Background. The evolving modalities of systemic treatment for non-small cell lung cancer (NSCLC) promotes the need to redefine different strategies for combined treatment in stage III and borderline-resectable lung cancer. Hereby we present the outcomes of a neoadjuvant chemo-immunotherapy regimen with subsequent individualized local control strategy of patients with locally advanced NSCLC.
Materials. Prospective, single-center, non-randomized observational study enrolled patients with the following criteria: age > 18 years, histologically confirmed NSCLC without driver mutations (EGFR, ALK, ROS1), clinically staged as IIIA–IIIC per the 8th edition TNM classification, including cases deemed resectable and borderline-resectable, and an Eastern Cooperative Oncology Group (ECOG) performance status of 0–2. The protocol comprised 4 cycles of neoadjuvant chemo-immunotherapy following MDT-based definition of surgical resection or radiotherapy — based on a technical resectability and a risk of cardiopulmonary complications.
Results. From September 2021 to October 2025, 119 patients were enrolled with male: female ratio 103:16 and median age 65 years (IQR, 59–69). Clinical stage distribution was: IIIA — 63 (52.9 %), IIIB — 51 (42.9 %), IIIC — 4 (3.4 %) and IIb — 1 (0.8 %). Histologically, adenocarcinoma and squamous cell carcinoma accounted for 41 (34.4 %) and 78 (65.6 %) cases respectively. The full course of neoadjuvant / induction therapy was completed by 109 (91.6 %) patients. Radiological response assessment by RECIST criteria revealed a partial (iPR), complete response (iCR) or stable disease (iSD) in 68 (57 %), 11 (9.2 %) and 35 (29.4 %) cases respectively. For local control 76 (63.9 %) patients underwent surgical resection and 26 (21.9 %) received radiotherapy. Postoperative complications (Clavien — Dindo classification) occurred in 11 of 76 surgical patients (14.5 %; 95 % CI, 8.3–24.1). A major pathological response (MPR) and complete response (pCR) were achieved in 21 (27.6 %) and 30 (39.5 %) cases respectively. Median overall survival (OS) and event-free survival (EFS) in the surgical cohort have not been reached, whereas in the radiotherapy group, median OS was 29 months (95 % CI, 17.3; not estimable) and median EFS was 15.5 months (95 % CI, 12.7; not estimable).
Conclusion. Our findings support consideration of induction / neoadjuvant chemo-immunotherapy for selected cohort of patients with locally-advanced and borderline-resectable stage III NSCLC. Future investigations are needed to explore the benefits of proposed strategy.

Introduction. There is no consensus regarding the optimal first-line chemotherapy regimen for locally advanced or metastatic esophageal squamous cell carcinoma. The efficacy of standard chemotherapy combinations is limited and therefore has to be improved. Due to the limited accessibility of modern immunotherapy, chemotherapy remains a valuable commonly used option. We conducted a non-randomized prospective study to evaluate the efficacy and tolerability of the triple combination mDCF.
Materials and Methods. The main inclusion criteria of the study were locally advanced or metastatic esophageal squamous cell carcinoma, age over 18 years, patients with an ECOG performance status of ≤ 2 (ECOG, Eastern Cooperative Oncology Group), and satisfactory blood test results. The primary endpoint of the study was the objective response rate (ORR); secondary endpoints included overall survival (OS) and progression-free survival (PFS). Patients received eight cycles of mDCF chemotherapy: docetaxel 40 mg / m2 on day 1, cisplatin 40 mg / m2 on day 1, calcium folinate 400 mg / m2 also on day 1, fluorouracil 400 mg / m2 by intravenous bolus on day 1, followed by a 48-hour infusion of fluorouracil 2000 mg / m2 (1000 mg / m2 daily) on days 1–2. This treatment regimen was administered every 2 weeks.
Results. From 2019 to 2025, 74 patients participated in the study. The median age was 62 years; 55 patients (74.3 %) were male and 19 (25.7 %) were female. The tumor was located in the upper third of the esophagus in 9 cases (12 %), the middle third in 31 cases (42 %), and the lower third in 34 cases (46 %). The ECOG performance status was 0 in 11 patients (14.9 %), 1 in 38 patients (51.3 %), and 2 in 25 subjects (33.8 %). The median OS was 13.6 months (95 % CI 10.6-NR), the median PFS was 9.7 months (95 % CI 7.1–22.0), the ORR was 55.4 % (95 % CI 44.1–66.2), and the disease control rate was 78.1 % (95 % CI 67.8–86.0). The most common grade 3–4 adverse events (AEs) during the study were leukopenia (11 cases, 14.8 %), neutropenia (12 cases, 16.2 %), anemia (10 cases, 13.5 %), and thrombocytopenia (15 cases, 20.2 %). There were no treatment-related deaths.
Conclusions. The modified 2-week mDCF chemotherapy regimen demonstrated significant improvements in ORR, OS, and PFS, as well as manageable toxicity as a first-line treatment for esophageal squamous cell carcinoma.

