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Relevance: Currently, in the world, including Kazakhstan, the increasing number of new cervical cancer cases among women of reproductive age is a socio-demographic problem. The increase in cervical cancer incidence among young women, the high prevalence of human papillomavirus (HPV) infection among young sexually active women, the lack of screening programs for the early detection of cervical cancer in young women, the need to take urgent measures to increase awareness of young women about risk factors for cervical cancer and methods of prevention and determined the relevance of this study. The study aimed to estimate the awareness, identify risk factors for cervical cancer, and assess the state of reproductive health of young women of Almaty by questioning. Methods: The article presents an analytical study of the intermediate results of a survey of young women aged 18 to 32 years and living in Almaty. Participants received full information on the upcoming survey. The questionnaire collected information on socio-demographic data, awareness of cervical cancer prevention, and women’s gynecological history. The questionnaire contained 30 questions in total and took 10 minutes to complete. Results: Among young women in Almaty, low awareness of primary and secondary prevention of cervical cancer was revealed in all age groups. The most common risk factors for cervical cancer among young women in Almaty were an early onset of sexual activity, smoking, and hormonal contraceptive uptake. Conclusion: The survey showed the problem of low awareness of girls about cervical cancer and the risk factors for developing cervical cancer. Based on these data, we can state the need for educational work on these issues among young people.

Relevance: Laparoscopic surgery supplies many benefits due to lower postoperative sequelae. Laparoscopic radical prostatectomy has become a first-line treatment for patients with localized prostate cancer worldwide. The study aimed to compare outcomes after traditional laparoscopic extraperitoneal radical prostatectomy with modified laparoscopic extraperitoneal radical prostatectomy (MLERPE). Methods: All information about patient treatment for this historical cohort study was obtained from the “Electronic In-patient Registry” of the Republic of Kazakhstan. The study included case records of 94 patients who underwent laparoscopic extraperitoneal radical prostatectomy from 2017 to 2021. Of them, 45 underwent a modified laparoscopic prostatectomy, and 49 – a traditional laparoscopic prostatectomy. Data are presented as the means ± standard deviation or as frequencies and percentages. Pearson’s Chi-square was used for qualitative data. T-test and Mann-Whitney U test were used to compare the means of the two groups. The statistical significance level was 0.05. Results: We revealed significant differences between the laboratory parameters of both groups after surgery. The mean difference in hemoglobin level between the two groups was 14.04, the mean difference in erythrocyte level was 0.69, the mean difference in leukocyte level was 1.26, and the mean difference in ESR level was 2.01. All differences were statistically significant (p=0.000). We found a statistical difference in the duration of operation and hospital stay between the two groups (p=0.000). Conclusion: The modified laparoscopic technique avoids adverse worse outcomes such as bleeding, pneumoperitoneum, and decreasing oxygen saturation. This technique is also beneficial in the early postoperative period for excluding peritonitis, and the late postoperative period avoids adhesive processes.

Relevance: Male breast cancer (BC) has always been behind female BC in detection, treatment, and surveillance. Lower BC frequency in men limits the usefulness of screening. However, BC incidence in men is growing. This paper demonstrate the results of surgical treatment and typical changes in clinical and morphological manifestations of male breast cancer under chemotherapy and surgery. Methods: The article describes a clinical case of a male patient diagnosed with “Cancer of the right breast St III (T4NxM0), edematous-infiltrative form with an intraductal component, upper outer localization. Immunohistochemically luminal subtype B without Her2neu expression”; the condition – after six neoadjuvant chemotherapy courses. Results: Ultrasonography of the mammary glands conducted after six preoperative courses of chemotherapy showed a hypoechoic formation, centralized, with fuzzy, uneven contours, 52.5×48.2×46.1 mm in size, V=60.98 cm3. Compared to March 2022 (the presence of a formation in the right breast craniolateral quadrant, with precise uneven contours, 9.0 cm in size, with infiltrating growth), the tumor formation decreased to US BI-RADS R6, L2. The multidisciplinary council prescribed surgery to the extent of radical mastectomy by Madden on the right and simple mastectomy on the left. The surgery was performed in August 2022. According to a postoperative histological conclusion, the therapeutic pathomorphism was index RCB-2.233, class RCB-II. Conclusion: This article shares the results of systemic and surgical treatment of a man with breast cancer. Considering the clinical picture and anamnesis, literature data, and the clinical protocol, the multidisciplinary group recommended radiation therapy with adjuvant endocrine therapy with tamoxifen for an initial period of five years. * clinical case, male breast cancer (BC), luminal subtype B without Her2neu expression, mastectomy, therapeutic pathomorphism, radiation therapy, endocrine therapy.

Relevance: From 2010 to 2019, prostate cancer morbidity increased, and prostate cancer mortality decreased in Kazakhstan. The peak incidence was observed in patients aged 70 years and older. The East Kazakhstan region had higher morbidity and mortality from prostate cancer than the national average. The study aimed to assess the indicators of prostate cancer epidemiology in the East Kazakhstan region from 2010 to 2019. Methods: The study calculated prostate cancer incidence, mortality, one-year and five-year survival, and early detection from 2010 to 2019. The statistical significance was assessed by the one-factor linear regression method. Intensive epidemiological indicators were calculated per 100 000 male population. Results: The prostate cancer incidence in East Kazakhstan increased from 2010 to 2019, while the mortality rate increased slightly. There was a statistically significant upward trend for morbidity (p=0.009) and a statistically insignificant trend for mortality (p=0.900). The one-year survival with prostate cancer tended to decrease. However, the trend of one-year survival rates had no statistical significance (p=0.202). The five-year survival rate of patients with prostate cancer in the East Kazakhstan region during the study period tended to decrease. However, the trend in the five-year survival rates of patients with prostate cancer in the East Kazakhstan region had no statistical significance (p=0.826). Early detection of prostate cancer in the early stages remained sustainable in the range of 72.7-77.4. In 2019, this indicator decreased to 63.2%. The share of prostate cancer cases detected at stage III tended to increase. The proportion of prostate cancer cases detected at stage IV tended to decrease during the study period. Conclusion: The prostate cancer epidemiological rates in East Kazakhstan were unstable in the study period. The incidence tended to increase; the mortality rate fluctuated within small limits and remained sustainable. The one-year survival rate tended to decrease. The five-year survival rate was slightly increasing. There was an increase in the detection of prostate cancer at stage III, while the detection at stage IV tended to decrease. Early detection of prostate cancer has decreased with an increase in detection at stage III. The proportion of prostate cancer cases detected at stage IV in the study period tended to decrease.

