Introduction: The treatment strategy for gastric cancer (GC) in patients with concomitant cardiovascular disease (CVD) remains a subject for debate due to the prevalence of CVD and the lack of clinical guidelines for surgical management of these patients.

   Aim: To review the outcomes of simultaneous and consequent surgical treatment of GC and Siewert type I–III gastroesophageal junction cancer (GJC) in patients with concomitant CVD.

   Materials and methods: Patients with resectable biopsy-proven GC and Siewert type I–III GJC were recruited between January 2020 and March 2024. Primary endpoints: numbers of deaths, intra- and postoperative complications, removed lymph nodes, and R1 resection margins rate. Secondary endpoints: duration of surgery, length of hospital stay, morbidity, and duration of the interval (days) between the stages of consequent procedures. The main group consisted of 31 GC patients with concomitant CVD (15 and 16 patients underwent simultaneous and staged procedures, respectively). The control group consisted of 69 GC patients without concomitant CVD. The groups were balanced in terms of sex, age, cancer stage, ECOG score, and type of surgical procedure. Patients in the main group had significantly higher ASA scores, and minimally invasive procedures were more common in the control group. There were no differences between the groups of simultaneous and staged surgery in any parameter.

   Results: There were no significant differences in the rate of intraoperative and postoperative complications and mortality between the groups. The duration of surgery and number of postoperative bed-days were significantly greater in the main group, and in the consequent surgery group than in the simultaneous surgery group. There were no significant differences in the rate of R1 resection margins or number of the lymph nodes removed between
the groups.

   Conclusions: No significant increase in intra- and postoperative complications were observed in patients with GC or GJC and concomitant CVD undergoing simultaneous or consequent procedures. The proportion of radically treated patients was not lower among those who had prior surgery for the concomitant disease. Neither the simultaneous nor the staged approach was more advantageous.

   Background: Gastric cancer (GC) is one of the most common malignancies which requires aggressive combined treatment with a high incidence of complications. The search for modifiable risk factors or predictors of complications’ development is ongoing.

   We aimed to investigate the prognostic value of cachexia in patients with resectable GC.

   Materials and methods: A multi-center retro-prospective cohort study included data of 144 GC patients who underwent potentially curative gastrectomy between 2019 and 2023. Cachexia and sarcopenia were diagnosed according to the most recent consensus definitions. Сachexia was defined according to the international consensus criteria as the loss of ≥ 5 % of weight in 6 months or the loss of 2 % body weight in the presence of sarcopenia or BMI < 20 kg / m². To assess the presence of sarcopenia we used Prado criteria (52.4 cm² / m² for men and 38.5 cm² / m² for women) and Martin criteria (41 cm² / m² for women and 43 cm2 / m2 for men with a BMI < 25 kg / m² and 53 cm² / m² with a BMI > 25 kg / m²) for L3 skeletal-muscle index. The 30-day incidence of postoperative complications and 90-day mortality were evaluated.

   Results: There were 57 (39.5 %) patients with cachexia. Cachexia was more prevalent in patients with TNM stage III (42.1 % vs 24.1 %, p = 0.023) and sarcopenic patients (measured by skeletal muscle mass, 49.1 % vs. 18.3 %, p < 0.001, as well as dynamometry, 14.3 % vs. 0 %, p = 0.006). Multivariate analysis revealed that cachexia was a significant predictor of postoperative complications (ОR = 2.208, 95 % CI 1.051–4.638, p = 0.036) and surgical site infection (OR = 3.916, 95 % CI 1.146–13.3874, p = 0.029). The 90-day mortality rate was higher among patients with cachexia (10.5 % vs. 2.3 %, p = 0.039).

   Conclusion: Preoperative cachexia is a potentially modifiable predictor of complications after gastric cancer surgery which may help to identify high-risk patients for proactive multimodal рrehabilitation.

   Aim: to study the possibilities of using interstitial photodynamic therapy as a part of complex therapy, a minimally invasive method of glioblastoma patients’ treatment.

   Material and methods: The study included 9 patients with glioblastoma who had one tumor focus with a maximum size of up to 3.5 cm and a Karnofsky score of at least 70 points. The study group included 6 (66.7 %) men and 3 (33.3 %) women. The average age of patients was 55.3 ± 9.8 years; 7 (77.8 %) patients had the first relapse of glioblastoma tumor, in 2 cases (22.2 %) glioblastoma was diagnosed for the first time. Photoditazine was used as a photosensitizer (PS), administered intravenously at a dose of 1 mg / kg. Interstitial irradiation was performed using a laser (Latus 2.5 (Atkus, Russia)) with a wavelength of 662 nm and a maximum power of 2.5 W and cylindrical scattering fibers. Spatial precise interstitial irradiation of the tumor volume was planned using special software. The duration of irradiation did not exceed 15 min. The light dose averaged 180 J / cm².

