Introduction. Th e growing incidence of oropharyngeal cancer is driven by an increase in frequency of HPV-associated oropharyngeal cancer. Th e morbidity pattern of oropharyngeal cancer is area-specific.

Aim. To analyze the oropharyngeal cancer diagnosis and treatment in the Republic of Bashkortostan for 2020.

Materials and methods. Th e authors carried out a 2020 retrospective analysis of the diagnosis and treatment results of patients with oropharyngeal cancer. 79 patients were identified with this diagnosis. 84.8% (67/79) among them were males and 15.2% females (12/79). Th e mean age of the patients was 59.1 years. Th e site of primary tumor was on the oropharynx lateral wall in 37.8% cases (30/79), in the tongue root area — 24.1% (19/79), in the tonsils area — 17.7% (14/79), on the soft palate — 16.5% (13/79), on the oropharynx posterior wall — 3.8% (3/79).

Results. Examination of tumor morphological types revealed squamous cell carcinoma (SCC) with various degrees of differentiation in 92.4% cases (73/79), adenocarcinoma of minor salivary gland — in 6.3% (5/79) and sarcoma in 1.2% (1/79). 57.5% of 73 patients with SCC (42/73) underwent protein (p16) immunohistochemistry, while 42.5% of the patients (31/73) did not. According to a surrogate marker for HPV, the following results were obtained for 42 patients: p16-positive in 23.8% cases (10/42), p16-negative in 76.2% (32/42). Stage distribution according to TNM-7: stage I — 11.4% (9/79), stage II — 17.7% (14/79), stage III — 36.7% (29/79), stage IV — 46.8% (37/79). Stage distribution according to TNM-8 (patients who underwent p16 immunohistochemistry): stage I — 11.9% (5/42), stage II — 23.8% (10/42), stage III — 19% (8/42), stage IV — 45.2% (19/42). In 2020, 72% of patients (57/79) received definitive treatment, 10.1% (8/79) — palliative care, 15.2% (12/79) — supportive care, and 2.5% (2/79) refused medical treatment.

Discussion. Th e various types of radiation therapy were used as the main defi nitive treatment for patients with oropharyngeal cancer in 69.2% cases (45/65). Only 18.5% of patients (12/65) underwent surgery, 58.3% of which (7/12) received post-surgery radiation therapy.

Conclusion. 57.5% of patients (42/73) were detected with HPV status, 23.8% (10/42) revealed surrogate markers for HPV association. 69.2% of patients (45/65) received radiation therapy as the definitive treatment. 18.5% of patients (12/65) underwent surgery, 58.3% of which (7/12) received postsurgery radiation therapy.

Introduction. Sentinel node biopsy is the gold standard in the diagnosis of lymph node basin lesions in breast cancer. Although the method has got a long history of its application, some practical issues related to its economic and social advantages and disadvantages remain unresolved.

Aims. To consider the efficiency of approaches to the diagnosis and minimally invasive treatment in breast cancer, following the experience of sentinel node biopsy in Regional Clinical Oncological Hospital, Yaroslavl.

Materials and methods. Th e present paper involves the analysis of 942 histories of breast cancer patients who have undergone surgical treatment at Regional Clinical Oncological Hospital, Yaroslavl. According to the study results, 16% of stage I and II patients had a change in the initial status of lymph node basins aft er pathoanatomical examination of the removed lymph nodes. Th is prompted a change in preoperative examination and appointment of MRI of breast and lymph regional outflow for 64 patients prior to planning a sentinel lymph node biopsy.

Results and discussion. Magnetic resonance imaging data correlated with the results obtained aft er histological examination and served to determine the extent of surgical treatment, reducing the risks of reintervention and locoregional recurrence.

Conclusion. Sentinel node biopsy is a method that combines high informativity, safety and economic benefits. However, in order to achieve greater patient focus, a comprehensive approach to preoperative examination and principle of cooperation in the choice of treatment strategy should be observed in all cases.

Introduction. The incidence of gastric cancer remains high, despite the increase in the share of stage I–II cancers — 37.1% in 2019. Surgical treatment remains relevant even in patients with “early” forms of gastric cancer (EGC). Therefore, the reliable means for determining the surgeon volume in such patients are to be urgently developed.

