Pub Date : 2022-04-13DOI: 10.17650/2686-9594-2022-12-1-41-48
Z. Dudaev, Dzh. Kh. Khudoerov, Z. Mamedli, V. Aliev, S. Gordeev, Z. N. Magarramova
Objective: to compare short-term and long-term treatment outcomes between patients with lower and middle rectal cancer with complete clinical and pathomorphological response after comprehensive treatment.Materials and methods. we performed retrospective analysis of treatment outcomes in patients with lower and middle rectal cancer. The experimental group included 27 patients with complete clinical response, whereas the control group comprised 31 patients with complete pathomorphological response (ypT0n0m0) who had undergone total mesorectal excision following neoadjuvant therapy. The main evaluated parameters included postoperative complications, proportion of R0 resections, proportion of sphincter-preserving surgeries, 2-year overall survival, and progression-free survival.Results. At a median follow-up time of 41 months (range: 25–114 months), 2 patients from the experimental group had progressive disease registered 18 and 19 months after treatment initiation; both patients underwent abdominoperineal extirpation of the rectum. The remaining 25 patients had sphincter sparing surgeries. At a median follow-up time of 48 months (range: 24–101 months), one patient was found to have liver metastasis 5 months following treatment initiation. He underwent simultaneous surgery that included low anterior resection of the rectum and liver resection and had no postoperative complications. In the group of surgical treatment, all patients underwent radical surgeries (R0), including those with permanent stoma formation (n = 11; 35.5 %) or preventive stoma formation (n = 20; 64.5 %) with subsequent bowel repair. The 2-year overall survival rate was 100 % in both groups. The 2-year progression-free survival rate was 92.6 % in the experimental group and 96.8 % in the control group (p = 0.473).Conclusion. The watch and wait strategy with active dynamic follow-up is a safe alternative to surgery in patients with complete clinical response after neoadjuvant therapy, since it ensures the results equivalent to those in patients with complete pathomorphological response.
{"title":"Short-term and long-term treatment outcomes in patients with lower and middle rectal cancer with complete clinical and pathomorphological response after comprehensive treatment","authors":"Z. Dudaev, Dzh. Kh. Khudoerov, Z. Mamedli, V. Aliev, S. Gordeev, Z. N. Magarramova","doi":"10.17650/2686-9594-2022-12-1-41-48","DOIUrl":"https://doi.org/10.17650/2686-9594-2022-12-1-41-48","url":null,"abstract":"Objective: to compare short-term and long-term treatment outcomes between patients with lower and middle rectal cancer with complete clinical and pathomorphological response after comprehensive treatment.Materials and methods. we performed retrospective analysis of treatment outcomes in patients with lower and middle rectal cancer. The experimental group included 27 patients with complete clinical response, whereas the control group comprised 31 patients with complete pathomorphological response (ypT0n0m0) who had undergone total mesorectal excision following neoadjuvant therapy. The main evaluated parameters included postoperative complications, proportion of R0 resections, proportion of sphincter-preserving surgeries, 2-year overall survival, and progression-free survival.Results. At a median follow-up time of 41 months (range: 25–114 months), 2 patients from the experimental group had progressive disease registered 18 and 19 months after treatment initiation; both patients underwent abdominoperineal extirpation of the rectum. The remaining 25 patients had sphincter sparing surgeries. At a median follow-up time of 48 months (range: 24–101 months), one patient was found to have liver metastasis 5 months following treatment initiation. He underwent simultaneous surgery that included low anterior resection of the rectum and liver resection and had no postoperative complications. In the group of surgical treatment, all patients underwent radical surgeries (R0), including those with permanent stoma formation (n = 11; 35.5 %) or preventive stoma formation (n = 20; 64.5 %) with subsequent bowel repair. The 2-year overall survival rate was 100 % in both groups. The 2-year progression-free survival rate was 92.6 % in the experimental group and 96.8 % in the control group (p = 0.473).Conclusion. The watch and wait strategy with active dynamic follow-up is a safe alternative to surgery in patients with complete clinical response after neoadjuvant therapy, since it ensures the results equivalent to those in patients with complete pathomorphological response.","PeriodicalId":34449,"journal":{"name":"Tazovaia khirurgiia i onkologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41730303","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 : 2022-04-13DOI: 10.17650/2686-9594-2022-12-1-58-66
O. A. Egenov, A. Tjulandina, E. Suleymanov, I. Stilidi
The aim of the work is to analyze all available literature data on the role of secondary cytoreduction, its effectiveness and safety in the recurrence of ovarian cancer (ОС) with isolated lymph node (LN) lesion.The importance and place of secondary cytoreduction in the combined treatment of recurrent ОС is one of the most controversial topics. The lesion of the LN in recurrent Ос varies from 12 % to 37 %, but an isolated recurrence in the LN is a very rare occurrence, about 5 %. The most common localization in recurrent ОС with isolated LN lesion is the paraaortic LN.The results of this literature review suggest that isolated Ln lesion should be clearly distinguished from recurrence at other sites (such as peritoneal and parenchymal), since patients with isolated recurrence in the LN have a relatively indolent course of the disease. The frequency of complete cytoreduction according to the available data of retrospective studies reaches 100 %. Paraaortic and pelvic lymph node dissection without a macroscopically detectable residual tumor in combination with postoperative systemic chemotherapy leads to improved survival rates compared only with systemic drug treatment of patients with isolated LN lesion in recurrent ОС. median survival from the moment of relapse detection and overall survival varies from about 2.5 to 4 years and >5 years, respectively. Systemic paraaortic and pelvic lymph node dissection is preferable compared to selective lymphadenectomy, as it is accompanied by an increase in progression-free survival, although it doesn’t significantly prolong overall survival.
