The paper reflects the current understanding of the concept of sentinel lymph nodes in malignant tumors. The status of the ly mph nodes is the most important predictor of survival and proper treatment depends on the number of involved nodes. The identification of the sentinel lymph node is the radiological method, both alone and in combination with the blue-dye. Applied during surgery lymphography technique is designed to identify the sentinel lymph node. In order to achieve appropriate accuracy of the method are required a special selection of patients, effective markers and some surgical experience. The key is a multidisciplinary approach with the involvement of a radiologist and pathologist. The concept of sentinel lymph node does not be used in all cases for predicting metastasis process. Region-specific modification and correction are required to optimize the use of SLN-imaging, especially for elderly patients with early-stage cancer. Using the method of identification of sentinel lymph nodes seems important in terms of studying the individual characteristics of lymph from different segments of the body, which may be different directions. SLN-biopsy is extremely helpful to find metastasis in node in the very early stages of cancer. Prior to the development of metastasis, VEGF-A induces a lymphangiogenesis in the sentinel lymph node, which gives grounds to assume that the primary tumor can prepare future path of metastasis, producing factors lymphangiogenesis, which provide efficient transport of tumor cells in the sentinel lymph node. This mechanism is to stimulate lymphangiogenesis in the sentinel lymph node, facilitating metastasis, represents a new therapeutic target for preventing metastasis. In elderly patients with malignant tumors, histologic heterogeneity replaces homogeneous morphology with numerous or large secondary follicles in welldeveloped cortex. Histological heterogeneity can modulate the movement of cancer cells with a high probability to the lymph nodes, having the age architectural changes. Lymphangiogenesis and increased  lymph flow through the tumor draining regional lymph node metastasis can strengthen the lymphatic tubules. Descriptions morphological rearrangements in the regional lymph nodes in the malignant growth are similar in nature and vary in severity depending on the changes in the tumor type, location, and time of development. 

The modern review of literatures devoted to molecular and genetic and immunological features of tumors of lyuminalny in a subtype of a breast cancer is presented in article. Tumors of this phenotype meet in 14–18% of cases, have considerably the worst forecast and a high probability of progressing,  than lyuminalny аnd subtype. Deeper understanding  of biology of this type of a breast cancer will allow to optimize and povyshit further efficiency of treatment at this category of patients. 

Nowadays great successes have been reached in chemotherapy treatment of cancer. New medications let increase time to progression,  overall survival and to improve a quality of life. Recently, antitumor activity of melatonin is actively investigated. Many in vitro/in vivo studies are devoted to this topic. In these trials was shown ability of melatonin to inhibit tumor growth and to potentiate the cytotoxic effects of chemotherapy. This review describes the use of melatonin in the treatment of patients with solid tumors. Melatonin has been used in both monotherapy and in combination with chemotherapy and immunotherapy. According to these studies, the use of melatonin increases the objective response and overall survival of patients and reduce the incidence of side effects of chemotherapy. However, this epiphyseal hormone does not routinely used in clinical oncology and will be must to investigate it in more clinical trials. 

The aim of this article is to describe the main epidemiological, clinical and morphological diagnostic features of one of the rare breast cancer form – mucinous carcinoma of the breast. Authors present their own results of twelve-year period of research accompanying by current scientific data.

Radiology patterns of mucinous carcinoma are difficult for interpretation. Mucinous carcinoma diagnosis can be improved by integrating of combination mammography with breast ultrasound with modern technologies, like sonoelastography. 

Elderly patients constitute  a significant part of patients undergoing liver resection. Non-specific cardio-vascular and pulmonary complications as well as postoperative delirium are common in this group of patients. We analyzed the impact of a standardized perioperative care protocol on the rate of such complications after resections of the liver in patients younger and older than 70 years. Material and methods We analyzed the results of elective liver resections, performed in the Department of Surgical Oncology of the Medical and Rehabilitation Center under the Ministry of Health from 2013 to 2016. There were 122 resection in 99 patients less than 70 years old and 30 procedures in 29 elderly patients. Patients in the elderly group had significantly more cardio-vascular co-morbidities whereas younger patients have had preoperative chemotherapy more often.

Results.There were no differences regading the extent of liver resection, bloodloss,  operating time. Severe morbidity (Clavien-Dindo III–IV grade) developed in 22 and 20% among patients younger and older 70, respectively, mortality was 6 and 7%. Elderly patients developed liver failure more often (13 vs 7%). There were 3 nonspecific complications: pneumonia and heart failure in patients younger than 70 years and atrial fibrillation in an elderly patient. Conclusion Standardized protocol of perioperative care in patients undergoing hepatectomy leads to a very low rate of non-specific postoperative complications.

In gynecology department  of oncologic institute of P. A. Herzen from July, 2010 to December, 2015, the laparoscopic hysterectomy with a pelvic lymphadenectomy concerning endometrial cancer of the I stage is executed at 210 women. Technology of operation is modified according to oncologic demands. Before installation of the uterine manipulator the main vessels participating in blood supply of a uterus for an operation ablastichnost were alloyed.