Aim. To estimate the probability of building a stable predictive model for patients with EGC in order to choose the proper surgical intervention.

Materials and methods. Th e research involved the data obtained from “Database of patients with gastric cancer, reflecting statistics of patients with a particular variant of surgical intervention, treated at Yaroslavl Regional Clinical Oncological Hospital during the period from 2009 to 2019”. All patients (n = 266) received different volume of surgery: intraluminal surgery (n = 128), wedge gastric resection (n = 36), classical gastrectomy or subtotal gastric resection (n = 102). According to the volume of intervention, the patients were ratified into several study groups. Statistical analysis involved case records of three groups of patients and was conducted using MedCalc Statistical Soft ware version 20.022 and Statistica 12.5.

Results. Ten factors were identified to form a patient model corresponding to each method of surgical treatment. Th e fairness of the division of patients into groups was checked by ROC-analysis in order to determine sensitivity and specificity of the set of criteria for the division. Th e following characteristics of the mathematical model were obtained by means of ROC analysis: concordance coefficient = 88.24%, AUC = 0.893; index J = 0.811; Se = 87.92; Sp = 89.04; +LR = 3.27; -LR = 1.31.

Conclusion. Introduction of this approach into clinical practice decreased the rate of gastrectomies and gastric resections by 15% for the last three years.

Introduction. A decrease in nutrition of cancer patients affects all vital functions of the body, which is, according to numerous studies, typical of patients with gastrointestinal disturbances.

Materials and methods. The study was set out to investigate the effect of correcting protein-energy malnutrition on the symptoms manifestation, including pain, fatigue, sleep disorder, poor appetite, nausea, vomiting, constipation and diarrhea in patients with generalized forms of gastrointestinal cancer. The study involved questionnaire method applied prior to the study and three months after. Three groups, equivalent in terms of selection criteria, participated in the study. For this purpose, the study participants were given nutridrink compact protein and omega-3 polyunsaturated fatty acid.

Results and discussion. This study found out that timely nutritional support contributes toward reducing the negative symptoms of cancer and, when combined with supportive care and pain management, leads to significantly better results in terms of improving quality of life.

Conclusion. Timely nutritional support has a positive effect on reducing the negative symptoms associated with cancer (pain, fatigue, sleep disorder, poor appetite, nausea, vomiting, constipation and diarrhea), and, along with supportive care and pain management, improves the quality of life more significantly.

Introduction. The most pressing problems in abdominal oncology surgery are the development of obstructive jaundice as a complication in patients with malignant tumors in the hepatobiliary and pancreatoduodenal area, and the ways to eliminate it and to reduce the risk of adverse events. Our earlier research revealed 14 predictors that together are more likely to cause undesirable postoperative complications, including deaths during minimally invasive biliary tract decompression. On the basis of the data obtained, a computer program “Risk Assessment of Treatment Methods for Obstructive Jaundice” was created.

Materials and methods. The program was introduced into clinical practice in Yaroslavl Regional Clinical Oncology Hospital and was tested on 144 patients from 2019 through 2022. Th e program issued a conclusion on the risk of adverse events and assigned the patient to one of the groups where drainage or stenting were recommended for the first stage of biliary tract decompression.

Results and discussion. Following a collegial decision based on the results obtained via the program, 58 patients (40.28 %) underwent endoscopic stenting and 86 patients (59.72 %) underwent percutaneous transhepatic biliary drainage. In the study group, adverse events developed in 10 patients (6.94 %), while in the control group — in 50 patients (22.94 %), and 134 patients (93.06 %) had no complications, as compared to 168 patients (77.06 %) in the control group.

Conclusion. Application of the program based on reliable and practically significant 14 predictors results in a decline in general complications induced by minimally invasive biliary tract decompression from 22.94 % to 6.94 % and a 3.5-fold decrease in mortality from 5.05 % to 1.39 % in patients with malignant neoplasms in the hepatobiliary and pancreatoduodenal area, complicated by obstructive and mixed jaundice.

Introduction. Simultaneous hernio-abdominoplasty allows solving a complex of problems of the anterior abdominal wall in one surgical intervention. Th e relevance of this issue is determined by the lack of a unified algorithm for solving the combinations of anterior abdominal wall pathologies and by the presence of a number of complications, both in isolated and combined surgical techniques.