Relevance: Human papillomavirus (HPV) is the most common sexually transmitted virus in sexually active men and women. The direct and proven relationship between HPV infection and cervical cancer development HPV global epidemiological studies to ensure prevention in areas with high HPV prevalence. The study aimed to analyze the global age-related HPV prevalence over the past decade. Methods: Sources for the literature review were obtained from the PUBMED and MEDLINE databases for the past ten years by the keywords “human papillomavirus,” “prevalence,” and “cervical cancer.” The review included randomized trials, systematic reviews, and meta-analyses. Results: HPV rates were the highest in Africa (24%), Eastern Europe (21.4%), and Latin America (16.1%). The most common HPV types worldwide were HPV 16 (3.2%), 18 (1.4%), 52 (0.9%), 31 (0.8%), and 58 (0.7%). HPV prevalence in the Republic of Kazakhstan is underexplored since epidemiological studies were conducted only in some regions. HPV high-risk types16 and 18 prevail in the Republic of Kazakhstan. Conclusion: The analysis of the global HPV epidemiology revealed its high prevalence in low- and middle-income countries. HPV’s higher prevalence in young women justifies the need to improve and implement HPV vaccination programs.

Relevance: The 5-year overall survival rate(s) in NSCLC p-stage IA is 73%, and the recurrence rate in radically treated patients is almost 10%. The study aimed to evaluate the prognostic significance of several clinical and morphological factors and apply machine learning algorithms to predict the results of the overall survival of patients with lung cancer. Methods: The forms 030-6/y C34 – lung cancer (n=19,379) from the EROB database for 2014-2018 were analyzed, and the impact of risk factors on overall survival was assessed using the Kaplan-Meier method. Accordingly, the training data set for constructing forecasting models included 19,379 observations and 15 factors. The machine learning algorithms such as Random Forest Classifier, Gradient Boosting Classifier, Logistic Regression Model, Decision Tree Classifier, and K Nearest Neighbors (KNN) Classifier were implemented in the Python programming language. The results were evaluated by constructing an error matrix and calculating classification metrics: the proportion of correctly classified objects (accuracy) during training and validation (validation), accuracy (precision), completeness (recall), Kappa-Cohen. Results: In our study, 19,379 patients were analyzed, including 15,494 men (79.95%) and 3,885 women (20.04%). At the time of the study, 6,171 men (39.8%) and 1,962 women (49.5%) were alive. Median survival was 8.3 months (SE – 0.154 months, 95% CI – 7.96-8.56) in men and 15.43 months (SE – 1.0 months, 95% CI – 13.497-17.363) in women. At diagnosis, 1,037 patients (5.35%) had stage I disease, and 4,145 (21.38%) had stage II. Most patients (61.4%) had advanced stage NSCLC: 9,189 people (47.4%) were diagnosed with stage III, and 4,655 (24%) – with stage IV. The reliability of differences in median survival (χ2=3991.6, p=0.00) indicated the prognostic significance of the tumor process stage and its influence on the patient’s survival. Also, the revealed significant difference in the median survival of patients with various morphological forms of lung cancer suggests the prognostic significance of the morphological factor (the difference between those indicators was statistically significant, χ2=623.4 p=0.000). Conclusion: Machine learning models can predict the risk of fatal outcomes for patients after surgical treatment and registration in the EROB database. The creation of patient-oriented systems to support medical decision-making makes it possible to choose the optimal strategies for adjuvant therapy, dispensary observation, and frequency of diagnostic studies.

Relevance: The 5-year overall survival rate(s) in NSCLC p-stage IA is 73%, and the recurrence rate in radically treated patients is almost 10%. The study aimed to evaluate the prognostic significance of several clinical and morphological factors and apply machine learning algorithms to predict the results of overall survival of patients with lung cancer. Methods: The forms 030-6/y C34 – lung cancer (n=19,379) from the EROB database for 2014-2018 were analyzed, and the impact of risk factors on overall survival was assessed using the Kaplan-Meier method. Accordingly, the training data set for constructing forecasting models included 19,379 observations and 15 factors. The machine learning algorithms such as Random Forest Classifier, Gradient Boosting Classifier, Logistic Regression Model, Decision Tree Classifier, and K Nearest Neighbors (KNN) Classifier were implemented in the Python programming lan- guage. The results were evaluated by constructing an error matrix, calculating classification metrics: the proportion of correctly classified objects (accuracy) during training and validation (validation), accuracy (precision), completeness (recall), Kappa-Cohen. Results: In our study, 19,379 patients were analyzed, including 15,494 men (79.95%) and 3,885 women (20.04%). At the time of the study, 6,171 men (39.8%) and 1,962 women (49.5%) were alive. Median survival was 8.3 months (SE – 0.154 months, 95% CI – 7.96-8.56) in men and 15.43 months (SE – 1.0 months, 95% CI – 13.497-17.363) in women. At diagnosis, 1,037 patients (5.35%) had stage I disease, other 4,145 (21.38%) had stage II. Most patients (61.4%) had advanced stage NSCLC: 9,189 people (47.4%) were diagnosed with stage III, and 4,655 (24%) – with stage IV. The reliability of differences in median survival (χ2=3991.6, p=0.00) indicated the prognostic significance of the tumor process stage and its influence on the patient’s survival. Also, the revealed significant difference in the median survival of patients with various morphological forms of lung cancer sug- gests the prognostic significance of the morphological factor (the difference between those indicators was statistically significant, χ2=623.4 p=0.000). Conclusion: Machine learning models can predict the risk of fatal outcomes for patients after surgical treatment and registration in the EROB database. The creation of patient-oriented systems to support medical decision-making makes it possible to choose the optimal strategies for adju- vant therapy, dispensary observation, and frequency of diagnostic studies

