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Purpose. To study the efficacy and safety of total neoadjuvant chemotherapy (NACT) with the FOLFIRINOX regimen for locally advanced gastric (GC) and cardioesophageal junction (CEJ) cancer.Patients and methods. Patients with histologically confirmed locally advanced gastric adenocarcinoma and CEJ, clinical stage cT3 or higher and/or regional lymph node involvement (cN+), without evidence of distant metastasis were included in our open-label, single-centre, non-randomised study. In the FLOT control group, patients received 4 courses preoperatively and 4 postoperatively with follow-up. I In the FOLFIRINOX group 8 courses of chemotherapy were administered in neoadjuvant mode, followed by surgery and observation. The tumor regression grade was assessed in accordance with Becker, Mandard and G. A. Lavnikova scales.Results. The study included 136 patients, 119 of whom started treatment according to the protocol (ITT population). Fiſty-nine patients were enrolled into the FLOT group and 60 into the FOLFIRINOX group. One-year progression-free survival (PFS) was 67,5 % in the FLOT group and 90,4 % in the FOLFIRINOX group (p = 0,29). The estimated 2-year PFS in the FLOT group was 61,4 % [95 % CI, 48,4–77,9 %]. Median PFS and overall survival (OS) were not reached. The incidence of events (progression or death) was lower in the FOLFIRINOX group (odds ratio [OR] 0,40 [95 % CI 0,16–0,97, p = 0,047]). Adverse prognostic factors regardless of treatment were lymphatic (L1), vascular (V1) and perineural invasion (Pn1), and regional lymph node involvement aſter chemotherapy (ypN+) [p = 0,046; p = 0,014; p = 0,0021; p = 0,04, respectively]. There was no correlation between pathological complete response and survival rates.Conclusion. Total neoadjuvant chemotherapy with the FOLFIRINOX regimen for locally advanced GC/ CEJ demonstrated comparable to the perioperative FLOT one-year PFS rate. No association was found between tumor regression grade and survival outcomes.

The treatment strategy for Paget’s breast cancer (PBC), as for other morphological forms, is determined by the spread of the invasive tumor process, as well as the absence or presence of adverse factors. Significant prognostic factors, e.g. the invasive component of Paget’s cancer, the involvement status of regional lymph nodes, morphological criteria, the grade of malignancy, overexpression of epidermal growth factor Her2/neu, the presence of BRCA 1/2 and CHEK2 gene mutations, as well as age, affect the prognosis of Paget’s disease. According to various sources, PBC in 90–98 % is combined with invasive or non‑invasive breast cancer. For the most part, the lesion is multifocal. There’s high expectation for PBC to form tumor node. A palpable tumor node in the mammary gland is detected in half of the patients. PBC has certain features and specificity in relation to treatment methods. The method of radical surgical treatment of patients is primarily based on performing oncoplastic resections. Sufficient breast volume is a significant criterion for the possibility of performing an organ‑ preserving operation. The organ‑ preserving treatment is oncologically safe in case of PBC. The removal of the nipple‑ areolar complex is mandatory in case of PBC. It is possible to improve survival statistics by analyzing the biological characteristics of the tumor and developing a more accurate approach to the treatment of patients in this category. Determining clear indications for organ‑p reserving operations is the main opportunity to improve the quality of life of patients and their further rehabilitation.

