Voprosy onkologii (Vopr Onkol)

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Other titles Voprosy onkologij
ISSN 0507-3758
OCLC 5692988
Material type Periodical
Document type Journal / Magazine / Newspaper

Publications in this journal

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    ABSTRACT: The role of cytoreductive nephrectomy in the current era of targeted therapy remains unknown. Two prospective randomized phase III trials (CARMENA and SURTIME) atr now opened to evaluate the efficacy of cytoreductive nephrectomy in patients with metastatic renal cell carcinoma. Now we just know well who does not need to undergo such surgery and whom it will be beneficial.
    Voprosy onkologii 08/2015; 61(3):494-8.
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    ABSTRACT: A steady increase of incidence of skin melanoma and soft tissue sarcomas of the extremities currently continues to be observed. Taking into account the high probability of developing of locally disseminated forms of skin melanoma and soft tissue sarcomas of extremities, the need to use combined methods in their treatment is quite high. In the 21st century the possibility of a use of isolated regional chemoperfusion provides a high objective response of tumor to chemotherapy without their systemic impact and improves the quality of life through preservation of the limb. This review contains a description of the currently used drug agents, the results of ongoing clinical research in the world as well as the results of own study.
    Voprosy onkologii 08/2015; 61(3):507-9.
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    ABSTRACT: The use of epidural anesthesia (EA) in 75 patients during abdominal surgery has revealed a number of advantages of EA over endotracheal anesthesia. EA reduces the consumption of analgesics and myorelaxants and the time of postoperative artificial ventilation of lungs as well as offers more qualitative analgesia.
    Voprosy onkologii 08/2015; 61(3):467-70.
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    ABSTRACT: During the period from April 2012 to December 2014 54 patients aged 2976 years, 36 (66.6%) males and 18 (33.4%) females, with esophageal cancer underwent minimally invasive esophagectomy as final phase of treatment. Squamous cell carcinoma was revealed in 50 patients and adenocarcinoma identified in 4 patients. The disease was staged as following: IA--5 (9.3%) patients, IB--11 (20.4%) patients, IIA-- (16,.%) cases, III -- (3,.%) cases, IIII --8 (33,.%), IIII -- (14,8%), III -- (1,.%). 37 (68,.%) patients had surgery after induction chemoradiation therapy. Of 54 surgical interventions there were 20 hybrid and 34 minimally inva-ive operations. 19 (35,.%) patients developed complications, postoperative lethality was 2 (3,.)%. Minimally invasive es-phagectomy meets basic oncological principles and leads to tolerable shortterm results.
    Voprosy onkologii 08/2015; 61(3):376-80.
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    ABSTRACT: The work is devoted to the methods of application of own adipose tissue as a plastic material and presents the summary of the currently known data on the use of transplantation of adipose tissue in order to correct various defects of the body in plastic and reconstructive surgery. There are analyzed theoretical basis for the use of adipose tissue, provided the methods of administration depending on the area of the use, the severity of the defect and its localization. Data on new methods of the use of adipose tissue and own observations are presented. As an example of the effective use there is provided a detailed analysis of the use of adipose tissue transplantation in breast cancer patients who have different area defects after reconstructive surgery.
    Voprosy onkologii 08/2015; 61(3):460-6.
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    ABSTRACT: Despite the modern achievements of different methods of treatment, primarily surgical, with recognized need of standardization of lymphadenectomy D2, gastric cancer still remains one of the most difficult malignant tumors characterized by high rates of one-year mortality and low rates of survival that are far from satisfactory. According to experts such unsatisfactory results are determined by a combination of factors: the characteristics of ill people, their functional status, age characteristics, the prevalence of the disease at diagnosis with the presence of systemic micrometastases, resistance to treatment, etc. Moreover, a factor of resistance to treatment i.e. to existing schemes and methods is mostly a key one that determines low levels of long-term survival.
    Voprosy onkologii 08/2015; 61(3):329-38.
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    ABSTRACT: In recent years there has been rapid growth in the incidence of melanoma. Due to the large number of patients with various pigmented lesions, suspicious for melanoma, requiring differential diagnosis there is an actual problem of excisional biopsy in this group of patients. This review extensively covered approaches to radical surgical treatment of patients with skin melanoma. There are described in detail results of the studies of foreign experts regarding the influence of excisional and incisional biopsy on overall and disease-free survival rates of patients. On a large representative material (1126 patients) there are widely reflected the results of our studies to assess the effect of different surgical approaches to treatment of patients with skin melanoma. At present the authors can not recommend to perform excisional biopsy of patients with primary skin melanoma in oncological practice. Obviously for a final resolution of this problem it is necessary to conduct a multicenter randomized trial.
    Voprosy onkologii 08/2015; 61(3):387-92.