Relevance: Human papillomavirus (HPV) is the most common sexually transmitted virus in sexually active men and women. The direct and proven relationship between HPV infection and cervical cancer development HPV global epidemiological studies to ensure prevention in areas with high HPV prevalence. The study aimed to analyze the global age-related HPV prevalence over the past decade. Methods: Sources for literature review were obtained from the PUBMED and MEDLINE databases for the past ten years by the keywords “human papillomavirus,” “prevalence,” and “cervical cancer.” The review included randomized trials, systematic reviews, and meta-analyses. Results: HPV rates were the highest in Africa (24%), Eastern Europe (21.4%), and Latin America (16.1%). The most common HPV types worldwide were HPV 16 (3.2%), 18 (1.4%), 52 (0.9%), 31 (0.8%), and 58 (0.7%). HPV prevalence in the Republic of Kazakhstan is underexplored since epidemiological studies were conducted only in some regions. HPV high-risk types16 and 18 prevail in the Republic of Kazakhstan. Conclusion: The analysis of the global HPV epidemiology revealed its high prevalence in low- and middle-income countries. HPV’s higher prevalence in young women justifies the need to improve and implement HPV vaccination programs.

Relevance: Male breast cancer (BC) is one of the rarest diseases and accounts for 1/100 of detected BC cases in both sexes. About 30-70% of breast cancer cases in men develop against the background of gynecomastia, particularly its nodular form. The biology of this disease differs in men, but the approaches to diagnostics and treatment are usually extrapolated from those used in women. This study aimed to demonstrate the results of each stage of a male patient with BC diagnostics and treatment. Methods: The article presents a clinical case of a male patient diagnosed with «Cancer in the right breast St III (T4NxM0), Edematous-infiltrative form with an intraductal component, upper outer localization. Immunohistochemically luminal subtype B without Her2neu expression». The data from literary sources and clinical protocols on the male BC diagnosis and treatment were also reviewed. Results: The patient received four courses of preoperative chemotherapy according to the “AС” scheme Doxorubicin 60 mg/m2 (CD 120 mg) + Cyclophosphamide 600 mg/m2 (CD 1200 mg). Intermediate instrumental and laboratory control and assessing the response to treatment according to the RECIST criteria are planned. Conclusion: The presented rare clinical case of male BC demonstrates that diagnostics and treatment at the initial stage remain the same as recommended for women. Identical preoperative and adjuvant chemotherapy regimens are applicable. Since most male BC express estrogen receptors, endocrine therapy such as tamoxifen is the kind of routine for adjuvant male BC treatment. This article describes the performed laboratory and instrumental diagnostics and preoperative chemotherapy treatment of the patient. The second part of the publication will present the results of the performed chemotherapy and surgical treatment and recommendations issued to the patient.

Relevance: Treating vaginal recurrence of gynecological cancer remains a complex clinical problem. Surgery is an effective and relatively safe strategy for these cases. Vaginectomy is a method of surgical treatment of gynecological cancer local recurrence. Although vaginectomy is considered an effective treatment for a vaginal recurrence of cervical, ovarian, or endometrial cancers, only a few published reports of vaginal resections have been found. In most cases, vaginal resections were performed by vaginal and/or/or open access. Several reports on laparoscopic vaginal resection for recurrence in gynecological cancer were found. The aim was to study the effectiveness of vaginectomy in recurrent gynecological cancer. Methods: Clinical cases of seven patients after vaginectomy were analyzed. Results: The patients were 42 to 62 years (median – 53 years). The duration of the operation varied from 240 to 480 minutes (median – 317 min), the volume of blood loss was from 90 to 220 ml (median 140 ml), and resection margins were negative in all cases. A ureteral catheter was installed in 2 cases. The Foley catheter was removed after ten days on average (1-11 days). The patients stayed in the hospital for 7-14 days (median – 7 days). No intraoperative complications were registered. All patients after vaginectomy are alive. Conclusion: Vaginal recurrence is the most common local recurrence in gynecological cancer, and there is no consensus regarding its treatment tactics. Although this article is somewhat limited in the number of patients, our results show the efficacy of vaginectomy in recurrent vaginal gynecological cancer

Relevance: Cervical cancer (CC) is a socially significant disease in the development of which the human papillomavirus (HPV) plays a central role. HPV is the most common sexually transmitted virus, affecting 80% of sexually active men and women by age 45. Since 2017, the World Health Organization has recommended that all countries implement HPV vaccination programs to reduce and eliminate CC. The study aimed to examine the role of HPV vaccination in eliminating CC over the past decade. Methods: The literature search was done in the PUBMED, MEDLINE, and Cochrane databases for the last ten years using the keywords «cervical cancer,» «vaccination,» and «human papillomavirus.» The review included the results of randomized studies and meta-analyses. Results: The literature provides evidence of the effectiveness and safety of HPV vaccination in countries that have introduced HPV vaccine immunization. The compelling evidence for the effectiveness of HPV vaccination in preventing HPV urge to move from control to elimination of HPV-related diseases. Conclusion: CC is only cancer that can be prevented by vaccination. The development of HPV vaccines and the introduction of HPV immunization into national vaccination schedules helped many countries reduce HPV prevalence and thus reduce HPV incidence.

