Pub Date : 2022-07-16DOI: 10.24060/2076-3093-2022-12-2-164-171
E. Karabina, D. Sakaeva, O. Lipatov
The off-label use of medicines is a routine clinical practice of oncology, especially in malignant-tumour patients with no treatment alternatives left when registered-drug options have been exhausted or standard therapies reveal contraindications. The recent shift from single-gene assays to multigene panels powered by full-exome or -genome sequencing expands the capacity of precision therapy, leading to a wider agnostic off-label use of targeted drugs for detecting a particular molecular genetic disorder. Studies of the off-label drug use in oncology will clarify the feasibility and safety of such prescriptions in patients with rare forms of malignancy when registered therapies have been exhausted or standard treatment reveals contraindications. This article examines the prevalence and landscape of off-label drug use in cancer patients and elaborates on the off-label principle. The paper presents a critical reflection on the off-label use of medicines in oncology.
{"title":"Off-Label Drug Use in Oncology","authors":"E. Karabina, D. Sakaeva, O. Lipatov","doi":"10.24060/2076-3093-2022-12-2-164-171","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-2-164-171","url":null,"abstract":"The off-label use of medicines is a routine clinical practice of oncology, especially in malignant-tumour patients with no treatment alternatives left when registered-drug options have been exhausted or standard therapies reveal contraindications. The recent shift from single-gene assays to multigene panels powered by full-exome or -genome sequencing expands the capacity of precision therapy, leading to a wider agnostic off-label use of targeted drugs for detecting a particular molecular genetic disorder. Studies of the off-label drug use in oncology will clarify the feasibility and safety of such prescriptions in patients with rare forms of malignancy when registered therapies have been exhausted or standard treatment reveals contraindications. This article examines the prevalence and landscape of off-label drug use in cancer patients and elaborates on the off-label principle. The paper presents a critical reflection on the off-label use of medicines in oncology.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43006923","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 : 2022-07-16DOI: 10.24060/2076-3093-2022-12-2-172-175
M. Nartaylakov, V. Panteleev, I. Z. Salimgareev, M. Loginov, K. Zolotukhin, V. D. Dorofeev, G. K. Mirasova, D. F. Shakurov, A. Petrov
Introduction. The third wave of the new coronavirus infection (COVID-19) pandemic warrants total mobilisation of healthcare and social resources. In this respect, a pressing issue remains the provision of routine and emergency surgical care in patients with hepatopancreatobiliary diseases.Materials and methods. A retrospective analysis of the surgical outcomes in 5,040 hepatopancreatobiliary patients was carried out; this accounted for 51.1 % of the total abdominal surgeries.Results and discussion. Biliary lithiasis and its complications — choledocholithiasis with obstructive jaundice and residual choledocholithiasis — (54.4 %) as well as acute calculous cholecystitis (18.7 %) were operated most frequently. A sharp decrease over all hepatopancreatobiliary nosologies was registered for the surgical interventions in first pandemic year 2020. Thus, the median annual number of operations for biliary lithiasis and its complications was 550 (482–592 year-range) in the precovid period, while dropping to only 321 at the onset of pandemic (p <0.05). A first sixmonth survey of year 2021 revealed a growth of surgical activity for all hepatopancreatobiliary nosologies.Conclusion. Hepatopancreatobiliary operations prevail (54.4 % cases) in the total structure of level 3 abdominal surgical interventions. A high annual rate of surgical operations over nearly all hepatopancreatobiliary nosologies was interrupted in the first year of the new coronavirus infection outbreak. Meanwhile, the first half of 2021 showed a clear tend towards restoring the precovid statistical indicators, despite the stressful conditions of persistently relapsing COVID-19 that surgical facilities had faced.
