Pub Date : 2023-06-23DOI: 10.17650/2686-9594-2023-13-2-46-53
S. Lukmonov, Ya. V. Belenkaya, M. S. Lebedko, S. Gordeev, Z. Mammadli
Background. The need of neoadjuvant treatment for upper rectal cancer remains the object of discussion, which makes further study of this topic important.Аim. To estimate the postoperative complications rate depending on the type of neoajuvant treatment.Materials and methods. A retrospective cohort multicenter study, that analyzed data of medical records of patients with upper rectal cancer from the archive of N.N. Blokhin Cancer Research Center of the ministry of Health of Russia, Ryzhikh national medical Research Center of Coloproctology of the ministry of Health of Russia and Stavropol Regional Clinical Oncology Center for 2007–2020. Patients were devided into 3 groups: the group of radiotherapy (5*5 gy), the group of neoadjuvant chemotherapy (4 courses of XELOX before surgery) and the group of surgery. The main endpoint was the study of anastomotic leak rate. Also we estimated the postoperative complications rate III–Iv degree (Clavien– Dindo), the sphincter-preserving surgery rate, the stoma creation rate, the postoperative mortality.Results. we included 110 patients in radiotherapy group, 188 patients in neoadjuvant chemotherapy group, 103 patients in surgery group. Study groups were comparable by sex, ASA status and histological grade. Postoperative grade III– Iv complications (in all cases were associated with anastomotic leak) developed in 8 (6.8 %) patients in neoadjuvant chemotherapy group versus 11 (10.0 %) patients in radiotherapy group (p = 0.379) and 12 (11.7 %) patients in surgery group (p = 0.208). There weren»t any significant differences in this parameter between the radiotherapy and the surgery group (p = 0.698). R0-resection was performed in 117 (99.2 %) patients in neoadjuvant chemotherapy group versus 107 (97.3 %) patients in radiotherapy group (p = 0.280) and 103 patients (100 %) in surgery group (p = 0.349). Radiotherapy and surgery groups didn’t differ significantly in R0-resection rate (p = 0.091). 1 patient (0.84 %) in neoadjuvant chemotherapy died before surgery, in other groups there weren’t any lethal outcomes (p = 0.283). Only the male sex, had a statistically significant effect on the anastomotic leak rate (risk ratio (HR) 2.875; 95 % confidence interval (CI) 1.24–6.63; p = 0.003).Conclusions. A study of these case histories of patients with cancer of the upper ampullary rectum, conducted by us, showed that neoadjuvant treatment didn»t affect the postoperative complications rate.
{"title":"The effect of neoadjuvant treatment on postoperative morbidity in upper rectal cancer","authors":"S. Lukmonov, Ya. V. Belenkaya, M. S. Lebedko, S. Gordeev, Z. Mammadli","doi":"10.17650/2686-9594-2023-13-2-46-53","DOIUrl":"https://doi.org/10.17650/2686-9594-2023-13-2-46-53","url":null,"abstract":"Background. The need of neoadjuvant treatment for upper rectal cancer remains the object of discussion, which makes further study of this topic important.Аim. To estimate the postoperative complications rate depending on the type of neoajuvant treatment.Materials and methods. A retrospective cohort multicenter study, that analyzed data of medical records of patients with upper rectal cancer from the archive of N.N. Blokhin Cancer Research Center of the ministry of Health of Russia, Ryzhikh national medical Research Center of Coloproctology of the ministry of Health of Russia and Stavropol Regional Clinical Oncology Center for 2007–2020. Patients were devided into 3 groups: the group of radiotherapy (5*5 gy), the group of neoadjuvant chemotherapy (4 courses of XELOX before surgery) and the group of surgery. The main endpoint was the study of anastomotic leak rate. Also we estimated the postoperative complications rate III–Iv degree (Clavien– Dindo), the sphincter-preserving surgery rate, the stoma creation rate, the postoperative mortality.Results. we included 110 patients in radiotherapy group, 188 patients in neoadjuvant chemotherapy group, 103 patients in surgery group. Study groups were comparable by sex, ASA status and histological grade. Postoperative grade III– Iv complications (in all cases were associated with anastomotic leak) developed in 8 (6.8 %) patients in neoadjuvant chemotherapy group versus 11 (10.0 %) patients in radiotherapy group (p = 0.379) and 12 (11.7 %) patients in surgery group (p = 0.208). There weren»t any significant differences in this parameter between the radiotherapy and the surgery group (p = 0.698). R0-resection was performed in 117 (99.2 %) patients in neoadjuvant chemotherapy group versus 107 (97.3 %) patients in radiotherapy group (p = 0.280) and 103 patients (100 %) in surgery group (p = 0.349). Radiotherapy and surgery groups didn’t differ significantly in R0-resection rate (p = 0.091). 1 patient (0.84 %) in neoadjuvant chemotherapy died before surgery, in other groups there weren’t any lethal outcomes (p = 0.283). Only the male sex, had a statistically significant effect on the anastomotic leak rate (risk ratio (HR) 2.875; 95 % confidence interval (CI) 1.24–6.63; p = 0.003).Conclusions. A study of these case histories of patients with cancer of the upper ampullary rectum, conducted by us, showed that neoadjuvant treatment didn»t affect the postoperative complications rate.","PeriodicalId":34449,"journal":{"name":"Tazovaia khirurgiia i onkologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48568147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-23DOI: 10.17650/2686-9594-2023-13-2-54-59
A. S. Gorbunova, D. Kuzmichev, Z. Mamedli, A. Aniskin, A. V. Polinovsky, D. V. Aleksantsev, A. V. Korshak
The formation of intestinal stoma is performed during routine and emergency operations. This review provides a brief historical overview of the main stages of development of methods colo- and ileostomy. The article presents indications, as well as possible complications that may happen during operative treatment. It is occurred that there is little evidentiary material of colo- or ileostomy in evaluating complications that are associated with the various surgical methods of intestinal stoma formation. The purpose of this review is to summarize the current data on stoma formation and determine the method to use.