Introduction. Currently, the algorithm for selecting first-line treatment for advanced adrenocortical carcinoma (ACC) is not clearly defined; the choice between mitotane monotherapy and its combination with platinum-based chemotherapy remains controversial. In a large retrospective study (n = 439), the BUCEN scoring system was proposed as a predictor of treatment response, which could help determine first-line therapy [9]. Our study aimed to evaluate the prognostic value of the BUCEN scores in the Russian population of patients with advanced ACC, treated with a combination of platinum-based chemotherapy and mitotane.
Materials and Methods. This retrospective single-center study included patients aged ≥ 18 years with advanced ACC and pre-assessed BUCEN scores who received platinum-based chemotherapy in combination with mitotane at the N. N. Blokhin National Medical Research Center of Oncology between 2016 and 2025.
Result. The study included 63 patients with BUCEN scores of 0–2 (n = 31; 49.2 %) and ≥ 3 (n = 32; 50.8 %). Fifty patients (79.4 %) received etoposide + cisplatin + doxorubicin (EDP), 5 patients (7.9 %) received etoposide + cisplatin (EP), and 8 (12.7 %) received etoposide + carboplatin (EC). Therapeutic serum levels of mitotane were achieved in 42 patients (66.7 %). The objective response rate (ORR), disease control rate (DCR) at ≥ 6 months, and DCR at ≥ 12 months were 20.6 %, 62.3 %, and 26.3 %, respectively. A BUCEN score of 0–2 was associated with an improved ORR (p = 0.03), a DCR at ≥ 6 months (p < 0.01), and a DCR at ≥ 12 months (p = 0.03). A multivariate analysis revealed that non-anthracycline regimens in patients with BUCEN ≥ 3 were associated with a statistically significant decrease in progression-free survival (PFS) and overall survival (OS). A statistically significant OS improvement was observed in patients with recurrence-free survival of ≥ 12 months post-adrenalectomy (p = 0.04).
Conclusion. The BUCEN scoring system is reproducible, simple to use, and could be applied for the stratification of patients with advanced ACC. Implementation of this system in clinical practice to pre-select patients for mitotane monotherapy as a first-line treatment requires prospective validation. The significantly poorer outcomes in the EP / EC group may partly reflect patient characteristics, as these regimens were used in those with contraindications to anthracyclines or cisplatin. However, based on our data, we do not recommend non-anthracycline regimens in patients without contraindications to EDP chemotherapy.

