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Background. The detection of primary tumor in patients with cervical lymph node metastases without the primary tumor found is very important, because its location often determines the treatment strategy. The study objective is to analyze the capabilities of upper respiratory tract fibroscopy for the detection of primary tumor in patients with cervical lymph node metastases from squamous-cell carcinoma without the primary tumor found.Materials in methods. A total of 70 patients with cervical lymph node metastases without the primary tumor found, in whom cytological examination of biopsy specimens collected from cervical lymph nodes revealed squamous-cell carcinoma, underwent upper respiratory tract fibroscopy in N.N. Blokhin National Medical Research Center of Oncology between January 2017 and May 2020.Results. In 24 out of 70 patients, fibroscopy helped to identify the primary tumor and collect biomaterial for morphological examination. Twelve patients were found to have oropharyngeal cancer; ten patients were diagnosed with nasopharyngeal cancer; and 2 patients had laryngopharyngeal cancer. Fifteen out of 24 patients had tumors less than 1.2 cm.Conclusion. Upper respiratory tract fibroscopy is a highly effective method for detecting small asymptomatic tumors. It can be recommended for the examination of patients with metastases from squamous-cell carcinoma without the primary tumor found, if the primary tumor is believed to be located in the upper respiratory tract

Introduction. Gestational trophoblastic neoplasias are rare tumors, which consist of about 1% of gynecological cancers. High rate of diagnostic and treatment mistakes leads to late diagnosis, metastatic appearance, resistance to chemotherapy, poor prognosis. Aim. To demonstrate possibilities of 18F-FDG PET/CT to find resistant lesions of gestational trophoblastic neoplasias. In the article, we analyze several medical reports to illustrate advantages of 18F-FDG PET/CT for evaluation of resistant gestational trophoblastic neoplasias.

The purpose of the study: to present an experience of the N. N. Blokhin Russian Cancer Research Center in the treatment of relapses of gestational trophoblastic neoplasias (GTN). Materials and methods. We performed a retrospective analysis of medical case histories at the N. N. Blokhin Russian Cancer Research Center from 1996 until 2019. 545 patients with GTN were treated. Relapses occurred in 25 (4.6%) patients: 8 (2.1%) patients with low risk of resistance (6 (75%) early relapses and 2 (25%) late relapses) and 17 (10%) patients with high risk of resistance (11 (65%) early relapses and 6 (35%) late relapses). Treatment of relapses was done by standard chemotherapy regimens (Dactinomycin 500mcg in days 15, EMA-CO, EMA-EP). Different surgical interventions and radiosurgery were used in some cases additionally. Results. Out of 6 patients with early relapses of low-risk GTN, 5 were cured with chemotherapy and one patient by lung resection only. Two patients with late relapses of low-risk GTN were cured with chemotherapy (EMA-CO) and hysterectomy/resection of uterus to achieve complete remission. As a result, all patients with relapses of low-risk GTN were cured, mainly (88%) by chemotherapy. Among 11 patients with early relapses of high-risk GTN, complete remission was achieved in 6 (55%) cases: in 2 patients as a result of EMA-EP chemotherapy, other patients needed combined approaches (chemotherapy + surgery). Three patients with recurrent course continue treatment, two patients died of progression. Of the 6 patients with late relapses of high-risk GTN, 4 (66%) patients were managed mainly through combined treatment (surgery + chemotherapy) and were cured. One patient continues treatment for more than 4 years, and one patient died of progression. In total, out of 17 patients with high-risk relapses, complete remission was achieved in 10 (59%) as a result of combined treatment in the majority of cases (80%). Conclusion. The optimal method of treatment for patients with relapses of low-risk GTN is chemotherapy; and for high-risk GTN combined approaches (chemotherapy + surgery)

The training module was developed by the staff of the department under the leadership of the head. Department of Academician of RAS, Professor I.V. Poddubnoy and Rector of FSBEI DPO RMANPO of the Ministry of Health of Russia, Corr. RAS, Professor D.A. Sychev.