{"title":"Surgical aspects of stoma formation in oncology. Literature review","authors":"A. S. Gorbunova, D. Kuzmichev, Z. Mamedli, A. Aniskin, A. V. Polinovsky, D. V. Aleksantsev, A. V. Korshak","doi":"10.17650/2686-9594-2023-13-2-54-59","DOIUrl":"https://doi.org/10.17650/2686-9594-2023-13-2-54-59","url":null,"abstract":"The formation of intestinal stoma is performed during routine and emergency operations. This review provides a brief historical overview of the main stages of development of methods colo- and ileostomy. The article presents indications, as well as possible complications that may happen during operative treatment. It is occurred that there is little evidentiary material of colo- or ileostomy in evaluating complications that are associated with the various surgical methods of intestinal stoma formation. The purpose of this review is to summarize the current data on stoma formation and determine the method to use.","PeriodicalId":34449,"journal":{"name":"Tazovaia khirurgiia i onkologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44716548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-23DOI: 10.17650/2686-9594-2023-13-2-38-45
A. E. Gulyaeva, E. A. Kim, Z. Grigorievskaya, D. Denchik, K. V. Gagulaeva, D. Khaylenko, A. A. Rumyantsev, A. Petrovsky
Introduction: Surgical site infections (SSI) are one of the key problems in surgical practice. Despite the achievements of modern medicine, ongoing preventive measures, the incidence of wound infection remains quite high. This is especially relevant for oncoplastic surgery, since in most cases the installation of foreign materials (expanders, implants, meshes) is required to achieve a satisfactory cosmetic result.The purpose of the study: to identify the most common cause of infectious complications after reconstructive operations on the mammary gland using endoprostheses.Materials and methods: In a retrospective review of 526 consecutive implant-based breast reconstructions at a single institution from June 2020 to June 2022 was conducted. The frequency of development of infectious complications was assessed, as well as the taxonomic structure of the main pathogens that were isolated in the department of oncomammology in 2020–2022.Results: The incidence of infectious complications that led to the loss of the endoprosthesis during reconstructive surgery on the mammary gland was 6.7 %. The main causative agents of SSI leading to the loss of implants and the need for reoperations were Corynebacterium striatum (35.2 %) and Staphylococcus aureus (27.2 %). The spectrum of the most common pathogens that led to the loss of implants corresponded to the flora most often detected during bacterial culture in the department. The probability of implant loss was higher in the group of patients who underwent chemotherapy (14 of 197, 7.1 %) or chemoradiotherapy (14 of 188, 7.4 %) compared with patients who did not receive specific anticancer treatment (7 of 141, 4.9 %). However, taking patients who did not receive drug or radiation treatment as a reference group, statistical significance could not be achieved (p = 0.56 in the chemotherapy group and p = 0.49 in the chemoradiotherapy group).Conclusions: Our own experience has shown that, despite the current preventive measures, the frequency of infectious complications remains quite high. In the etiological structure of SSI pathogens, microorganisms of the genera Staphylococcus and Corynebacterium predominate. The use of broad-spectrum antibiotics in perioperative prophylaxis did not guarantee the absence of SSI in the postoperative period. An analysis of the sensitivity of isolated pathogens to antibacterial drugs, an assessment of the effectiveness of various antibiotic regimens in the future may allow us to develop an optimal antibiotic prophylaxis scheme for infectious complications during breast reconstructive surgery, therefore, further prospective studies in this direction are needed.