The purpose of the study. Mesenchymal tumors of the esophagus comprise 2 % of all esophageal tumors. Leiomyosarcoma is the most common mesenchymal tumor in the esophagus (up to 80 %). It is located in the lower third of the esophagus. The main treatment modality of leiomyosarcoma is surgery. Due to the low frequency of occurrence, there are no unified approaches to the choice of surgical volume and access. Minimally invasive techniques have advantages over open approaches. However, final treatment approach depends on many factors: localization and location of the tumor around the circumference of the esophagus, as well as size. Endoscopic resection is feasible for small tumors with an intramural growth. In case of large leiomyomas, Lewis operation should be performed. In all other cases, tumor enucleation is the gold standard of treatment. The issue of minimally invasive surgical access is relevant. Thoracoscopic access has limitations for tumors located in the lower thoracic esophagus closer to the esophageal-gastric junction. In this regard, a laparoscopic approach with the possibility of transhiatal mobilization of the esophagus provides an adequate opportunity for tumor enucleation.Clinical case description. We hereby report our case study in which we employ the use of laparoscopic transhiatal enucleation to remove leiomyoma of the lower thoracic part of the esophagus. A 47-year-old female presented to P.A. Herzen Moscow Oncology Research Institute with complaints of pain in the epigastrium, discomfort behind the sternum when taking solid food. R0 resection was performed. During the one year follow-up period no sign of disease recurrence was observed.Conclusion. This approach, in our opinion, is fully justified, with careful selection of patients and compliance with guidelines of cancer surgery. Laparoscopic approach with transhiatal mobilization of the esophagus provides a good opportunity to perform the enucleation of mesenchymal tumors localized in the lower third of the thoracic region, at the level of the supraphrenic and abdominal segments.

Alveolar rhabdomyosarcoma is one of the four subtypes of rhabdomyosarcoma identified by the World Health Organization. This type of malignant neoplasms more often affects deep soft tissues of extremities and occurs in young ages, regardless of gender. According to the medical literature, no more than 45 cases of the development of primary cutaneous rhabdomyosarcoma have been reported in the world. In this report, we describe a clinical case of a 40-year-old woman with primary localization of alveolar radbomyosarcoma in the skin of the mammary gland.

Analysis of treatment results of 165 primary adult patients with diffuse B large-cells lymphoma (DBLCL) treating in Moscow municipal clinics is presented. Study aimed on analysis of efficacy of various dose intensity chemotherapy schedule according to disease molecular genetics variants. 28 adolescents and young adults (median age — 21.7 years) have received treatment according to pediatric BFM-NHL 90m and BFM-NHL 2004M protocols, 46 (median age — 29.0 years) and 91 (median age — 59.5) adults according to courses CHOP and R-CHOP, respectively. It was not randomized study. Germinal and postgerminal variants DBLCL were determined using immunohistochemical technique for 58 (35%) patients with appropriate primary samples. For young patients with germinal DBLCL therapy superiority of intensive BFM-NHL 90m and B-NHL 2004M protocols in relation to postgerminal variants was revealed: 5-years event-free survival (EFS) was 1.0 ± 0.0 (n = 6) versus 0.44 ± 0.15 (n = 9), respectively (p 0.05). Data receiving proves expediency of treatment adolescents and young adults with DBCLC from germinal center cells according to intensity BFM-like protocols.

Gastric cancer (GC) is the fifth most common malignant neoplasm in the world among all malignant tumors. Currently, the “gold” standard of treatment for patients with non‑metastatic cancer of the stomach and esophageal–gastric junction is surgical treatment, which is complemented by perioperative chemotherapy according to the FLOT scheme, which includes four courses of therapy before surgery and four after. However, according to statistics, less than half of patients complete all adjuvant courses of FLOT chemotherapy due to the high toxicity of the regimen and a decrease in the functional status of patients in the postoperative period. In this regard, studies are being conducted to study the tolerability of total neoadjuvant chemotherapy, when all courses are held at the preoperative stage in order to carry out all stages of treatment in full. International studies have shown the results of the use of targeted (ramucirumab, trastuzumab, pertuzumab), immune drugs (pembrolizumab, nivolumab, ipilimumab), S‑1 in combination with chemotherapy as part of the combined treatment of gastric and esophageal‑ gastric junction cancer. The emergence of new therapeutic agents previously studied in metastatic GC may change approaches to the treatment of localized and locally advanced GC.The review presents the features of perioperative therapy regimens in patients with resectable gastric and esophageal‑ gastric junction cancer in order to reduce the frequency of local and long‑term relapses and improve further prognosis.