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    ABSTRACT: For the period from September 2010 to September 2014 there were operated 513 patients with endometrial cancer using laparoscopic installation the Karl Storz company. 304 patients (59.2%) underwent hysterectomy with appendages, 209 (40.8%)--hysterectomy with appendages and pelvic lymphadenectomy, including 11 patients (2.2%) with the addition of omentectomy in serous and serous-papillary forms of endometrial cancer. The average age of patients was 58.4 years (44-75 years). Body mass index over 25.0 was determined in 456 patients (88.9%), of whom 183 patients (35.6%) had an excess of body weight, in 159 (31.0%)--obesity of I degree, in 79 (15.5%)--obesity of II degree and in 35 patients (6.8%)--obesity of III degree. There were no reported complications during surgery. The postoperative period in the majority of patients was characterized by the minimal complications and absence of contraindications for adjuvant radiotherapy. During follow-up period there were registered 4 relapses: in 1 patient with serous--papillary form of endometrial cancer during the first year after surgery--in the form of dissemination of tumor in the abdomen and pelvis; in 3 patients--in the form of a cytological detection of glandular cancer cells in vaginal stump. As a result, regardless of age and comorbidities, laparoscopy allows performing to endometrial cancer patients the entire volume of planned radical surgery with minimum damage and with minimal risk of intra- and postoperative complications, favorable and accelerated rehabilitation period.
    Voprosy onkologii 08/2015; 61(3):362-8.
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    ABSTRACT: The paper presents a clinical case of a patient of 29 years old with a diagnosis of cervical cancer sIIA1 stage with the modern therapeutic approach: as a diagnostic and treatment phase there was performed videoendoscopic pelvic lymph node dissection at a 16-week pregnancy, excluded lymphogenous spread of tumor and on the basis of which it was decided to prolong pregnancy, given the strong desire of the patient to keep the baby. At a 19-week and a 23-week pregnancy there were two courses of neoadjuvant chemotherapy and at a 34-week--Cesarean delivery with simultaneous radical hysterectomy and ovarian transposition followed by a course of adjuvant distant radiotherapy. The final diagnosis was as pT2aN0M0. The observation was during 7 months: the patient is alive without recurrence, the child develops without physical and psychomotor abnormalities.
    Voprosy onkologii 08/2015; 61(3):486-93.
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    ABSTRACT: For the period from 2003 to 2014 at the Oncogynecology Department laparoscopic surgery for ovarian cancer was performed in 49 patients aged 19 to 76 years. During the surgical interventions special attention was paid to the principles of oncological radicalism and ablastics, the volume of surgery depended on the extent of tumor process, morphological characteristics of tumor, a patient's age and the desire to preserve reproductive function. In 42 (85.7%) cases laparoscopic procedures were conducted to restaging (after non-radical operations in gynecological hospitals). In all 49 patients a histological form of ovarian tumor corresponded to adenocarcinoma. Mean operative time was 140 ± 10,5 minutes, the average blood loss--80,2 ± 14,3 ml. Postoperative complications (bleeding from the omentum) were recorded in 1 (2%) patient, the need for conversion was occurred in 4 (8.2%) cases due to the adhesive process or signs of dissemination. As a result of laparoscopic surgery an increase in staging of disease was fixed in 14 cases (28.6%). Follow-up median was 45 months, relapses occurred in 5 (10.2%) patients. Of 49 patients 2 (4.1%) died from disease progression. Disease-free and overall survival rates were 89.8% and 95.9%, respectively. Thus, data of world literature and our own experience indicate the potential equivalent of laparoscopic and laparotomy approaches in treatment for early ovarian cancer.
    Voprosy onkologii 08/2015; 61(3):369-75.
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    ABSTRACT: Patients with resectable non-small cell lung cancer have a chance to reach a 5-year survival rates ranging from 70% or more for stage IA and 20% for stage IIIA. These figures have remained stable for the past 20 years. Moreover, the inability to improve long-term outcomes is generally determined by a fatal disease progression due to the emergence of distant metastases or local recurrence often in combination with systemic progression process. Thus the use of chemotherapy both in neoadjuvant and adjuvant regimens has stimulated for a long time the search for the optimal scheme and treatment options. This article presents a critical analysis of the current state of the problem of neoadjuvant and adjuvant chemotherapy as well as chemoradiotherapy in order to optimize the tactics of combined treatment of these groups of patients.
    Voprosy onkologii 08/2015; 61(3):499-506.
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    ABSTRACT: The development of endoscopic techniques of surgery of patients with early gastric cancer (high and moderately differentiated adenocarcinoma) by endoscopic mucosal resection and endoscopic submucosal dissection with regard to their minimally invasion, high efficiency and quality of life after treatment allowed seriously establishing itself and be accepted for use in worldwide.
    Voprosy onkologii 08/2015; 61(3):407-12.
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    ABSTRACT: Sarcoma of the pulmonary artery is a rare tumor. At present the literature describes single cases. However the number of publications increases in recent time due to improved diagnostics. There are appeared papers, which provide a series of observations of surgical treatment for this kind of tumor exceeded more than 10 cases. It can be assumed that today the number of these cases in the literature contains several hundreds. Thus despite the rarity of this tumor there is a certain understanding of the clinical picture of this disease and treatment that we tried to do in this paper being studied the available literature and bringing four of our observation.
    Voprosy onkologii 08/2015; 61(3):452-9.