{"title":"Surgical Aid to Patients with Hepatopancreatobiliary Situations in Precovid Period and under Persistent Relapse of New Coronavirus Infection SARS-CoV-2","authors":"M. Nartaylakov, V. Panteleev, I. Z. Salimgareev, M. Loginov, K. Zolotukhin, V. D. Dorofeev, G. K. Mirasova, D. F. Shakurov, A. Petrov","doi":"10.24060/2076-3093-2022-12-2-172-175","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-2-172-175","url":null,"abstract":"Introduction. The third wave of the new coronavirus infection (COVID-19) pandemic warrants total mobilisation of healthcare and social resources. In this respect, a pressing issue remains the provision of routine and emergency surgical care in patients with hepatopancreatobiliary diseases.Materials and methods. A retrospective analysis of the surgical outcomes in 5,040 hepatopancreatobiliary patients was carried out; this accounted for 51.1 % of the total abdominal surgeries.Results and discussion. Biliary lithiasis and its complications — choledocholithiasis with obstructive jaundice and residual choledocholithiasis — (54.4 %) as well as acute calculous cholecystitis (18.7 %) were operated most frequently. A sharp decrease over all hepatopancreatobiliary nosologies was registered for the surgical interventions in first pandemic year 2020. Thus, the median annual number of operations for biliary lithiasis and its complications was 550 (482–592 year-range) in the precovid period, while dropping to only 321 at the onset of pandemic (p <0.05). A first sixmonth survey of year 2021 revealed a growth of surgical activity for all hepatopancreatobiliary nosologies.Conclusion. Hepatopancreatobiliary operations prevail (54.4 % cases) in the total structure of level 3 abdominal surgical interventions. A high annual rate of surgical operations over nearly all hepatopancreatobiliary nosologies was interrupted in the first year of the new coronavirus infection outbreak. Meanwhile, the first half of 2021 showed a clear tend towards restoring the precovid statistical indicators, despite the stressful conditions of persistently relapsing COVID-19 that surgical facilities had faced.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48816698","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 : 2022-07-16DOI: 10.24060/2076-3093-2022-12-2-159-163
A. Urakov
Post-injection abscess, which is the sad finale of Nicolau syndrome, continues to attract the attention of researchers due to the need to clarify the causes of this iatrogenic disease in order to develop effective measures for its prevention. For many years, researchers from all over the world have tried from different perspectives to explain the mechanism of the drugs effect that causes post-injection pain syndrome, infiltration, inflammation, erimatous skin damage, necrosis and abscess (Nicolau syndrome), but to no avail. This has been done only in recent years. There are findings in Russia that show that drugs considered to be of high quality today, in some cases, in addition to specific pharmacological activity, may have necrotic activity of a non-specific nature of action. The findings showed that according to the established pharmaceutical practice and in full compliance with the pharmacopoeia requirements for the quality of medicines, pharmaceutical products produced by different pharmaceutical companies, as well as those included in different series of the same pharmaceutical company, may have different compositions (formulations), contain different ingredients, therefore they may have different physico-chemical properties. In this regard, drugs of different serial numbers and/or different manufacturers, which are considered high-quality today, can be hypertonic solutions, have acidifying or alkalizing activity, have alcohols, aldehydes and heavy metal salts in denaturing concentrations. This is the reason that in some cases drugs have necrotic (cauterizing) activity. In this regard, to prevent Nicolau syndrome, it is proposed to reduce the physico-chemical aggressiveness of drugs. Today, this can be done successfully by diluting them with water for injection 2 to 8 times before injection.