{"title":"The main causative agents of infectious complications during reconstructive surgery using allomaterials in patients with breast cancer","authors":"A. E. Gulyaeva, E. A. Kim, Z. Grigorievskaya, D. Denchik, K. V. Gagulaeva, D. Khaylenko, A. A. Rumyantsev, A. Petrovsky","doi":"10.17650/2686-9594-2023-13-2-38-45","DOIUrl":"https://doi.org/10.17650/2686-9594-2023-13-2-38-45","url":null,"abstract":"Introduction: Surgical site infections (SSI) are one of the key problems in surgical practice. Despite the achievements of modern medicine, ongoing preventive measures, the incidence of wound infection remains quite high. This is especially relevant for oncoplastic surgery, since in most cases the installation of foreign materials (expanders, implants, meshes) is required to achieve a satisfactory cosmetic result.The purpose of the study: to identify the most common cause of infectious complications after reconstructive operations on the mammary gland using endoprostheses.Materials and methods: In a retrospective review of 526 consecutive implant-based breast reconstructions at a single institution from June 2020 to June 2022 was conducted. The frequency of development of infectious complications was assessed, as well as the taxonomic structure of the main pathogens that were isolated in the department of oncomammology in 2020–2022.Results: The incidence of infectious complications that led to the loss of the endoprosthesis during reconstructive surgery on the mammary gland was 6.7 %. The main causative agents of SSI leading to the loss of implants and the need for reoperations were Corynebacterium striatum (35.2 %) and Staphylococcus aureus (27.2 %). The spectrum of the most common pathogens that led to the loss of implants corresponded to the flora most often detected during bacterial culture in the department. The probability of implant loss was higher in the group of patients who underwent chemotherapy (14 of 197, 7.1 %) or chemoradiotherapy (14 of 188, 7.4 %) compared with patients who did not receive specific anticancer treatment (7 of 141, 4.9 %). However, taking patients who did not receive drug or radiation treatment as a reference group, statistical significance could not be achieved (p = 0.56 in the chemotherapy group and p = 0.49 in the chemoradiotherapy group).Conclusions: Our own experience has shown that, despite the current preventive measures, the frequency of infectious complications remains quite high. In the etiological structure of SSI pathogens, microorganisms of the genera Staphylococcus and Corynebacterium predominate. The use of broad-spectrum antibiotics in perioperative prophylaxis did not guarantee the absence of SSI in the postoperative period. An analysis of the sensitivity of isolated pathogens to antibacterial drugs, an assessment of the effectiveness of various antibiotic regimens in the future may allow us to develop an optimal antibiotic prophylaxis scheme for infectious complications during breast reconstructive surgery, therefore, further prospective studies in this direction are needed.","PeriodicalId":34449,"journal":{"name":"Tazovaia khirurgiia i onkologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42379700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-23DOI: 10.17650/2686-9594-2023-13-2-11-16
T. G. Gevorkyan, I. Fainshtein, I. Stilidi
{"title":"Celiac plexus neurolysis in treatment of chronic pain syndrome in patients with unresectable pancreatic cancer","authors":"T. G. Gevorkyan, I. Fainshtein, I. Stilidi","doi":"10.17650/2686-9594-2023-13-2-11-16","DOIUrl":"https://doi.org/10.17650/2686-9594-2023-13-2-11-16","url":null,"abstract":"","PeriodicalId":34449,"journal":{"name":"Tazovaia khirurgiia i onkologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48899173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-23DOI: 10.17650/2686-9594-2023-13-2-60-65
V. Lyadov, T. S. Boldyreva, E. V. Prokhorov, V. Galkin
Background. The high frequency of frailty and sarcopenia in patients with cancer led to the development of «prehabilitation» concept. multimodal prehabilitation includes physical training, nutritional and psychological support before anticancer treatment.Aim. we aim to present the results of treatment of a patient with frailty and severe sarcopenia who underwent a multimodal prehabilitation program before surgery for colorectal cancer.Materials and methods. A 81-year-old woman with colon cancer was diagnosed with frailty and severe sarcopenia. The patient underwent a multimodal prehabilitation for 12 days prior to surgery, which included nutritional and psychological support as well as a supervised physical exercise program based on nordic walking.Results. The patient gained weight. Also, she increased grip strength and gait speed. The postoperative period went uneventfully and the patient was discharged home 7 days after surgery.Conclusions. multimodal prehabilitation is a potentially beneficial option in sarcopenic patients with frailty and colon cancer who need surgery.