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    ABSTRACT: There is performed an analysis of treatment outcomes of patients operated in the volume of exenterations for locally advanced cancer of the pelvic organs. During the period from 2006 to 2013 at the Leningrad Regional Oncology Dispensary there were carried out 218 exenterations of the pelvis. Postoperative complications occurred in 68 patients (31.2%), 17 patients died, lethality was 7.8%. The average surgery time was 186 minutes. The average blood loss was 860 ml. In assessing the oncological effectiveness of surgical interventions it was revealed that a 5-year survival rate ranged from 32% in bladder cancer, up to 50% in cervical cancer. Careful selection of patients, multidisciplinary approach to the problem has paramount importance to achieve satisfactory outcomes.
    Voprosy onkologii 08/2015; 61(3):448-51.
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    ABSTRACT: There is analyzed the international and own expenence of using different dyes in the identification of sentinel lymph nodes in oncogynecological practice. There is regarded a possibility of using indocyanine green (ICG) in the detection of sentinel lymph nodes in patients with endometrial and cervical cancer. The first results of the use of ICG at the Oncogynecology Department of the N.N.Petrov Research Institute of Oncology are presented.
    Voprosy onkologii 08/2015; 61(3):471-6.
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    ABSTRACT: The data of literature on possibility of the use of perfusion technologies in combined treatment for malignant tumors of different sites are presented. Possible complications during hyperthermic chemoperfusion are discussed and the effectiveness of this method is analyzed.
    Voprosy onkologii 08/2015; 61(3):477-85.
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    ABSTRACT: There are presented results of photodynamic therapy (PDT) for patients with chemo- and radioresistant intradermal metastases of breast cancer using the matrix light-emitting diodes apparatus. To all patients prior to irradiation there was performed fluorescence diagnostics to assess the accumulation of the photosensitizer of chlorine series and photobleaching during PDT. The size of the irradiation area was 400 sm, the total dose of irradiation was 250J/cm2. PDT was accompanied by mild pain, which was stopped by administration of non-narcotic analgesics. Complete regression of intradermal lesions was registered in 2 of 4 cases, partial response was observed in 1 patient and the progression of the process in 1 case.
    Voprosy onkologii 08/2015; 61(3):430-4.
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    ABSTRACT: In the randomized phase 2 study there was evaluated the efficacy of neoadjuvant endocrine treatment (anastrozole, exemestane) in comparison with chemotherapy (doxorubicini plus paclitaxel). Preoperative endocrine therapy was well tolerated. There was a trend towards higher overall rates of objective response and breast conserving surgery (BCS) among patients with tumors expressing high levels of ER (luminal A) in endocrine therapy group compared with chemotherapy group (43% vs 24%; p = 0,054). In HER2-positive breast cancer patients the addition of trastuzumab to neoadjuvant chemotherapy improved the overall and pathological complete response. Trastuzumab provided increasing a number of breast conserving surgery (23% vs 13%; p = 0,022). No patient treated with trastuzumab with chemotherapy had a local recurrence after BCS.
    Voprosy onkologii 08/2015; 61(3):381-6.
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    ABSTRACT: There are presented results of recently published large multicenter randomized trials on the effectiveness of different adjuvant therapy regimens after gastrectomy D2 in patients with gastric cancer. It is shown that adjuvant chemotherapy as monotherapy by drug S-1 and polychemotherapy by XELOX improves long-term outcomes of patients with stages 2-3. At the same time the intensification of therapy--additional administration of paclitaxel, the combination FOLFIRI scheme with docetaxel and cisplatin--have not led to a significant increase in survival rate. In regard of the advisability of combination of adjuvant chemotherapy and radiotherapy. The data obtained do not allow to make a define conclusion up to date. Promising areas of research is the use of targeted drugs in adjuvant regimen as well as the search for biomarkers to identify patients at high risk of recurrence and to predict the effectiveness of adjuvant therapy.
    Voprosy onkologii 08/2015; 61(3):339-45.
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    ABSTRACT: Radical cystectomy is the standard method for treatment of muscle-invasive and locally advanced bladder cancer. Several less invasive approaches have been suggested recently, including totally laparoscopic radical cystectomy and robotic cystectomy. However despite significant improvements in surgical techniques the overall occurrence of perioperative complications is still high. Analysis of the literature data and comparison of these data with the results of our study was performed with respect to perioperative complications after radical cystectomy and oncological outcomes. In most of the studies, operating time during laparoscopic cystectomy was longer than that of open approach. Despite that, there was no influence of type of surgery on intraoperative complications. Major complication rates were similar between all groups. However laparoscopic cystectomy had lower rate of minor complications compared to open cystectomy. Laparoscopic cystectomy is safe and associated with lower blood loss, decreased postoperative ileus and lower length of stay compared with open radical cystectomy. Laparoscopic surgery for bladder cancer decreased minor complications (mainly due to lower bleeding and gastrointestinal complication rate) and had no impact on major complications. Moreover, if performed following the oncologic principles of open surgery, our results and literature data suggest that LRC is safe and determines non-inferior long-term cancer control compared with open surgery.
    Voprosy onkologii 08/2015; 61(3):352-61.