{"title":"Nikolau Syndrome: Necrotic Activity of Drugs and Ways to Prevent Post-Injection Abscesses (In memory of Professor László A Gömze)","authors":"A. Urakov","doi":"10.24060/2076-3093-2022-12-2-159-163","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-2-159-163","url":null,"abstract":"Post-injection abscess, which is the sad finale of Nicolau syndrome, continues to attract the attention of researchers due to the need to clarify the causes of this iatrogenic disease in order to develop effective measures for its prevention. For many years, researchers from all over the world have tried from different perspectives to explain the mechanism of the drugs effect that causes post-injection pain syndrome, infiltration, inflammation, erimatous skin damage, necrosis and abscess (Nicolau syndrome), but to no avail. This has been done only in recent years. There are findings in Russia that show that drugs considered to be of high quality today, in some cases, in addition to specific pharmacological activity, may have necrotic activity of a non-specific nature of action. The findings showed that according to the established pharmaceutical practice and in full compliance with the pharmacopoeia requirements for the quality of medicines, pharmaceutical products produced by different pharmaceutical companies, as well as those included in different series of the same pharmaceutical company, may have different compositions (formulations), contain different ingredients, therefore they may have different physico-chemical properties. In this regard, drugs of different serial numbers and/or different manufacturers, which are considered high-quality today, can be hypertonic solutions, have acidifying or alkalizing activity, have alcohols, aldehydes and heavy metal salts in denaturing concentrations. This is the reason that in some cases drugs have necrotic (cauterizing) activity. In this regard, to prevent Nicolau syndrome, it is proposed to reduce the physico-chemical aggressiveness of drugs. Today, this can be done successfully by diluting them with water for injection 2 to 8 times before injection.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49510040","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 : 2022-07-15DOI: 10.24060/2076-3093-2022-12-2-112-117
M. V. Timerbulatov, T. M. Murasov, A. M. Murasov
Background. Superficial thrombophlebitis of lower extremities is among the most frequent acute vascular pathologies. Concomitant undifferentiated connective tissue dysplasia exerts specific changes in its clinical course.Aim: A study of the specific dynamics of acute lower limb superficial thrombophlebitis (ST) and its surgical treatment in patients with undifferentiated connective tissue dysplasia (UCTD).Materials and methods. The case histories, surgery reports and follow-up examinations of patients treated at the Vascular Surgery Unit during 2012–2020 were analysed. A total of 86 patients had signs of UCTD and underwent classical crossectomy of the great saphenous vein (Troyanov operation).Results and discussion. Duplex ultrasound of lower limb veins in 34 (39.53 %) patients revealed a discrepancy between the upper localisation of thrombotic masses in the great saphenous lumen and the external boundary registered for clinical manifestations, hyperaemia and tissue thickening. In 69 (80.23 %) patients, four or more phenotypic UCTD markers were exposed. In 74 (86.05 %) cases, a classical Babcock phlebectomy was performed as a next stage within one year after an acute thrombophlebitis attack had subsided. Of 12 (13.95 %) patients not having had a second-stage phlebectomy within one year: 4 people had UCTD signs — they refused surgery due to absent significant complaints or marked saphenous reflux; 3 had a deep vein thrombosis episode; 5 had no saphenous reflux of lower extremities in ultrasound examination.Conclusion. The registration of phenotypic signs of undifferentiated connective tissue dysplasia is recommended in choosing a surgical tactic to treat acute ascending thrombophlebitis of lower limb saphenous veins.
{"title":"Surgical Specifics of Lower Limb Superficial Thrombophlebitis Combined with Undifferentiated Connective Tissue Disease","authors":"M. V. Timerbulatov, T. M. Murasov, A. M. Murasov","doi":"10.24060/2076-3093-2022-12-2-112-117","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-2-112-117","url":null,"abstract":"Background. Superficial thrombophlebitis of lower extremities is among the most frequent acute vascular pathologies. Concomitant undifferentiated connective tissue dysplasia exerts specific changes in its clinical course.Aim: A study of the specific dynamics of acute lower limb superficial thrombophlebitis (ST) and its surgical treatment in patients with undifferentiated connective tissue dysplasia (UCTD).Materials and methods. The case histories, surgery reports and follow-up examinations of patients treated at the Vascular Surgery Unit during 2012–2020 were analysed. A total of 86 patients had signs of UCTD and underwent classical crossectomy of the great saphenous vein (Troyanov operation).Results and discussion. Duplex ultrasound of lower limb veins in 34 (39.53 %) patients revealed a discrepancy between the upper localisation of thrombotic masses in the great saphenous lumen and the external boundary registered for clinical manifestations, hyperaemia and tissue thickening. In 69 (80.23 %) patients, four or more phenotypic UCTD markers were exposed. In 74 (86.05 %) cases, a classical Babcock phlebectomy was performed as a next stage within one year after an acute thrombophlebitis attack had subsided. Of 12 (13.95 %) patients not having had a second-stage phlebectomy within one year: 4 people had UCTD signs — they refused surgery due to absent significant complaints or marked saphenous reflux; 3 had a deep vein thrombosis episode; 5 had no saphenous reflux of lower extremities in ultrasound examination.Conclusion. The registration of phenotypic signs of undifferentiated connective tissue dysplasia is recommended in choosing a surgical tactic to treat acute ascending thrombophlebitis of lower limb saphenous veins.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46614963","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 : 2022-07-15DOI: 10.24060/2076-3093-2022-12-2-128-138