The review presents literature data on the possibilities of modern diagnostic methods in detecting and determining the nature of secondary lung tumors, and also analyzes their main advantages and disadvantages.

The aim of the study is to assess the positive and negative prognostic factors of survival in patients with bilateral synchronous renal cancer (BRC). Materials and methods. The study was conducted on the basis of N.N.Blokhin National Medical Research Center of Oncology of the Ministry of Health of the Russian Federation. Cohort of patients with the synchronous BRC consisted of 160 patients between 1996 and 2014. All patients after finishing treatment were observed on an ambulatory basis during the period from 11 months to 12 years (median follow-up 81.05±46.7 months). We studied factors affecting 5-year survival rate, both positive and negative. Statistical analysis of the obtained results carried out using generally accepted statistical methods such as SPSS 23.0 - block of programs for Windows. Results. In case of synchronous BRC in 2/3 (65%) of patients the first kidney was operated on using organ-preserving surgery, in 1/4 of patients (n=21, 26.2%) both kidneys were operated on using organ-preserving surgery. In case of synchronous renal cancer the best results of survival, but without statistical significance (p=0.112) had patients with bilateral renal cancer who operated on using organ-preserving surgery. The 10-year overall survival in this group of patients was 90.5% in comparison with 62.5% - when nephrectomy was performed on the first stage and 76.4% in patients who had nephrectomy performed because of the renal cancer in the second kidney. Conclusions. The main factors affecting the 5-year survival rate of patients with synchronous BRC were: smoking, primary tumor size, age and type of surgery.

The neglect of lung cancer and the unsatisfactory results of its treatment depend to a large extent on untimely diagnosis in the early stages of the disease. The reason for this is the absence of pathognomonic clinical signs and a specific radiographic picture of early lung cancer, which has to be differentiated from other respiratory diseases, including those occurring with infiltrative changes. According to statistical data, hyperdiagnosis of infiltrative pulmonary tuberculosis in patients with oncological diseases of the respiratory system was from 14 to 39%, which leads to long-term monitoring of patients with lung cancer in phthisiological institutions with anti-tuberculosis therapy, which causes delays in the treatment of patients with lung cancer. The pronounced visual similarity of various pathological processes of the lungs, the mixed incidence and immunodeficiency combined with subjective factors, such as gaps in the training of doctors, omissions in the survey method and the lack of continuity, can collectively be the cause of differential diagnostic errors. This article describes the similarities and differences between these diseases, the main causes of erroneous diagnosis, as well as the prospects for the development of modern diagnostic methods.

Renal cancer morbidity grows in most of the developed countries. Incidence of bilateral renal cell carcinoma, per various authors, amounts to 2–6 % of all cases of this disease. The study included 160 patients with bilateral kidney cancer who received surgical treatment at the N.N. Blokhin National Medical Research Center of Oncology in the period from 1996 to 2014. Median follow-up duration for all patients included in the analysis was 81.05 ± 46.7 months. In our study, the groups for synchronous and metachronous cancer were equal (n = 80) and constituted 3.5 % of all cases of kidney cancer. For synchronous and metachronous cancer types, the most common concomitant disease was arterial hypertension. The most common morphological variant for the first, as well as the second, kidney tumor was clear cell carcinoma. Smoking and ischemic heart disease as a concomitant pathology negatively affected relapse-free and overall survival. Overall 5-year survival for synchronous renal cancer was 84.4 ± 4.2 %, for metachronous – 64.8 ± 9.3 %.

