Background: At a time lots of cases of HPV associated oropharyngeal squamous cell carcinoma (HPV + OPSCC) are on the rise and excellent outcomes are seen when comparing HPV-OPSCC, identification of HPV status has become a powerful and widely used marker. Despite this, 20–25 % of HPV + OPSCC patients relapse within 3 years. The most significant barrier to identifying patients at high risk of relapse and death is the lack of clinically useful prognostic markers.

Methods: The study included 62 patients treated with OPSCC T1–4N0–3M0 (7th edition, AJCC) in 2015–2020 in clinics located in two large cities of Uzbekistan (Tashkent and Samarkand). The study analyzed the prognostic value of PD-L1 and p53 proteins in OPSCC, taking into account HPV status. In addition, the relationship between PD-L1, p53 and HPV status was analyzed, as well as their impact on patient survival.

Results: Positive HPV status with positive PD-L1 expression improves overall survival of patients compared to their negativity (p = 0.261). The mutant type of p53 protein has a negative correlation with HPV status, which reduces survival time (p < 0.001). Wild type p53 is detected in a small number of patients, but it shows a positive correlation with HPV status as a strong protective factor that reduces the risk of death (p = 0.01).

Conclusion: Positive HPV status is not always a reliable predictor of risk stratification for patients with OPSCC, because additional indicators associated with the development of OPSCC need to be identified to reinforce the value of predictive predictors other than HPV status.

Background: The newly diagnosed pelvic cancer appears to be locally advanced in every third patient, which requires a comprehensive approach to treatment and often extensive combined surgical interventions. Long duration of operations, blood loss, complications of the tumor process during or after previous treatment often lead to the development of complications, slow rehabilitation and increasing cost of treatment. The use of fast track protocol (FTP) and blood-saving technologies can reduce the impact of these adverse factors.

Aim: The evaluation of the pharmaco-economic efficiency of fast track protocol and blood-saving technologies in patients after extended combined operations for pelvic tumors.

Materials and methods: The study included 111 patients with pelvic tumors who underwent an extensive combined surgery for rectal or gynecological tumors. Among them, 52 patients were underwent the same fast track protocol with a focus on the use of blood-saving technologies (2020–2021), the management of patients in the control group was more conservative (n = 59, 2018–2019). After analyzing the factors affecting the treatment outcomes, 2 groups of 16 patients comparable in basic clinical indications were formed by selection of pairs patients using quasi-randomization to assess the direct costs of treatment.

Results: The cost of treatment in the FTS group and the control group was 157744 ± 32728,72 and 273429 ± 217931,5 (P < 0,05) rubles,  respectively. The lower blood loss (206 ± 70 ml vs 430 ± 208, р = 0,3) allowed for a statistically significant difference in the frequency of transfusion of blood components (2 vs 12, p < 0,0009), despite the higher cost of supplies in the FTS group (132913 vs 57347 rubles). Also, the resuscitation bed-day (1,75 ± 1,3 vs 3,5 ± 2, р = 0,5) and the postoperative bed-day (16,8 ± 8; 8–32; vs 27 ± 18, р = 0,6) were lower in the FTS group.

Conclusion: According to our data using the fast track protocol and blood-saving technologies in a group of patients with locally extensive pelvic organs tumors has helped to reduce the cost of treatment and improve the efficiency of the hospital.

Breast cancer is the most common female cancer and cause of death from cancer in women worldwide. Overexpression of HER2 / neu, which is an unfavorable predictor associated with a more aggressive course of the disease, is detected in every 5th breast cancer patient. Over the past 20 years, targeted therapy has changed the natural course of breast cancer. However, standard neoadjuvant chemotherapy regimens in combination with targeted therapy are poorly tolerated and, therefore, are considered suboptimal. Evidently, not all patients require such toxic treatment regimens. In this review article, we present our view whether neoadjuvant therapy can be de-escalated in patients with HER2‑positive breast cancer.

Non-small cell lung cancer (NSCLC) is the leading cause of cancer mortality both in Russia and worldwide. At diagnosis, most patients have advanced disease when the use of local treatment modalities is limited and systemic chemotherapy fails to provide a pronounced and sustained benefit. The advent of targeted therapies has significantly changed the treatment paradigm of NSCLC. Genetic alterations representing potential molecular targets have been identified in up to 60 % of non-squamous NSCLC cases, and agents directed against 50 % oncogenic targets have been approved. Various activat ing mutations of the MET signaling pathway (gene amplifications and alterations) associated with unfavorable disease outcomes occur in 2–4 % of NSCLC patients. Recently, significant advances in the development of therapies targeting this signaling pathway have been made. The article provides an overview of the key studies evaluating novel therapeutic options for NSCLC with MET alterations.

Background: Liver resection for intrahepatic cholangiocarcinoma is accompanied by a high recurrence rate (up to 70 %) in the first 2 years after surgery. The results of treatment of recurrent intrahepatic cholangiocarcinoma are evaluated inconsistently.

Aim: The results of repeated liver resections and methods of locoregional therapy for reccurent intrahepatic cholangiocarcinoma were analysed based on literature data.

Materials and methods: Two publication databases have been used for search: PubMed and Google Scholar. Finally, 35 papers published from 2010 to 2022 were included in review.

Results: Repeated liver resections followed by chemotherapy provide better long-term results compared to other methods of local therapy and systemic drug treatment. The rate of perioperative morbidity does not differ from resections for primary tumors. Repeat liver resection is possible in a limited number of patients (8–10 %). Thorough selection of patients is necessary in terms of prognosis and biological behavior of the tumor.

Conclusion: Evidence for the benefit of resections in the treatment of recurrent intrahepatic cholangiocarcinoma is based on a scarse number of studies analyzing relatively small and heterogeneous patient cohorts. Patient selection is needed, the criteria for which are still being discussed.

Metastatic colorectal cancer (mCRC) is a major challenge in the treatment of malignant neoplasms. However, with the development of cytotoxic chemotherapy, targeted therapy and local therapies, survival rates have improved significantly. Treatment of patients with CRC in the third and subsequent lines of therapy suggests the use of regorafenib / TAS102, as well as a return to previously used chemotherapy. Late-line treatment with anti-EGFR antibodies (cetuximab, panitumumab) is the choice for mCRC as it has been shown to improve survival rates. BRAF inhibitor and an anti-EGFR antibody is effective in BRAF mutations. A feature of the HER2 / neu mutation is the requirement for dual blockade with trastuzumab + lapatinib or pertuzumab + trastuzumab. For MSI-high, anti-PD therapy (nivolumab, pembrolizumab, or nivolumab + ipilimumab combination therapy) is highly effective. Adagrasib and sotorasib have demonstrated their value in the treatment of CRC with the KRAS G12C mutation. Two inhibitors are approved for NTRK-positive colorectal cancer — larotrectinib and entrectinib. It is also worth noting that one of the local options for the treatment of mCRC is stereotactic radiation therapy. This article presents the current possibilities of therapy for chemoresistant CRC.

Mediastinal teratoma is a rare germ cell tumor. The mediastinum is the most common extragonadal site. Malignant tumors of the mediastinum account for 4 % of all extragonadal tumors of the mediastinum. We present a case of successful surgical treatment of a 24‑year-old man with a gigantic immature mediastinal teratoma complicated by severe cardiorespiratory disorders.

A clinical case of an atypical course of paraneoplastic cerebellar degeneration that occurred during chemotherapy in a patient with an established diagnosis of metastatic endometrial cancer is presented.