R. K. Minyazeva, G. Battalova, I. Sakhautdinova, I. Gilyazova
Cervical cancer comprises a major female health problem worldwide. Despite population screening programmes, broad vaccination, precision pathogenesis studies and emergent diagnostics and treatment strategies, its prevalence is rising by year. We increasingly report the spread of disease, particularly of metastatic cervical cancer. The such patients’ prognosis is far from favourable. We review the literature relevant to diagnostic and treatment options in metastatic cervical cancer. The options and survival rates described vary by the locality of metastatic lesions and routes of metastasis. Patients with haematogenous metastases have a worse prognosis than patients with lymphogenous ones. From a diagnostic point of view, 2-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG PET) and PET-computed tomography remain efficacious for detecting distant metastases. Adjuvant chemotherapy and concurrent chemoradiotherapy are effective in lymphogenous metastases. Haematogenous lung metastases resection and/or chemotherapy are the tactics of choice to contain relapsed metastatic cervical cancer. Accordingly, chemoradiotherapy is the optimal choice in patients with stage IVB cervical cancer. Multimodal therapy has revealed better survival prognosis. Stereotactic radiosurgery or craniotomy is indicated in oligometastatic brain lesions, with treatment outcomes and survival rates improving for the techniques’ combination with whole-brain radiation therapy. However, in multiple metastasis to brain or extracranial metastasis, chemotherapy combined with palliative whole-brain radiation are left as the only option.
{"title":"Modern diagnostics and treatment of distant metastasis of cervical cancer","authors":"R. K. Minyazeva, G. Battalova, I. Sakhautdinova, I. Gilyazova","doi":"10.24060/2076-3093-2022-12-2-128-138","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-2-128-138","url":null,"abstract":"Cervical cancer comprises a major female health problem worldwide. Despite population screening programmes, broad vaccination, precision pathogenesis studies and emergent diagnostics and treatment strategies, its prevalence is rising by year. We increasingly report the spread of disease, particularly of metastatic cervical cancer. The such patients’ prognosis is far from favourable. We review the literature relevant to diagnostic and treatment options in metastatic cervical cancer. The options and survival rates described vary by the locality of metastatic lesions and routes of metastasis. Patients with haematogenous metastases have a worse prognosis than patients with lymphogenous ones. From a diagnostic point of view, 2-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG PET) and PET-computed tomography remain efficacious for detecting distant metastases. Adjuvant chemotherapy and concurrent chemoradiotherapy are effective in lymphogenous metastases. Haematogenous lung metastases resection and/or chemotherapy are the tactics of choice to contain relapsed metastatic cervical cancer. Accordingly, chemoradiotherapy is the optimal choice in patients with stage IVB cervical cancer. Multimodal therapy has revealed better survival prognosis. Stereotactic radiosurgery or craniotomy is indicated in oligometastatic brain lesions, with treatment outcomes and survival rates improving for the techniques’ combination with whole-brain radiation therapy. However, in multiple metastasis to brain or extracranial metastasis, chemotherapy combined with palliative whole-brain radiation are left as the only option.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42223043","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 : 2022-07-15DOI: 10.24060/2076-3093-2022-12-2-151-158
E. Spevak, D. Y. Christophorando, V. Shutov, A. V. Ermakova
The occurrence of drug-induced osteonecrosis of the jaw in cancer patients treated using bone-modifying medications (bisphosphonates and denosumab) is a highly relevant research problem studied by dentists, maxillofacial surgeons, and oncologists. Despite the large number of publications, practical approaches to preventing drug-induced osteonecrosis of the jaw remain to be developed, which is confirmed by the increasing prevalence and severity of the clinical course of the disease. In this article, we review the most significant works and position papers published in Russia and abroad over the past 10 years, as well as the authors’ scientific and clinical experience, in order to identify key reasons behind the ineffective prevention of drug-induced osteonecrosis of the jaw in cancer patients and to suggests possible solutions. Questions concerning the legal protection of patients and clinicians in relation to this complication are discussed. Most recent achievements in the field of laboratory diagnostics and risk assessment of drug-induced osteonecrosis of the jaw in cancer patients, including the determination of bone metabolism markers, are presented. The following criteria for the safe use of bisphosphonates and denosumab in cancer patients were identified: dental screening; clinical and laboratory monitoring; individualizing drug dosage, duration and withdrawal regimens; application of an interdisciplinary approach.