Relevance: Treating vaginal recurrence of gynecological cancer remains a complex clinical problem. Surgery is an effective and relatively safe strategy for these cases. Vaginectomy is a method of surgical treatment of gynecological cancer local recurrence. Although vaginectomy is considered an effective treatment for a vaginal recurrence of cervical, ovarian, or endometrial cancers, only a few published reports of vaginal resections have been found. In most cases, vaginal resections were performed by vaginal and/or/or open access. Several reports on laparoscopic vaginal resection for recurrence in gynecological cancer were found. The aim was to study the effectiveness of vaginectomy in recurrent gynecological cancer. Methods: Clinical cases of seven patients after vaginectomy were analyzed. Results: The patients age ranged from 42 to 62 years (median 53 years). The duration of the operation varied from 240 to 480 minutes (median 317 min), the volume of blood loss – from 90 to 220 ml (median 140 ml), and resection margins were negative in all cases. An ureteral catheter was installed in 2 cases. The Foley catheter was removed after 10 days on average (from 1 to 11 days). The patients stayed in the hospital for 7-14 days (median – 7 days). No intraoperative complications were registered. All patients after vaginectomy are alive. Conclusion: Vaginal recurrence is the most common local recurrence in gynecological cancer, and there is no consensus regarding its treatment tactics. Although this article is somewhat limited in the number of patients, our results show the efficacy of vaginectomy in recurrent vaginal gynecological cancer

Relevance: Breast cancer (BC) is one of the most common diseases among women in developed countries worldwide. BC ranks first in incidence and third in mortality among malignant neoplasms in women. Despite many advances in the treatment of BC, the prognosis for patients with metastatic BC remains poor. The life expectancy of these patients is usually about one year. The accuracy of diagnosis and determining the number and sizes of oligometastases by contrasted brain MRI or PET-CT with methionine is vital for effective cancer treatment. The emergence of treatment techniques, such as stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRSR), significantly improved the disease prognosis. The use of high-tech radiation therapy in patients with oligometastases from breast carcinoma improves local control of intracranial lesions, prevents death, maintains the quality of life, and improves overall survival. The study aimed to analyze the results of key prospective studies on aspects of radiation therapy for BC metastases to the brain. Methods: This review included key randomized trials on the use of radiation therapy for BC metastases in the brain. The search was conducted in the PubMed database for 2005-2020 by the keywords “radiation therapy,” “breast cancer,” and “brain metastases.” Results: Reduced treatment time due to stereotactic radiosurgery and radiotherapy allows for maintaining productive life without expressed neurological symptoms. SRS is efficient in patients with up to five oligometastases in BC. More metastases require total brain exposure, which is a poor prognostic factor. In prospective studies, SRS in BC with brain metastases is recommended to improve the quality of life. Conclusion: The treatment of BC with brain metastases requires a multidisciplinary approach based on the prevalence of the process, previous therapy, general somatic status, comorbidities, and available therapy options. Systemic therapy for BC patients with brain metastases follows several schemes that demonstrate their therapeutic effectiveness.

Relevance: Colorectal cancer is one of today’s most critical health issues globally and in the Republic of Kazakhstan. Taking leading positions in the general structure of oncopathology, this nosological form of tumors forces clinicians to develop ways to improve statistical indicators. ЭПИДЕМИОЛОГИЯ Онкология и радиология Казахстана, №1 (63) 2022 31 Purpose of the article – to review the epidemiological aspects of colorectal cancer in the Republic of Kazakhstan in 2011-2020. Results: We revealed an increase in the share of early (I-II) stage colon and rectal cancer cases. The share of early stages of rectal cancer was 61.5% in 2011 compared to 68.5% in 2020; in colon cancer, it was 36.5% and 53.1%, respectively. The share of advanced (locally advanced) stage III cases of visually accessible rectal cancer has decreased from 25.2% in 2011 to 18.3% in 2020. The overall 5-year survival in 2020 amounted to 50.7% for colon cancer and 46.0% for rectal cancer, and these were the best rates in the entire decade. We also found territorial specifics in this pathology incidence. The one-year and overall mortality from these diseases have decreased, amounting to 29.2 in 2011 and 18.8 in 2020 for rectal cancer, 31.9 and 19.8 for colon cancer, 4.5 and 3.9 in rectal cancer, 4.8 and 4.1 in colon cancer, respectively. Conclusions: An analytical assessment of the statistical indicators of colorectal cancer over the decade showed that there are regions that excel in incidence rates from year to year. At the same time, indicators of early diagnosis and overall 5-year survival have improved, and one-year and overall mortality has decreased.

Relevance: Colorectal cancer is one of today’s most critical health issues globally and in the Republic of Kazakhstan. Taking leading positions in the general structure of oncopathology, this nosological form of tumors forces clinicians to develop ways to improve statistical indicators. The study aimed to review the epidemiological aspects of colorectal cancer in the Republic of Kazakhstan from 2011 to 2020. Methods: In a comparative aspect, the analytical assessment method was used to analyze the statistical indicators of the oncological service of the Republic of Kazakhstan for a decade, from 2011 to 2020. Results: We revealed an increase in the share of early (I-II) stage colon and rectal cancer cases. The percentage of early stages of rectal cancer was 61.5% in 2011 compared to 68.5% in 2020; in colon cancer, it was 36.5% and 53.1%, respectively. The share of advanced (locally advanced) stage III cases of visually accessible rectal cancer has decreased from 25.2% in 2011 to 18.3% in 2020. The overall 5-year survival in 2020 amounted to 50.7%for colon cancer and 46.0%for rectal cancer, and these were the best rates in the entire decade. We also found territorial specifics in this pathology incidence. The one-year and overall mortality decreased from 2011 to 2020. The one-year mortality went down from 29.2 to 18.8 for rectal cancer and 31.9 to 19.8 for colon cancer; the overall mortality went from 4.5 to 3.9 for rectal cancer and 4.8 to 4.1 for colon cancer. Conclusions: An analytical assessment of the statistical indicators of colorectal cancer over the decade showed that there are regions that excel in incidence rates from year to year. At the same time, indicators of early diagnosis and overall 5-year survival have improved, and one-year and overall mortality has decreased.