Aim. The present paper analyzes the treatment results of patients undergoing simultaneous surgery for ventral hernia and deformations of the anterior abdominal wall.

Materials and methods. Th e study enrolled 17 women (mean age 35.6 ± 7.0) undergoing inpatient and outpatient treatment in the Department of Plastic Surgery, Mother and Child Clinical Hospital, Ufa, in the period from 2019 to 2022. All patients had various aesthetic deformations of the anterior abdominal wall (laxity and excess skin, skin-fat apron, diastasis of the rectus abdominis muscles, excessive fat deposits) and midline ventral hernia of various sizes. 100 % patients had a history of pregnancy and childbirth; 64.7 % – grade 2 and 3 obesity.

Results and discussion. Two cases (11.76 %) showed local complications as hematoma of the epigastric region and necrosis of the navel. In the first case, this can be explained by the fact that extensive liposuction of the anterior abdominal wall was performed, and in the second – by the presence of a multidefect ventral hernia of large size, in particular, an umbilical hernia with dimensions of 15x8 cm. Complications were mitigated on an outpatient basis within a period of 1.5 to 3 months by means of conservative therapy and physiotherapy.

Conclusion. All patients were satisfied with the obtained aesthetic result

Endometrial cancer is one of the most common gynaecological cancers in both the United States and the Russian Federation, and the rate continues to rise. Although early-stage endometrial cancer is associated with a favourable 5-year survival rate (96%), this rate in patients with distant metastases accounts for only 18%. A combination of paclitaxel and carboplatin is standard first-line therapy for advanced, recurrent and metastatic endometrial carcinoma. Pembrolizumab, a monoclonal antibody targeting the programmed death-1 receptor, is approved for therapy of metastatic solid tumors with high microsatellite instability that have progressed aft er previous therapy and have no alternative treatment options. Lenvatinib is an oral multikinase inhibitor that blocks vascular endothelial growth factor receptors 1-3, fibroblast growth factor receptors 1-4, platelet-derived growth factor receptor alpha, RET and KIT. Phase II and III studies (KEYNOTE-146/ Study111 and KEYNOTE-775) on the combination of lenvatinib and pembrolizumab in advanced endometrial carcinoma, irrespective of MMR and MSI status, have shown new potential for the treatment of this pathology. Th e results obtained, including progression-free and overall survival, allow the combination of lenvatinib and pembrolizumab to be considered a new standard for the treatment of this pathology.

A steady worldwide increase in the number of people living with HIV (PLHIV) and diagnostic methods requires a separate review of patient-specific nosologies, including lymphoproliferative diseases, some of which are directly associated with the virus due to its oncogenic effect and those that do not relate directly to HIV but introduce nuances to diagnostic and therapeutic approaches when a patient is HIV-positive. Towards this, the paper generally reviews lymphomas in PLHIV, presents the WHO classification of HIV-associated lymphomas, describes a contemporary view of the known mechanisms of pathogenesis, including the role of opportunistic infections, and general principles of diagnostic and therapeutic tactics, provides recommendations on modifying the doses of chemotherapy correlated with the immune status and on preventing CNS involvement. Specific types of lymphoma (Burkitt’s lymphoma, diff use large B-cell lymphoma) are considered separately, including those most frequently associated with patients living with HIV (primary effusion lymphoma, plasmablastic lymphoma, primary central nervous system lymphoma), but rare in the uninfected population.

Peritoneal metastasis occurs in a number of heterogeneous tumors originating from the ovaries, stomach, intestines, pancreas, lungs, breast, and melanoma. Peritoneal carcinomatosis significantly reduces overall survival. While being almost unresponsive to treatment, dissemination of tumor cells along the peritoneum aggravates the course of the disease. Despite the use of locoregional treatment, peritoneal carcinomatosis is still considered to be an aggravating factor with a poor prognosis. Peritoneal carcinomatosis cannot be defined as a separate locoregional process with its own biology and oncogenesis due to the lack of clear understanding the molecular and biological features of peritoneal metastasis, as well as generally recognized standards for diagnosis and treatment of malignant neoplasms with various localizations. Addressing peritoneal carcinomatosis as a separate developing molecular event will enhance the understanding of its morpho- and oncogenesis and strengthen the search for therapeutic, diagnostic and preventive approaches to its management. Th e paper presents a bibliographic study of publications on exploring peritoneal metastases from various sites, including the abdominal and pelvic organs. Th e known mechanisms of tumors metastasis to the peritoneum are characterized in the paper. Diagnostic approaches to peritoneal carcinomatosis were assessed and compared. Th e collected data analysis revealed the main gaps in the understanding of peritoneal carcinomatosis oncogenesis.