{"title":"Prevention Of Drug-Induced Osteonecrosis Of The Jaw In Cancer Patients","authors":"E. Spevak, D. Y. Christophorando, V. Shutov, A. V. Ermakova","doi":"10.24060/2076-3093-2022-12-2-151-158","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-2-151-158","url":null,"abstract":"The occurrence of drug-induced osteonecrosis of the jaw in cancer patients treated using bone-modifying medications (bisphosphonates and denosumab) is a highly relevant research problem studied by dentists, maxillofacial surgeons, and oncologists. Despite the large number of publications, practical approaches to preventing drug-induced osteonecrosis of the jaw remain to be developed, which is confirmed by the increasing prevalence and severity of the clinical course of the disease. In this article, we review the most significant works and position papers published in Russia and abroad over the past 10 years, as well as the authors’ scientific and clinical experience, in order to identify key reasons behind the ineffective prevention of drug-induced osteonecrosis of the jaw in cancer patients and to suggests possible solutions. Questions concerning the legal protection of patients and clinicians in relation to this complication are discussed. Most recent achievements in the field of laboratory diagnostics and risk assessment of drug-induced osteonecrosis of the jaw in cancer patients, including the determination of bone metabolism markers, are presented. The following criteria for the safe use of bisphosphonates and denosumab in cancer patients were identified: dental screening; clinical and laboratory monitoring; individualizing drug dosage, duration and withdrawal regimens; application of an interdisciplinary approach.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42081871","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 : 2022-07-15DOI: 10.24060/2076-3093-2022-12-2-139-150
K. Menshikov, A. Sultanbaev, Shamil I. Musin, Irina R. Rakhmatullina, I. Menshikova, Abdeev, Nadezhda I. Sultanbaeva, Ekaterina V. Popova, G. Serebrennikov
Liver cancer remains a global challenge of healthcare, with the incidence growing worldwide. According to various authors, over 1 million patients will be diagnosed with liver cancer each year by 2025. The molecular pathogenesis of HCC varies with respect to genotoxic lesions and aetiologies. Although our understanding of the HCC pathophysiology and drivers tends to improve, it is still distant from translation into clinical practice. About 25 % of HCC cases are associated with variant mutations. HCC pathophysiology is a complex multi-step process. The interaction of various factors underlies the early stages of malignant hepatocyte transformation towards the development of HCC. Overall, about 20–25 % of HCC patients have at least one potential driver mutation. Obesity should also be noted as being associated with a higher risk of HCC and various other cancers. Despite many issues in the HCC pathogenesis being already known, the unresolved questions remain. Modern molecular genetic diagnostics and animal modelling of malignant tumours are expanding our horizons of knowledge in this field.
{"title":"Hepatocellular Carcinoma: Aetiology and Mechanisms of Development. A Literature Review","authors":"K. Menshikov, A. Sultanbaev, Shamil I. Musin, Irina R. Rakhmatullina, I. Menshikova, Abdeev, Nadezhda I. Sultanbaeva, Ekaterina V. Popova, G. Serebrennikov","doi":"10.24060/2076-3093-2022-12-2-139-150","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-2-139-150","url":null,"abstract":"Liver cancer remains a global challenge of healthcare, with the incidence growing worldwide. According to various authors, over 1 million patients will be diagnosed with liver cancer each year by 2025. The molecular pathogenesis of HCC varies with respect to genotoxic lesions and aetiologies. Although our understanding of the HCC pathophysiology and drivers tends to improve, it is still distant from translation into clinical practice. About 25 % of HCC cases are associated with variant mutations. HCC pathophysiology is a complex multi-step process. The interaction of various factors underlies the early stages of malignant hepatocyte transformation towards the development of HCC. Overall, about 20–25 % of HCC patients have at least one potential driver mutation. Obesity should also be noted as being associated with a higher risk of HCC and various other cancers. Despite many issues in the HCC pathogenesis being already known, the unresolved questions remain. Modern molecular genetic diagnostics and animal modelling of malignant tumours are expanding our horizons of knowledge in this field.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48079116","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 : 2022-07-15DOI: 10.24060/2076-3093-2022-12-2-98-105
