Vol 16, No 6 (2011)

The paper describes the experience in treating 389 breast cancer patients undergoing organ-sparing operations with and without plastic surgery. Both the patients' tissues and their combination with a silicone endoprosthesis were used for repair. The specific features of a recurrence were analyzed after organ-sparing surgery depending on the stage, treatment method (surgical or combination) and histogenesis of a tumor.

The paper analyzes the immediate and early results of surgical treatment in 266 patients with breast cancer. To prevent postoperative complications, new intraoperative methods were used. These include air plasma currents; plasty of the axillary region with a flap from the broadest spinal muscle; lymph vessel ligation in the axillary-subclavian-subscapular region, by using microsurgical magnifiers; plasty of the axillary-subclavian-subcapular region with a composition of anterior pectoral muscles. The application of the new methods reduces postoperative lymphorrhea from 43.8 to 98.5%; a drain-free procedure of radical mastectomy accelerates and improves rehabilitation in patients with breast cancer and contributes to reductions in postoperative bed-days and in the financial cost of health care facilities.

The effect of cisplatin on the effectiveness of photodynamic therapy (PDT) was experimentally studied using leukemia P-388 as a tumor growth model. Treatment was initiated in the presence of a disseminated tumor process. Photosens was administered once in dose of 5 mg/kg on day 5 of tumor growth; PDT was made 24 hours after administration of the sensitizer. Cisplatin was given once in a dose of 7 mg/kg 48, 24, 2, and 0.25 hours before PDT concurrently with the start of radiation or 0.25, 2 or 24 hours after it. A local antitumor effect was judged from the suppression of growth in a primary (irradiated) tumor focus; a systemic effect was from the increased lifespan of mice. The local effect of combination treatment during its all used regimens was higher than that of PDT or chemotherapy (CT) alone. The efficiency of systemic CT in during combination treatment versus its individual components was increased only when the cytostatic was injected prior to PDT.

The clinical picture of abdominal tuberculosis that manifests as cancer masks was studied. Forty of 136 patients were examined. Abdominal tuberculosis was multiorgan in all the examinees and concurrent with pulmonary tuberculosis in 35% of cases. The symptoms of abdominal tuberculosis mimicked primary and metastatic tumor processes in the abdominal organs and less frequently blood cancers. Despite the similarity of the clinical manifestations of cancers and tuberculosis, in favor of abdominal tuberculosis are signs, such as prior family contacts with patients with tuberculosis (12.5%), tuberculosis-infected and prior tuberculosis (40%), infectious fever, lymphopenia in the presence of inflammation markers, the presence of calcifications in the liver, spleen (17.5%) and intraabdominal lymph nodes (25%) and a fourth of cases showed a hyperergic response to the Mantoux test with tuberculin 2 TU.

The paper considers the organizational and methodic issues of establishing a Federal Cancer Registry in Russia. A normative and legal base of the registry has been set up; a computer program for the automated system of the register has been elaborated. This program has received approval from the International Agency for Research on Cancer as it meets international standards. The cancer registry has two levels: regional and federal ones. This program has been introduced regionally in 62 areas of the Russian Federation. Its other 21 regions, organizational work is under way to convert a database into single standard. The data base of regional registries is used to monitor the implementation of measures to improve medical care to cancer patients. The Cancer Registry program is drawn up as a module and, if needed, may be augmented by additional information. This registry gives not only descriptive epidemiological data (morbidity, prevalence, morbidity, survival), but also qualitative on-line information on a wide range of important problems in the functioning of both a branch as a whole and its individual areas. It provides a way of obtaining valid information on used diagnostic methods, the efficiency of standard and newly developed treatment options, such as surgical, radiation, drug, and combination ones.

The overview deals with methods for evaluating the functional state of the hepatic parenchyma in patients with colorectal cancer while planning surgical treatment for liver metastases. The intact hepatic parenchyma should be estimated to reduce the risk of postoperative complications and mortality. Noninvasive diagnostic techniques fail to provide an objective assessment. Only a morphological study of parenchymal biopsy specimens will help rule out hepatic steatosis/ fibrosis and give surgeons information on the postresection liver remnant.