   Results: No complications or side effects associated with the introduction of PS were noted in patients in the early postoperative period. Transient increase in neurological deficit after iPDT in the early postoperative period was noted in 2 (22.2 %). In 1 patient an increase in hemiparesis was noted, in another patient dysarthria and dysphasia appeared. At the same time, in one patient with hemiparesis, neurological deficit after surgery persisted for more than five weeks after iPDT, but significant regression of symptoms was noted in the following five weeks. Catamnesis was monitored in all 9 patients. The duration of observation after iPDT was up to 61 months. The main cause of death in all 9 patients was tumor progression. The median overall survival was 29.1 months. The median relapse-free survival was 13.3 months.

   Conclusion: iPDT is a selective minimally invasive technique with promising results and minimal side effects in the treatment of patients with glioblastomas. The technique is a potential treatment option for small and deep tumors in patients with high surgical risk and for patients with tumor recurrence.

   Background: Gastric type 1 neuroendocrine neoplasms (gNENs) are relatively indolent malignancies with low metastatic potential. Endoscopic resection (ER) is considered the primary treatment, while somatostatin analogs (SSAs) have proven anti-secretory and anti-proliferative effects. However, routine adjuvant SSA therapy after ER is not universally recommended.

   Objective: To determine whether adjuvant therapy with SSAs in patients with type 1 gNENs affects the rate of repeated endoscopic resections due to metachronous lesions.

   Methods: We conducted a retrospective, single-center study which included patients with gNENs cT1–2N0M0, Grade I–II who underwent ER from 2007 to 2024. Two groups were compared: one received SSAs in the adjuvant setting, the other remained under observation only. Propensity score matching using a “cardinality matching” approach ensured balanced cohorts. The primary endpoint was the frequency of repeated ER. Statistical analyses were performed using Student’s t-test.

   Results: After matching, there was no statistically significant reduction in repeated ER among patients receiving SSAs (p > 0.05). Furthermore, no significant difference in the number of endoscopic examinations was observed between the groups.

   Conclusion: Routine adjuvant SSA therapy after ER does not appear to reduce the frequency of repeated resections in patients with type 1 gastric NENs, suggesting that such practice may be unnecessary.

   The study of the role of neoadjuvant chemotherapy (NACT) began with pioneering works in the early 1980^s and has been ongoing for over 40 years. During this period, numerous randomized clinical trials have been conducted, many scrupulous meta-analyses have been performed, and clinical guidelines have been revised more than once. However, the results available at the moment can hardly be regarded as completely satisfying. After 40 years of walking in the desert of evidence-based medicine, we have no clear knowledge about the basic things: is there a place for NACT in the treatment of cervical cancer? If so, when and to whom should it be prescribed? What to do when the tumor response to chemotherapy is far from being satisfactory? The clinical application of NACT remains largely intuitive, based on extrapolation of available knowledge from other areas of oncology. The authors look at the future of NACT in the treatment of cervical cancer with cautious optimism, and invite the readers to recall the main points of the study of this method to help them understand where to go next.

   Introduction: Ewing sarcoma is the second most common bone tumor, behind osteosarcoma, and is the most common bone tumor among children under 15 years of age. Quite rarely, these tumors occur in patients over 30 years of age and under 5 years of age. Ewing sarcoma of the chest wall is a rare malignant neoplasm, which is rarely reported in the scientific literature. An integrated approach combining chemotherapy, surgery, and radiation therapy is commonly used in the treatment of this neoplasm. However, there is no standard treatment for this tumor when the disease progresses during the first-line treatment.

   Although modern combined approaches to treatment, including chemotherapy, surgery, and radiation therapy, help achieve disease control in some patients, the lack of standardized protocols for the treatment of refractory and recurrent forms results in significant difficulties in determining optimal therapeutic options. In real-world clinical practice, physicians have limited personal experience in managing such patients, which leads to variability in the chosen treatment plans for refractory disease and the need to make decisions based on limited data. The article discusses the main approaches to the treatment, as well as the potential and role of radiation therapy in the treatment of this disease and presents a case report of unresectable Ewing sarcoma of the chest wall in a 50-year-old male patient with local progression during first-line chemotherapy.

   The Russian consensus on prevention, diagnostic and treatment of gastric cancer was prepared on the initiative of the Moscow clinical scientific center named after A. S. Loginov on the Delphi method.

   Its aim was to clarify and consolidate the opinions of specialists on the most relevant issues of prevention, diagnosis and treatment of gastric cancer.

   An interdisciplinary approach was provided by the participation of leading gastroenterologists, oncologists and surgeons.