I. V. Seregin, A. Seregin, E. V. Filimonov, N. Shustitskiy, A. D. Morozov, L. Sinyakova, O. Loran
Background. Renal stones of ≤ 2cm size occur most commonly, with several treatment options currently available that include remote shockwave lithotripsy, percutaneous nephrolithotripsy (PCNL) and retrograde intrarenal surgery (RIRS). The choice of treatment for ≤ 2 cm kidney stones remains a relevant and hotly debated issue.Aim. A study of the efficacy, safety, advantages and disadvantages of ultra-mini percutaneous nephrolithotripsy (ultra-mini PCNL) and retrograde intrarenal surgery (RIRS) in treatment of ≤ 2 cm kidney stones.Materials and methods. Treatment outcomes in urology patients of the Botkin Hospital were analysed retrospectively for years 2017–2022. The patients were divided between cohorts: cohort 1 consisted of patients who underwent ultra-mini PCNL; cohort 2 included 41 patients with RIRS.Results and discussion. The incidence of complete stone absence on the day after surgery was significantly higher in cohort 1 (39; 92.8 %) vs. 2 (33; 80.4 %). Mean operation time was significantly less in cohort 1 (55 [30–80] min) vs. 2 (78 [30–125] min). Mean hospital stay did not differ significantly between the cohorts: 3 (1–5) vs. 2.8 (2–4) days in cohorts 1 and 2, respectively. Haematuria was statistically more severe in cohort 1 (7 cases; 16.6 %) vs. 2 (4 cases; 9.7 %); mean postoperative haemoglobin decrease was also significantly higher in cohort 1 (11.6) vs. 2 (6.4 g/L).Conclusion. Both ultra-mini PCNL and RIRS are effective, safe and complementary procedures in treatment for ≤2 cm renal stones. Ultra-mini PCNL is more effective over RIRS in terms of single-intervention complete stone removal and shorter operation time, whereas the overall complications rate did not significantly differ between cohorts.
{"title":"Ultra-Mini Percutaneous Nephrolithotripsy and Retrograde Intrarenal Surgery in Treatment of Less than 2 cm Kidney Stones: Comparative Efficacy and Safety","authors":"I. V. Seregin, A. Seregin, E. V. Filimonov, N. Shustitskiy, A. D. Morozov, L. Sinyakova, O. Loran","doi":"10.24060/2076-3093-2022-12-2-98-105","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-2-98-105","url":null,"abstract":"Background. Renal stones of ≤ 2cm size occur most commonly, with several treatment options currently available that include remote shockwave lithotripsy, percutaneous nephrolithotripsy (PCNL) and retrograde intrarenal surgery (RIRS). The choice of treatment for ≤ 2 cm kidney stones remains a relevant and hotly debated issue.Aim. A study of the efficacy, safety, advantages and disadvantages of ultra-mini percutaneous nephrolithotripsy (ultra-mini PCNL) and retrograde intrarenal surgery (RIRS) in treatment of ≤ 2 cm kidney stones.Materials and methods. Treatment outcomes in urology patients of the Botkin Hospital were analysed retrospectively for years 2017–2022. The patients were divided between cohorts: cohort 1 consisted of patients who underwent ultra-mini PCNL; cohort 2 included 41 patients with RIRS.Results and discussion. The incidence of complete stone absence on the day after surgery was significantly higher in cohort 1 (39; 92.8 %) vs. 2 (33; 80.4 %). Mean operation time was significantly less in cohort 1 (55 [30–80] min) vs. 2 (78 [30–125] min). Mean hospital stay did not differ significantly between the cohorts: 3 (1–5) vs. 2.8 (2–4) days in cohorts 1 and 2, respectively. Haematuria was statistically more severe in cohort 1 (7 cases; 16.6 %) vs. 2 (4 cases; 9.7 %); mean postoperative haemoglobin decrease was also significantly higher in cohort 1 (11.6) vs. 2 (6.4 g/L).Conclusion. Both ultra-mini PCNL and RIRS are effective, safe and complementary procedures in treatment for ≤2 cm renal stones. Ultra-mini PCNL is more effective over RIRS in terms of single-intervention complete stone removal and shorter operation time, whereas the overall complications rate did not significantly differ between cohorts.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47767491","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 : 2022-07-15DOI: 10.24060/2076-3093-2022-12-2-106-111