{"title":"Paraaortic and pelvic lymph node dissection in the combined treatment of recurrent ovarian cancer with isolated lymph node lesion: a literature review","authors":"O. A. Egenov, A. Tjulandina, E. Suleymanov, I. Stilidi","doi":"10.17650/2686-9594-2022-12-1-58-66","DOIUrl":"https://doi.org/10.17650/2686-9594-2022-12-1-58-66","url":null,"abstract":"The aim of the work is to analyze all available literature data on the role of secondary cytoreduction, its effectiveness and safety in the recurrence of ovarian cancer (ОС) with isolated lymph node (LN) lesion.The importance and place of secondary cytoreduction in the combined treatment of recurrent ОС is one of the most controversial topics. The lesion of the LN in recurrent Ос varies from 12 % to 37 %, but an isolated recurrence in the LN is a very rare occurrence, about 5 %. The most common localization in recurrent ОС with isolated LN lesion is the paraaortic LN.The results of this literature review suggest that isolated Ln lesion should be clearly distinguished from recurrence at other sites (such as peritoneal and parenchymal), since patients with isolated recurrence in the LN have a relatively indolent course of the disease. The frequency of complete cytoreduction according to the available data of retrospective studies reaches 100 %. Paraaortic and pelvic lymph node dissection without a macroscopically detectable residual tumor in combination with postoperative systemic chemotherapy leads to improved survival rates compared only with systemic drug treatment of patients with isolated LN lesion in recurrent ОС. median survival from the moment of relapse detection and overall survival varies from about 2.5 to 4 years and >5 years, respectively. Systemic paraaortic and pelvic lymph node dissection is preferable compared to selective lymphadenectomy, as it is accompanied by an increase in progression-free survival, although it doesn’t significantly prolong overall survival.","PeriodicalId":34449,"journal":{"name":"Tazovaia khirurgiia i onkologiia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41385810","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 : 2022-04-13DOI: 10.17650/2686-9594-2022-12-1-49-57
A. Moskalenko, V. Lyadov, I. Sagaydak, M. Chernykh, N. N. Britskaya
The purpose of the systematic review is to summarize the data regarding safety and efficacy of stereotactic body radiation therapy in patients with oligometastases of colorectal cancer to the liver.Published scientific articles on the topic were identified by searching the databases mEDLInE, Pubmed, EmBASE. The review includes publications reporting on the results of treatment of patients undergoing stereotactic radiation therapy for. The systematic review includes all retrospective and prospective studies found over the past 15 years with at least 10 patients with liver metastases of colorectal origin included and standardized methodology of radiation therapy. We included into the review 20 studies comprising 919 patients. Comparative analysis was complicated because of the absence of control groups in all of the studies. moreover, 16 studies were single-center with heterogeneous groups of patients and various regimens of stereotaxic radiation therapy. Despite this, the researchers achieved 60–100 % rates of one-year local control, 56–100 % one-year overall survival with median overall survival up to 45 months and the number of clinically significant complications less than 10 %.From our point of view, the results of published studies support the safety and efficacy of stereotactic radiation therapy in patients with colorectal cancer and oligometastatic liver disease. we consider stereotactic body radiation therapy to be one of the local control options in case of careful patient selection and the use of modern radiation therapy options. further randomized controlled trials are needed.
{"title":"Stereotactic body radiation therapy in patients with liver oligometastases from colorectal cancer: a systematic review","authors":"A. Moskalenko, V. Lyadov, I. Sagaydak, M. Chernykh, N. N. Britskaya","doi":"10.17650/2686-9594-2022-12-1-49-57","DOIUrl":"https://doi.org/10.17650/2686-9594-2022-12-1-49-57","url":null,"abstract":"The purpose of the systematic review is to summarize the data regarding safety and efficacy of stereotactic body radiation therapy in patients with oligometastases of colorectal cancer to the liver.Published scientific articles on the topic were identified by searching the databases mEDLInE, Pubmed, EmBASE. The review includes publications reporting on the results of treatment of patients undergoing stereotactic radiation therapy for. The systematic review includes all retrospective and prospective studies found over the past 15 years with at least 10 patients with liver metastases of colorectal origin included and standardized methodology of radiation therapy. We included into the review 20 studies comprising 919 patients. Comparative analysis was complicated because of the absence of control groups in all of the studies. moreover, 16 studies were single-center with heterogeneous groups of patients and various regimens of stereotaxic radiation therapy. Despite this, the researchers achieved 60–100 % rates of one-year local control, 56–100 % one-year overall survival with median overall survival up to 45 months and the number of clinically significant complications less than 10 %.From our point of view, the results of published studies support the safety and efficacy of stereotactic radiation therapy in patients with colorectal cancer and oligometastatic liver disease. we consider stereotactic body radiation therapy to be one of the local control options in case of careful patient selection and the use of modern radiation therapy options. further randomized controlled trials are needed.","PeriodicalId":34449,"journal":{"name":"Tazovaia khirurgiia i onkologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45977536","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 : 2022-04-12DOI: 10.17650/2686-9594-2022-12-1-11-26
O. A. Egenov, A. S. Tjulyandina, S. Nered, A. E. Kalinin, A. Shevchuk, P. Arkhiri, E. Suleymanov, I. Stilidi
Objective: analysis of the immediate and long-term results of surgical treatment of patients with lymph node (Ln) involvement in recurrent ovarian cancer (OC), as well as the search for prognostic factors for progression-free survival (PfS) and overall survival (OS).Materials and methods. The retrospective analysis included patients under the age of 75 who underwent surgery for recurrence of OC with Ln involvement at n.n. Blokhin national medical Research Center of Oncology in the period from 2005 to 2020. All patients had previously received combined treatment due to a primary diagnosis of OC. Exclusion criteria: the presence of concomitant pathology in the decompensation phase, primary multiple malignant tumors and recurrences of non-epithelial ovarian tumors. The analysis of the main operational characteristics, the frequency of postoperative complications according to Clavien–Dindo within 30 days after surgery, PfS, OS, as well as parameters affecting the long-term results of treatment were performed.Results. The study included 123 patients: a cohort of isolated lesions of the Ln (n = 65) and a group of combined recurrence in the Ln and other anatomical locations (n = 58). The frequency of complete cytoreduction was significantly higher in the group of patients with isolated recurrence in the Ln: 86.62 % versus 53.4 % in patients with combined relapse, p <0.0001. The median duration of the operation was also significantly higher in patients with combined recurrence: 245 min versus 180 min in a cohort of patients with isolated recurrence in the Ln, p <0.0001. Postoperative complications of grade III B were more often observed in the group of combined recurrence: 6.8 % versus 1.5 % in the group of isolated recurrence in the Ln, p = 0.148. none of the patients in the group of isolated recurrence in the Ln had postoperative mortality, while in the group of combined recurrence 2 (3.4 %) patients died after surgery from developed complications. In patients with isolated recurrence in the Ln and combined recurrence of OC, the median PfS was significantly higher when complete cytoreduction was achieved: 31.0 months and 18.0 months versus 10.0 months and 9.0 months with incomplete repeated cytoreduction, p <0.0001. In patients with isolated recurrence in the Ln and combined recurrence of OC, the median OS was identically significantly higher when complete repeated cytoreduction was achieved: 97.0 months and 60.0 months versus 34.0 months and 27.0 months with incomplete cytoreduction, p <0.0001.Conclusion. Surgical treatment of recurrence of OC is justified only if it is possible to achieve complete cytoreduction and platinum-sensitive type of recurrence of OC. Low grade tumor, platinum-sensitive type of recurrence, absence of marker recurrence of OC, isolated recurrence in Ln, complete repeated cytoreduction and lymphodissection were identified as predictors of PfS in multivariate analysis. The following factors had an independent favorable effect on
{"title":"Surgical treatment of patients with lymph node involvement in recurrent ovarian cancer: immediate and long-term results","authors":"O. A. Egenov, A. S. Tjulyandina, S. Nered, A. E. Kalinin, A. Shevchuk, P. Arkhiri, E. Suleymanov, I. Stilidi","doi":"10.17650/2686-9594-2022-12-1-11-26","DOIUrl":"https://doi.org/10.17650/2686-9594-2022-12-1-11-26","url":null,"abstract":"Objective: analysis of the immediate and long-term results of surgical treatment of patients with lymph node (Ln) involvement in recurrent ovarian cancer (OC), as well as the search for prognostic factors for progression-free survival (PfS) and overall survival (OS).Materials and methods. The retrospective analysis included patients under the age of 75 who underwent surgery for recurrence of OC with Ln involvement at n.n. Blokhin national medical Research Center of Oncology in the period from 2005 to 2020. All patients had previously received combined treatment due to a primary diagnosis of OC. Exclusion criteria: the presence of concomitant pathology in the decompensation phase, primary multiple malignant tumors and recurrences of non-epithelial ovarian tumors. The analysis of the main operational characteristics, the frequency of postoperative complications according to Clavien–Dindo within 30 days after surgery, PfS, OS, as well as parameters affecting the long-term results of treatment