Relevance: Breast cancer is one of the most common diseases among women in developed countries worldwide. Breast cancer ranks first in incidence and third in mortality among malignant neoplasms in women. Despite many advances in breast cancer treatment, the prognosis for patients with metastatic breast cancer remains poor. The life expectancy of these patients is usually about one year. The accuracy of diagnosis and determining the number and sizes of oligometastases by contrasted brain MRI or PET-CT with methionine is vital for effective cancer treatment. The emergence of treatment techniques, such as stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRSR), significantly improved the disease prognosis. The use of high-tech radiation therapy in patients with oligometastases from breast carcinoma improves local control of intracranial lesions, prevents death, maintains the quality of life, and improves overall survival. The study aimed to analyze the results of key prospective studies on aspects of radiation therapy for breast cancer metastases to the brain. Methods: This review included key randomized trials on using radiation therapy for breast cancer metastases in the brain. The search was conducted in the PubMed database for 2005-2020 by the keywords “radiation therapy,” “breast cancer,” and “brain metastases.” Results: Reduced treatment time due to stereotactic radiosurgery and radiotherapy allows for maintaining productive life without expressed neurological symptoms. SRS is efficient in patients with up to five oligometastases in breast cancer. More metastases require total brain exposure, which is a poor prognostic factor. In prospective studies, SRS in breast cancer with brain metastases is recommended to improve the quality of life. Conclusion: The treatment of breast cancer with brain metastases requires a multidisciplinary approach based on the prevalence of the process, previous therapy, general somatic status, comorbidities, and available therapy options. Systemic therapy for breast cancer patients with brain metastases follows several schemes that demonstrate their therapeutic effectiveness.

Relevance: Globocan reported 4,390 new breast cancer cases and 1,654 deaths from breast cancer in the Republic of Kazakhstan (RK) in 2020. Molecular diagnostics of breast cancer includes the determination of Hormone Receptor (HR), HER2, and Ki-67 status to detect patients with HR-positive tumors and administer effective treatment. Methods: This observational study included a retrospective analysis of incidence, molecular diagnostics, and treatment regimens in women with a confirmed breast cancer diagnosis aged 18 years old and older, registered in the RK Electronic Registry of Cancer Patients (ERCP) from 1 January 2014 till 31 December 2019. Results: In the study period (2014 to 2019), the number of breast cancer cases registered annually has doubled. The incidence increased by 46.9%. The share of locally advanced and advanced forms of breast cancer has decreased. The proportion of Luminal type A (HR+/HER2-) among newly diagnosed patients ranged from 17.9% to 30%. Chemotherapy and endocrine therapy with goserelin, buserelin, leuprorelin, and fulvestrant are standard first- and second-line treatments for HR+ breast cancer. Since fulvestrant indications have been expanded, more than 50% of patients with HR-positive advanced breast cancer receive fulvestrant as the first-line therapy. Conclusion: Breast cancer incidence growth and a decrease in the share of locally advanced and advanced breast cancer cases in the RK could be attributed to increased coverage of eligible women aged 40 to 70 with breast cancer mammographic screening. Although international guidelines support the administration of hormone therapy with or without targeted therapy in women with HR-positive, HER2-metastatic breast cancer, upfront use of chemotherapy remains common in the RK even in the absence of visceral crisis. The use of CDK4/6 inhibitor palbociclib in combination with hormone therapy has become routinely available since 2019.

Relevance: Cancer control is among the key social policy priorities in the Republic of Kazakhstan. 14,000 people die from cancer every year. As a result, our country faces an epidemiologic crisis caused by the increasing malignancy-related incidence and mortality, plus the increasing number of people living with cancer. In 2019, 186 326 patients with malignant neoplasms were under dynamic supervision in Kazakhstan; 52.5% lived for five years or more [1]. WHO prognosis a 1.5-2 times growth of annual malignancy-related incidence and mortality worldwide by 2022. The Republic of Kazakhstan follows the same trend, taking into account the growing welfare and life expectancy of the population and an increase in the detection of malignant neoplasms due to the introduction of early detection programs [2]. This study aimed to assess the implementation in 2019 of the Comprehensive Cancer Control Plan in the Republic of Kazakhstan for 2018-2022. Results: Intermediate Comprehensive Plan implementation results showed the efficacy of the conducted measures as reflected by major cancer service indicators. Thus, the early detection has improved: stage 0-I detection amounted to 27.1% of all new cases (2019 target – 25.2%). This had a positive impact on cancer survival: in 2019, the proportion of 5-year or more survival was 54.7% for breast cancer (2019 target – 54.5%), 56.8% for cervical cancer (2019 target – 55.8%), 46.6% for colorectal cancer (2019 target – 45.8%) [1]. Conclusion: The Comprehensive Cancer Control Plan implementation results evidence cancer service improvement in the Republic of Kazakhstan as of 2019 (increased 5-year survival and decreased mortality). However, a high share of detection of visually accessible malignant neoplasms at generalized and advanced stages should be addressed in the coming years.

The article talks about the Chemotherapy Department of the Kazakh Research Institute of Oncology and Radiology (KazIOR), which is an important part of cancer patients’ treatment in the Republic of Kazakhstan. The roll-out of clinical chemotherapy as one of the main cancer treatment methods was initiated by Professor S.N. Nugmanov, the director of KazIOR, in 1963, three years after the Institute was established. In addition to clinical activities, the department staff conducts research, participates in clinical trials, provides consulting and methodological assistance in consolidating the national chemotherapy service, and develops national clinical cancer treatment guidelines.