The purpose of the study was to evaluate the efficacy and safety of laparoscopic transgastric resection for mesenchymal tumors of the proximal stomach.Material and Methods. A retrospective-prospective study was carried out. Surgical techniques of laparoscopic transgastric resection and the history of the development of this surgical method were described in detail. A total of 11 laparoscopic transgastric resections were performed. The course of the postoperative period and the postoperative management of patients were described. The immediate and long-term results of surgical treatment and the quality of life of patients were presented.Results. The assessment of the quality of life of patients after surgery showed that there were no cases of gastroesophageal reflux disease compared to proximal subtotal resection of the stomach or endoscopic tunnel resection. All patients underwent radical resection. In our study, we did not encounter cases of conversion of the surgical approach, as well as serious postoperative complications (Clavien–Dindo>III ). The analysis of long-term treatment outcomes showed that there were no cases of recurrence or disease progression. All patients are alive and followed up.Conclusion. This technique is fully justified, with careful selection of patients and compliance with all the rules of surgical oncology. Transgastric resection of gastric mesenchymal tumors located in the region of the cardioesophageal junction is a justified and safe technique. Surgery is performed under clear visual control, EGDS is not required to detect the tumor. This method allows the reduction of the frequency of contamination of the gastric flora into the abdominal cavity as well as the reduction of the wound area of the anterior abdominal wall.

The purpose of the study was to present the most recent data on the outcomes of breast-conserving surgery after neoadjuvant chemotherapy for breast cancer patients.Material and methods. We analyzed relevant publications available in the pubmed, cochrane library, e-library databases between 1990 and 2020, and 24 of them were used to write this review.Results. Neoadjuvant chemotherapy for breast cancer patients is currently a widespread treatment option. The main advantage of this type of treatment for patients with early stage breast cancer is the feasibility of performing breast-conserving surgery in cases of partial or complete clinical response and, therefore, the improvement of the quality of life of patients with equivalent rates of disease-free survival compared to radical mastectomies.Conclusion. Numerous studies have shown that breast-conserving surgery following neoadjuvant chemotherapy is the safe surgery with good oncologic outcomes and an alternative to radical mastectomies in breast cancer patients. However, further studies are required to determine the optimal safe resection margin width in patients with complete and partial responses to neoadjuvant chemotherapy.

The recurrence rate after organ-sparing surgeries for breast cancer depends on the resection margins: R1 status is associated with a higher risk of recurrence than R0.We analyzed a group of breast cancer patients with an R1 resection margin who underwent organ-sparing/oncoplastic surgeries. The R1 resection margin was detected in 62 out of 1279 patients who had organ-sparing/oncoplastic surgeries (4.9 % ± 0.6 %). In the group with invasive cancer and R1 resection margin, 80 % of patients were diagnosed with lobular carcinoma, whereas 14.8 % of patients had invasive cancer with no specific signs.We divided the group of repeated surgeries according to their histological structure at the resection margin: 28 patients were found to have carcinoma in situ, while 13 patients had invasive cancer.Among patients with carcinoma in situ, the resection margin after repeated surgery had no signs of malignancy in 14 women (50 %), while 10 (35.7 %) and 4 (14.3 %) women were diagnosed with carcinoma in situ and invasive cancer, respectively.In case of invasive cancer, 4 patients (30.8 %) had no signs of malignancy in their resection margins, while 1 (7.7 %) and 8 (61.5 %) patients were found to have carcinoma in situ and invasive cancer, respectivelyFollow-up of patients with an R1 resection margin after repeated surgery or radiotherapy revealed no cases of local recurrence between 3 and 65 months.