were performed.Results. The study included 123 patients: a cohort of isolated lesions of the Ln (n = 65) and a group of combined recurrence in the Ln and other anatomical locations (n = 58). The frequency of complete cytoreduction was significantly higher in the group of patients with isolated recurrence in the Ln: 86.62 % versus 53.4 % in patients with combined relapse, p <0.0001. The median duration of the operation was also significantly higher in patients with combined recurrence: 245 min versus 180 min in a cohort of patients with isolated recurrence in the Ln, p <0.0001. Postoperative complications of grade III B were more often observed in the group of combined recurrence: 6.8 % versus 1.5 % in the group of isolated recurrence in the Ln, p = 0.148. none of the patients in the group of isolated recurrence in the Ln had postoperative mortality, while in the group of combined recurrence 2 (3.4 %) patients died after surgery from developed complications. In patients with isolated recurrence in the Ln and combined recurrence of OC, the median PfS was significantly higher when complete cytoreduction was achieved: 31.0 months and 18.0 months versus 10.0 months and 9.0 months with incomplete repeated cytoreduction, p <0.0001. In patients with isolated recurrence in the Ln and combined recurrence of OC, the median OS was identically significantly higher when complete repeated cytoreduction was achieved: 97.0 months and 60.0 months versus 34.0 months and 27.0 months with incomplete cytoreduction, p <0.0001.Conclusion. Surgical treatment of recurrence of OC is justified only if it is possible to achieve complete cytoreduction and platinum-sensitive type of recurrence of OC. Low grade tumor, platinum-sensitive type of recurrence, absence of marker recurrence of OC, isolated recurrence in Ln, complete repeated cytoreduction and lymphodissection were identified as predictors of PfS in multivariate analysis. The following factors had an independent favorable effect on ","PeriodicalId":34449,"journal":{"name":"Tazovaia khirurgiia i onkologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43970456","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 : 2022-04-12DOI: 10.17650/2686-9594-2022-12-1-27-34
E. Polyanskaya, M. Fedyanin, U. Boyarskikh, A. Kechin, E. Moroz, A. N. Polyakov, N. Kudashkin, D. V. Podluzhniy, E. Khrapov, I. Oskorobin, D. Shamovskaya, V. Aliev, Z. Mamedli, A. Tryakin, M. Filipenko, S. Tjulandin
Background. Circulating tumor DnA (ctDnA) may act as a potential biomarker for predicting disease progression in patients with colorectal cancer (CRC), which are radically cured or receiving chemotherapy.Objective: to evaluate the sensitivity of the investigated ctDnA detection assay and quantify the concordance of genomic alterations between ctDnA and matched primary tumor tissue of patients with CRC.Materials and methods. we included patients with histologically confirmed stage I–Iv CRC treated in n.n. Blokhin Cancer Research Center from 2016 to 2021. DnA was purified from tissue samples using QIAamp DnA formalin-fixed paraffin-embedded (ffPE) Tissue Kit (QIAgEn, germany). next-generation sequencing (ngS) technique was used to detect genetic mutations in primary tumor. ctDnA mutations were detected by droplet digital PCR.Results. The sensitivity of platform (assay) for detecting genetic alterations in tissue samples was 97.82 %; in ctDnA – 51.20 % for all stages and 64.5 % for stage Iv CRC. Across eight genes (KRAS, TP53, APC, PIK3CA, BRAF, FBXW7, MB21D2, and SMAD4) concordance between primary tumor and ctDnA was 69.4 % (95 % CI 62.2–76.0). Sensitivity for all stages is 51.2 % (95 % CI 45.8–56.6), for metastatic CRC 64.5 % (95 % CI 53.3–74.5). The concordance across all genes was 65.4 % (95 % CI 57.1–73.1) and 83.8 % (95 % CI 69.6–92.9) for stage I–III and stage Iv CRC, respectively. The concordance rate between ctDnA and primary tumor tissue for KRAS alterations across all stages and stage Iv CRC was 78.3 % (95 % CI 66.7–87.3) and 90.9 % (95 % CI 64.7–99.0), respectively. with increasing tumor stage (T), the number of matches raised across all genes with the highest number observed in nx category.Conclusion. The study indicates high concordance between tumor tissue and ctDnA, especially for KRAS and BRAF genes in patients with metastatic CRC, suggesting the clinical utility of ctDnA testing as a minimally invasive method and alternative to tissue biopsy.
{"title":"Concordance between the tumor mutational status and circulating tumor DNA in patients with colorectal cancer","authors":"E. Polyanskaya, M. Fedyanin, U. Boyarskikh, A. Kechin, E. Moroz, A. N. Polyakov, N. Kudashkin, D. V. Podluzhniy, E. Khrapov, I. Oskorobin, D. Shamovskaya, V. Aliev, Z. Mamedli, A. Tryakin, M. Filipenko, S. Tjulandin","doi":"10.17650/2686-9594-2022-12-1-27-34","DOIUrl":"https://doi.org/10.17650/2686-9594-2022-12-1-27-34","url":null,"abstract":"Background. Circulating tumor DnA (ctDnA) may act as a potential biomarker for predicting disease progression in patients with colorectal cancer (CRC), which are radically cured or receiving chemotherapy.Objective: to evaluate the sensitivity of the investigated ctDnA detection assay and quantify the concordance of genomic alterations between ctDnA and matched