{"title":"Multimodal prehabilitation in a patient with right colon cancer, frailty and severe sarcopenia: a case report","authors":"V. Lyadov, T. S. Boldyreva, E. V. Prokhorov, V. Galkin","doi":"10.17650/2686-9594-2023-13-2-60-65","DOIUrl":"https://doi.org/10.17650/2686-9594-2023-13-2-60-65","url":null,"abstract":"Background. The high frequency of frailty and sarcopenia in patients with cancer led to the development of «prehabilitation» concept. multimodal prehabilitation includes physical training, nutritional and psychological support before anticancer treatment.Aim. we aim to present the results of treatment of a patient with frailty and severe sarcopenia who underwent a multimodal prehabilitation program before surgery for colorectal cancer.Materials and methods. A 81-year-old woman with colon cancer was diagnosed with frailty and severe sarcopenia. The patient underwent a multimodal prehabilitation for 12 days prior to surgery, which included nutritional and psychological support as well as a supervised physical exercise program based on nordic walking.Results. The patient gained weight. Also, she increased grip strength and gait speed. The postoperative period went uneventfully and the patient was discharged home 7 days after surgery.Conclusions. multimodal prehabilitation is a potentially beneficial option in sarcopenic patients with frailty and colon cancer who need surgery.","PeriodicalId":34449,"journal":{"name":"Tazovaia khirurgiia i onkologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45572462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-23DOI: 10.17650/2686-9594-2023-13-2-17-26
H. Sun, S. Nered, A. Tryakin, E. Artamonova, A. Kalinin, V. Bugaev, A. Stroganova, N. Besova, P. Arkhiri, V. Marshall, R. S. Abdulaeva, I. Stilidi
Background. microsatellite instability (MSI) is a prognostic marker of survival in many malignant diseases and show resistance to chemotherapy at early stages of colorectal cancer and show no benefits from chemotherapy at early stages of colorectal cancer. However, the role of MSI in resectable gastric cancer (GC) remains unknown.Aim. To study the results of treatment of resectable gastric cancer with microsatellite instability.Materials and methods. The study included 286 patients with resectable gC who received treatment at the N. N. Blokhin national medical Research Center of Oncology. All patients underwent PCR testing for MSI-H in 5 markers (BAT25, BAT26, NR21, NR24, NR27). Tumor regression grades (TRG) were evaluated according to the mandard tumour regression score, including disease-free survival and overall survival.Results. MSI indicated in 27 cases (9.44 %) out of 286 resectable gastric cancer. In group patients who received only surgical treatment, 2-year disease-free survival in patients with MSI-H was 77.80 % versus 88.29 % in MSS patients (hazard ratio (HR) 1.82, 95 % confidence interval (CI) 0.37–8.82, p = 0.45), 2-year overall survival in patients with MSI-H was 88.90 % versus 95.36 % in MSS patients (HR 2.03, 95 % CI 0.20–19.8, p = 0.54). In patients who received perioperative chemotherapy, 28.57 % (4 / 14) had progression in MSI-H tumor versus 3.61 % (6 / 166) in MSS tumor (p <0.001). In group patients who received treatment combined with chemotherapy, 2-year disease-free survival in patients with MSI-H was 59.60 % versus 67.36 % (HR 1.96, CI 95 % 0.88–4.35, p = 0.09), 2-year overall survival in patients with MSI-H was 67.30 % versus 85.86 % in MSS patients (HR 1.86, 95 % CI 0.64–5.41, p = 0.25)Conclusion. MSI-H is not a favorable prognosis factor in patients with resectable GC who are treated surgically combined with chemotherapy. The prevalence of progression in patients with MSI-H-status is higher than MSS-status with perioperative chemotherapy (FLOT / FOLFIRINOX).