Background. Neoadjuvant chemotherapy (NACT) is a standard of care for locally advanced breast cancer patients. One of the main advantages of NACT is the reduction of the tumor size and regression of lymph node metastasis.The aim of the study was to analyze the outcomes of breast-conserving surgery after NACT compared to adjuvant chemotherapy, including the examination of the width of resection margins and the frequency of re-operations, the volume of tissue removed and cosmetic outcomes.Material and Methods. We analyzed 1219 publications available from pubMed, Medline, Cochrane Library, 1057 of them did not meet the inclusion criteria, 162 publications were selected to cover all the following inclusion criteria: surgical margin status, frequency of re-operations, volume of tissue removed and cosmetic outcomes. Finally, 22 studies met fully specified criteria.Results. Studies included in this review demonstrated a different frequency of positive resection margins (2–39.8 %), reoperations (0–45.4 %), the volume of tissue removed (43.2–268 cm3), and the weight of the resected breast tissue (26.4–233 grams) after NACT. Conclusion. The data obtained showed a decrease in the frequency of positive resection margins and re-operations in patients who received NACT compared to patients who did not receive NACT (5–39.8 % versus 13.1–46 % and 0–45.4 % versus 0–76.5 %, respectively), as well as a decrease in the amount of the removed breast tissue without the negative effect on the frequency of resection margins, thus allowing minimization of the extent of surgery and improvement of cosmetic outcomes.

Aim. To determine the frequency of local recurrence of breast cancer (BC) after performing breast-conserving surgery (BCS) during and after complex treatment, to study the risk factors for local recurrence and survival.Materials and methods. A retrospective cohort study of 675 patients with breast cancer who underwent BCS followed by remote radiotherapy was conducted. The frequency of local relapse and risk factors were studied, 3- and 5-year local-free survival. The odds ratios (OR) and 95% confidence intervals (CI) were calculated, and the Kaplan–Meyer curves were constructed.Results. Radical breast resections (RBR) were performed in 46.7% of patients, and oncoplastic breast resections (OBS) in 53.3% of patients. The most common histological type in both groups was invasive cancer with no signs of specificity: 76.9% and 84.1% – in the OBS and RBR groups, respectively. The incidence of cancer in situ was higher in the OBS group: 14.7% vs. 3.3% in the RBR group (p < 0.001), metastases in regional lymph nodes were more frequent in the RBR group: 34.3% against 20.3% in OBS (p < 0.001). According to the immunohistochemical type and degree of differentiation, the groups did not differ. For 3 years, the relapse-free survival rate was 99.7% in both groups, and for 5 years – 99.2% in the OBS group. and 99.7% in the RBR group, 6 years – 98.3% and 98.7%, respectively; no significant differences were found between the groups. There were no statistically significant differences in the frequency of relapses depending on the width of the resection edges from

Purpose of the study. To give a qualitative and quantitative assessment of different types of tumor microvessels depending on the histological type of cervical cancer (CC).Material and methods. The tumor samples from 76 patients with CC stage I–IIA who received the surgical treatment on the first phase were the object of study. The immunohistochemical study was performed using antibodies to CD34 and podoplanin. Statistical analysis of the data was performed using the Statistica 6.0 software.Results. In CC, the following types of tumor microvessels have been identified: normal microvessels, dilated capillaries (DCs) with a normal endothelial lining, DCs with a weak expression of CD34, DCs of contact type, capillaries in the solid component of tumor, the atypical dilated capillaries (ADCs), the structures with partial endothelial lining and the lymphatic capillaries in lymphoid and polymorphic cell infiltrates. It was found that DCs with a mild expression of CD34 (p=0.0005), DCs of contact type (p=0.000005), and capillaries in the solid component of tumor (p=0.006) were correlated with the prognosis in early CC. The detection frequency of this tumor microvessels was lower in more prognostically favorable squamous non-keratinizing CC, while in the prognostically unfavorable squamous cell keratinizing CC and adenocarcinoma of the cervix uteri, the higher DCs values with a mild expression of CD34 (р=0,004 and р=0.005, respectively) and DC of contact type (p=0.02 and p=0.14, respectively) were typical.Conclusion. We consider it is expedient to further study the relationship of different types of tumor microvessels with clinical and morphological characteristics and prognosis of cervical cancer.