primary tumor tissue of patients with CRC.Materials and methods. we included patients with histologically confirmed stage I–Iv CRC treated in n.n. Blokhin Cancer Research Center from 2016 to 2021. DnA was purified from tissue samples using QIAamp DnA formalin-fixed paraffin-embedded (ffPE) Tissue Kit (QIAgEn, germany). next-generation sequencing (ngS) technique was used to detect genetic mutations in primary tumor. ctDnA mutations were detected by droplet digital PCR.Results. The sensitivity of platform (assay) for detecting genetic alterations in tissue samples was 97.82 %; in ctDnA – 51.20 % for all stages and 64.5 % for stage Iv CRC. Across eight genes (KRAS, TP53, APC, PIK3CA, BRAF, FBXW7, MB21D2, and SMAD4) concordance between primary tumor and ctDnA was 69.4 % (95 % CI 62.2–76.0). Sensitivity for all stages is 51.2 % (95 % CI 45.8–56.6), for metastatic CRC 64.5 % (95 % CI 53.3–74.5). The concordance across all genes was 65.4 % (95 % CI 57.1–73.1) and 83.8 % (95 % CI 69.6–92.9) for stage I–III and stage Iv CRC, respectively. The concordance rate between ctDnA and primary tumor tissue for KRAS alterations across all stages and stage Iv CRC was 78.3 % (95 % CI 66.7–87.3) and 90.9 % (95 % CI 64.7–99.0), respectively. with increasing tumor stage (T), the number of matches raised across all genes with the highest number observed in nx category.Conclusion. The study indicates high concordance between tumor tissue and ctDnA, especially for KRAS and BRAF genes in patients with metastatic CRC, suggesting the clinical utility of ctDnA testing as a minimally invasive method and alternative to tissue biopsy.","PeriodicalId":34449,"journal":{"name":"Tazovaia khirurgiia i onkologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43376542","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 : 2022-03-15DOI: 10.17650/2686-9594-2021-11-3-4-11-17
M. Fedyanin, L. Vladimirova, V. Chubenko, L. Zagorskaya, A. Belyaeva, O. L. Fakhrutdinova, S. Belukhin, A. Zhabina, L. Khalikova, L. Bolotina, R. Orlova, F. Moiseenko, G. Mukhametshina, A. Khasanova, A. Belonogov, Kh.Sa. Musaeva, O. Novikova, I. Stradaeva, I. Popova, S. Erdniev, A. Ivanova, A. Androsova, P. Feoktistova, E. Kuzmina, E. Karabina, O. V. Nekrasova, O. Sekhina, Ales Mishchenko, L. A. Mukova, B. Kertiev, G. I. Kosar, S. N. Osodoeva, A. I. Kats, R. Malina, M. Lyadova, A. Tryakin, S. Tyulandin
Objective: to compare the efficacy and toxicity of aflibercept and bevacizumab in combination with fOLfIRI in secondline therapy for patients with metastatic colon cancer.Materials and methods. we performed a retrospective analysis of data on patients with metastatic colon cancer treated in 9 clinics in the Russian federation. The inclusion criteria were as follows: metastatic or locally advanced colon cancer; treatment with bevacizumab or aflibercept plus fOLfIRI in the second-line therapy. The primary outcome measure was progression-free survival (PfS). Secondary outcome measures included objective response rate and incidence of adverse events.Results. A total of 271 patients with metastatic colon cancer who received second-line therapy with bevacizumab (n = 81) or aflibercept (n = 190) between 2014 and 2018 were selected for this study. Study groups were matched for main prognostic signs. The objective response rate was 18.1 % in the bevacizumab group and 20.5 % in the aflibercept group (p = 0.7). The median PfS was 5 months (95 % confidence interval 3.8–6.1) in the aflibercept group and 7 months (95 % confidence interval 0.81–2.1) in the bevacizumab group (hazard ratio 1.4; 95 % confidence interval 0.99–2.1; p = 0.04). multivariate regression analysis demonstrated that the type of the targeted drug independently had no effect on PfS (hazard ratio 1.3; 95 % confidence interval 0.9–1.9; p = 0.2). we observed no statistically significant differences in the incidence of complications of any grades between the groups (58 % vs 72 %, p = 0.1). Patients receiving aflibercept were more likely to develop grade III–Iv arterial hypertension (2 % vs 9.5 %) and diarrhea (0 % vs 5.4 %), whereas thrombotic complications were more common in the bevacizumab group (10 % vs 1.8 %).Conclusion. we observed no significant differences in objective response rate and PfS between patients with metastatic colon cancer receiving bevacizumab or aflibercept in combination with fOLfIRI as second-line therapy. The toxicity profiles were different. Our findings can be used for choosing an optimal targeted drug for second-line treatment.
目的:比较阿非利西普与贝伐单抗联合fOLfIRI二线治疗转移性结肠癌患者的疗效和毒性。材料和方法。我们对俄罗斯联邦9家诊所治疗的转移性结肠癌患者的数据进行了回顾性分析。纳入标准如下:转移性或局部晚期结肠癌;在二线治疗中使用贝伐单抗或阿非利塞普加fOLfIRI。主要结局指标为无进展生存期(PfS)。次要结局指标包括客观有效率和不良事件发生率。在2014年至2018年期间，共有271例接受贝伐单抗(n = 81)或阿非利塞普(n = 190)二线治疗的转移性结肠癌患者被纳入本研究。各研究组对主要预后体征进行匹配。贝伐单抗组客观有效率为18.1%，阿非利西普组为20.5% (p = 0.7)。阿非利西普组的中位PfS为5个月(95%可信区间3.8-6.1)，贝伐单抗组的中位PfS为7个月(95%可信区间0.81-2.1)(风险比1.4;95%置信区间0.99-2.1;P = 0.04)。多因素回归分析显示，单独的靶向药物类型对PfS没有影响(风险比为1.3;95%置信区间0.9-1.9;P = 0.2)。我们观察到两组间任何级别并发症的发生率无统计学差异(58% vs 72%， p = 0.1)。接受阿非利西普治疗的患者更容易发生III-Iv级动脉高血压(2%对9.5%)和腹泻(0%对5.4%)，而贝伐单抗组血栓并发症更常见(10%对1.8%)。我们观察到转移性结肠癌患者接受贝伐单抗或阿非利塞普联合fOLfIRI作为二线治疗的客观缓解率和PfS无显著差异。毒性谱是不同的。我们的发现可以用于选择最佳的靶向药物进行二线治疗。
