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Background. More than 80 % of cases ovarian cancer are detected at stage III–IV. One of the most important predictive factors is the cytoreductive surgery without residual tumor. Aim. To determine the selection criteria for cytoreductive surgery in the advanced ovarian cancer patients. Materials and methods. The study included 190 primary IIB–IV stage ovarian cancer patients who underwent surgical treatment in the oncogynecological department of the N. N. Petrov NMRC on Oncology in the period from August 2017 to August 2020. All patients underwent pelvic magnetic resonance imaging, chest and abdominal computed tomography, and diagnostic laparoscopy. Assessment of the peritoneal carcinomatosis index (PCI) was performed according to P. Sugarbaker. The outcome of cytoreductive surgery was determined by the size of the residual tumor: complete – without a macroscopically detectable tumor, optimal – residual tumor ≤1 cm, suboptimal – residual tumor ≥1 cm. Results. The complete or optimal cytoreduction achieved in 72.6 % of cases (48.9 % (93 / 190) and 23.7 % (45 / 190), respectively), suboptimal in 22 % (42 / 190) of cases, 5 % (10 / 190) only a diagnostic laparoscopy due to the initial underestimation of the tumor dissemination. In the entire sample PCI value ranged from 0 to 35 points, the median was 4 points (2; 11). In the group of optimal cytoreductions PCI ranged from 0 to 19 points, median – 3 points (2; 6), in the group of suboptimal from 5 to 35 points, median – 19.5 points (15; 23) (p < 0.0001, Mann–Whitney test). No optimal cytoreduction was performed in PCI >20 points. The optimal cut-off PCI point was 9.5 points (sensitivity 92.1 %, specificity 86.2 %, overall accuracy 87.4 %), if PCI ≤ 9 points – the operation will be hypothetically optimal, if PCI ≥ 10 then hypothetically suboptimal. The main cause of non-optimal interventions (n = 52) were: diffuse carcinomatosis of the small bowel and its mesentery – 73 % (38 / 52), carcinomatosis of the hepatoduodenal zone – 9 % (5 / 52) and a total of 16 % (9 / 52) were other non-resectable tumors (paraaortal, intrathoracic lymph nodes, invasion of the pancreas or pleura, lung metastases). Radiation diagnostic and intraoperative revision were comparable in 60.5 % (115 / 190) of cases. The sensitivity of radiological diagnostic methods in detecting of the small intestine lesions was 23.7 %, the specificity was 90 %, while for laparoscopic diagnostics, the sensitivity in detecting of the small intestine lesions was 93.3 %, and the specificity was 100 %. In assessing of carcinomatosis of the hepatoduodenal zone, the advantage belongs to radiation diagnostic methods: the sensitivity of computed tomography was 66.7 %, the specificity was 97 %, while the sensitivity of diagnostic laparoscopy was 0 %. Conclusions. Determination of a high score in assessing the index of peritoneal carcinomatosis, detection of damage to the hepatoduodenal zone, diagnosed mainly by radiation imaging methods, detection of diffuse lesions of the small intestine, determined mainly by laparoscopic diagnosis reduces the frequency of suboptimal cytoreductive operations from 67 % to 13 %.

Objective: to assess the efficacy of fluorescence sentinel lymph node (SLN) detection with indocyanine green (ICG) in patients with cervical cancer.Materials and methods. We analyzed the results of examination and treatment in 80 patients with morphologically verified stage IA1–IIA1 cervical cancer. All patients underwent laparoscopic surgery with fluorescence SLN detection with ICG using a high-resolution infrared camera.Results. SLNs were detected in 78 out of 80 patients (97.5 %); the rate of bilateral SLN detection was 80.0 % (64 out of 80). SLNs were not identified in 2 patients only (2.5 %). The majority of SLNs (99 out of 176; 56.28 %) were located in the internal group of lymph nodes, near to the common iliac artery bifurcation. Eleven out of 80 patients (13.75 %) were found to have pelvic lymph node metastasis. SLN metastatic lesions were observed in 10 out of 80 patients (12.5 %), whereas only one participant had non-SLN metastasis. Therefore, the sensitivity of the fluorescence method with ICG was 98.75 %.Conclusion. Fluorescence SLN mapping with ICG in patients with stage IA1–IIA1 cervical cancer is an effective diagnostic method allowing SLN topical diagnosis, intraoperative restaging, and correction of the treatment strategy.

Surgery remains the main method of treatment for endometrial cancer (EC). Treatment of elderly and senile patients is particularly difficult due to the high prevalence of comorbidities in this population and large number of intraand postoperative complications that can potentially occur. The article compares laparoscopic and laparotomic approaches in surgical treatment of patients with EC. We analyzed clinical and morphological features of EC, characteristics of intraoperative and postoperative periods, complications and long-term treatment outcomes in patients treated at the N.N. Petrov Research Institute of Oncology.

Introduction. The main method of treatment of endometrial cancer, the most common oncological disease, is surgery. Introduction of high-tech operations into gynecological practice promoted active use of laparoscopy in treatment of malignant tumors of the endometrium.Objective. To evaluate effectiveness of video endoscopic surgery in treatment of endometrial cancer.Materials and methods. In the period from 2010 to 2016, 1127 patients with endometrial cancer underwent surgery using video endoscopic complex with high resolution cameras at the N.N. Petrov National Medical Research Oncology Center, Ministry of Health of Russia.Results. Using video endoscopic technology, excision of the uterus with appendages was performed in 588 (52.3 %) patients, excision of the uterus with appendages and pelvic lymph node dissection was performed in 523 (46.4 %) patients including 16 (1.4 %) patients with serous and papillary serous forms of endometrial cancer who also underwent omentectomy. No intraoperative complications were observed. In the majority of patients, postoperative period was characterized by early activization, satisfactory intestinal peristalsis on day 1, minimal complications, absence of contraindications for adjuvant beam therapy.Conclusion. Video endoscopic technology is a modern method of surgical treatment allowing to perform the full scope of planned radical surgical intervention in patients with endometrial cancer irrespectively of age and concomitant disorders with minimal traumatization, risk of intraand postoperative complications as well as favorable and fast rehabilitation period.