Vol 20, No 6 (2015)

The incidence of melanoma in the world has been growing steadily. In recent years, more attention is paid to the biological profile of melanoma that affects disease-free and overall survival, and, respectively, prognosis of the disease. Today the world medicine has a number of drugs which target biological functions of the tumor. Having an arsenal of analysis of biological characteristics of melanoma will soon start developing individual prognosis and possible treatment options for an individual patient and the population as a whole, i.e. to personalize therapy. The purpose of the study - to analyze the results of disease-free survival in patients with locally advanced melanoma taking into account tumor biological characteristics of the Krasnodar region. Methods. Histological analysis of postoperative material and evaluation of B-RAF mutation and Ki67 marker in patients with melanoma who received surgical treatment in 2013. Results. The data of biological characteristics of tumors in patients after surgical treatment with skin melanoma I-IV stage at the Department of Surgery of skin tumors and soft tissue in 2013 analysis found that the incidence of MK was detected more frequently in the female population of the working age group. The level of Ki-67 mutation showed no correlation with the age, sex and disease stage. BRAF-mutation detection was high that led to reduction of disease-free survival compared to patients who had no mutations, with the greatest number of mutations in gene BRAFV600 in the older age group.

The article presents the results of application vascularized fascio-cutaneous flaps to replace partial and circular defects of the pharynx and cervical esophagus in patients with recurrent cancer of the larynx and hypopharynx. For a long time gastroepiploic flap, fragments of small and large intestine were usedfor restoring continuity of the pharynx, however, since high morbidity radiation and anterio-lateral thigh flaps are more justified to be used.

The article presents issues of diagnosis, course of disease, results of target therapy and surgery of a patient with metastatic melanoma Material and methods. Patient B., aged 19, referred to the department of tumors of the skin and soft tissues of COD № 1MOH KR with complaints on painful tumors in soft tissues of the body, right thigh and left inguinal area. On the basis of the examination she was diagnosed skin metastatic melanoma with multiple soft tissue lesions in the body, right thigh, left inguinal area and left ovary. The patient had surgical treatment: left laparoscopic adnexectomy, left inguinal-femoral lymphadenectomy, surgical excision of multiple soft tissue tumors in the body and right thigh. Results. We achieved a partial response to vemurafenib in the patient that allowed further surgical treatment. The postsurgical period was rather tolerable; the patient was discharged from the hospital under the surveillance of a cancer specialist near her place of residence.

We analyzed special features of re-recognized disability due to cancer in adults in the Russian Federation in 2005-2014. We studied the absolute number, the level, and the age structure of the persons re-recognized as disabled. We determined the proportion of the re-recognized disability due to cancer among all the people re-recognized as disabled because of other disease types. Re-recognized disability due to cancer increased in the Russian Federation. However, the level of the disability among young and middle-aged population decreased, whereas it increased in retirement-age people. The level of the re-recognized disability in this age group of the adult Russian Federation people increasedfrom 10.1% to 41.6% per 10 thousands of the relevant population over 10 years (from 2005 to 2014). Malignant tumors ranked second after the blood system diseases as the re-recognized disability cause in the Russian Federation (in 2014).

The analysis of cancer patients’ statistics in the Smolensk region population in 2010-2014 revealed that the sickness (general and primary incidence indices) and the mortality rates are increasing every year. The mortality rate due to cancer in the Smolensk region over 2010-2014 increased by 16%. The proportion of cancer patients under regular medical check-up increased by 11.4% over 2010-2014. Breast cancer patients were the most prevalent in 2010 - 404 persons (12.3%); and patients with skin tumors (excluding melanoma) dominated in 2014 - 550 (14.2%). Gastric cancer was the most frequent cause of mortality due to malignant tumors in 2010 (16.5%); lung, trachea, bronchial tubes cancer - in 2014 (14.6%). The number of the patients who were followed up for 5 years and more from the moment of the diagnosis increased by 4% in the periodfrom 2010 to 2014. Prophylaxis based on cancer susceptibility determination as well as early tumor diagnostics are necessary to decrease these indices.

The review discusses coagulation peculiarities due to cancer that are the pathophysiological basis for choice among low-molecular-weight heparins represented in Russia today.