Vol 16, No 1 (2011)

The paper analyzes synchronous polyneoplasias in radically operated patients with gastric cancer, which were detected in 2.9% of cases, including 7.3% among the patients with early gastric cancer. Among second tumors, there was a preponderance of neoplasms of the colon, urinary bladder, throat, lung, and kidney. Preoperative examination of patients with gastric cancer should exclude synchronous tumors of the most common sites. Conversely, gastroscopy should be included in a diagnostic algorithm for patients with the above neoplasms to exclude gastric cancer. Synchronous multiplicity of the disease is shown to be a contraindication to the radical treatment of each neoplasm. If reasonably effective palliative therapy for a second tumor can be performed during its generalizations, radical surgical treatment for gastric cancer is warranted. If there are technical feasibilities and the patient's functional status is adequate, simultaneous removal of both tumors is the method of choice. Radical treatment for synchronous tumors ensures high survival rates. In this patient category, the cardinal cause of death is second tumor progression, which is associated with the predominance of early gastric cancer.

The authors studied the results of reconstructive-plastic and combined operations when neoadjuvant systemic anti-tumor treatment and intraoperative radiotherapy were performed in patients with locally advanced non-small cell lung cancer. Additional chemoradiation was found to have no substantial impact on its postoperative course, to reduce the number of patients with disease progression, and to increase relapse-free and overall survival.

Leiomyosarcoma of the corpus uteri is a rare malignancy that is difficult in diagnosis, randomization, and pathomorphological assessment of prognostic criteria. The authors estimated the prognostic value of determining the degree of malignancy of soft tissue tumors by the FNCLCC system in relation to Ag-NOR proteins and Ki-67. The findings indicated that the degree of malignancy was of the greatest prognostic value and an independent criteria for 10-year survival (χ2 = 18.9). A slightly less, but statistical significance was shown by Ki-67 expression (χ2 = 9.8) and the number of Ag-NOR proteins (χ2 = 13.4).

Postoperative thromboembolic and hemorrhagic complications (TEC and HC) were analyzed in 300 cancer surgical patients of a different profile in the same period of time, by assessing multiple risk factors and their prognostic value. There was a preponderance of postoperative HC (5%) over TEC (3%); the patients who received anticoagulant prevention (ACP) developed HC by twice more frequently than those who did not. In different periods after surgery the patients, including ACP-receiving ones, developed TEC: deep vein thrombosis of the lower extremity on days 7-20 mainly after operations on abdominal and small pelvic organs, pulmonary artery thromboembolism on days 1-7 after thoracoabdominal operations. HO was prevalent in patients who had undergone removal of tumors of the head and neck in the complete absence of TEC. All complications were abolished without any fatal outcomes. The authors show it necessary to apply a differential approach to using ACP before extensive cancer operations (including those in patients at risk for thrombus), by taking into account the risk for high intraoperative blood loss and postoperative hemorrhage in the presence of large wound surfaces and posthemorrhagic and drug-induced hypocoagulation. It is expedient to develop an algorithm for the management of cancer surgical patients of a different profile, which provides the prevention of not only TEC, but also HC.

Prostate cancer (PC) was 5% of all revealed male malignancies in the Russian Federation in 2009. Among 23845 detected patients with PC, 53.4% had its Stage III or IV. This paper gives the results of a follow-up of patients with locally advanced and generalized PC treated by different hormonal therapy regimens. The purpose of the study was to search for the optimal hormonal therapy regimen, by maintaining the quality of life, whose criteria were potency level, libido, and normal physical activity. The follow-up data may lead to the conclusion that the 6-month use of luteinizing hormone-releasing hormone (LHRH) agonists causes an irreversible reduction in potency and libido and a considerable decrease in testosterone levels. Sustained-release LHRH agonists decrease testosterone levels (below 20 ng/dl), are an easy-to-use and simple dosage form, and may be recommended for outpatient administration.

The paper describes a rare localization of non-small cell lung cancer with solitary metastasis to the large intestine wall. The authors recommend active surgical policy for solitary metastases since it prolongs life for patients.

The review provides information on the role of antiangiogenic therapy for glioblastoma multiforme. Bevacizumab in combination with irinotecan allows tumor growth to be controlled in the majority of patients. Thalidomide may be an alternative to bevacizumab although its efficacy requires further investigations and confirmation. The activity of tyrosine kinase VEGRF inhibitors in monotherapy for glioblastoma is minimal; in this connection their combinations with standard chemoradiotherapy is being studied. Certain hopes are pinned on the new group of drugs - integrin receptor inhibitors.