Introduction. Smoking not only causes cancer but also worsens the prognosis of cancer patients. 
Objective. To compare the effects of smoking cessation with the efficacy of FDA-approved immune checkpoint inhibitors (ICIs).
Materials and Methods. A cohort of 1,240 patients diagnosed with non-small cell lung cancer (NSCLC) (stages I–IIIa) treated from 2007 to 2016 was followed until 2021. Published results of randomized clinical trials (RCTs) evaluating the efficacy of FDA-approved ICIs were analyzed. Overall survival (OS), progression-free survival (PFS), and NSCLC-specific mortality, along with the corresponding hazard ratios (HRs), were calculated. OS and PFS were compared between NSCLC patients who quit smoking and those who received ICIs.
Results. In a cohort of 521 patients who smoked at diagnosis, adjusted median OS and PFS were 21.6 months longer in patients who quit smoking than in patients who continued smoking (6.6 vs. 4.8 years, p = 0.001; 5.7 vs. 3.9 years, p = 0.004). Smoking cessation is associated with a reduced risk of all-cause mortality (HR = 0.67 [95 % CI 0.53–0.85]), lung cancer progression (HR = 0.70 [95 % CI 0.56–0.89]), and lung cancer-specific mortality (HR = 0.75 [95 % CI 0.58–0.98]). The median PFS benefit of 21.6 months from smoking cessation exceeds the benefit achieved with nivolumab in combination with chemotherapy, which is 10.8 months (RCT CheckMate 816), and with pembrolizumab in the adjuvant setting, which is 16.6 months (PEARLS / KEYNOTE-091). A 30 % (HR = 0.70) reduction in the risk of progression resulting from smoking cessation is comparable to a 37 % (HR = 0.63) reduction in the risk associated with nivolumab in combination with chemotherapy in the neoadjuvant setting and a 24 % (HR = 0.76) reduction in the risk associated with pembrolizumab in the adjuvant setting. A 42 % (HR = 0.58) risk reduction (KEYNOTE-671 RCT) resulting from perioperative use of pembrolizumab exceeds the PFS benefit of smoking cessation. Overall, the benefit of smoking cessation is not inferior to that associated with the use of ICIs in patients diagnosed with NSCLC. The effectiveness of smoking cessation is virtually universal and is not limited by any clinical parameters, unlike ICIs, whose effectiveness is limited to certain clinical subgroups, particularly PD-L1‑positive tumors. The absence of adverse side effects also supports smoking cessation.
Conclusion. Smoking cessation should be a critical component of medical care for cancer patients. This will improve the effectiveness of all anticancer treatments, including surgery, medication, and radiation therapy.

Objectives. To evaluate of short-term outcomes of emergency surgeries for right-sided and left-sided colon cancer complicated by acute obstruction, to determine the independent predictors of postoperative complications.
Material. A cohort retrospective study was performed, including 250 patients: group 1‑patients who underwent emergency operations for cancer of the right colon complicated by acute obstruction, n = 73 (29,2 %); group 2‑patients who underwent emergency surgeries for cancer of the left colon complicated by acute obstruction, n = 177 (70,8 %). The study included the period from 01.09.2016 to 10.11.2025 in clinical hospitals in Smolensk. All complications, were analysed within 60 days after surgery.
Results. Statistically significant differences between the groups were found in degree of acute obstruction severity (p = 0.042), preoperative leukocyte level (p = 0.001), hemoglobin level (p < 0.0001), and C-reactive protein levels (p = 0.032). Preoperatively, patients in group 1 had a lower hemoglobin level (< 120 g / L) and more cases with subcompensated obstruction, while those in group 2 had more cases with decompensated obstruction, higher leukocytosis, and elevated C-reactive protein levels above 10 mg / l. Postoperative complications Clavien—Dindo Grade IIIb-V occurred more frequently among patients suffering from right-sided colon cancer complicated by acute obstruction compared to left-sided colon cancer (39.7 % vs. 10.7 %, respectively, p = 0.0031). In group 1, colon resection with primary anastomosis formation were performed more often during the first emergency stage.
Conclusions. Independent predictors that influenced the risk of developing complications Clavien—Dindo Grade IIIb–V were: age ≥ 70 years, Charlson Comorbidity Index (CCI) ≥ 7, overall status by ASA ≥ 3, preoperative hemoglobin level < 100 g / L, emergency colon resection, blood loss during surgery ≥ 400 ml, operation time ≥ 90 min, pT4 criterion, positive status for regional lymph nodes (pN+), presence of moderate or severe COVID-19. The study indicates that surgical duration exceeding 90 minutes at the emergency operation increases the risk of serious postoperative complications by 1.64 times.

