Introduction. Breast cancer systematically occupies a leading place among cancer incidence in Russia. Moreover, hereditary forms of tumors occur in 2–8 % of patients. Almost 30 % are associated with pathogenic variants in the BRCA1/2 genes. Since the beginning of 2023, patients with BRCA-associated breast cancer at the Sverdlovsk Regional Oncology Center have been examined using next-generation (NGS) sequencing to carry out the necessary preventive, diagnostic and treating measures.

The purpose of the study was to evaluate the effectiveness of next-generation sequencing in comparison with polymerase chain reaction (PCR) tests and to assess the relevance of the existing PCR panel.

Materials and methods. This work is based on an analysis of the results of molecular genetic testing of 132 breast cancer patients aged 29 to 66 years. Firstly, the biological material of all patients was tested using the polymerase chain reaction in real time method to search for frequent pathogenic variants. If the result was negative, patients were referred for a study using next-generation sequencing to look for rare variants.

Results and discussions. A study of common pathogenic variants of the BRCA1/2 genes using real-time PCR showed the presence of “founder mutations” in 3.0 % of patients. The search for rare pathogenic germline variants using NGS made it possible to identify pathogenic gene variants in another 25 patients (18.9 % of examined).

Conclusion. Taking into account the more aggressive course of hereditary forms of breast cancer, the early age of manifestation of the disease, a lot of rare mutations in the Sverdlovsk region and high probability of transmitting them to children, it is necessary to develop follow-up programs of relatives for the purpose of timely diagnosis and treatment.

Introduction. Despite extensive studies devoted to comprehensive comparisons of the expression of mRNA, proteins, mutations in cell cultures and tissue samples of breast cancer, there is insufficient data on the comparability of their receptor apparatus.

The purpose of the study was to determine changes in receptor expression levels in a cell culture obtained from a sample of the luminal B over five passages.

Materials and methods. A cell culture was obtained. Estrogen and Ki‑67, pancytokeratin and vimentin were analyzed over five passages. Paraffin blocks were prepared from part of the material for immunohistochemical analysis.

Results and discussion. A culture was obtained with high levels of Ki‑67 and estrogen expression during the first three passages. The cells maintained their epithelial nature throughout the culture. Perhaps this culture can demonstrate the processes occurring during regional metastasis. This is evidenced by the detection of tumor cells expressing vimentin from the first to the fourth passage. Thus, studying the processes occurring in in vitro models will help to come closer to understanding the processes in the biology of breast cancer and clarify the nature of the heterogeneity of this disease.

Conclusions. Studying the differences between primary culture cells and tumor tissue samples will provide an effective in vitro model.

Introduction. Stomach cancer continues to be one of the leading causes of mortality among malignant diseases. The study of various methods of surgical treatment is one of the directions of scientific search.

The purpose of the study — comparison of the frequency of postoperative complications with laparoscopic and laparotomic access in patients who underwent radical treatment of gastric malignancies.

Materials and methods. Retrospective evaluation of 189 patients diagnosed with malignant neoplasms of the stomach, operating under stationary conditions of the department of abdominal oncology of the Sverdlovsk Regional Oncology Center in 2023.

Results and discussion. Length of hospitalization of patients operated by laparoscopic method, was reliably lower than the same number of patients, operated with laparotomy, which allows you to start adjuvant chemotherapy at an earlier date and thereby improve the distant results. In general, the traumatic indicators of surgery were less important in patients, operated laparoscopic method.

Conclusion. Based on the data we’ve gathered, that although there is no statistically significant difference in the incidence of intraoperative and postoperative problems when performing laparoscopic and open radical operations in patients with malignant neoplasms of the stomach, the more benefits have laparoscopic access.

Introduction. Currently, there is an increase in the incidence of breast cancer during pregnancy, which is likely due to the trend toward increasing age at childbirth. The incidence rate of pregnancy-associated breast cancer ranges from 17.5 to 39.9 per 100,000 births.

The purpose of our study is to identify distinctive characteristics, evaluate disease-free survival (RFS) and overall survival (OS) in a group of patients with pregnancy-associated breast cancer.

Materials and methods. The results of treatment of 68 patients diagnosed with breast cancer detected during pregnancy or within 12 months after childbirth were analyzed. As a comparison group, the results of treatment of 165 patients aged from 20 to 45 years were analyzed.