背景。微卫星不稳定性(microsatellite instability, MSI)是许多恶性疾病生存的预后指标，在结直肠癌早期表现出对化疗的耐药性，而在结直肠癌早期表现出化疗无益处。然而，MSI在可切除胃癌(GC)中的作用尚不清楚。目的探讨可切除胃癌伴微卫星不稳定的治疗效果。材料和方法。该研究包括286例可切除的胃癌患者，他们在N. N. Blokhin国家肿瘤医学研究中心接受治疗。所有患者均对5个标记(BAT25、BAT26、NR21、NR24、NR27)进行MSI-H PCR检测。肿瘤消退等级(TRG)根据标准肿瘤消退评分进行评估，包括无病生存期和总生存期。286例可切除的胃癌中有27例(9.44%)有MSI表现。在仅接受手术治疗的患者组中，MSI-H患者的2年无病生存率为77.80%，而MSS患者的2年无病生存率为88.29%(风险比(HR) 1.82, 95%可信区间(CI) 0.37-8.82, p = 0.45)， MSI-H患者的2年总生存率为88.90%，而MSS患者的2年总生存率为95.36% (HR 2.03, 95% CI 0.20-19.8, p = 0.54)。在接受围手术期化疗的患者中，28.57%(4 / 14)的MSI-H肿瘤进展，而3.61%(6 / 166)的MSS肿瘤进展(p <0.001)。在联合化疗治疗组患者中，MSI-H患者2年无病生存率为59.60% vs 67.36% (HR 1.96, CI 95% 0.88-4.35, p = 0.09)， MSI-H患者2年总生存率为67.30% vs MSS患者85.86% (HR 1.86, 95% CI 0.64-5.41, p = 0.25)。对于手术联合化疗的可切除胃癌患者，MSI-H并不是一个有利的预后因素。在围手术期化疗(FLOT / FOLFIRINOX)中，msi - h状态患者的进展率高于mss状态患者。
{"title":"The results of treatment for resectable gastric cancer with microsatellite instability","authors":"H. Sun, S. Nered, A. Tryakin, E. Artamonova, A. Kalinin, V. Bugaev, A. Stroganova, N. Besova, P. Arkhiri, V. Marshall, R. S. Abdulaeva, I. Stilidi","doi":"10.17650/2686-9594-2023-13-2-17-26","DOIUrl":"https://doi.org/10.17650/2686-9594-2023-13-2-17-26","url":null,"abstract":"Background. microsatellite instability (MSI) is a prognostic marker of survival in many malignant diseases and show resistance to chemotherapy at early stages of colorectal cancer and show no benefits from chemotherapy at early stages of colorectal cancer. However, the role of MSI in resectable gastric cancer (GC) remains unknown.Aim. To study the results of treatment of resectable gastric cancer with microsatellite instability.Materials and methods. The study included 286 patients with resectable gC who received treatment at the N. N. Blokhin national medical Research Center of Oncology. All patients underwent PCR testing for MSI-H in 5 markers (BAT25, BAT26, NR21, NR24, NR27). Tumor regression grades (TRG) were evaluated according to the mandard tumour regression score, including disease-free survival and overall survival.Results. MSI indicated in 27 cases (9.44 %) out of 286 resectable gastric cancer. In group patients who received only surgical treatment, 2-year disease-free survival in patients with MSI-H was 77.80 % versus 88.29 % in MSS patients (hazard ratio (HR) 1.82, 95 % confidence interval (CI) 0.37–8.82, p = 0.45), 2-year overall survival in patients with MSI-H was 88.90 % versus 95.36 % in MSS patients (HR 2.03, 95 % CI 0.20–19.8, p = 0.54). In patients who received perioperative chemotherapy, 28.57 % (4 / 14) had progression in MSI-H tumor versus 3.61 % (6 / 166) in MSS tumor (p <0.001). In group patients who received treatment combined with chemotherapy, 2-year disease-free survival in patients with MSI-H was 59.60 % versus 67.36 % (HR 1.96, CI 95 % 0.88–4.35, p = 0.09), 2-year overall survival in patients with MSI-H was 67.30 % versus 85.86 % in MSS patients (HR 1.86, 95 % CI 0.64–5.41, p = 0.25)Conclusion. MSI-H is not a favorable prognosis factor in patients with resectable GC who are treated surgically combined with chemotherapy. The prevalence of progression in patients with MSI-H-status is higher than MSS-status with perioperative chemotherapy (FLOT / FOLFIRINOX).","PeriodicalId":34449,"journal":{"name":"Tazovaia khirurgiia i onkologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43866853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-23DOI: 10.17650/2686-9594-2023-13-2-27-37
V. Lozovaya, O. Malikhova, A. Tumanyan, A. Malikhov, O. Gusarova
Background. The gastritis-like form of primary non-Hodgkin’s lymphomas (NHL) of the stomach is the rarest macroscopic variant of malignant neoplasms of the stomach, endoscopically resembling inflammatory changes in the mucous membrane and, in single observations, polypoid and flatly elevated forms of neuroendocrine tumors (NET) of the stomach. Despite the great experience gained in the diagnosis and treatment of primary NHL of the stomach and NET of the stomach, in clinical practice there are examples that cause difficulties in the correct interpretation of the endoscopic picture and the timely diagnosis.Aims. To analyze the data of a comprehensive endoscopic examination of patients with diagnoses of a gastritis-like form of primary NHL and NET of the stomach, and to identify the main differentially significant endoscopic criteria characteristic of each individual type of neoplasia.Materials and methods. In a prospective study conducted at the FSBI “N.N. Blokhin national medical Research Center of Oncology” of the ministry of Health of Russia in the period from 2017 to 2022, data from endoscopic and morphological studies of 69 patients with gastritis-like malignancies were analyzed. All patients underwent a comprehensive endoscopic examination of the upper gastrointestinal tract – esophagogastroduodenoscopy using all clarifying examination methods (narrow-spectrum mode, examination in magnification mode, a combination of narrow-spectrum examination with magnification mode), accompanied by the taking of biopsy material for the purpose of morphological verification of the diagnosis, and endosonographic study.Results. According to the results of a morphological study, the diagnosis of primary NHL of the stomach was confirmed in 38 patients (55.1 %), NET of the stomach – in 31 patients (44.9 %). A change in diagnosis based on the results of a morphological study occurred in 3 (4.3 %) of 69 (100 %) patients. The sensitivity and diagnostic accuracy of complex endoscopic examination were higher compared to endoscopic examination in white light mode, and amounted to 92.11, 95.65 and 13.16 %, 52.17 %, respectively.Conclusion. for a correct assessment of the endoscopic picture, it is necessary to conduct a comprehensive endoscopic examination using all clarifying diagnostic methods, which shows greater sensitivity and specificity compared to examination in white light mode.
