tumorsMalignant tumoursMalignant tumours2224-50572587-6813Rosoncoweb10.18027/2224-5057-2024-002tumors-1310Research ArticleОБЗОРЫ И АНАЛИТИКАREVIEWS AND ANALYSISОпухолевые клетки по краю хирургического разреза после попытки радикального лечения больных местнораспространенной уротелиальной карциномой: обзор литературы и описание клинических наблюденийPositive surgical margin after attempted radical surgery in patients with locally advanced urothelial carcinoma: literature review and case reportshttps://orcid.org/0000-0001-7754-6624ВолковаМ. И.VolkovaМ. I.

Мария Игоревна Волкова

117152; Загородное шоссе, 18А; 125993; ул. Баррикадная, 2 / 1, стр. 1; Москва 

117152; 18A Zagorodnoe Shosse; 125993; Build. 1, 2 / 1 Barrikadnaya St.; Moscow

mivolkova@rambler.ruhttps://orcid.org/0000-0002-9015-2002ГридневаЯ. В.GridnevaYa. V.

Яна Владимировна Гриднева

117152; Загородное шоссе, 18А; 119991;  ул. Трубецкая, 8, стр. 2; Москва 

117152; 18A Zagorodnoe Shosse; 119991; Build. 2, 8 Trubetskaya St.; Moscow 

https://orcid.org/0000-0002-2855-5767Аль-АкелИ. С.Al-AkelI. S.

Ибрагим Самерович Аль-Акел

117152; Загородное шоссе, 18А; Москва

117152; 18A Zagorodnoe Shosse; Moscow

РябининР. И.RyabininR. I.

117152; Загородное шоссе, 18А; Москва

117152; 18A Zagorodnoe Shosse; Moscow

Онкологический центр № 1 «Городской клинической больницы имени С. С. Юдина Департамента здравоохранения города Москвы»; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияOncology Center No. 1 of the City Clinical Hospital named after S. S. Yudin of the Moscow Department of Health; Russian Medical Academy of Continuing Professional Education, Ministry of Health of RussiaRussian FederationОнкологический центр № 1 «Городской клинической больницы имени С. С. Юдина Департамента здравоохранения города Москвы»; ФГАОУ ВО «Первый Московский государственный медицинский университет им. И. М. Сеченова» Минздрава России (Сеченовский Университет)РоссияOncology Center No. 1 of the City Clinical Hospital named after S. S. Yudin of the Moscow Department of Health; I. M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)Russian FederationОнкологический центр № 1 «Городской клинической больницы имени С. С. Юдина Департамента здравоохранения города Москвы»РоссияOncology Center No. 1 of the City Clinical Hospital named after S. S. Yudin of the Moscow Department of HealthRussian Federation2024150520241425864Copyright © Волкова М.И., Гриднева Я.В., Аль-Акел И.С., Рябинин Р.И., 20242024Волкова М.И., Гриднева Я.В., Аль-Акел И.С., Рябинин Р.И.Volkova М.I., Gridneva Y.V., Al-Akel I.S., Ryabinin R.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.malignanttumors.org/jour/article/view/1310

   Опухоль по краю разреза после радикального хирургического лечения местнораспространенного уротелиального рака (R+) выявляется примерно в 10 % препаратов и ассоциирована с повышением риска локорегионарного рецидива, метастазов и смерти. Пациенты с R+ — неоднородная группа больных, подход к лечению которых должен быть индивидуальным. Стандартного метода ведения пациентов с R+ нет, допустимые опции включают наблюдение, удаление резидуальной опухоли, послеоперационную химиотерапию (ХТ), иммунотерапию (ИТ), лучевую терапию (ЛТ) и химиолучевую терапию (ХЛТ). На выбор лечебной тактики влияют локализация и характеристики первичной опухоли, проведенная неоадъювантная химиотерапия (НХТ), до операции и ответ на неё, степень лечебного патоморфоза, наличие определяемой резидуальной опухоли, а также потенциальная переносимость немедленного послеоперационного лечения.

   Positive surgical margin is observed in approximately 10 % of specimens after radical surgery for locally advanced urothelial carcinoma, and is associated with an increased risk of locoregional recurrence, metastases, and death. R+ patients are a heterogeneous group of patients requiring individual treatment approaches. There is no standard of care for R+ patients; acceptable options include observation, removal of residual tumor, postoperative chemotherapy (CT), immunotherapy (IT), radiation therapy (RT), and chemoradiotherapy (CRT). The choice of treatment plan depends on the location and characteristics of the primary tumor, use of neoadjuvant chemotherapy (NACT) before surgery and the response to it, the pathological response, the presence of detectable residual tumor, as well as the potential tolerability of immediate postoperative treatment.

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The authors declare that there are no conflicts of interest present.