Current approaches to the treatment of patients with metastatic malignant tumors have changed significantly over the past decade. Instead of a purely palliative systemic or just supportive therapy, a large proportion of patients receive an aggressive local treatment directed not only to the primary tumor, but also to metastatic foci, and a number of studies demonstrate the advantage of such approach. This review provides information on the role of radiation therapy as a local method of treatment of cancer patients with oligometastases.

Diagnostic difficulties of regional metastases, especially lesion of the central neck, is the main problem with choosing the type of surgical intervention for patients with differentiated thyroid cancer diagnosis. The frequency of differentiated thyroid cancer regional metastasis to the neck lymph nodes is about 60 %. This article includes the search and identification of risk factors of differentiated thyroid cancer regional metastases, as well as a review of the literature on this problem. We have analyzed the results of surgical treatment of patients with papillary thyroid cancer of Stage I–III (T1–4aN0–1bM0) who underwent surgical treatment at the St. Petersburg State Healthcare Institution «City Clinical Oncology Center» in 2018–2019. As a result of the study, the data revealed a relationship between regional metastases and intrathyroid vascular invasion of the primary tumor (p < 0.05), while multifocality, extrathyroid extension and the incidence of BRAF mutation have not demonstrated this correlation (p > 0.05). After the surgical treatment we should focus on the presence of vascular invasion and, if it is detected, perform final thyroidectomy and central lymph node dissection with subsequent radioiodine therapy.

The article discusses the choice of different surgical procedures in patients with locally advanced vulvar cancer, depending on the volume of resected tissues and the possibility of reconstructive plastic surgery. The advantages and disadvantages of various plastic reconstructive techniques are provided. The issue of wound closing after the vulvectomy and the plastic techniques has always been controversial and led to the sophistication of the reconstructive component, as well as to the limitations or refusal of this surgical procedure use.

Prostate cancer (PCa) of high risk is one of the crucial problems in urological oncology. Radiation therapy (RT), along with radical prostatectomy, is an important component of the complex treatment of patients with high‑risk PCa. To improve the long‑term oncological results of RT dose escalation is advocated. Currently, dose escalation can be reached via external beam irradiation and interstitial RT techniques. The study included 109 patients with high‑risk PCa who underwent either external beam RT up to 76 Gy, or combined RT (external beam + interstitial RT) using ¹²⁵I sources with long‑term androgen deprivation therapy. Comparative analysis of long‑term results of patients with high‑risk PCa treatment showed an improvement in 5‑year disease‑free survival rates after combined RT compared with external beam RT. Acute rectal toxicity was decreased in combined RT group compared to patients after external beam RT: 13.2 % and 46.4 %, respectively (p < 0.01).

The management and treatment of patients with various malignancies during pregnancy appears to be a pressing issue to date. Ovarian tumors take the 4th place among all neoplasms diagnosed during pregnancy. The study aimed to investigate an interdisciplinary integrative approach to pregnancy management in case of benign and borderline ovarian tumors.
The article presents the analysis of the pregnancy course in women with borderline and malignant ovarian tumors. When detecting a tumor during pregnancy, obstetric and surgical tactics is determined in a multidisciplinary team together with an oncologist.
It is possible not only to prolong pregnancy without additional chemotherapy but also to preserve fertility in the future in patients with borderline tumors and stage I malignant tumors.