Objective is to identify regularity of metastases distribution of the squamous cell carcinoma (SCC) in the lymph nodes of the neck without revealed primary focus, as well as to evaluate the effectiveness of various methods of treatment. Materials and methods . Performed the retrospective 45 patients data analysis with metastases of SCC in cervical lymph nodes without the revealed primary focus treated in different departments of N.N. Blokhin National Medical Research Center of Oncology from 2005 to 2012. The source of information were outpatient studies and medical histories, histological preparations and paraffin blocks. Results. Metastases of SCC without revealed primary focus are most typical for nodes of a neck and upper part of the body, there are among the patients mostly males aged 50–59 years. To establish the localization of the primary focus, traditional diagnostic procedures are not always effective: in morphological analysis, the primary focus can be hidden behind inflammatory changes, in addition, the tumor lesion can be of a primary focus. Tumors, similar to lymphoepithelioma-like carcinoma, could also simulate metastasis in the lymph node. Tonsil cancer is very often not detected even with repeated biopsies, therefore diagnostic tonsillectomy is justified. Survival depends slightly on the identification of the source of metastasis. The range of treatment methods for SCC is limited, combined and complex methods demonstrate greater efficiency, chemotherapy is less reasonable. The leading prognostic factor is the degree of distribution of metastatic lesion. Virologic analysis allows only to assume localization of the tumor process in the nasopharynx in patients with human papillomavirus and predict their greater survival, and the number of patients with Epstein–Barr virus is too small for reasonable hypotheses. Conclusion . With metastases of SCC in the lymph nodes of the neck without the revealed primary focus, the hidden distributing tumor is most often appears in the pharyngeal tonsils and in the root region of the tongue. In some cases, the metastatic node can be the primary focus. The most effective complex therapy is surgical intervention with followed radiation therapy in combination with chemotherapy. The spectrum (range) of diagnostic procedures can include bilateral tonsillectomy and mucosectomy of the root region of the tongue.

This article continues a series of papers dwelling on endo-surgery techniques in diagnosing lymphomas. It describes the history of the thoracoscopic surgery and its potential and current use when malignant lymphoproliferative diseases with involvement of chest organs and tissues. It provides brief description of basic instruments, equipment and technique of surgical interventions via the thoracic access. It lists indications and contraindications for the thoracoscopic surgery. In addition, the paper presents analysis of video-assisted thoracoscopic surgeries in 178 patients with suspected malignant lymphoproliferative diseases. During these surgeries, samples for further morphological assessment were obtained from all patients. Lymphomas were confirmed in 120 patients. The article contains two case reports on the video-assisted thoracoscopic interventions performed.

Th e aim of this study was to investigate clinical pecuiliarities of ovarian tumors in colon cancer patients and determination of complex diagnostic methods. Subjec t and methods. Russia n N.N. Blokhin Cancer Research Center archives were used for retrospective study, patients, who underwent treatment during 1989–2013 were included. Colon cancer patients with ovarian metastases and with synchronous or metachronous tumors were included. Results . 14 1 patients were included: 91 patients had colon cancer with ovarian metastases (group 1) and 50 patients had synchronous or metachronous ovarian tumours (group 2). Ovarian tumors were diagnosed during the 1 year in 74 (81.3 %) patients in group 1 and in 23 (46 %) in group 2. Patients in group 2 less frequently had children (9 (18.0 %) vs 5 (5.5 + 2.3 %), р < 0.05), family history of cancer (3 (6 %) vs 16 (17.6 %), р < 0.05) and concomitant diseases. Median CA 125 level in group 1 was 64.96 ng/ml and 180 ng/ml in group 2. Ovarian tumors had solid and cystic structure during US examination in 66 (73 %) patients in group 1 and 31 (62 %) patients in group 2 had solid ovarian tumors on US examination. Conclusions . Th e differential diagnostics of primary and metastatic ovarian tumors must include CEA, CA 19–9 and CA 125 serum levels and pelvic US.

The cytotoxic activity of peripheral blood platelets and mononuclears from 82 patients with cancer, 9 with diseases other than cancer, and 18 healthy donors towards a continuous cell line of pulmonary adenocarcinoma was studied. There were no appreciable differences in the killer activity of platelets in cancer patients (32±3.5%), patients with diseases other than cancer (33±8.1%), and healthy donors (30±6.7%). In contrast to platelets, mononuclears of cancer patients possessed a higher cytotoxicity than mononuclears of healthy donors. The cytotoxicity of platelets of cancer patients was found to reliably drop in cases with disseminated metastases and after polychemo-and radiotherapy.