Introduction: Signet ring cell carcinoma of the rectum (SRCCR) is a rare rectal tumor, therefore, only limited information is available on the management of patients with this diagnosis. Since literature data on the susceptibility of signet ring cell carcinoma to radiation therapy (RT) are controversial, one of the questions that specialists may have is whether the RT is effective as the first stage of treatment.
Materials and methods: We conducted a retrospective analysis of medical records of patients with SRCCR treated at Research Institute FSBI «N. N. Blokhin Oncology Center» of the Ministry of Health of Russia from 1998 to 2020. The inclusion criteria were as follows: histologically confirmed primary SRCCR, disease stage I–III, use of RT or chemoradiotherapy at the first stage. A case control study design was used to select a control group of patients with rectal adenocarcinoma, and each case of the control group was compared with the study group by the following criteria: the year of treatment, the cT and cN clinical stage, the use of RT or CRT. The main endpoint was the rate of Dworak tumor regression grade 3–4; secondary endpoints included 5-year overall survival (OS) and progression-free survival (PFS) rates.
Results: The study and control groups included 16 patients each. In each group, 14 (87,5 %) patients received CRT and 2 (12,5 %) received RT; cT3, cT4 stages were diagnosed in 7 (43,8 %) and 9 (56,3 %) patients, respectively; cN0 and cN1–2 stages were diagnosed in 3 (18,8 %) and 13 (81,2 %) patients, respectively. Eight (50 %) patients in the SRCCR group and 4 (25,0 %) patients in the control group had Dworak tumor regression grade 3–4 (p = 0.273), and one (6,3 %) patient in each group showed pathological complete response (p > 0.99). The 5-year OS in the SRCCR group and the control group was 34,9 % and 51,4 %, respectively (p = 0.833); the 5-year PFS was 30,8 % and 35,6 %, respectively (p = 0.094).
Conclusions: SRCCR is at least as susceptible to RT / CRT as rectal adenocarcinoma, for which neoadjuvant RT / CRT is the standard of care; the use of combination therapy produces comparable long-term results.

Purpose: To evaluate efficacy of TIP (paclitaxel, ifosfamid, cisplatin) in the 1st line treatment of germ cell tumors patients with unfavorable decline of serum tumor markers after 1 cycle of the standard regimen of chemotherapy.

Patients and methods: In this phase II multicenter, nonrandomized trial, patients were enrolled from 4 centers of the Russian Federation. Patients were included if they were older than 18 years, had evidence of testicular, retroperitoneal, or mediastinal nonseminoma based on histologic findings or clinical evidence (high serum human chorionic gonadotropin or alpha-fetoprotein levels) that matched International Germ Cell Cancer Consensus Group (IGCCCG) intermediate and poor prognosis criteria. All patients got one cycle of BEP regimen (bleomycin 30 mg on days 1, 3, 5, etoposide 100 mg / m² on days 1–5, cisplatin 20 mg / m² on days 1–5). Patients with unfavorable serum tumor markers decline after the first cycle of chemotherapy at day 18–21 received four cycles of TIP regimen (paclitaxel 120 mg / m² on days 1–2, ifosfamide 1500 mg / m² on days 2–5, and cisplatin 25 mg / m² om days 2–5, granulocyte-colony stimulating factor 5 mg / kg on days 6–15). In the presence of a residual tumor larger than 1 cm and the technical possibility of its removal, surgical treatment was performed. The primary endpoint was 1-year progression-free survival.