B. Bebezov, R. A. Sultangaziev, T. Abdykadyrov
Background. Portal hypertension-triggered oesophageal and gastric variceal bleeding is the most dangerous and threatening complication, with an up to 50–70 % mortality at first episode. High-mortality repeated bleeding develops subsequently in 30–50 % patients, with the proved 100 % recurrence rate in the first two years following the first episode. The world experience dictates further research to continue towards developing new surgical methods and approaches.Aim: to evaluate the treatment efficacy of pneumatic endoscopic band ligation of bleeding oesophageal varices (OV).Materials and methods. The experience of applying pneumatic endoscopic ligation treatment in the patients managed at the General Surgery Unit of the Clinical Hospital of the Kyrgyz Republic Presidential Administration during 2017–2019 was analysed. Endoscopic ligation is a modern minimally invasive and less traumatic intervention used to markedly reduce mortality and improve quality of life in patients with portal hypertension syndrome. The evidence on 76 patients following endoscopic OV ligation was summarised. The patient age ranged from 11 to 70 years (mean 46.26 years); 40 men (52.6 %) and 36 women (47.4 %) were included. Among the 76 patients, portal hypertension was caused by viral cirrhosis in 38, hepatitis B in 5, delta agent hepatitis B in 18, hepatitis C in 13, a hepatitis B–C combination in 1 and a delta agent hepatitis B — hepatitis C combination in 1 patient. In 21 patients, cirrhosis was of unknown aetiology. A portal vein malformation was observed in 13 people of whom 4 had it combined with thrombosis.Results. A total of 94 ligation procedures were performed in 76 patients with grade II–III OV. Some patients needed to undergo the procedure several times, 18 patients had 2 sessions. Two cases required 3 and 4 sessions each. Moderate oesophageal soreness was reported in 32 patients for 1–6 days following the ligation. No complications were registered during the operation. In early postoperative period, 2 patients developed recurrent bleeding, with haemostasis re-achieved by a repeated vein ligation below bleeding.Conclusion. Hence, small invasiveness and minor traumatism coupled with high efficiency and lesser complications render endoscopic ligation the method of choice in primary and secondary prophylaxis and treatment of OV. Endoscopic ligation improves the patient’s quality of life, allows an extra time for conservative treatment and longer period to liver transplantation.
{"title":"Endoscopic Prophylaxis and Treatment of Portal-Genesis Oesophageal Haemorrhage","authors":"B. Bebezov, R. A. Sultangaziev, T. Abdykadyrov","doi":"10.24060/2076-3093-2022-12-2-106-111","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-2-106-111","url":null,"abstract":"Background. Portal hypertension-triggered oesophageal and gastric variceal bleeding is the most dangerous and threatening complication, with an up to 50–70 % mortality at first episode. High-mortality repeated bleeding develops subsequently in 30–50 % patients, with the proved 100 % recurrence rate in the first two years following the first episode. The world experience dictates further research to continue towards developing new surgical methods and approaches.Aim: to evaluate the treatment efficacy of pneumatic endoscopic band ligation of bleeding oesophageal varices (OV).Materials and methods. The experience of applying pneumatic endoscopic ligation treatment in the patients managed at the General Surgery Unit of the Clinical Hospital of the Kyrgyz Republic Presidential Administration during 2017–2019 was analysed. Endoscopic ligation is a modern minimally invasive and less traumatic intervention used to markedly reduce mortality and improve quality of life in patients with portal hypertension syndrome. The evidence on 76 patients following endoscopic OV ligation was summarised. The patient age ranged from 11 to 70 years (mean 46.26 years); 40 men (52.6 %) and 36 women (47.4 %) were included. Among the 76 patients, portal hypertension was caused by viral cirrhosis in 38, hepatitis B in 5, delta agent hepatitis B in 18, hepatitis C in 13, a hepatitis B–C combination in 1 and a delta agent hepatitis B — hepatitis C combination in 1 patient. In 21 patients, cirrhosis was of unknown aetiology. A portal vein malformation was observed in 13 people