{"title":"Efficacy and toxicity of aflibercept and bevacizumab in combination with FOLFIRI in second‑line therapy for metastatic colon cancer: a retrospective multicenter study","authors":"M. Fedyanin, L. Vladimirova, V. Chubenko, L. Zagorskaya, A. Belyaeva, O. L. Fakhrutdinova, S. Belukhin, A. Zhabina, L. Khalikova, L. Bolotina, R. Orlova, F. Moiseenko, G. Mukhametshina, A. Khasanova, A. Belonogov, Kh.Sa. Musaeva, O. Novikova, I. Stradaeva, I. Popova, S. Erdniev, A. Ivanova, A. Androsova, P. Feoktistova, E. Kuzmina, E. Karabina, O. V. Nekrasova, O. Sekhina, Ales Mishchenko, L. A. Mukova, B. Kertiev, G. I. Kosar, S. N. Osodoeva, A. I. Kats, R. Malina, M. Lyadova, A. Tryakin, S. Tyulandin","doi":"10.17650/2686-9594-2021-11-3-4-11-17","DOIUrl":"https://doi.org/10.17650/2686-9594-2021-11-3-4-11-17","url":null,"abstract":"Objective: to compare the efficacy and toxicity of aflibercept and bevacizumab in combination with fOLfIRI in secondline therapy for patients with metastatic colon cancer.Materials and methods. we performed a retrospective analysis of data on patients with metastatic colon cancer treated in 9 clinics in the Russian federation. The inclusion criteria were as follows: metastatic or locally advanced colon cancer; treatment with bevacizumab or aflibercept plus fOLfIRI in the second-line therapy. The primary outcome measure was progression-free survival (PfS). Secondary outcome measures included objective response rate and incidence of adverse events.Results. A total of 271 patients with metastatic colon cancer who received second-line therapy with bevacizumab (n = 81) or aflibercept (n = 190) between 2014 and 2018 were selected for this study. Study groups were matched for main prognostic signs. The objective response rate was 18.1 % in the bevacizumab group and 20.5 % in the aflibercept group (p = 0.7). The median PfS was 5 months (95 % confidence interval 3.8–6.1) in the aflibercept group and 7 months (95 % confidence interval 0.81–2.1) in the bevacizumab group (hazard ratio 1.4; 95 % confidence interval 0.99–2.1; p = 0.04). multivariate regression analysis demonstrated that the type of the targeted drug independently had no effect on PfS (hazard ratio 1.3; 95 % confidence interval 0.9–1.9; p = 0.2). we observed no statistically significant differences in the incidence of complications of any grades between the groups (58 % vs 72 %, p = 0.1). Patients receiving aflibercept were more likely to develop grade III–Iv arterial hypertension (2 % vs 9.5 %) and diarrhea (0 % vs 5.4 %), whereas thrombotic complications were more common in the bevacizumab group (10 % vs 1.8 %).Conclusion. we observed no significant differences in objective response rate and PfS between patients with metastatic colon cancer receiving bevacizumab or aflibercept in combination with fOLfIRI as second-line therapy. The toxicity profiles were different. Our findings can be used for choosing an optimal targeted drug for second-line treatment.","PeriodicalId":34449,"journal":{"name":"Tazovaia khirurgiia i onkologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43511724","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 : 2022-03-15DOI: 10.17650/2686-9594-2021-11-3-4-23-28
M. S. Lebedko, S. Gordeev, S. G. Gaydarov, Z. Mamedli, V. Kosyrev, A. Aniskin, S. O. Kochkina
Background. Colorectal anastomotic leakage remains on of the most significant challenges in rectal surgery.Objective: to assess the impact of pelvic peritoneal floor reconstruction on the incidence of postoperative complications associated with colorectal anastomosis.Materials and methods. In this retrospective cohort study, we analyzed medical records of rectal cancer patients who had undergone rectal resection with anastomosis formation between 2013 and 2020. we compared patients who had no pelvic peritoneal floor reconstruction (from 2013 to 2017) and those who had it (2018–2020). Only patients with favorable prognosis (tumor located at least 5 cm above the transitional anal fold and no history of chemoradiotherapy) were included. The primary outcome measure was the incidence of peritonitis and colorectal anastomosis leakage. Secondary outcome measures included overall incidence of complications (Clavien–Dindo), mortality rate, blood loss, and duration of surgery.Results. A total of 120 patients were included into the experimental group, while the control group was composed of 125 patients. Ten patients from the control group developed peritonitis (8.0 %), whereas in the experimental group, there were no cases of peritonitis (p = 0.002). Anastomotic leakage was registered in 12 individuals from the experimental group (12.5 %) and 14 controls (11.2 %) (p = 0.753). The overall incidence of postoperative complications was 23.3 % (n = 28) among patients who had pelvic peritoneal floor reconstruction and 18.4 % (n = 23) among those who did not have it (p = 0.342). Colostomy was required in 92 patients from the experimental group (76.7 %) and 78 patients from the control group (62.4 %) (p = 0.018). The postoperative mortality was 0.8 % in the control group (n = 1) and 0 % in the experimental group (p = 1).Conclusion. Pelvic peritoneal floor reconstruction reduces the risk of peritonitis, but does not affect the overall risk of anastomotic leakage. This method is effective for the prevention of severe postoperative complications.