{"title":"Endoscopic differential diagnosis of the gastritis-like form of primary non-Hodgkin’s lymphomas and neuroendocrine tumors of the stomach","authors":"V. Lozovaya, O. Malikhova, A. Tumanyan, A. Malikhov, O. Gusarova","doi":"10.17650/2686-9594-2023-13-2-27-37","DOIUrl":"https://doi.org/10.17650/2686-9594-2023-13-2-27-37","url":null,"abstract":"Background. The gastritis-like form of primary non-Hodgkin’s lymphomas (NHL) of the stomach is the rarest macroscopic variant of malignant neoplasms of the stomach, endoscopically resembling inflammatory changes in the mucous membrane and, in single observations, polypoid and flatly elevated forms of neuroendocrine tumors (NET) of the stomach. Despite the great experience gained in the diagnosis and treatment of primary NHL of the stomach and NET of the stomach, in clinical practice there are examples that cause difficulties in the correct interpretation of the endoscopic picture and the timely diagnosis.Aims. To analyze the data of a comprehensive endoscopic examination of patients with diagnoses of a gastritis-like form of primary NHL and NET of the stomach, and to identify the main differentially significant endoscopic criteria characteristic of each individual type of neoplasia.Materials and methods. In a prospective study conducted at the FSBI “N.N. Blokhin national medical Research Center of Oncology” of the ministry of Health of Russia in the period from 2017 to 2022, data from endoscopic and morphological studies of 69 patients with gastritis-like malignancies were analyzed. All patients underwent a comprehensive endoscopic examination of the upper gastrointestinal tract – esophagogastroduodenoscopy using all clarifying examination methods (narrow-spectrum mode, examination in magnification mode, a combination of narrow-spectrum examination with magnification mode), accompanied by the taking of biopsy material for the purpose of morphological verification of the diagnosis, and endosonographic study.Results. According to the results of a morphological study, the diagnosis of primary NHL of the stomach was confirmed in 38 patients (55.1 %), NET of the stomach – in 31 patients (44.9 %). A change in diagnosis based on the results of a morphological study occurred in 3 (4.3 %) of 69 (100 %) patients. The sensitivity and diagnostic accuracy of complex endoscopic examination were higher compared to endoscopic examination in white light mode, and amounted to 92.11, 95.65 and 13.16 %, 52.17 %, respectively.Conclusion. for a correct assessment of the endoscopic picture, it is necessary to conduct a comprehensive endoscopic examination using all clarifying diagnostic methods, which shows greater sensitivity and specificity compared to examination in white light mode.","PeriodicalId":34449,"journal":{"name":"Tazovaia khirurgiia i onkologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45265857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-21DOI: 10.17650/2686-9594-2023-13-1-45-53
A. N. Polyakov, Y. Patyutko, I. . Pogrebnyakov, B. Dolgushin, V. N. Sholohov, O. S. Vlasenko, I. Bazin, D. Kantieva, K. A. Romanova, V. A. Kozhushkov, I. A. Kozhushkov, D. Podluzhnyi
Background. The results of local destruction methods in locally advanced pancreatic cancer (LAPCa) are contradictory. Radiation therapy is the most commonly used. Other methods are used much less frequently, irreversible electroporation (IRE) is one of them. Most authors indicate an acceptable level of complications and mortality, but without an improvement in long-term results. The results of two meta-analyses have been published, the authors indicate the possibility of using the IRE in selected patients. The authors also point out that minimally invasive methods of using the IRE be preferred. Some experience has been gained in the use of percutaneous access for IRE in LAPCa. Computed tomography, ultrasound guidance can be used for navigation. The level of complications can reach 50 %. Mortality with percutaneous access, as a rule, is absent or does not exceed 5 %. Long-term results are the same with the results of open IRE.Aim. To share authors experience of using percutaneous irreversible electroporation in pancreatic cancer, because there are no references to the use of percutaneous IRE in LAPCa in Russia.Materials and methods. The IRE was performed for 53-year female patient with LAPCa after successful induction therapy. A step-by-step pulse effect of electrodes installed under ultrasound control on the tumor infiltrate was carried out. Magnetic resonance imaging, computed tomography and other types of studies were used for diagnostic purposes.Results. The involvement of the common hepatic artery and portal vein remained after the induction therapy, which did not allow performing pancreatoduodenal resection. Ultrasonic navigation and flat-detector computed tomography allowed to install the electrodes adequatly and safely. The impact zone almost completely blocked the infiltrate zone, a more optimal location of the electrodes was limited by the wide network of venous collaterals. Magnetic resonance imaging data performed before and after the procedure showed no progression of the disease within more than three months after the procedure, including in the affected area. Tumor shrinkage was noted as a partial response.Conclusion. The first experience confirmed the safety and the absence of subsequent complications when using the percutaneous access method of IRE for LAPCa. Follow-up monitoring of the patient will allow to say more correctly about the possibility of the method to provide long-term local control.