Results. When comparing the histological types of tumors in the group of pregnancy-associated malignancies, statistically significant differences were observed in the group of triple negative subtypes. However, there were no differences in long-term survival between groups.

Conclusions. The most common histological subtype in breast cancer associated with pregnancy is triple negative, while luminal subtypes are less common than in the general population. There is a tendency to detect cancer in pregnant women at later stages. The effect of pregnancy on OS is currently not fully understood and additional research is required on pregnancy as an unfavorable prognostic factor.

Introduction. Integrated approach — modern standard of treatment of stomach cancer. At the same time, it is necessary to assess the influence of chemotherapy on the pre-operative stage to the distant results of treatment in real practice.

The purpose of the study — determine the impact of neoadjuvant chemotherapy on patient survival.

Material and methods. A retrospective study of 612 patients receiving neoadjuvant chemotherapy in the conditions of Sverdlovsk Regional Oncological Center was conducted from January 2021 to December 2023.

Results and discussion. The study found that neoadjuvant chemotherapy does not affect overall survival and diseasefree overall survival compared to adjuvant, does not increase the risk of postoperative complications and mortality. Findings suggest that more careful selection of patients is needed who require neoadjuvant chemotherapy, taking into account the somatic status associated with associated pathology.

Conclusion. Based on our findings, we can state that neoadjuvant chemotherapy as part of perioperative chemotherapy is the standard of patient treatment of gastric cancer II–III stage.

Introduction. After radical nephroureterectomy for the upper tract urothelial carcinoma (UTUC), 15–50 % of patients have a relapse in the bladder. Non-muscle invasive relapse in the bladder (NMIR) occurs in 80–90 % of all types of bladder relapses.

The purpose of the study is to evaluate the effect of NMIR on patient survival after RNUE, and study the characteristics of the primary tumor and its effect on the occurrence of NMIR.

Materials and methods. 157 patients underwent surgical treatment for UTUC during the period from 2011 to 2021. Overall (OS), progressive free (PFS), and cancer-specific (CSS) survival in patients with a relapse in the bladder was analyzed. Cox regression analysis was used to estimate the risk of NMIR.

Results. NMIR was observed in 32 patients (20.4 %). 5‑year OS, PFS and CSS of patients with NMIR was higher than in the group of patients without NMIR and amounted to 92.4 %, 96.6 %, 93.4 % versus 61.4 %, 74.9 %, 68.9 % respectively. When comparing the clinical and pathomorphological characteristics, it was found that the primary tumor G3, locally advanced tumor are significantly less common in the NMIRC group, while concomitant bladder cancer, simultaneous lesion of the renal pelvis and ureter, as well as non-muscle-invasive cancer are significantly more common in the NMIRC group. According to the multivariate regression analysis, the risk of NMIRC increases by 2 times with simultaneous tumor lesion of the renal pelvis and ureter (HR — 2.93; 95 % CI — 1.43–7.13; p = 0.005) and concomitant bladder cancer (HR — 2.89; 95 % CI — 1.01–6.11; p = 0.035).

Conclusion. Significantly better survival rates were found for patients with UTUC in the presence of NMIR. Patients with NMIR are significantly less common to have aggressive forms of the primary tumor and a locally advanced disease.

Introduction. Despite advances in early diagnosis, in 5–10 % of cases, melanoma is detected at stage IV. In recent years, there have been breakthroughs in the drug treatment of metastatic melanoma. Against this background, modern data on overall survival (OS) of this group of patients in Russia are relevant, but rarely published.

Objective — to assess the OS of patients with stage IV melanoma depending on the clinical and biological characteristics of the tumor and the treatment performed in real clinical practice.

Materials and methods. We retrospectively studied medical documentation in the Medofis medical information system and the regional information system ONKOR of 300 patients, residents of the Sverdlovsk region, with the first stage IV of skin melanoma, first identified from 1 January 2014 to 1 January 2023. Observation was carried out until 1 February 2024.

Results. 61.3 % of patients received antitumor drug therapy. Analysis for the BRAF mutation was performed in 46.3 % of the total number of patients (75.5 % of those who received specialized treatment). A mutation in the BRAF gene was detected in 52.5 % of cases. The 1‑year OS of patients with malignant melanoma of the skin was 47.0 %, the 3‑year OS was 27.3 %. Survival rates for patients receiving targeted or immune therapy were higher. From 2014 to 2023, the proportion of patients receiving targeted therapy or checkpoint inhibitor therapy increased from 11.5 % to 69.7 %.

