Vol 15, No 5 (2010)

The paper analyzes the results of surgical treatment in 85 patients with malignant liver tumors. According to the nature of a tumor process, all the patients were divided into two group: 1) 16 (18.8%) patients with hepatocellular carcinoma (HCC) and 2) 69 (81.9%) with colorectal cancer liver metastases (CCLM). The staging distribution of patients was as follows: 1) (TNM) 7 (43.7%) patients with Stages II-III and 9 (56.3%) with Stage IVA; 2) mTNM) 1 (1.4%) patient with Stage I, 12 (17.4%) with Stage II, 15 (21.7%) with Stage III, and 31 (44.9%) with Stage IVA, and 10 (14.5%) with Stage IVB. Choice of a resection mode was determined by the clinical and pathological factors of a tumor and the functional reserve of the liver. Extended hemihepatectomy (EHH) was carried out in 6 patients with HCC; hemihepatectomy (HH) in 2; bisegmentectomy in 2, and segmentectomy in 1; nonanatomic resections in 4; a combination of anatomic and non-anatomic resections in 1. Fifty-three (77%) and 7 (10%) patients with CCLM underwent anatomic and anatomic resections, respectively; a combination of both resection modes was performed in 9 (13%0 cases. According to the volume of anatomic resection, the patient distribution was as follows: EHH in 15 (28%) patients, HH in 21 (40%), bisegmentectomy in 7 (15%), and segmentectomy in 10 (19%). The preoperative risk for hepatic failure was assessed by ultrasonography and a methacetin breath test. No extensive resection was made if the hepatectomy index was less 3.8%. Postoperative complications occurred in 4 patients with HCC. Post-CCLM mortality was 4.3%. In patients with HCC, 5-year survival was 48%; in those with CCLM, 5-year overall and relapse-free survival were 35.1 and 22.4%, respectively.

The authors present the immediate and long-term results of atypical hepatectomies carried out in 124 patients for colorectal cancer metastases in 1999 to June 2009. Hepatectomies were performed using radiofrequency (RF) devices in 32 patients and electric, ultrasonic, and argon-beam coagulations in 92. Combined operations in the volume of resection of different portions of the colorectum and hepatectomy were made in 112 patients; hepatectomies for metachronic metastases were carried out in 12. Hepatectomies using RF devices versus conventional hepatectomy reduce intraoperative blood loss, the time of resection, and the incidence of complications. Three-year survival rates in the patients who had undergone RF-assisted hepatectomies are comparable with those in the patients who had conventional atypical hepatectomies.

The results of treatment are analyzed in 48 patients (22 boys and 26 girls; mean age 10.5±3.7 years) with synovial sarcoma at various sites. The patients were divided into 2 groups matched for gender, age, the site and extent of the process, TNM stage, and a history of recurrences. These were a study group (n = 19) and a control one (n = 29). All the patients received multimodality treatment. The study group was treated by the regimen: multidrug therapy (vepesid, cyclophosphanum, and carboplatin as 4 to 8 courses; radiotherapy to a primary focus in a cumulative focal dose (CFD) of 45-50 Gy; if indicated, large-field radiation of the lung in a CFD of 12 Gy; organ-sparing surgery. Subtransplantation doses of autologous peripheral blood stem cells were reinfused in all the patients. In the study group patients, 2-year overall and relapse-free survival rates were 75.6±10.6 and 66.1±11.3%, respectively.

The antiviral efficiency of photodynamic therapy (PDT) was studied in 54 women infected with high-oncogenic human papillomavirus (HPV) DNA genotypes: 8 patients with moderate dysplasia (Group 1), 32 with severe dysplasia (Group 2); 14 with carcinoma in situ (Group 3). Types 16, 18 of HPV DNA were identified in virtually two thirds of cases or their combination with other high-oncogenic genotypes (31, 33, 35, 45, 58) were noted. A multiplex, quantitative, real-time polymerase chain reaction (PCR) assay was made. PDT used the photosensitizer Photosens. A follow-up lasted 3 months to 1 year. The antiviral efficiency of PDT was evaluated, by comparatively analyzing the results of the multiplex real-time PCR performed before PDT and 3, 6, and 12 months after treatment. Complete eradication of HPV was achieved in 4 women with the low clinically significant amount of virus and in 10 with a clinically significant viral load. There was a complete antiviral effect in 21 of the 36 patients with a higher viral load and a low clinically significant amount of virus in the others. Therefore, PDT has not only antitumor activity, but also a pronounced antiviral effect.

The paper presents the results of using thermography to diagnose pigmented nevi and to define a surgical scope.

The paper analyzes two cases demonstrating that remote radiotherapy and chemotherapy may be used in the medical treatment of desmoid tumors of the chest.

The paper gives an update on the causes of neuropathic pain, the specific features of its pathogenesis during malignancies, epidemiological data on the prevalence of neuropathic pain in cancer patients in our country, its classifications and details the causes of its occurrence during antitumor treatment, in the generalization of the tumor process, and in systemic metabolic disturbances.