Relevance: Despite a high survival with localized prostate cancer, metastatic prostate cancer remains virtually incurable even after intensive multimodal therapy. Death in advanced stages of the disease is caused by the lack of therapeutic regimens able to produce a long-term tumor reaction due to its extreme genetic and cellular heterogeneity. According to epidemiological studies, a family history of prostate cancer significantly increases the risk. Clinical diagnosis is often based on a single biopsy made to determine the molecular status of a particular cancer case. Pathological and genomic heterogeneity can lead to bias in diagnosis. Therefore, the use of genetic research technologies is highly relevant. The purpose wasto justify the use of genetic profiling technologies for patients with prostate cancer. Results: Many cases lack an understanding of the multifactorial impact of current treatment methods on the patient’s immune system. Combination therapy efficacy and tolerability depend on the choice of an optimal treatment regimen. Approaches to prioritizing the types of combination therapy should be developed. Cancer genome affects the disease course and progression. Simulation of these interactions in a genetic model allows predicting the treatment outcome and effectiveness. Conclusions: The conducted systematic review shows that a deep understanding of prostate cancer biology and genetics and genetic profiling can save and improve the lives of many patients with serious diseases.

Relevance: Kidney cancer is among the most common oncourological malignancies, which incidence is currently growing. Risk factors for kidney cancer include tobacco smoking, overweight, and a history of hypertension and chronic kidney diseases. Kidney cancer is twice more often in men than in women. The purpose was to study the epidemiological trends in Kazakhstan in 2010-2019 years. Results: In the study period, the kidney cancer incidence increased from 5.64 to 6.74, and mortality decreased from 2.65 to 1.96 per 100 000 population. Both unadjusted and standardized incidence was high at the age of 50-69 years in both sexes. The incidence decreased in the age group below 29, was stable at the age of 30-49, was unstable at the age of 50-69, and was growing at 70 years and above. Unadjusted mortality was high at the age of 70 and above. Standardized mortality was high at the age of 50-69. Conclusion: In Kazakhstan, in 2010-2019, there was an increase in kidney cancer incidence against the background of a decrease in mortality from this disease. The most unfavorable in terms of incidence was the age group of 50-69 years in both sexes. The highest absolute mortality was registered at the age of 70 and above, while standardized mortality rates were the highest at 50-69.

Relevance: Over the past decades, lung cancer (LC) incidence worldwide is adding about 1.5% each year. The risk of LC development increases 4-5 times with age. The mortality-to-incidence ratio (MIR) in LC is the most unfavorable – up to 95.6% of patients die. The purpose of this study was to analyze the epidemiological situation with lung cancer in the Republic of Kazakhstan over the past five years, with the assessment of key epidemiological indicators by gender. Results: In the previous five years (2014-2018), the men to women ratio among LC patients was equal to 4.2:1 and remained stable. A gradual decline in mortality (16‰ in 2014 to 12.9‰ in 2018) correlated with the MIR dynamic pattern (67.5% in 2014 to 60.0% in 2018). The standardized LC incidence in men was declining steadily (46.8‰ in 2014 to 43.0‰ in 2018). A more evident decrease in male mortality from LC (32.0‰ in 2014 to 24.2‰ in 2018) was due to the progress recently achieved in LC diagnostics and treatment in the Republic of Kazakhstan. On the contrary, the LC incidence in women increased by 2.6% a year (7.6‰ in 2014 to 7.8‰ in 2018). The female mortality from LC was declining steadily (4.6‰ in 2014 to 3.5‰ in 2018), with a negative growth rate of minus 31.4%. Conclusion: The analysis of epidemiologic indicators for LC in the Republic of Kazakhstan showed a general downward trend in incidence and mortality regardless of gender. However, we can expect an increase in the female incidence of LC in sync with the global trend. The study period has witnessed the improvement in both the primary diagnostics (due to the renewal of diagnostic equipment in the country) and treatment of LC (through the introduction in the Republic of methods of molecular genetic studies which are the basis for the state-financed personalized drug therapy with targeted agents).

Introduction/Background* Radical trachelectomy with pelvic lymphadenectomy, originally described by Dargent et al. in 1988 became a new treatment option for young patients in the world with early invasive cervical cancer who want to maintain their fertility. Recent data indicate that cancer outcomes after radiation therapy are comparable to those after standard radical hysterectomy .Fertility-sparing radical trachelectomy was revolutionary when it first appeared. This procedure now allows patients to survive cancer and save uterus for future bearing of the child. Initially, they approached him as a vaginal procedure with laparoscopic evaluation. This approach is comparable to type B or modified radical hysterectomy, but with greater limited resection of parametrium. Methodology statistical analysis Result(s)* Since 2013, radical trachelectomy has been performed at KazIOR. From 2013 to 2021, 8 operations were performed, 7 of them by abdominal access, 3 by laparoscopic approach. 6 (75%) of the patients had stage 1 in 1 from 2 to 4 cm; 2 (25%) had a 1a1 stage. No patient had a tumor larger than 4 cm on examination, MRI, and histological examination. No patient received neoadjuvant chemotherapy. 2 patients (25%) underwent a biopsy for the purpose of establishing a diagnosis, 6 patients (75%) conization of the cervix. The average age of the patients was 28 years (from 26 to 37 years). 5 (62.5%) patients were nulliparous, 2 patients had 2 children, 1 patient had 1 child. LVSI was negative in preoperative histological examination, and resection margins were also negative. In 1 patient (12.5%) after histological examination LVSI was positive, in 7 it was negative. Of the 8 patients who retained fertility, there were 5 pregnancies, 2 miscarriages at 9–10 weeks, and 3 deliveries at 36–37 weeks of gestation. Conclusion* Thus, in 2013–2021, 8 radical trachelectomy operations were successfully performed. The data presented in this publication demonstrate that patients with stage IB1 tumors ranging in size from 2 to 4 cm and with favorable histology are acceptable candidates for attempted radical trachelectomy. These patients must be clearly informed of all the options if they want to consider maintaining fertility.