{"title":"Percutaneous irreversible electroporation in locally advanced pancreatic cancer – a review and a case report","authors":"A. N. Polyakov, Y. Patyutko, I. . Pogrebnyakov, B. Dolgushin, V. N. Sholohov, O. S. Vlasenko, I. Bazin, D. Kantieva, K. A. Romanova, V. A. Kozhushkov, I. A. Kozhushkov, D. Podluzhnyi","doi":"10.17650/2686-9594-2023-13-1-45-53","DOIUrl":"https://doi.org/10.17650/2686-9594-2023-13-1-45-53","url":null,"abstract":"Background. The results of local destruction methods in locally advanced pancreatic cancer (LAPCa) are contradictory. Radiation therapy is the most commonly used. Other methods are used much less frequently, irreversible electroporation (IRE) is one of them. Most authors indicate an acceptable level of complications and mortality, but without an improvement in long-term results. The results of two meta-analyses have been published, the authors indicate the possibility of using the IRE in selected patients. The authors also point out that minimally invasive methods of using the IRE be preferred. Some experience has been gained in the use of percutaneous access for IRE in LAPCa. Computed tomography, ultrasound guidance can be used for navigation. The level of complications can reach 50 %. Mortality with percutaneous access, as a rule, is absent or does not exceed 5 %. Long-term results are the same with the results of open IRE.Aim. To share authors experience of using percutaneous irreversible electroporation in pancreatic cancer, because there are no references to the use of percutaneous IRE in LAPCa in Russia.Materials and methods. The IRE was performed for 53-year female patient with LAPCa after successful induction therapy. A step-by-step pulse effect of electrodes installed under ultrasound control on the tumor infiltrate was carried out. Magnetic resonance imaging, computed tomography and other types of studies were used for diagnostic purposes.Results. The involvement of the common hepatic artery and portal vein remained after the induction therapy, which did not allow performing pancreatoduodenal resection. Ultrasonic navigation and flat-detector computed tomography allowed to install the electrodes adequatly and safely. The impact zone almost completely blocked the infiltrate zone, a more optimal location of the electrodes was limited by the wide network of venous collaterals. Magnetic resonance imaging data performed before and after the procedure showed no progression of the disease within more than three months after the procedure, including in the affected area. Tumor shrinkage was noted as a partial response.Conclusion. The first experience confirmed the safety and the absence of subsequent complications when using the percutaneous access method of IRE for LAPCa. Follow-up monitoring of the patient will allow to say more correctly about the possibility of the method to provide long-term local control.","PeriodicalId":34449,"journal":{"name":"Tazovaia khirurgiia i onkologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47289044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-21DOI: 10.17650/2686-9594-2023-13-1-54-57
E. K. Kharbediya, I. Peregorodiev, S. S. Magamedova, S. Nered, I. Stilidi
Tumoural portal vein thrombosis is a rare manifestation in gastric cancer. There is no reliable information in the worldwide literature on the overall survival of this category of patients. Few clinical cases have been described. This is a clinical case: a patient has diagnosed with body and antral gastric cancer complicated by tumour thrombosis of the portal vein and ingrowth into the pancreas. The clinical case described by the authors demonstrates yours the relevance of a number of issues. How can we namely be staging, treatment options and prognosis. The aim of this publication is to draw attention to a rare but common category of patient in oncologists’ clinical practice.
