The paper presents long-term results of radical treatment for stage III colorectal cancer patients. The prognostic factors affecting cancer-specific survival (CSS) are analysed, and the impact of the devised technique of adjuvant chemotherapy (ACT) on CSS is evaluated.

Objective of the study: Enhancing the efficacy of stage III colorectal cancer treatment by devising and using a novel technique of ACT.

Materials and methods. The study enrolled 395 primary colorectal cancer patients. Radical treatment alone was administered to 203 patients, the remaining 192 patients (of 395) received adjuvant therapy supplementary to radical treatment.ACT was carried out according to the regimen we had devised: 30-minute intravenous infusion of calcium-folinate (leucovorin) at a dose of 200 mg/m2 immediately followed by 4-hour intravenous infusion of 5-fluorouracil at a dose of 400 mg/m2. The first course of chemotherapy was started on day 28–30 after radical surgery. The duration of each course was 5 days with 4-week intervals between them. A total of 4–6 chemotherapy courses was performed.

Conclusions .The proposed ACT regimen made it possible to improve 5-year CSS of stage III colorectal cancer patients from 51.1 ± 3.8 to 63.3 ± 4.9 % (p = 0.009).

Combination of neoadjuvant chemoradiotherapy and surgery is the basic treatment for locally advanced rectal tumors. Despite that, a subgroup of patients does not benefit from combined treatment. A wide search of biological markers predicting neoadjuvant chemoradiotherapy efficacy is currently conducted. Tumor cell signal pathways are investigated (EGFR, Wnt), cell cycle and apoptosis, tumor stroma. Several studies with DNA microarray analysis were conducted. Predictive value of these biological markers is reviewed in this article.

Development of an optimal algorithm of ray diagnostic examinations in the case of colorectal cancer liver metastases is extremely important. The paper reviews the literature on the diagnosis of colorectal cancer liver metastases. Diagnosis of liver metastases is based on imaging techniques that allow you to assess the condition of the liver, the number and size of lesions and the number of parameters on which the patient is suitable for radical surgery. Described ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) semiotics of liver metastases, and reflect additional information that can be obtained using beam methods of research, which is of great importance in determining resectability and preoperative planning of surgery. We consider differential diagnosis with benign tumors of the liver. The value and priority of such methods of radiation diagnosis as ultrasound with contrast, CT and MRI contrast agents, is widely debated among experts.

Current knowledge concerning impact of certain mutations on targeted therapy efficacy underlines the necessity to perform genetical analysis in order to choose appropriate treatment. Panitumumab addition to 1st line metastatic colorectal cancer chemotherapy in patients with wild-type RAS allows to achieve median progression-free survival up to 13 months and median overall survival of 41,3 months.

Preoperative chemoradiotherapy and surgery for low rectal cancer involving anorectal region are discussed in this article.

Subjects .and .methods . 42 patients were included in this study, 18 received neoadjuvant chemoradiotherapy 5 × 5 Gy and 24 had chemo-radiotherapy up to 40 Gy in 4 Gy fractions.

Results . Treatment had acceptable toxicity levels with grade III toxicity of 11.1 % and 8.3 % accordingly. 20.8 % had pathological complete response following 40 Gy chemoradiotherapy. 22.2 % patients in 5 × 5 Gy group had intershinctering resections comparing to 75 % patients in 40 Gy group. No local or distant recurrences were observed with a median followup of 42.9 months and 18.1 months accordingly.

Conclusions . Developed treatment scheme have high efficacy, improving surgery ablastics and leading to good long-term outcome, improving sphincter preservation rate and patients quality of life.

In this study we have analyzed 120 cases of extensive liver resection with pre- and postoperative regional chemotherapy in poor prognosis patients: 54 (45 %) of them had multiple liver metastases, 72 (60 %) – had bilobar lesions, 26 (22 %) had extrahepatic metastases. Adding bevacizumab to preoperative regional intra-arterial chemotherapy (FOLFOX) has increased objective response rate up to 65 vs 44 % in group without bevacizumab and grade III morphological response rate up to 59 vs 5 % in group without bevacizumab.Difference in overall survival in both groups was not statistically significant: 5-year survival was 16 ± 8 % and 21 ± 6 %, median survival was 35 months and 29 months in groups with or without bevacizumab, respectively.Preoperative regional intra-arterial chemotherapy has not increased the rate of bleeding and postoperative complications.

The aim of this study was to estimate efficacy of first line chemotherapy with bevacizumab in metastatic colorectal cancer patients and investigate the impact of different prognostic factors on treatment outcome.

Methods.During 2004–2008 48 colorectal cancer patients were included (29 in Russian N.N. Blokhin Cancer Research Center, 19 in St. Petersburg), who had unresectable distant metastases. Primary tumor was resected in 93.8 % patients. 52.1 % had rectal cancer. 87.5 % had liver metastases, 43.8 % had more than 1 organ affected. 66.7 % received chemotherapy with bevacizumab 5 mg/kg biweekly, 33.3 % received bevacizumab 7,5 mg/kg every 3 weeks. 62.5 % patients had oxaliplatin-based regimens, 35.4 % – only fluorpyrimidines, 2.1 % – chemotherapy with irinotecan.

Results.Median time of bevacizumab use was 7.8 months. 60.3 % had objective response, 87.4 % had stable diseases during more than 6 months. Median progression-free survival (PFS) was 11.5 months. Median overall survival (OS) was 24.1 months.

Conclusions.Survival and efficacy results are comparable to international experience. Combination of fluorpyrimidines with bevacizumab had comparable efficacy to combined chemotherapy regimens with no impact on quality of life. Integration of bevacizumab in combined treatment regimens reduced the impact of negative prognostic factors on PFS and OS. 

An experience of successful surgical treatment of patients with locally advanced colon cancer in referral cancer center is presented. Both patients had been proclaimed to be incurable in their local hospitals.