Average age of all patients made 55 ± 11,5 years. More than a half (64%) of patients had the excess body weight, or an obesity (BMI median  = 27). Duration of operation varied from 105 to 305 minutes, averaged 167,3±43,1, a median 173 minutes. An average hemorrhage  made 95 ml (a median of 65 ml). At 37,1% of patients  (N=78) formation of lymphatic cysts is noted. The general duration of stay in a hospital made 9,8 ± 2,8 days, after operation – 6,9 ± 1,7 days. Thus, the postoperative period was characterized in general by a smooth current and the minimum of complications.

The laparoscopic hysterectomy with a pelvic lymphadenectomy can be considered as a safe alternative to classical laparotomy techniques. 

Triple-negative breast cancer (TNBC) is characterized by an aggressive behavior, highly sensitivity to chemotherapy, early recurrence, and also the absence of known targets for targeted therapies. TNBC is extremely impotant search for intensive regimens of neoadjuvant chemotherapy, because of insufficient effectiveness of conventional therapies. The aim of the study was to evaluate the efficacy and toxicity of cisplatin, doxorubicin, paclitaxel in patients with early breast cancer with triple-negative phenotype in preoperative mode. The study included 41 patients with early breast cancer, triple negative phenotype (T1–2 N0–1M0). Patients were treated with cisplatin 30 mg/m2 / IV., Doxorubicin 25 mg/m2 / IV., Paclitaxel  100 mg/m2 / IV. weekly for planned 8 weeks  with G-CSF 300 mcg 2–4 days followed by surgery. The rate of objective response was 38/40 (95%) complete response – 12/40 (30%), partial regression – 26/40 (65%), stabilization – 2/40 (50%). 40 hftients were treated with surgery, 26/40 (65%) achieved a complete pathological regression. 2-year disease-free survival – 89.4%. 2-year overall survival – 95.1%. Combination of cisplatin, doxorubicin, paclitaxel, it proved its high efficacy in patients with early breast cancer with triple-negative phenotype, despite it’ high toxicity. 

The combination of fluoropyrimidines with oxaliplatin is one of the standard first line chemotherapy of metastatic colorectal cancer (mCRC). In Russian cancer research center was performed a full cycle of production the drug Oxaliplatin-RONC®, showed equivalence to Eloxatin® in vitro and in vivo. The main purpose of this study was to evaluate the therapeutic equivalence of Oxaliplatin-RONC ® and Eloxatin®  in mFOLFOX6 combination as a first line of chemotherapy  in patients  with mCRR. The second purpose was to compare the safety of drugs.

A total of 59 patients were enrolled in the study. Patients were assigned in a 1:1 ratio to receive up to 9 cycles of mFOLFOX6 with Oxaliplatin-RONC® or Eloxatin®; cycles were repeated every 14 days. 30 patients were randomly assigned to OxaliplatinRCRC®  and 29 to Eloxatin®.

The objective response rate was 46,67% in the OxaliplatinRONC® group and 37,93% in the Eloxatin® group (р (non inferiority)=0,046); 97,5% CI,–0,16–0,33). The median progression-free survival was 6,9 months in the OxaliplatinRONC® group, as compared with 7 months in the Eloxatin® group (P=0.571). The median of duration response rate was 5,5 months in the Oxaliplatin-RONC®  and 6,2 months in the Eloxatin® group (p=0.8). The incidence of adverse events grade 3 or 4 was comparable in groups. Oxaliplatin-RONC®  and Eloxatin®  in the mFOLFOX6 combination showed comparable efficacy and safety in patients with mCRC.

 

In recent years, immunotherapy is the main emphasis approach for malignant tumors treatment due to the development and registration of a new class of drugs –immune checkpoint inhibitors. Results of the randomized clinical trials, which showed a benefit in overall survival in comparison with standard therapy, was the basis for registration of this class of medicines [1–3]. Their toxicity profile is more favorable. However, the adverse reactions, which accrues during immunotherapy, are essentially new and different from standard chemotherapy. The standard management algorithm compensates the variety of immunemediated adverse reactions [4]. Early detection and timely treatment is necessary for the successful management of these adverse reactions. 

High mortality rates from cancer and related considerable socioeconomic losses allow reasonably considered a struggle with cancer as a state problem. The main work for the early detection of cancer accounts for general health services. Currently, results of general health services to actively identify malignancies not fully meet the diagnostic capabilities of modern medicine. These statistics are the main base for the development of measures to improve the morbidity and mortality from cancer. 

The article describes a case of diagnosis of rare stromal tumor of the breast, which was interpreted as a suspected carcinoma on the stages of diagnosis.  Only the immunohistochemistry analysis has helped to finally establish  the nature and benign neoplasm.