{"title":"Immediate results of rectal resections for cancer in depending on the restoration of the integrity of the pelvic peritoneal floor: retrospective study","authors":"M. S. Lebedko, S. Gordeev, S. G. Gaydarov, Z. Mamedli, V. Kosyrev, A. Aniskin, S. O. Kochkina","doi":"10.17650/2686-9594-2021-11-3-4-23-28","DOIUrl":"https://doi.org/10.17650/2686-9594-2021-11-3-4-23-28","url":null,"abstract":"Background. Colorectal anastomotic leakage remains on of the most significant challenges in rectal surgery.Objective: to assess the impact of pelvic peritoneal floor reconstruction on the incidence of postoperative complications associated with colorectal anastomosis.Materials and methods. In this retrospective cohort study, we analyzed medical records of rectal cancer patients who had undergone rectal resection with anastomosis formation between 2013 and 2020. we compared patients who had no pelvic peritoneal floor reconstruction (from 2013 to 2017) and those who had it (2018–2020). Only patients with favorable prognosis (tumor located at least 5 cm above the transitional anal fold and no history of chemoradiotherapy) were included. The primary outcome measure was the incidence of peritonitis and colorectal anastomosis leakage. Secondary outcome measures included overall incidence of complications (Clavien–Dindo), mortality rate, blood loss, and duration of surgery.Results. A total of 120 patients were included into the experimental group, while the control group was composed of 125 patients. Ten patients from the control group developed peritonitis (8.0 %), whereas in the experimental group, there were no cases of peritonitis (p = 0.002). Anastomotic leakage was registered in 12 individuals from the experimental group (12.5 %) and 14 controls (11.2 %) (p = 0.753). The overall incidence of postoperative complications was 23.3 % (n = 28) among patients who had pelvic peritoneal floor reconstruction and 18.4 % (n = 23) among those who did not have it (p = 0.342). Colostomy was required in 92 patients from the experimental group (76.7 %) and 78 patients from the control group (62.4 %) (p = 0.018). The postoperative mortality was 0.8 % in the control group (n = 1) and 0 % in the experimental group (p = 1).Conclusion. Pelvic peritoneal floor reconstruction reduces the risk of peritonitis, but does not affect the overall risk of anastomotic leakage. This method is effective for the prevention of severe postoperative complications.","PeriodicalId":34449,"journal":{"name":"Tazovaia khirurgiia i onkologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48981800","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 : 2022-03-15DOI: 10.17650/2686-9594-2021-11-3-4-29-34
M. N. Saryev, M. Nechushkin, R. Valiev, M. B. Nurberdyev, V. Aliev, E. A. Tizilova
The aim of this study was to analyze currently available information on the risks of fistulas in patients with cervical cancer after radiation therapy and possible treatment options.This review includes data from Russian and foreign articles devoted to this problem. It covers the frequency of fistulas of after radiation therapy in cervical cancer patients, as well as some treatment methods.Attempts to change the approaches to radiation therapy for advanced cervical cancer were unsuccessful; therefore, patients with cervical cancer will be at high risk of developing fistulas in the next few years. Different treatments for fistulas demonstrate contradictory results and dictate the need for a tailored-approach in such cases. The development of new surgical methods for the correction of vesicovaginal and rectovaginal fistulas is still highly relevant.
{"title":"Surgical correction of fistulas in patients with cervical cancer after radiation therapy","authors":"M. N. Saryev, M. Nechushkin, R. Valiev, M. B. Nurberdyev, V. Aliev, E. A. Tizilova","doi":"10.17650/2686-9594-2021-11-3-4-29-34","DOIUrl":"https://doi.org/10.17650/2686-9594-2021-11-3-4-29-34","url":null,"abstract":"The aim of this study was to analyze currently available information on the risks of fistulas in patients with cervical cancer after radiation therapy and possible treatment options.This review includes data from Russian and foreign articles devoted to this problem. It covers the frequency of fistulas of after radiation therapy in cervical cancer patients, as well as some treatment methods.Attempts to change the approaches to radiation therapy for advanced cervical cancer were unsuccessful; therefore, patients with cervical cancer will be at high risk of developing fistulas in the next few years. Different treatments for fistulas demonstrate contradictory results and dictate the need for a tailored-approach in such cases. The development of new surgical methods for the correction of vesicovaginal and rectovaginal fistulas is still highly relevant.","PeriodicalId":34449,"journal":{"name":"Tazovaia khirurgiia i onkologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42500738","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 : 2022-03-15DOI: 10.17650/2686-9594-2021-11-3-4-35-39
V. A. Ivanov, S. Gordeev
Targeted therapy for colorectal cancer usually includes anti-vEgf and anti-EgfR antibodies. The initiation of first-line therapy for metastatic colorectal cancer depends on the baseline patient’s characteristics, tumor spread, and its mutational status. Despite the wide range of possible combinations of these factors, an oncologist should choose between standard platinum-based chemotherapy regimens and combination of similar chemotherapeutic agents with bevacizumab or cetuximab. Disease progression after first-line therapy poses a dilemma to an oncologist, since the range of potentially beneficial targeted drugs or immunotherapeutic agents is much wider along with the lack of sufficient evidence. This article focuses on the efficacy of aflibercept as a second-line treatment for colorectal cancer, indications for its use, and outlooks.
