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Introduction. Surgical intervention with subsequent chemoradiation therapy is one of the treatment standards in squamous cell carcinoma of the nasal cavity and paranasal sinuses. However, the question of the optimal therapy for this pathology remains open.Aim. To compare treatment results in patients with locally advanced squamous cell carcinoma of the nasal cavity and paranasal sinuses after conservative and surgical treatment.Materials and methods. The study included 86 patients with squamous cell carcinoma of the nasal cavity and paranasal sinuses, stages III–Iva, who between 2000 and 2020 received treatment at the N.N. Blokhin National medical Research Oncology Center. Surgical treatment with subsequent radiation or chemoradiation therapy was performed in 31 patients, conservative treatment (radiation or chemoradiation therapy) was performed in 55 patients.Results. Five-year overall survival in the conservative treatment group was 46.2 %, in the surgical treatment group – 59.7 % (р = 0.081); 5-year progression-free survival was 17 and 50.5 %, respectively (p = 0.002). In patients with Т3N0 tumor who received surgical treatment, 5-year progression-free survival was significantly higher than in patients who received conservative treatment (p

The larynx is a vital and socially important organ performing respiratory, vocal, and protective functions. Therefore, organ-preserving approaches are the preferred methods in treatment of patients with laryngeal cancer.The article presents a possibility of performing organ-preserving surgical treatment of locally advanced laryngeal cancer, describes a clinical case of extended resection of the larynx, demonstrates options for defect reconstruction stages. The goal of the presented technique is to improve patients’ quality of life.

Introduction. In case of cancer of the oral mucosa at the first stage, the standard treatment approach is radical surgical intervention, with the formation of extensive defects leading to aesthetic and functional disorders. Taking into account the characteristics of defects, choosing a flap is a difficult task. Currently, there is a wide selection of regional and microvascular free flaps. However, not all flaps meet the requirements. The supraclavicular fasciocutaneous flap, being a regional flap, has a number of advantages: easy to harvest, reliable due to the constancy of the vascular pedicle, primary closure of the donor site, scarcity of hair, the possibility of closing various defects of the oral cavity. Aim. To evaluate the possibility of using a supraclavicular flap in patients with oral cancer to restore the defects after surgical treatment.Materials and methods. The study included 10 patients with malignant tumors of the oral cavity who underwent surgical intervention with defect replacement using supraclavicular flap at the N. N. Blokhin National Medical Research Center of Oncology between February of 2015 and May of 2021. In 4 cases, buccal mucosa was affected; in 3 cases, the retromolar area; in 1 case, oral floor mucosa; in 1 case, mandibular alveolar ridge; in 1 case, mobile tongue. Flap sizes were 5–10 × 5–8 cm. Three (3) patients had history of radiotherapy, and 1 of them had a radical dose.Results. In 4 patients without previous radiotherapy, partial flap necrosis was observed. In 1 patient, sutural diastasis in the oral cavity after partial flap necrosis was diagnosed. There were no cases of total flap necrosis and fistula formation. Suture dehiscence in the donor bed was observed in 1 patient only.Conclusion. Use of supraclavicular flap is an option for oral cavity defect replacement after surgical intervention in patients with malignant tumors of the oral cavity producing satisfactory esthetic and functional results. The advantages of this flap are simple flap dissection, reliability of vascular pedicle, flexibility, possibility of replacing large defects, scant hair coverage.

Introduction. Lymphomas are a heterogenic group of tumors of the lymphatic and hematopoietic systems, and in many cases tumor process develops in the area of the head and neck including skin and mucosa, orbit, nasal cavity and paranasal sinuses, oral cavity, oropharynx, salivary glands, thyroid, and cervical lymph nodes. Differential diagnosis of lymphomas of the head and neck is complicated because it can be accompanied by another non-tumor pathology. High heterogeneity of lymphomas of the head and neck requires structurization of knowledge on their epidemiological and clinical manifestations.The study objective is to optimize early diagnosis as it allows to significantly increase cancer alertness in local practitioners, oncologists, diagnosis specialists and, in turn, to decrease verification frequency in generalized disease processes. Study of clinical characteristics of lymphoproliferative disorders of the head and neck leads to increased quality of differential diagnosis.Materials and methods. A study of lymphoproliferative disorders affecting head and neck was performed. Study material consisted of data on 174 patients hospitalized at the N.N. Blokhin National medical Research Center of Oncology between 1999 and 2020.Results. Based on the current clinical and morphological classification of lymphoproliferative disorders, data on location of lesions, characteristic signs of extranodal lesions and cervical lymph nodes involvement, as well as methods of diagnosis of lymphomas of the head and neck, are presented.Conclusion. The obtained data helps solve problems of diagnosis of lymphoproliferative disorders affecting the head and neck and serve as a basis for successful, predictable treatment of lymphomas.