Pancreatic cancer remains one of the most aggressive malignancies with an extremely poor prognosis. Despite advances in systemic therapy five-year survival rates for patients with disseminated forms of the disease still do not exceed a few percent. Surgical treatment for advanced pancreatic cancer is not performed in routine practice and is considered palliative.
However, efforts to introduce surgery for stage IV disease continue to be investigated particularly in patients with oligometastatic disease. This group of patients occupies an intermediate position in terms of tumor biology between localized cancer and disseminated disease, providing a theoretical rationale for the use of radical local treatment modalities in combination with effective systemic therapy.
The aim of this review is to systematize current data regarding the role efficacy and safety of surgical treatment in patients with oligometastatic pancreatic cancer as well as to define the selection criteria for patients most suitable for combined treatment. This work analyzes the results of key studies and discusses prognostic factors that enable the selection of the most appropriate candidates for combined treatment.

Objective. To analyze current evidence on the impact of radiation therapy on the risk of capsular contracture in patients undergoing nipple-sparing and skin-sparing mastectomy with immediate implant-based reconstruction, and to evaluate strategies for optimizing radiation delivery in order to reduce reconstructive complications without compromising oncologic outcomes.
Materials and methods. A review of randomized clinical trials, prospective and retrospective cohort studies, as well as dosimetric analyses addressing radiation therapy in patients after nipple-sparing and skin-sparing mastectomy with immediate implant-based reconstruction was performed. The literature search was conducted in PubMed, Cochrane Library, Elsevier, and eLIBRARY. RU databases. Data regarding the incidence of capsular contracture, clinical and dosimetric risk factors, the impact of radiation target volumes, fractionation schedules, planning techniques (3D-CRT, IMRT, VMAT), the use of deep inspiration breath hold (DIBH), and implant-specific dose constraints were analyzed.
Results. The incidence of clinically significant capsular contracture following radiation therapy ranges from 15 % to 30 % and depends on a combination of surgical, clinical, and radiation-related factors. Radiation dose delivered to the implant and surrounding tissues, including Dmean and Dmax parameters, appears to be a potential predictor of fibrotic changes. Individualization of clinical target volumes, justified de-escalation of regional nodal irradiation in selected clinical scenarios, the use of hypofractionation, advanced planning techniques (IMRT / VMAT), implementation of DIBH, and application of implant dose constraints may reduce the risk of late complications while maintaining adequate target coverage.
Conclusions. Optimization of radiation therapy planning and delivery after nipple-sparing and skin-sparing mastectomy with immediate implant-based reconstruction using modern technologies, individualization of target volumes and fractionation schedules, and careful control of dose to the implant may minimize the risk of capsular contracture without compromising oncologic outcomes. Further prospective studies are required to refine dose constraints and develop standardized clinical recommendations.

Introduction. Treatment of elderly cancer patients is challenging due to high risk of adverse events. Comprehensive Geriatric Assessment (CGA) is the gold standard but time-consuming. The G8 screening tool rapidly identifies patients requiring CGA.
Aim. To summarize current evidence on the predictive value of the G8 for chemotherapy toxicity, assess its diagnostic accuracy, compare it with other geriatric scales, and evaluate its applicability in the Russian population.
Materials and methods. A systematic search of PubMed, Google Scholar, eLibrary, and CyberLeninka (2012–2024) was performed. Prospective cohort studies, RCTs, meta-analyses, and validation studies of the G8 were included; 40 publications met the inclusion criteria.
Results. A G8 score ≤ 14 is associated with a 2.3‑fold increased risk of grade 3–4 toxicity (OR 2.3; 95 % CI 1.7–3.1) and significantly worse overall survival (HR 2.72; 95 % CI 1.89–3.91; p < 0.001). Pooled sensitivity for detecting geriatric impairments is 74–89 %, specificity 55–65 %. The Russian version demonstrated good internal consistency (α = 0.709). Compared with CARG and CRASH, the G8 is best suited for first-line screening (AUC 0.72–0.85), while CARG / CRASH refine toxicity prediction before chemotherapy (AUC 0.65–0.72).
Conclusion. The G8 is a valid, reliable screening tool for risk stratification and selection for CGA. Its combination with CARG / CRASH provides an evidence-based approach to managing older adults with cancer. Further validation studies of CARG and CRASH in the Russian population are required.