Primary thyroid-like follicular renal cell carcinoma is an extremely rare type of renal cell cancer with low malignancy potential and relatively good prognosis. It has not been included into the World Health Organization classification of renal tumors. This tumor is characterized by morphology similar to primary thyroid follicular cancer, but with different immune phenotype, which is important for morphological diagnosis. Surgery has been recognized as the only curative treatment. We describe our own observation of follicular renal carcinoma in a 68-year old man, in whom renal tumor was identified during his regular examination due to past colon cancer. The disease was asymptomatic. The patient had elective laparoscopic nephrectomy. At pathological assessment, the tumor looked like a follicular thyroid neoplasm. Immunohistochemistry revealed no expression of RCC, TTF-1, thyroglobulin, CD-10, synaptophysin, and chromogranin A. The differential diagnosis included metastatic primary thyroid malignancy as the most probable diagnosis, as well as highly differentiated neuroendocrine tumor and the so-called “thyroid kidney” that might occur in long-standing chronic pyelonephritis. Conclusion: The case of primary follicular renal carcinoma illustrates that this rare renal tumor is heterogeneous both in its structure and tumor cell immunophenotypes. Longer follow-up and accumulation of larger numbers of the disease is needed. This would allow for a more objective assessment of its prevalence in the population, of its clinical characteristics and morphological variability.

Prostate cancer (Pca) is the most common urogenital tumour in men. The most common histological form of prostate cancer is acinar adenocarcinoma. Rare morphological types of prostate cancer present an urgent clinical problem due to their aggressive course and the lack of rigorous standards for the management of such patients. Squamous and combined adenosquamous (ASC) prostate cancers are extremely rare histological forms of Pca, occurring in 0.5–1% of cases. The age of patients with these conditions varies from 52 to 79 years. Squamous cell and ASC cancers are among the most aggressive morphological types of prostate cancer. By the time of the diagnosis, most patients develop distant metastases, which are frequently localized in the lymph nodes and bones. In tumours of such a morphological structure, bone metastases are of osteolytic nature. The prognosis is unfavourable due to the rapid metastasis and development of the malignant process. The survival rate of patients averages 16 months after combined treatment. Only 20% of the patients with distant metastases at the time of diagnosis live longer than 6 months. In most cases, squamous cell Pca manifests itself through local symptoms, such as dysuria, bone pain and hematuria. The vast majority of patients have a normal level of prostate-specific antigen (PSA) in serum. Since ASC Pca is a fairly rare form of prostate cancer, no treatment standards have thus far been developed. Hormone therapy, chemotherapy and radiation therapy are believed to either be ineffective or show low efficacy in the treatment of ASC Pca. In cases where ASC Pca is localized, surgical treatment in the amount of radical prostatectomy, cystoprostatectomy or simultaneous surgical interventions with rectal resection can significantly extend the life of such patients. The article presents the clinical case of managing a patient with ASC Pca.