Conclusions. There was an increase in median OS, 1‑year and 3‑year OS depending on the time of diagnosis of the disease, specialized treatment, number of lines of drug therapy, use of targeted drugs, checkpoint inhibitors.

Introduction. Determination of biological subtypes of breast cancer after clinical and instrumental examination methods is a routine practice to determine individualized treatment tactics, to clarify the prognosis of the disease, and to prevent overtreatment. Polymorphism of breast cancer manifestations is associated with heterogeneity of biological subtypes of breast tumors. Identification of metastatic axillary lymph nodes has clinical and prognostic significance.

Objective — to assess the significance of ultrasound examination of axillary lymph nodes in patients with various biological subtypes of breast cancer in real clinical practice.

Materials and methods. The study included 895 patients aged from 28.8 to 91.8 years with a verified diagnosis of breast cancer, observed at the Sverdlovsk Regional Oncology Center in 2022. All patients underwent clinical, ultrasound evaluation of axillary lymph nodes, histological verification of the tumor at the preoperative stage, as well as routine and intraoperative histological examination of the sentinel axillary lymph nodes. Statistical processing and data visualization were performed using R version 4.3.2 (build 2023-10-31).

Results. In our sample of patients, TNR was less associated with metastasis to axillary LU compared with luminal cancers. There was no effect of different molecular subtypes on the preoperative ultrasound and intraoperative histologic examination parameters.

Conclusions. Among our patients TNC was less associated with metastasis to axillary lymph nodes compared to luminal cancers. There was no effect of different molecular subtypes on the performance of ultrasound and intraoperative histological methods of examination.

Relevance. Lung cancer occupies leading positions in oncologic morbidity, but despite the successes in the development of chemotherapy and radiation therapy, surgical radical operations are in the first place in the treatment of this pathology. In operations with tumor localization in the central bronchi bronchoplastic operations are irreplaceable in the practice of oncologic surgeon.

Objective to analyze our experience in performing bronchoplastic operations, to identify factors influencing the course of early postoperative period, development of complications.

Materials and methods. The study is based on the results of surgical treatment of 102 patients in the period from 2018 to November 2023, who underwent organ-preserving sleeve lobectomy. The choice of the method of surgical treatment was substantiated, the immediate and long-term results were presented. Preoperative evaluation included blood tests, computed tomography (CT) of the chest, abdomen, and brain; pulmonary function tests to assess the state of the respiratory and cardiovascular systems. Videobronchoscopy with preoperative biopsy of central masses was performed in all patients. Positron emission tomography combined with CT (PET-CT), magnetic resonance imaging (MRI), skeletal bone scanning were performed as needed. All patients underwent double-lumen endotracheal intubation. The surgical access was an anterolateral thoracotomy in the fifth or sixth intercostal space. Intraoperative histologic examination of bronchial resection lines was performed in all cases. All patients underwent systematic mediastinal lymphodissection and it was performed before bronchial reconstruction.

Results. 102 patients underwent bronchoplastic lobectomy for lung tumors. Concomitant pathology of varying severity was present in 79 patients (77.5 %). 73 operations (71.6 %) were performed on the right lung and 29 (28.4 %) on the left lung. Patients who underwent wedge resection of the TBT were 57 (55.9 %), with circular resection of the bronchus — 45 (44.1 %). There were no statistically significant differences by sex, age, concomitant pathology and process prevalence among the patients.

Discussion. Bronchoplastic operations have a pronounced safety profile in the surgical treatment of lung cancer, as indicated by low mortality and complication rates: subcutaneous emphysema (5; 4.90 %), recurrent pneumothorax (3; 2.90 %), residual cavity (3; 2.90 %), bronchopleural fistula (4; 3.90 %), postoperative bleeding (1; 0.98 %), pulmonary artery anastomosis thrombosis (1; 0.98 %), acute respiratory distress syndrome with respiratory failure (3; 2.90 %), acute myocardial infarction (2; 1.92 %), coagulated hemothorax (1; 0.98 %), pulmonary embolism (1; 0.98 %). Postoperative mortality — 4 (3.90 %.)