Background. Vulvar cancer (VC) is a rare malignancy in women, accounting for no more than 4 % of all cancers. Sebaceous histologic subtypes of VC are exceptionally uncommon. We summarize our own experience and that of other authors regarding presentation, diagnosis, and management.
Objective. To present a clinical case of vulvar sebaceous carcinoma and synthesize the available literature to clarify the clinicopathologic features, diagnostics, treatment, and prognosis of this malignancy.
Materials and Methods. We described a clinical case of vulvar sebaceous carcinoma treated at our center. In addition, we conducted a systematic literature review (PubMed, MEDLINE, Cochrane Library, eLibrary.ru; 1970–2025; keywords “sebaceous carcinoma”, “vulvar cancer”) of published cases.
Results. Immunohistochemistry confirmed sebaceous carcinoma (EMA+, pan-CK+, S100 / Melan-A–); stage IB (pT1bN0M0). A hemivulvectomy achieved a clear margin ≥ 10 mm; no adjuvant therapy was given; at 21‑month follow-up there was no recurrence. The literature review of 16 cases showed that the vast majority of patients (~ 80 %) underwent surgical treatment; inguinal lymph-node metastases were reported in ~ 20 %, and distant metastases in < 10 %. In isolated reports, adjuvant radiotherapy and immunotherapy (PD-1 inhibitors) were used for advanced disease.
Conclusion. Vulvar sebaceous carcinoma is exceedingly rare and insufficiently studied, requiring an individualized, multidisciplinary approach. In localized stages, radical surgical excision provides a favorable prognosis. Regional lymph-node assessment is preferably performed via sentinel lymph-node biopsy, and all patients should undergo immunohistochemical evaluation of the mismatch-repair (MMR) system to exclude Muir — Torre syndrome and to determine eligibility for targeted and / or immunotherapy.

On January 27, 2026, an Advisory Board was held to discuss issues of molecular genetic diagnosis of the BRAF V600E mutation in patients with advanced non-small cell lung cancer (NSCLC), as well as current treatment options for NSCLC patients with the BRAF V600E mutation. Next generation sequencing (NGS) is the most sensitive and specific method for molecular genetic testing. Its implementation in routine clinical practice will improve the detection rate of BRAF positive NSCLC patients. The accepted standard of care for patients with advanced NSCLC and the BRAF V600E mutation is targeted therapy with BRAF / MEK inhibitors. In the Russian Federation, the combination of dabrafenib and trametinib is approved for use. At the Advisory Board, results were presented from a study of a new targeted combination: encorafenib (a BRAF inhibitor) and binimetinib (a MEK inhibitor). In the Phase II PHAROS clinical trial, the encorafenib — binimetinib combination demonstrated a high rate and durability of antitumor response in adult patients with advanced NSCLC and the BRAF V600E mutation. The objective response rate in treatment naive and previously treated patient groups was 75 % and 49 %, respectively. The median progression free survival (PFS) in the subgroups was 30.4 months and 9.3 months, respectively. At the time of publication, the indication “advanced NSCLC with the BRAF V600E mutation” for the targeted drug combination of encorafenib and binimetinib has not been registered in the Russian Federation.