{"title":"Aflibercept as a treatment for malignant tumors","authors":"V. A. Ivanov, S. Gordeev","doi":"10.17650/2686-9594-2021-11-3-4-35-39","DOIUrl":"https://doi.org/10.17650/2686-9594-2021-11-3-4-35-39","url":null,"abstract":"Targeted therapy for colorectal cancer usually includes anti-vEgf and anti-EgfR antibodies. The initiation of first-line therapy for metastatic colorectal cancer depends on the baseline patient’s characteristics, tumor spread, and its mutational status. Despite the wide range of possible combinations of these factors, an oncologist should choose between standard platinum-based chemotherapy regimens and combination of similar chemotherapeutic agents with bevacizumab or cetuximab. Disease progression after first-line therapy poses a dilemma to an oncologist, since the range of potentially beneficial targeted drugs or immunotherapeutic agents is much wider along with the lack of sufficient evidence. This article focuses on the efficacy of aflibercept as a second-line treatment for colorectal cancer, indications for its use, and outlooks.","PeriodicalId":34449,"journal":{"name":"Tazovaia khirurgiia i onkologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47535603","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 : 2022-03-15DOI: 10.17650/2686-9594-2021-11-3-4-18-22
T. Mirzaev, D. V. Podluzhniy, R. Izrailov, A. Kotelnikov, E. Glukhov, I. M. Faynshteyn, P. A. Kerimov, N. Kudashkin, A. N. Polyakov, B. I. Sakibov
Objective: to compare short-term and long-term postoperative complications between patients who have undergone central pancreatectomy (CP) and distal pancreatectomy (DP).Materials and methods. This retrospective study included patients who had CP for benign pancreatic tumors and tumors of low malignant potential (cases) and patients who had DP for similar reasons (controls). The controls were randomly selected and matched cases for tumor size, presence of diabetes mellitus (Dm), and ASA physical status. we evaluated the incidence of grade ≥III complications (Clavien–Dindo classification), clinically significant pancreatic fistulas, Dm, and impaired exocrine pancreatic function in the late postoperative period.Results. There were 25 cases and 25 controls. Both groups were matched for the main clinical characteristics. Surgeries were significantly longer in the CP groups compared to the DP group (230 min vs 180 min, р < 0.0001). There was no difference in the overall incidence of postoperative complications (9 (36 %) vs 14 (56 %), р = 0.26); there was a trend towards a higher incidence of postoperative complications in the CP group. Two patients after CP (8 %) required repeated surgeries. none of the study participants died. Clinically significant (B and C) pancreatic fistulas were registered in 8 (32 %) and 11 (44 %) patients, respectively (p = 0.56). Two patients in the DP group (8 %) developed impairments of exocrine pancreatic function that required pharmacotherapy. none of the patients developed Dm postoperatively.Conclusion. Despite the fact that CP and DP outcomes were comparable in terms of the main parameters evaluated, severe post-CP complications indicate that there is a need for careful selection of patients for such interventions and further accumulation of experience. Our findings can be used in the subsequent analysis of the experience of different clinics.
{"title":"Central or distal pancreatectomy in patients with pancreatic tumors: assessment of short‑term outcomes","authors":"T. Mirzaev, D. V. Podluzhniy, R. Izrailov, A. Kotelnikov, E. Glukhov, I. M. Faynshteyn, P. A. Kerimov, N. Kudashkin, A. N. Polyakov, B. I. Sakibov","doi":"10.17650/2686-9594-2021-11-3-4-18-22","DOIUrl":"https://doi.org/10.17650/2686-9594-2021-11-3-4-18-22","url":null,"abstract":"Objective: to compare short-term and long-term postoperative complications between patients who have undergone central pancreatectomy (CP) and distal pancreatectomy (DP).Materials and methods. This retrospective study included patients who had CP for benign pancreatic tumors and tumors of low malignant potential (cases) and patients who had DP for similar reasons (controls). The controls were randomly selected and matched cases for tumor size, presence of diabetes mellitus (Dm), and ASA physical status. we evaluated the incidence of grade ≥III complications (Clavien–Dindo classification), clinically significant pancreatic fistulas, Dm, and impaired exocrine pancreatic function in the late postoperative period.Results. There were 25 cases and 25 controls. Both groups were matched for the main clinical characteristics. Surgeries were significantly longer in the CP groups compared to the DP group (230 min vs 180 min, р < 0.0001). There was no difference in the overall incidence of postoperative complications (9 (36 %) vs 14 (56 %), р = 0.26); there was a trend towards a higher incidence of postoperative complications in the CP group. Two patients after CP (8 %) required repeated surgeries. none of the study participants died. Clinically significant (B and C) pancreatic fistulas were registered in 8 (32 %) and 11 (44 %) patients, respectively (p = 0.56). Two patients in the DP group (8 %) developed impairments of exocrine pancreatic function that required pharmacotherapy. none of the patients developed Dm postoperatively.Conclusion. Despite the fact that CP and DP outcomes were comparable in terms of the main parameters evaluated, severe post-CP complications indicate that there is a need for careful selection of patients for such interventions and further accumulation of experience. Our findings can be used in the subsequent analysis of the experience of different clinics.","PeriodicalId":34449,"journal":{"name":"Tazovaia khirurgiia i onkologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42013008","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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