{"title":"Gastric cancer with tumour thrombosis of the portal vein: literature review and clinical case","authors":"E. K. Kharbediya, I. Peregorodiev, S. S. Magamedova, S. Nered, I. Stilidi","doi":"10.17650/2686-9594-2023-13-1-54-57","DOIUrl":"https://doi.org/10.17650/2686-9594-2023-13-1-54-57","url":null,"abstract":"Tumoural portal vein thrombosis is a rare manifestation in gastric cancer. There is no reliable information in the worldwide literature on the overall survival of this category of patients. Few clinical cases have been described. This is a clinical case: a patient has diagnosed with body and antral gastric cancer complicated by tumour thrombosis of the portal vein and ingrowth into the pancreas. The clinical case described by the authors demonstrates yours the relevance of a number of issues. How can we namely be staging, treatment options and prognosis. The aim of this publication is to draw attention to a rare but common category of patient in oncologists’ clinical practice.","PeriodicalId":34449,"journal":{"name":"Tazovaia khirurgiia i onkologiia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41870346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-20DOI: 10.17650/2686-9594-2023-13-1-19-26
P. Bulychkin, M. Chernykh, S. Tkachev, T. A. Krylova, V. Matveev, A. Pronin, G. I. Akhverdieva, T. M. Khripchenko, A. V. Khachaturyan
Background. Salvage radiation therapy is the “gold standard” of treatment for patients with recurrent prostate cancer after radical prostatectomy. However, the results of the effectiveness of salvage radiation therapy in patients with regional recurrences are significantly lower than in patients with local one of prostate cancer, and, as a rule, the progression of the disease more often continues lymphogenic, affecting the next barrier of lymph outflow – retroperitoneal lymph nodes.Aim. To develop a new more effective radical method of salvage radiation therapy in patients with regional relapses of prostate cancer after radical prostatectomy.Materials and methods. The radiotherapy department of the N. N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of Russia has developed a new method of hypofractionation salvage radiation therapy of patients with regional recurrences of prostate cancer after radical prostatectomy, which includes treatment not only to regional recurrences, the bed of prostate and regional lymph nodes of the pelvis, but also and prophylactic radiation treatment to retroperitoneal lymph nodes.Results. 25 patients were treated with prophylactic radiation treatment to retroperitoneal lymph nodes from 2018 to 2021. The median follow-up of patients was 19 (7–22) months. In all patients, radiotherapy was performed in combination with hormone therapy with analogues of luteinizing hormone releasing hormone with a median duration of administration of 8 (6–10) months. All patients were treated without interruption according to the previously planned dosimetric treatment plans. At the end of the course of radiation therapy, none of the patients had any pronounced negative effects of the III–IV degree (according to the RTOG /EORTC scale). The 1-year local and biochemical control of the disease were 100 and 88 %, respectively.Conclusions. Initial data assessing the safety of the newly developed salvage radiation therapy technique in hypofractionation mode with additional prophylactic of retroperitoneal lymph nodes demonstrate good tolerability. However, further study and randomized phase III clinical trial are required to determine clinical efficacy.
{"title":"Radiotherapy of patients with regional recurrence of prostate cancer after radical prostatectomy","authors":"P. Bulychkin, M. Chernykh, S. Tkachev, T. A. Krylova, V. Matveev, A. Pronin, G. I. Akhverdieva, T. M. Khripchenko, A. V. Khachaturyan","doi":"10.17650/2686-9594-2023-13-1-19-26","DOIUrl":"https://doi.org/10.17650/2686-9594-2023-13-1-19-26","url":null,"abstract":"Background. Salvage radiation therapy is the “gold standard” of treatment for patients with recurrent prostate cancer after radical prostatectomy. However, the results of the effectiveness of salvage radiation therapy in patients with regional recurrences are significantly lower than in patients with local one of prostate cancer, and, as a rule, the progression of the disease more often continues lymphogenic, affecting the next barrier of lymph outflow – retroperitoneal lymph nodes.Aim. To develop a new more effective radical method of salvage radiation therapy in patients with regional relapses of prostate cancer after radical prostatectomy.Materials and methods. The radiotherapy department of the N. N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of Russia has developed a new method of hypofractionation salvage radiation therapy of patients with regional recurrences of prostate cancer after radical prostatectomy, which includes treatment not only to regional recurrences, the bed of prostate and regional lymph nodes of the pelvis, but also and prophylactic radiation treatment to retroperitoneal lymph nodes.Results. 25 patients were treated with prophylactic radiation treatment to retroperitoneal lymph nodes from 2018 to 2021. The median follow-up of patients was 19 (7–22) months. In all patients, radiotherapy was performed in combination with hormone therapy with analogues of luteinizing hormone releasing hormone with a median duration of administration of 8 (6–10) months. All patients were treated without interruption according to the previously planned dosimetric treatment plans. At the end of the course of radiation therapy, none of the patients had any pronounced negative effects of the III–IV degree (according to the RTOG /EORTC scale). The 1-year local and biochemical control of the disease were 100 and 88 %, respectively.Conclusions. Initial data assessing the safety of the newly developed salvage radiation therapy technique in hypofractionation mode with additional prophylactic of retroperitoneal lymph nodes demonstrate good tolerability. However, further study and randomized phase III clinical trial are required to determine clinical efficacy.","PeriodicalId":34449,"journal":{"name":"Tazovaia khirurgiia i onkologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46047568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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