Introduction/Background* According to Globocan 2020, ovarian cancer (OC) is the 11th most common cancer among women worldwide. It is more than 320,000 new cases of OC were registered each year and more than 200,000 deaths worldwide in 2020. To date, there are no recommended methods for screening of OC. More than 70 per cent of OC is detected in the late stages. In Kazakhstan (KZ), OC is the 3rd most common gynaecological cancer with the one of highest mortality rate in women. The proportion of OC among all cancers was 2.9% in 2020. The purpose of this study was to analyse OC incidence, mortality and survival for 15 years (2005-2020) in KZ. Methodology Incidence data, mortality statistics were sourced from the cancer registry database. All incidence and mortality rates were directly age-standardised to the World Standard Population. Data on survival were obtained from specific reports. We used Kaplan-Meier method to estimate cumulative observed survival. The statistical processing was carried out with SPSS 23.0 for Windows Result(s)* In KZ 14.125 new cases of OC have been diagnosed from 2005 to 2020. In the analysis of Standardized Incidence of OC, there is a stable rate for 10 years: 9.8 per 100,000 female population in 2005 and 10.0 per 100,000 female population in 2020. OC is found in all age groups and a noticeable increase in a group of 65-69 years. In the analysis of OC by stages is marked a decrease in the detection rate of the disease at the 4th stage for the period from 2005 to 2020, from 20 to 8.8%. Despite this, mortality from OC for ten years remains stable high and it is 4.6 per 100,000 female population in 2020. It is 7.458 women with OC who died from 2005 to 2020. Five-year relative survival for all stages of OC estimates of 20.3% (95%CI: 18.7-21.1). Conclusion* Analysis of OC Incidence in KZ showed a stable rate. Despite the reduction in the detection of ovarian cancer at stage 4, mortality from this disease remains high. According to these results, Kazakhstan is among the counties with low five-year OC survival.

With the aim of studying the reasons for the discrepancies between the cross sections determined for total and partial photoneutron reactions from various experiments in beams of quasimonoenergetic annihilation photons, data on such cross sections are analyzed for 103Rh and 165Ho target nuclei. Objective physical criteria of data reliability are used in this analysis. It is shown that significant systematic uncertainties the methods of photoneutron multiplicity sorting that were used in those experiments result in the unreliability of experimental data on the cross sections of (γ, 1n), (γ, 2n), and (γ, 3n) partial reactions over wide regions of photon energies. New cross sections of photoneutron reactions on 103Rh and 165Ho nuclei and data reliability criteria are obtained by employing the experimental—theoretical method developed earlier for evaluating partial reaction cross sections. The evaluated photoneutron reaction cross sections are compared with experimental data.

Experimental data for 140, 142Се and 153Eu nuclei are analyzed jointly using the cross sections for total and partial photoneutron reactions obtained with quasimonoenergy photon beams formed during the annihilation of relativistic positrons. The results from an experiment performed on a bremsstrahlung beam are also used for such an analysis for the 153Eu nucleus. Well-known systemic discrepancies between the results of different experiments are analyzed using the objective physical criteria of data reliability, and ways of allowing for them are considered. New data on the cross sections of (γ, 1n) and (γ, 2n) reactions for 140, 142Се nuclei, on the cross section of (γ, 3n) reaction for 153Eu nucleus, and on the cross section of total photoneutron reaction for all three nuclei were obtained additionally the cross sections of partial reactions that satisfy the established criteria of reliability. It was shown that substantial deviations of the experimental reaction cross sections from those evaluated are due to an unreliable sorting of neutrons between the channels with a multiplicity of 1, 2 due to the abovementioned systematic uncertainties.

According to Globocan 2018, it is more than 295,000 new cases of ovarian cancer (OC) were registered and more than 184,000 deaths worldwide in 2018. In Kazakhstan OC is the 8th most common cancer among women with the one of highest mortality rate in women. Objectives was to evaluate the OC incidence, mortality, 5-year overall survival rate in Kazakhstan for 2004–2019. Methods Incidence, mortality data were sourced from the cancer registry database. A total 1028 patients with OC analyzed using the data of Cancer Registry for 2014. The primary endpoint was death from OC. Survival was performed using the life table method (Kaplan-Meier).The statistical processing was carried out with SPSS 23.0 for Windows. Results Incidence over the past 15 years has been characterized by stable rates: 10.2 in 2004 and 11.1 per 100,000 female population in 2019. OC is found in all age groups and a increase in a group of 65–69 years. It is a decrease in the detection rate of the disease at the 4th stage for the analyzed period, from 18.1% to 8.4%. Mortality remains stable high and it is 5.3 per 100,000 female population in 2019. The overall 5-year observed survival of OC was 20.3±0.88% (95%CI: 18.7–21.9). Conclusions Analysis of OC Incidence in KZ showed a stable rate. Despite the reduction in the detection of ovarian cancer at stage 4, mortality from this disease remains high. According to these results, Kazakhstan is among the countries with low five-year OC survival.

Introduction In Kazakhstan, cervical cancer (CC) takes 2nd place among woman cancer and 7th place in general cancer mortality. Cytological screening in country have started in 2008. Kazakhstan plans to join the program for the global elimination of cervical cancer by introducing vaccination, improving screening and treatment. Methods The analysis was carried out using the National Cancer Register (2020). The incidence and mortality in the period before the introduction of screening (2004–2007) were studied. The screening period is conditionally divided into the first stage (2008–2014) and the second stage (2015–2018). Results In 2004–2007, the average annual incidence was 15.1 per 100,000 women. Indicators varied from 14.5 to 15.8 with an average annual growth ratio +1.9%. The average annual mortality rate was 7.4 per 100,000 female population fluctuating within 7.0–7.6%. After the introduction of screening, an increase in the incidence was noted with the ratio of 19.9–20.1 per 100,000 of women. The average annual incidence in the first stage of screening was 17.4% with an average annual growth rate +3.9%, whereas, the second stage showed a decrease in incidence with the average growth rate T=-1.4%, and the average annual incidence at 18.9%. Mortality in the first stage had an annual growth rate of T=+1.9%, in the second – T=-5.4%. Screening increased stage I from 41.7% to 62.5%, and pre-cancer – from 0.06% to 0.51%. Conclusion In the first eight years of screening, an increase of incidence and mortality was noted. Further, the growth of the initial stage and pre-cancer diseases was pointed out.