The expansion in the number of primary joint replacements worldwide is causing a rise in revision joint replacements due to bacterial infection. Revision surgery with cementless implants appears to be beneficial for long-term outcome, and using antibiotic-impregnated bone grafts can control infection and provide good implant support. Autologous bone graft s (autografts) areused in surgery to fill defects and impaction bone grafting in spinal reconstruction. Because of their superior osteoinductive ability, autograft sare considered the “gold standard” for these treatments. However, due to a better cost-benefit ratio, allografts are also often used. In case of limited donor availability for autologous or allogeneic bone graft s, bone grafting materials are a reasonable alternative or adjunct. Bone grafting materials combine or are based on different substances. Growth factors of the bone morphogenetic protein family are recombinant proteins that specifically induce bone and cartilage growth. One advantage of bone grafting materials is that they can be combined with several antibiotics. Th e choice of antibiotics should consider possible dose-dependent cellular and pharmacological side effects at the implantation site, as well as be based on antimicrobial efficacy. Thus, microbiologists, pharmacologists and surgeons must decide together which combination is more appropriate. Bone grafting materials with active ingredient supplements are considered to be combination drugs, characterised by a primary effect (bone replacement function) and a secondary effect (prevention of bacterial recolonization of the bone grafting materials). Both functions must be clinically validated during the registration process as a Class III medical device. Currently, only a few combination products are available on the market. In this review, we considered the existing hydroxyapatite-based bone grafting materials and the potential for their use in spine surgery.

Introduction. Inguinal hernia repair is one of the most common elective surgeries today. In our clinic, the majority of inguinal hernia repairs are performed laparoscopically. The most frequent complication after transabdominal preperitoneal inguinal hernia repair is postoperative seroma.

Materials and methods. A 35-year-old patient C. with a right-sided inguinal hernia sought medical care in our clinic. He underwent robot-assisted TAPP with fluorescence lymphography using indocyanine green (ICG).

Results and discussion. The present paper describes the possible relationship between intraoperative damage of the lymphatic vessels within the spermatic cord induced by robot-assisted transabdominal preperitoneal inguinal hernia repair and postoperative development of inguinal seroma. 5 mg/ml of indocyanine green was injected into the testicle on the side with the hernial bulge to visualize the lymphatic vessels. In this case such procedure is safe and feasible. Due to the tight fusion of the hernia sac with two visualized lymphatic vessels, they were excised during surgery. In the early postoperative period, an ultrasound scan revealed a subclinical seroma in the inguinal region of approximately 10 ml.

Conclusion. A case series of ICG fluorescence lymphography during robot-assisted TAPP should be performed further to elucidate the relationship between lymphatic vessel damage and hydrocele.

Aim. The study is aimed at describing pancreatic islets as one of the SARS-CoV-2 targets.

Materials and methods. The object of the study was the pancreas. The study involved histological staining.

Results and discussion. The autopsy study revealed the signs typical of bilateral viral interstitial pneumonia. Histological examination revealed alveoli with disatelectasis, intra-alveolar edema, hyaline membranes in a part of alveoli. The pancreas histological examination showed hemorrhages, necrotic areas of the islets and detected the following DIC signs: small hyaline thrombi in the heart cavities and large vessels, petechial hemorrhages in the internal organs and adrenal glands, foci of adrenal cortex necrosis with perifocal infiltration (Waterhouse—Friderichsen syndrome); as well as signs of necronephrosis with fibrinoid areas of necrosis in the glomerular capillary network and perivascular lymphoid infiltrates.

Conclusion. SARS-CoV-2 was revealed to target human pancreatic islets, where areas of necrosis developed.