The study objective is to demonstrate the difficulties associated with treatment of HPV-negative oropharyngeal cancer.Material and methods. A 52-year-old male patient visited a doctor in P.A. Herzen Moscow Oncology Research Institute in January 2017 with complaints of pain in the right part of the oropharynx irradiating to the right ear and difficulties with swallowing food and liquids. The patient was diagnosed with stage IVA oropharyngeal cancer (cT3N2bM0).Results. The patient underwent a course chemoradiotherapy (CRT); as a result, the tumor in the area of the right tonsil became indeterminable 2 weeks later. Three months after completing the course of CRT, the patient underwent modified radical right-sided lymph node dissection. Histological examination revealed metastases from poorly differentiated squamous cell carcinoma in 3 lymph nodes (LNs) with an invasion into adjacent adipose tissue. In October 2017, we received a histological confirmation of ongoing tumor growth in the area of the tongue root and LN metastases in the left side of the neck (yrpT4aN2cM0). We performed resection of the mandible, tongue, soft tissues of the oral floor, and right side of the oropharynx with installation of an oropharyngeal stoma, extended radical left-sided neck lym-phadenectomy with excision of soft tissues (levels I—V), defect repair using an autologous pectoral musculocutaneous flap, and tracheostomy. In March 2018, the patient was found to have continuing tumor growth in the area of the epiglottis and floor of the oral cavity. The patient underwent laryngectomy with oropharyngeal resection and end tracheostomy. In July 2018, we again received a histological confirmation of tumor growth in soft tissues of the anterior neck. We performed resection of the tumor and soft tissues with subsequent plastic reconstruction of the defect. In October 2018, the patient presented with multiple metastases in both lungs. He received a course of immune therapy. Positron emission tomography revealed neoplastic foci with pathological metabolic activity in the area of the alveolar process of the mandible (left side), soft tissues of the neck, lungs, left-sided axillary LNs, and mediastinal LNs. It was decided to continue immune therapy.Conclusion. HPV-negative oropharyngeal cancer requires an optimized treatment algorithm and, possibly, more aggressive therapeutic measures, such as increased radiation doses. Both overall management strategy and recommended standard scheme of CRT should be revised; the role of surgical and chemotherapeutic components of treatment should also be reassessed. We believe that surgical intervention should be considered regardless of the effect of radiation therapy, while the duration of follow-up after CRT should be reduced.

Purpose. Comparative analysis of the diagnostic value of traditional cytology (TC) and liquid cytology (LC) in the identi­fication of cervical intraepithelial neoplasia (CIN) and cervical cancer (CC).Patients and methots. The study included 87 women aged 18 to 80 years. All women were referred with suspicion of CIN, or underwent a control cytological examination after treatment for CIN and cervical cancer. Smears were taken sep­arately from ecto-, endocervix and mixed. Various tools were used (trowel, brushes type D, F and Cervex-Brush Combi). Each patient was sampled at the same time by different types of instruments. All surveyed women were performed at the same time traditional and fluid cytology. Liquid preparations were prepared using SurePath™ technology (BD and Company, Netherlands, USA) and E‑Prep (Biodyne, South Korea). Traditional cytological preparations were stained ac­cording to the Pappenheim method, liquid preparations — by Papanicolaou. A comparative analysis of cytological and histological findings was carried out.Results. According to our data, the number of non-informative material practically coincides in the shopping center and in the LC, from the instruments used the best results were obtained when using a cytobrush of type D and a wood­en spatula. The frequency of detection of CIN squamous epithelium in the LC is somewhat less than in the shopping center (60% vs. 62%). This is due to the lack of experience in evaluating the life cycle drugs. Despite the fact that the overall frequency of CIN detection is somewhat lower in the LC than in the TC, the frequency of detection of high grade squamous intraepithelial lesion (HSIL) is higher in the LC (51% versus 46%). This is due to the fact that cellular elements are concentrated in a limited area and single small HSIL complexes that are missed in the shopping center are better detected in the LC. The sensitivity of the TC smear from the cervix was 96.2%, life cycle — 92.4%. The accuracy of the shopping center is 92%, the life cycle is 89.6%.Conclusion. LC is an alternative to traditional cytological examination in order to detect pretumor diseases and cervical cancer. For an objective assessment of liquid preparations, additional training of cytologists is necessary.

In the structure of oncological morbidity of the upper respiratory tract, malignant tumors of the larynx, including tumors of mesenchymal origin, are the most common. From 1959 to 2013, 55 cases of laryngeal leiomyosarcoma were described in scientific literature. Rarity of this localization of the tumor was the reason for publication of a clinical observation of a patient with endophytic tumor of the right vocal fold.Differential diagnosis for myofibro-, fibro-, and leiomyosarcoma was conducted. Based on immunohistological examination, well-differentiated laryngeal leiomyosarcoma was diagnosed.

