article describes the main stages of the development of sphincter-saving surgery for rectal cancer. An historical look at this issue from the standpoint of research of past years in our country and abroad, as well as analysis of current sphincter-preserving surgery and future directions in this area.

The therapeutic strategy in rectal cancer has substantially changed in the past decade. Total mesorectumectomy has been widely used. Many specialized health facilities have accepted radio/chemoradiotherapy for locally advanced rectal cancer as a standard. At the same time as high as one quarter of the patients receiving neoadjuvant therapy demonstrate a complete pathomorphological regression of a tumor. In this connection, the current literature discusses whether medical treatment is permissible in this group of patients.

Diagnostic and treatment of rectal cancer local recurrences, risk factors and treatment tactics are discussed in this article. Chemoradio-therapy is a method of choice as the first stage of treatment for this patient group, however its application is limited by pelvic radiotherapy anamnesis. Surgery is the only method of potentially curative treatment, but it should be applied only in patients with high probability of R0-resection.

Purpose. Treatment tactics for metastatic colorectal cancer changed towards a more aggressive approach using rational combination of all available treatment methods. Perioperative treatment becomes more widespread for patients with isolated lung or liver metastases.

Methods. Preliminary analysis of combined treatment of 36 metastatic colorectal cancer patients, age 38–76, who received perioperative treatment in medical oncology department since 2005 is presented. All patients received 3 months of chemotherapy as initial treatment with oxaliplatin/irinoteca-based regimens +/- targeted therapy. RECIST criteria were used for response estimation. Following treatment employed surgery ot radiofrequency ablation of metastatic disease. Postoperative chemotherapy (6 cycles) was carried out using the same regimens.

Results. 4–8 cycles of chemotherapy were carried out preoperatively, which allowed to carry out surgery in 35 patients after 3–7.5 weeks. Objective response or disease stabilization was observed in 34 patients, 2 patients had progressive disease. Median followup was 35 months. 10 patients experienced disease progression during 1–6 months after treatment. Median time to progression among these 10 patients was 4 months. 5 patients died of disease progression after 35–48 months.

Conclusions. Perioperative chemotherapy represents a rational treatment strategy, improving treatment results, survival, time to progression in metastatic colorectal cancer patients. Further research is warranted to confirm results of pilot studies.

Bowel preparation remains an important issue despite vast clinical experience in this field.

Methods. 530 patients were included in retrospective analysis. 234 (44.2 %) patients in group 1 used sodium phosphate (SP) for bowel preparation, 176 (33.2 %) patients in group 2 used polyethylene glycol (PEG), 120 (22.6 %) patients used castor oil. Quality of bowel preparation was assessed according to following grading system: «good», «acceptable», «bad».

Results. «Good», «acceptable», «bad» bowel preparation was observed in following number of patients: 160 (68.4 %), 46 (19.7 %) and 28 (12 %) patients who used SP, 38.6, 40.3 and 20.1 % who used PEG and 43.3, 20.8, 35.8 % who used castor oil. Results of «good» preparation were significantly better in patients who used SP comparing to other treatment groups.

Conclusions. Better bowel preparation with SP was observed in our study, though results need to be validated in randomized trials.

The identification of small colon lesions is one of the major problems in laparoscopic colonic resection.

Research objective: to develop a technique of visualization of small tumors of a colon by preoperative endoscopic marking of a tumor.

Materials and methods. In one day prior to operation to the patient after bowel preparation the colonoscopy is carried out. In the planned point near tumor on antimesentery edge the submucous infiltration of marking solution (Micky Sharpz blue tattoo pigment, UK) is made. The volume of entered solution of 1–3 ml. In only 5 months of use of a technique preoperative marking to 14 patients with small (the size of 1–3 cm) malignant tumors of the left colon is performed.

Results. The tattoo mark was well visualized by during operation at 13 of 14 patients. In all cases we recorded no complications. Time of operation with preoperative marking averaged 108 min, that is significantly less in comparison with average time of operation with an intra-operative colonoscopy – 155 min (р < 0.001).

Conclusions. The first experience of preoperative endoscopic marking of non palpable small tumors of a colon is encouraging. Performance of a technique wasn't accompanied by complications and allowed to reduce significantly time of operation and to simplify conditions of performance of operation.

Squamous-cell anal cancer is a rare disease that requires a comprehensive approach in treatment and skilled professionals. Modern diagnostics is important for rational choice of treatment tactics. Radiotherapy is the cornerstone of sphincter-sparing anal cancer treatment. Radiotherapy dose, volume and duration are the key factors affecting treatment efficacy and toxicity.3D-conformal radiotherapy is a priority treatment allowing exact reproduction of treatment conditions, controlled by OBI (on-board imager) and kV X-Ray and cone-beam CT analysis. Intensity-modulated radiation therapy (IMRT) is a next-generation treatment with improved technologies, allowing better protection of normal tissues.Our experience with 21 squamous-cell anal cancer patients treated with IMRT during Nov 2011 – March 2013 is presented in this article.