Cross sections of partial photoneutron reactions free of the shortcomings of different ways of determining the multiplicity of neutrons used on beams of quasi-monoenergetic annihilation photons are evaluated for 139La. The experimental-theoretical method of evaluation of partial reaction cross sections satisfying proposed data reliability criteria is used to obtain new data on the cross sections of reactions (γ, 1n), (γ, 2n), and (γ, 3n). It is shown that noticeable deviations of experimental cross sections from evaluated values are due to the unreliable sorting of neutrons between channels with multiplicities of 1, 2, and 3.

The cross sections of partial photoneutron reactions for 98Mo were evaluated. These cross sections are free from the shortcomings of various methods for neutron multiplicity determination used at the beams of quasimonoenergetic annihilation photons and bremsstrahlung radiation. New data on the cross sections of reactions (γ, 1n), (γ, 2n), and (γ, 3n) were obtained using the experimental–theoretical method for evaluation of cross sections of partial reactions satisfying the introduced physical reliability criteria. It is demonstrated that considerable deviations of the experimental cross sections from the evaluated ones result from an inaccurate sorting of neutrons between channels with a multiplicity of 1, 2, and 3.

The current state of Kazakhstani oncomastology comes of former scientific advances and is of certain interest for future oncologists. The article describes the main stages of the formation and development of mastology service in Kazakhstan, the biography of the Kazakh scientist, Doctor of Medicine, professor, honored worker of the Republic of Kazakhstan, academician of the International Informatization Academy Asker Esenkulov, and his scientific and practical contribution to the development of domestic mastology.

Introduction/Background The primary aim was to determine whether different adjuvant treatment modalities (CT, RT, and CRT) improve survival outcomes in stage III endometrioid EC patients based on the specific sub-stage of the disease. The secondary aim was to assess the prognostic factors in stage III endometrioid EC. Methodology SATEN III was a retrospective study involving 13 centers from 10 countries. Patients who had been operated on between 1998 and 2018 and diagnosed with stage III endometrioid EC were analyzed. Results A total of 990 women overall were identified; 317 with stage IIIA, 18 with stage IIIB, and 655 with stage IIIC diseases. The median follow-up was 42 months. The 5-year DFS of patients with stage III EC by adjuvant treatment modality was 68.5% for radiotherapy (RT), 54.6% for chemotherapy (CT), and 69.4% for chemoradiation (CRT) (p=0.11). The 5-year OS for those patients was 75.6% for RT, 75% for CT, and 80.7% for CRT (p=0.48). Negative peritoneal cytology (Hazard ratio [HR]: 0.45, 95% confidence interval [CI]: 0.23–0.86; p=0.02) and performance of lymphadenectomy (HR: 0.33, 95% CI: 0.16–0.77, p=0.001) were independent predictors for improved OS for stage IIIA EC. Independent prognostic factors for better OS for stage IIIC disease were age Conclusion Although not statistically significant, CRT seemed to be a better adjuvant treatment option for stage IIIA endometrioid EC. However, we were not able to show the superiority of adjuvant CRT in stage IIIC endometrioid EC.Systematic lymphadenectomy seemed to improve survival outcomes in stage III endometrioid EC. Disclosure Nothing to disclose.

Objectives To compare disease-free survival (DFS) between patients who underwent open (ORT) versus minimally invasive (MIS) radical trachelectomy (RT) [laparoscopic (LRT) or robotic (RRT)]. Methods Eligibility criteria included 1) RT and pelvic lymphadenectomy with/without sentinel lymph node mapping, 2) 1/2005 to 12/2017 3) squamous, adenocarcinoma, or adenosquamous histology, 4) stage IA2-IB1, 5) tumors ≤2 cm, 6) 15 or more cases per center. Results A total of 698 patients [open (n=388) vs. MIS (310)] were included. The median follow-up time was 40.9 months (range, 1–179.1) [MIS 38.6 (range, Conclusions Surgical approach in radical trachelectomy for low-risk cervical cancer was not associated with differences in recurrence rates or survival. MIS had worse perioperative outcomes.

Background: There were not any evaluation of sexual dysfunction of cervix cancer patients in Almaty, Kazakhstan, to date. The study of 58 CC patients is an attempt to start filling this gap and to develop recommendations for the treatment of this kind of patients. Aim: The objective of this study was to examine sexual function of cervical cancer (CC) survivors receded different treatment approaches. Methods: 58 women subjected to CC treatment of at least 1 year in the past were examined at the initial stage of the research. The examined women were split into 5 groups by treatment methods: conization of cervix, hysterectomy with removal of ovaries, hysterectomy without removal of (one or both) ovaries, chemotherapy with radiotherapy, and those passed exclusively radiotherapy. The sexual function of the examined women was evaluated through Female Sexual Function Index (FSFI) instrument consisted of 19 questions. The questions were mainly related to the main aspects like desire, arousal, lubrication, orgasm, satisfaction and pain. The data were collected by online and face-to-face interviews. Results: The median age of the 58 interviewed women was 44.5 years. 49 of the interviewees reported that they experienced desire. 79% of the interviewed women had sexual activity, among which 74% answers pointed out high lubrication condition above 2 within 0-5 possible range, 66% indicated high score of excitation, while 72% replied positively on orgasm section of the questionnaire. The highest portion of sexual active women experienced satisfaction (76%) although 33 of the interviewees felt the pain during coitus. The total FSFI score varied between 3.9 and 32.4 in the group of women who reported their sexual activity. Conclusion: This study demonstrates that lower total score of sexual function index is found in the patients passed chemotherapy with radiotherapy, or those cured exclusively with radiotherapy. In parallel, the highest score is traced in the women treated surgically. Therefore, it proves that surgery is more preferable treatment to keep higher level of sexual function in patients with cervix cancer. For the purpose of higher accuracy at the next stages of the research the inclusion of control group of women without history of cancer and with similar social, economic and demographic characteristics is needed.