Background. Lymphomas are a heterogeneous group of the lymphoid and hematopoietic system tumors. Neoplastic process often develops in head and neck area, including the integumentary tissues, orbit, nasal cavity, paranasal sinuses, oral cavity, pharynx, salivary glands, thyroid gland, as well as neck lymph nodes. The difficulties of head and neck lymphomas diagnosis are significant, since very often there is a combined non-tumor pathology. The high heterogeneity of lymphomas in the head and neck area requires structuring knowledge about their epidemiology and clinical manifestations.Objective: to study the epidemiological and clinical features of the head and neck lymphoproliferative diseases, which will lead to an improvement in diagnostic quality of this nosology’s.Materials and methods. The frequency of head and neck lymphoproliferative diseases detection was estimated based on the study of epicrisis and clinical data of 174 patients hospitalized at the N.N. Blokhin National Medical Research Center of Oncology in the period from 2000 to 2020.Results. Taking into account the modern clinical and morphological classification of lymphomas of the World Health Organization (2017), information about the features of localization, characteristic signs of extranodal foci and lymph nodes is presented. Detection frequency of various subtypes non-Hodgkin’s and Hodgkin’s lymphomas were determined on a sufficient cohort of patients.Conclusion. Based on the analysis of clinical and morphological features of head and neck lymphomas, epidemiological and clinical features are described in detail, and differences in the symptoms and clinical manifestations of non-Hodgkin’s and Hodgkin’s lymphomas with a predominant head and neck involvement are revealed.

Cutaneous melanoma (CM) is a highly aggressive malignant tumor. The incidence of CM is 1–4 % of all cancers and 3–5 % of all malignant neoplasms of the skin. According to different authors, CM is localized in the area of head and neck (H&N) in 22–46 %. Despite revolutionary discoveries in recent years in the treatment of metastatic melanoma, the main treatment option of primary СМ is still surgery. However, the question about the size of surgical margins and tissue sparing excision is still pending, particularly in the area of the head and neck. Despite the possibilities of modern methods of revealing of metastases in lymph nodes (LN), diagnosis of “latent” metastases in LN and further tactics of treatment remains the matter of argument. The purpose of this publication is to review the literature on the current problem in the surgical treatment of СМ of the H&N.This article is the result of analysis of publication devoted to surgical treatment and diagnosis of СМ metastases in the LN of the H&N.

Introduction. Prognosis of patients with localized primary cutaneous melanoma depends on various clinical and pathomorphological aspects. The latest ones are the Breslow depth, Clark invasion, ulceration and mitoses in primary tumor. All of this prognostic features have been studied and discussed during last 30 years. The analyses of the prognostic value of this factors is being continued till nowadays, and that is the main idea of our current study.The aim of our study is to determine the influence of pathomorphological factors on long-term treatment results in patients with primary head and neck cutaneous melanoma.Materials and methods. 174 patients with localized primary head and neck cutaneous melanoma were included (were considered for the analysis) (1995–2014). All the patients were considered for Breslow depth (T), Clark invasion, and ulceration using archived pathomorphological tissue samples. The proliferative tumor activity (mitotic rate) was determined in 24 cases with tumor with tumor thickness less than 1.0 mm.Results. Recurrence-free survival according to ulceration and N0 correlated with long-term treatment results. So, 5-year survival was worse in group with ulceration – 51,8 ± 5,9 % rather than group without ulceration – 69,5 ± 6,4% (р = 0,046). Recurrence-free survival according to Clark invasion and N0 correlated with long-term treatment results and worsened with growth of invasion level. So, 5-year survival in I level group was 100 % versus 27,8 ± 9,4 % in V level group (р = 0,00014). Recurrence-free survival according to mitotic rate did not correlate with long-term treatment results. So, 5-year survival was 79,5 ± 13,0 % and 81,8 ± 11,6 % respectively.Conclusions. Ulceration of the primary tumor is a factor affecting the rate of regional metastases, which subsequently leads to decrease in relapse-free survival. Also, a direct relation exists between increased rate of regional and distant metastases and increased Clark level of invasion. Mitotic index has a certain effect on the rate of regional metastases, but it doesn’t manifest in analysis of long-term results. Supposedly, this factor is not “strong” enough.

The paper outlines the possibilities of surgical treatment in patients with generalized skin cancer of the head and neck. The use of different types of free revascularized flaps can yield acceptable functional and cosmetic results.

The article is determined to the analysis of different types of plastic reconstruction of the external nose with local and combine flaps after radical surgery in oncology. Reconstruction of the external nose is discussed under consideration of experience of our research center, which includes surgical treatment of 35 oncologic patients.

The use of the oncological principle – en bloc ablastic tumor resection – can expect a breakthrough in the treatment of baseline unfavorable patient groups. In the described case of atypical meningioma, its en bloc resection presents significant technical difficulties when accomplishing the task associated with the giant sizes of a tumor as an iceberg growing outside and into the cranial cavity, its rich vascularization from both the internal and external carotid artery system, with the involvement of the superior sagittal sinus, the presence of a dense bone crown that combines the three-component construction of a neoplasm, which made difficult safe mobilization and scanning in the cranial cavity.In such topographic variants, the criteria for the Simpson radical meningioma resection are inapplicable and only en bloc tumor resection may reflect the oncological principles of surgery. The technologies of en bloc resection of intracranial meningiomas should be more frequently used because preoperative neurovisualization and even histological diagnosis does not always allow the grade of meningiomas to be specified.

The paper presents the specific features of the diagnosis and treatment of thyroid cancer metastases to parapharyngeal lymph nodes.