The main treatment for cervical cancer are surgery, radiation and combined (surgery + radiotherapy), the role of chemotherapy in this localization is studied less fully. In recent years the new possibilities of chemotherapy, including neoadjuvant intraarterial chemotherapy, are explored. Theoretical prerequisites for this are the best drug delivery to the tumor by blood vessels, undamaged due to radiation therapy and surgery. This paper describes a clinical case of a patient with primary inoperable cervical cancer. As an alternative to preoperativ e radiotherapy the patient was proposed neoadjuv ant com bination chemotherapy with the use of regional administration of platinum drugs and systemic administration of drugs of taxan series as a stage of preparation for further surgical treatment. According to the prevalence of the tumor process patient underwent 2 courses of neoadjuv ant chemotherapy by a method of superselective intra-arterial administration of cisplatin and paclitaxel intravenously. According to a comprehensive examination after treatment data for the presence of tumor was absent. During the second stage the patient underwent surgical treatment in the volume of nerve-sparing radical hysterectomy with appendages. The next step, according to the histological form of the tumor, stage of disease, was the radiotherapy in the postoperative period on the pelv ic area and routes of lym ph drainage. The patient underwent external beam radiotherapy to the pelvic area of FD = 20 Gr, intracavitary gamma-therapy and external beam radiation on the area of parametrial and lymphopenia FD = 50 Gr.The patient passed the control examinations every 3 months. According to a comprehensive survey a year after the start of treatment — there is no data for the presence of recurrence and spread of tumor process.

Background. Papillary thyroid carcinoma (PTC) accounts for 80 % of all well-differentiated thyroid cancers. Mutation of the BRAF gene (V600E) is one of the most common prognostic factors for PTC. Various studies showed different degree of correlation between BRAF (V600E) mutation and other prognostic factors.Materials and methods. 60 patients with PTC treated in P.A. Herzen Moscow Oncology Research Institute during 2014–2016 were included in this prospective study. Selection of patients was based on the results of fine-needle aspiration biopsy and polymerase chain reaction. Study participants were randomized into 2 groups: the first one included 45 patients harboring BRAF V600E mutation, the second one included 15 patients who lack this mutation. The following prognostic factors were evaluated in postoperative period: histological subtype of PTC, tumor invasion into the capsule of thyroid gland, multicentricity, presence of metastases in regional lymph nodes and distant metastases, TNM stage. Statistical data analysis was carried out using GraphPad Prism software.Results. Papillary thyroid cancer was diagnosed in 40 % of the patients, follicular thyroid cancer – in 60 % in both groups. Tumor invasion into the capsule of thyroid gland was identified in 88 and 40 % of the cases in the first and second group respectively; thyroid capsular invasion – in 26 and 10 %; multicentricity – in 20 and 10 %; microcarcinomas (0.3–1.0 cm) – in 57 and 60 %, metastasis to regional lymph nodes – in 40 and 30 %. 51 % of the patients in the first group were found to have pT1 thyroid cancer with tumor capsular invasion without spreading beyond. After surgical treatment 23 % of the patients from the first group had changes in tumor stage from cT1–2 to pT3 according to routine histological examination results. Distant metastases were observed in 5 % of the cases in the first group and in 10 % in the second group. We found a statistically significant association between BRAF (V600E) mutation and tumor invasion into the capsule of thyroid gland (p < 0.05). At the same time neither multicentricity nor metastases in regional lymph nodes were associated with BRAF-mutation (p > 0.05). Conclusions. BRAF mutation in patients with PTC is associated with tumor invasion into the capsule of thyroid gland; this should imply the use of more aggressive treatment strategy (surgery). Further studies are needed to clarify the existing data.

The article tells about the evolution in the development of endoscopic diagnostic methods for early central lung cancer, from rigid bronchoscopes to modern high-resolution video endoscopes. The current multimodal diagnostic methods are described, including the recent data on the use of confocal laser endomicroscopy and endocytoscopy which allow to detect lesions caused by intramucosal cancer in the tracheobronchial tree as well as to study the cellular-level morphology in vivo. Long-term clinical experience of the P.A. Herzen Moscow Oncology Research Institute in the diagnosis of central lung cancer is presented.