of whom 4 had it combined with thrombosis.Results. A total of 94 ligation procedures were performed in 76 patients with grade II–III OV. Some patients needed to undergo the procedure several times, 18 patients had 2 sessions. Two cases required 3 and 4 sessions each. Moderate oesophageal soreness was reported in 32 patients for 1–6 days following the ligation. No complications were registered during the operation. In early postoperative period, 2 patients developed recurrent bleeding, with haemostasis re-achieved by a repeated vein ligation below bleeding.Conclusion. Hence, small invasiveness and minor traumatism coupled with high efficiency and lesser complications render endoscopic ligation the method of choice in primary and secondary prophylaxis and treatment of OV. Endoscopic ligation improves the patient’s quality of life, allows an extra time for conservative treatment and longer period to liver transplantation.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49389862","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 : 2022-07-15DOI: 10.24060/2076-3093-2022-12-2-118-122
R. Khalikov, D. D. Gromenko, S. Galimova, K. Danilko, I. D. Gromenko, S. Galimov, P. Litvitsky
Background. Melittin is a major constituent of honeybee venom and comprises a water-soluble surfactant peptide with cytolytic effects potentially applicable in anticancer therapy. We evaluated the impact of melittin from Bashkir honeybee (Apis mellifera mellifera L.) venom on cell viability of various prostate cancer lineages.Materials and methods. MTT assays with cell viability index estimation were used to evaluate the effect of melittin on cell proliferation in various-grade malignancy prostate cancer (PC) lineages, LNCaP, PC-3 and DU145.Results and discussion. Lineage DU145 revealed a low sensitivity to melittin, because a relatively high peptide concentration of 10 μg/mL had a suppressive effect on its proliferation. With PC-3 cells, a 0.1 μg/mL concentration suppressed proliferation significantly to 46.15 %, while melittin at a 10 μg/mL dose had a cytolytic effect on most cells (4.27 % viability). LNCaP cells experienced the lowest toxicity at 10 μg/mL melittin compared to PC-3 and DU145 lineages. The LNCaP, PC-3 and DU145 PC lineages demonstrated suppressed proliferation at melittin levels 0.01–100 μg/mL.Conclusion. The study reveals a significant reduction of the PC lineages viability at a minimal melittin concentration of 0.01 μg/mL, which indicates a high cytolytic activity of this peptide and renders it a candidate agent in antitumour therapy.
{"title":"Impact of Honeybee Venom Melittin on Cell Viability of Different Prostate Cancer Lineages","authors":"R. Khalikov, D. D. Gromenko, S. Galimova, K. Danilko, I. D. Gromenko, S. Galimov, P. Litvitsky","doi":"10.24060/2076-3093-2022-12-2-118-122","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-2-118-122","url":null,"abstract":"Background. Melittin is a major constituent of honeybee venom and comprises a water-soluble surfactant peptide with cytolytic effects potentially applicable in anticancer therapy. We evaluated the impact of melittin from Bashkir honeybee (Apis mellifera mellifera L.) venom on cell viability of various prostate cancer lineages.Materials and methods. MTT assays with cell viability index estimation were used to evaluate the effect of melittin on cell proliferation in various-grade malignancy prostate cancer (PC) lineages, LNCaP, PC-3 and DU145.Results and discussion. Lineage DU145 revealed a low sensitivity to melittin, because a relatively high peptide concentration of 10 μg/mL had a suppressive effect on its proliferation. With PC-3 cells, a 0.1 μg/mL concentration suppressed proliferation significantly to 46.15 %, while melittin at a 10 μg/mL dose had a cytolytic effect on most cells (4.27 % viability). LNCaP cells experienced the lowest toxicity at 10 μg/mL melittin compared to PC-3 and DU145 lineages. The LNCaP, PC-3 and DU145 PC lineages demonstrated suppressed proliferation at melittin levels 0.01–100 μg/mL.Conclusion. The study reveals a significant reduction of the PC lineages viability at a minimal melittin concentration of 0.01 μg/mL, which indicates a high cytolytic activity of this peptide and renders it a candidate agent in antitumour therapy.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46636459","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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