Results: Between 2017 and 2021, 28 patients were included in our study: seven patients with an intermediate prognosis according to IGCCCG classification and twenty-one with poor risk. Median follow-up was 15,5 months (range, 4,4–38,3 months). The 1-year progression-free survival and overall survival in intention-to-treat population were 76,6 % and 81,0 %, respectively. One-year progression-free survival and overall survival according IGCCCG classification were 100 % and 100 % for an intermediate risk patients and 68 % and 73,8 % for a poor risk, respectively. The favorable response rate (complete response + partial response with normalization STM) was observed in 19 (68 %) patients. During the follow-up period, disease progression was noted in 9 (32 %) patients, 7 (25 %) patients died, including one from an aggressive growing mature teratoma syndrome. Eleven (39 %) patients underwent surgical treatment: retroperitoneal lymph node dissection (55 %), mediastinal lymph node dissection (36 %), pulmonary resection (9 %). Pathological complete response was achieved in 6 (55 %) patients, mature teratoma — 2 (18 %), viable tumour — 3 (27 %). TIP showed acceptable safety profile and only in one case tumor lysis syndrome was observed.

Conclusions: The TIP regimen may improve the results of treatment in the first line with unfavorable decrease of serum tumor markers after the first cycle of chemotherapy, which requires further study in a randomized trial.

Molecular-genetic study of uveal melanoma (UM) is crucial in predicting the risk of metastasis of this tumor. Such analysis is also possible during organ-sparing treatment based on fine-needle aspiration biopsy (FNAB), however, not all patients may consider this study appropriate and/or accessible.

The goal of this study was to analyze the needs of patients with UM for individual metastasis risk prognosis.

This retrospective cohort study was conducted using a questionnaire in 94 patients with UM (mean age 60 ± 13 years; 69 % women and 31 % men). Despite the rather high proportion of interested patients (77 %), only half (51 %) of them ultimately agreed to undergo a ”prognostic” FNAB, which was primarily due to the high cost of this study (it was the main reason for refusal in 76 % of cases). Patients were mainly motivated to know their risk by: a sense of control of the situation and the possibility of taking preventive measures (78 %), future planning for themselves and/or their loved ones (47 %), the possibility of participating in metastatic UM treatment programs (35 %), receiving the maximum amount of information about the disease (28 %). Patients without such intention cited a fear of revealing a high risk of metastases and an impossibility of psychological stabilization based on results of this test.

Predicting the risk of metastasis is an important component of an integrated approach to the management of patients with uveal melanoma, including organ-sparing treatment. State funding of this study will increase the satisfaction of psychological needs in this category of cancer patients and improve understanding of the metastasis of uveal melanoma.

Common surgical treatment options for colorectal cancer (CRC) are high-risk interventions. The accumulation of various digital health data is critical to improving the quality of cancer care. The article analyzes cases of using the composite unified quality criteria (QC) in CRC surgery and highlights the directions of further development of specific quality indicators and an evaluation system for CRC treatment outcomes. Integrative multiparametric approaches to quality analysis have the potential to improve the quality of surgical oncology. They can be implemented along with other approaches after approval for use in real-world clinical practice.

The development of new rehabilitation techniques for cancer patients is relevant, on the one hand, due to the increasing cancer incidence, and, on the other hand, due to breakthroughs in cancer treatment. Following successful treatment, female patients often do not receive due attention since there are no recommendations for their further management. All patients with gynecological cancer undoubtedly need further medical and social support after cancer therapy since many of them face a lot of challenges related to impaired physiological functions, psychological problems, the need to rebuild professional and family relationships, i. e., decreasing quality of life. Therefore, there is an obvious need for the development of cancer rehabilitation programs. This type of care must be available to everyone regardless of their social status, financial welfare and place of residence. The full spectrum of rehabilitation activities should be based on the latest researches and guidelines.

Despite the development of contemporary surgical management of retroperitoneal liposarcomas, local recurrence remains the major challenge in the treatment of these tumors. Currently, surgery is the main treatment option for liposarcoma. The international cancer community faces a global goal — the development of new combined treatment options for the treatment of retroperitoneal liposarcoma to reduce the postoperative recurrence rate and increase the overall survival. This article presents the world literature data on the treatment of retroperitoneal liposarcomas and demonstrates a case report describing treatment of a patient with this disease in the N. N. Blokhin NMRC of Oncology.