The article describes the historical background of the first described case of detection of solitary fibrous tumor of the pleura, reflects the principles of clinical, instrumental and morphological diagnosis. Presented clinical case of successful surgical treatment of recurrent solitary fibrous tumor of the pleura after previously performed lung resection for water intended metastatic breast cancer.

Androgenic pathway plays a pivotal role in the development of benign and malignant prostate tumors. Most of the prostate neoplasms are hormone-dependent at the time of diagnosis. Therapeutic interventions aimed at reducing the level of testosterone in the blood allow to stop progression of the disease. But over time, the tumor almost inevitably starts to progress, moving in the castration-resistant state (CRPC), representing a serious problem of oncourology. In recent years, the possibility of CRRPC therapy increased significantly – there was developed a number of new drugs that effectively inhibit the development of castration-resistant tumors and significantly push back the start of chemotherapy. This review describes the major drug targets and mechanisms of action of abiraterone, enzalutamide, galeterone, VT-464 and other approved and promising CRPC therapies.

The results of 4-year clinical follow-up in the patient with obstructive inoperable retropericardial esophageal cancer are represented. According to cardiac co-morbidity (myocardial infarction, postinfarction cardiosclerosis) the palliative care for patient was managed. To preserve patency of esophagus multiple courses of endoscopic photodynamic therapy by means of the approach developed in P.A. Herzen MCRI were performed. From 2011 to 2014 thirteen courses of photodynamic therapy with photosens were conducted. The patient was under follow-up for 4 years and 3 months to his death in 2015. For follow-up period the patient had oral feeding with no signs of dysphagia, not significant weight loss and with good quality of life.

Breast cancer (BC) ranks first in the pattern of female malignancies (20.7 %) and remains the top cancer among women. Paget’s disease (PD) is a rare BC form that occurs in the orifice of the lactiferous tubes and that is characterized by involvement of the nipple, large ducts, often to form a lump in the breast; this rare abnormality is encountered in 0.5–5 % of all BC cases. PD has a number of peculiarities. According to different authors, PD is attended with invasive or noninvasive BC in most cases (90–98 %). The involvement is commonly multifocal. PD has a very high risk for a lump (100 and 96 % for palpable and nonpalpable breast tumors, respectively). Almost 50 % of these patients have palpable breast lumps. Despite the fact that the course of PD has its peculiarities because of the rarity of this abnormality, the approaches to its treatment are not different from those in other histopathological types of BC. As for the surgical treatment of PD, until the present time there have been many unsolved problems that remain a matter of debate. The surgical treatment of PD does not differ from the treatment of BC and is primarily determined by disease stage and tumor subtype. The volume of operations for PD varies: from Madden’s radical mastectomy to lumpectomy and sentinel lymph node biopsy. It should be kept in mind that besides nipple-areole complex involvement, invasive or noninvasive BC is often detected in PD. Organ-sparing surgery for PD is mainly a method of rehabilitation for patients. Whether organsparing surgery can be performed is also determined by breast size. Oncoplaplastic resections may be carried out for PD. If the patient wishes to preserve her breast, the range of both single-stage and delayed reconstructive operations is wide. The assessment of the biological features of a tumor and the more differentiated approach to therapy in this cohort of patents might improve considerable survival rates; the determination of indications for organ-sparing treatment is to improve quality of life in patients and their rehabilitation.

Sarcomas in the head and neck are rare, and account for approximately 5-15% of all sarcomas in adults, is less than 1% of all neoplasms of the head and neck. Due to anatomical and physiological features of the structure of the nasopharynx, surgical treatment of tumors of this localization is associated with a number of technical difficulties, the high risk of non-radical removal of the tumor, it was therefore necessary for adequate surgical access. The article describes video-assisted access for removal of tumors of the nasopharynx with good visualization of the tumor process simultaneously after laryngectomy with the formation of pharyngotomy, providing the opportunity to monitor the postoperative area of the nasopharynx and early detection of continued tumor growth in patients with soft tissue sarcoma of the nasopharynx and combined lesions of the larynx.