Conclusions. It has been established that bronchoplastic operations have a low number of complications in the postoperative period — 22 (21.5 %). In planning the type of bronchoplastic when planning the type of bronchoplastic surgery, preference should be given to circular resection of the bronchial resection, as it reliably reduces the number of reoperations due to complications: in the wedge resection group 9 reoperations (15 %) were required in the wedge resection vs. wedge resection group versus 2 (4.4 %) in the circular resection group (p < 0.05). However, the choice of resection technique does not affect either the number of complications or the rate of local recurrence development.

Giant cell tumor (GCT) of bone is a relatively rare, benign neoplasm characterized by local destructive growth. Also in a small percentage of cases (2–3 %) there is a primary malignant GCT or malignancy during treatment. The tumor has a high risk of local recurrence after primary treatment. Considering most often the epiphyseal and metaepiphyseal lesions, the tumor is characterized by a high risk of pathological fracture, and leads to damage to the joint and disruption of its function. Difficulty in treatment arises with GCT of complex localization of the pelvic bones, spine, and skull bones. Considering the high risks of surgical treatment, the option of conservative long-term targeted therapy with denosumab is proposed in order to stabilize the process. This article highlights a clinical case of treatment and observation of a patient with pelvic localization of the primary process. During treatment, the patient completely regained weight bearing ability and quality of life. Denosumab is becoming a good option in the treatment of giant cell bone tumors of complex localization. Drug treatment with proper patient support is an alternative method of treating patients if it is possible to avoid unnecessarily aggressive surgical tactics in order to preserve the patient’s quality of life.

Introduction. Breast cancer (BC) has a leading position among oncological diseases in women. Early diagnosis and search for predictors of malignant neoplasms using radiation imaging methods allows timely diagnosis and treatment, which improves the prognosis for BC. Most of the data obtained by radiological imaging is largely non-specific at the molecular level. Radiomics is engaged in solving these issues, which performs a comprehensive quantitative assessment of tumor phenotypes by extracting a large number of quantitative signs from medical images.

Purpose — systematization of modern scientific directions of radiomics in the radiation diagnosis of BC.

Methods. Comprehensive analysis of PubMed and eLibrary.ru electronic databases over the past 5 years.

Results. Based on the studied literature data, we identified the main promising scientific directions for the development of radiomics in the radiation diagnosis of BC: the study of the prevalence of BC, its risk factors, new screening approaches in the early diagnosis of BC; the search for specific markers and available visualization of signs of a certain molecular type of BC; the search for prognostic predictors and the study of the accuracy of the forecast based on the identified characteristics; identification of the possibilities of personalized therapy, assessment of the most effective treatment and modern management of cancer patients; expansion of the possibilities of radiomics in combination with other scientific fields.

Tumors of the chest wall are a relatively rare disease in clinical practice. Most published studies of chest wall tumors are typically single-center, retrospective studies involving small numbers of patients. Thus, evidence for clinical findings regarding chest wall tumors is currently lacking. The article reviews the literature and highlights the epidemiology of chest wall tumors. The types of materials for reconstruction, the methods used for chest wall plastic surgery for extensive resections, and complications are described in detail. The authors presented their own experience in treating 42 patients who, for one reason or another, underwent resection of the bone structures of the breast. According to the etiology, the tumors were divided into: non-small cell lung cancer with invasions into the chest wall (9 patients, 21.4 %), invasion of breast cancer (2 patients, 4.8 %), sarcomas (chondrosarcomas, osteosarcomas, soft tissue sarcomas; 13 patients, 31 %), metastases of malignant tumors of various origins and localization (9 patients, 21.4 %), benign tumors (8 patients, 19 %), dysmoid tumor (1 patient, 2.4 %). 22 (52.3 %) patients underwent plastic surgery of the resulting defect. Of these, myoplasty, plastic surgery with a diaphragm, local tissues (8 patients, 36.4 %), alloplasty with a polypropylene mesh (6 patients, 27.3 %), alloplasty with a polymer plate (7 patients, 16.7 %). In 3 cases, alloplasty was supplemented by replacement of soft tissues with a thoracodorsal flap. The methods of plastic surgery and the materials used are described. In the postoperative period, the authors did not observe complications associated with paradoxical breathing.