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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">oncotomsk</journal-id><journal-title-group><journal-title xml:lang="ru">Сибирский онкологический журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Siberian journal of oncology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1814-4861</issn><issn pub-type="epub">2312-3168</issn><publisher><publisher-name>Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21294/1814-4861-2025-24-3-5-14</article-id><article-id custom-type="elpub" pub-id-type="custom">oncotomsk-3659</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL STUDIES</subject></subj-group></article-categories><title-group><article-title>Результаты комбинированного лечения больных колоректальным раком с синхронными метастазами в печень</article-title><trans-title-group xml:lang="en"><trans-title>Treatment outcomes in colorectal cancer patients with synchronous liver metastases</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2748-0644</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Добродеев</surname><given-names>А. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Dobrodeev</surname><given-names>A. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Добродеев Алексей Юрьевич - доктор медицинских наук, главный научный сотрудник отделения абдоминальной онкологии, Научно-исследовательский институт онкологии, SPIN-код: 5510-4043. Researcher ID (WOS): B-5644-2017. Author ID (Scopus): 24832974200.</p><p>634009, Томск, пер. Кооперативный, 5</p></bio><bio xml:lang="en"><p>Aleksey Yu. Dobrodeev - MD, DSc, Chief Researcher, Abdominal Oncology Department, Cancer Research Institute, Researcher ID (WOS): B-5644-2017. Author ID (Scopus): 24832974200.</p><p>5, Kooperativny St., Tomsk, 634009</p></bio><email xlink:type="simple">dobrodeev@oncology.tomsk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5691-2349</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Костромицкий</surname><given-names>Д. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Kostromitsky</surname><given-names>D. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Костромицкий Дмитрий Николаевич - кандидат медицинских наук, старший научный сотрудник отделения абдоминальной онкологии, Научно-исследовательский институт онкологии.</p><p>634009, Томск, пер. Кооперативный, 5</p></bio><bio xml:lang="en"><p>Dmitry N. Kostromitsky - MD, PhD, Senior Researcher, Abdominal Oncology Department, Cancer Research Institute.</p><p>5, Kooperativny St., Tomsk, 634009</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4701-0375</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Афанасьев</surname><given-names>С. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Afanasyev</surname><given-names>S. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Афанасьев Сергей Геннадьевич - доктор медицинских наук, профессор, заведующий отделением абдоминальной онкологии, Научно-исследовательский институт онкологии, SPIN-код: 9206-3037. Researcher ID (WOS): D-2084-2012. Author ID (Scopus): 21333316900.</p><p>634009, Томск, пер. Кооперативный, 5</p></bio><bio xml:lang="en"><p>Sergey G. Afanasyev - MD, DSc, Professor, Head of Abdominal Oncology Department, Cancer Research Institute. Researcher ID (WOS): D-2084-2012. Author ID (Scopus): 21333316900.</p><p>5, Kooperativny St., Tomsk, 634009</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6247-3434</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тарасова</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Tarasova</surname><given-names>A. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Тарасова Анна Сергеевна - кандидат медицинских наук, старший научный сотрудник отделения абдоминальной онкологии, Научно-исследовательский институт онкологии, SPIN-код: 1554-3063. Researcher ID (WOS): V-1388-2018.</p><p>634009, Томск, пер. Кооперативный, 5</p></bio><bio xml:lang="en"><p>Anna S. Tarasova - MD, PhD, Senior Researcher, Abdominal Oncology Department, Cancer Research Institute. Researcher ID (WOS): V-1388-2018.</p><p>5, Kooperativny St., Tomsk, 634009</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0562-3878</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бабышкина</surname><given-names>Н. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Babyshkina</surname><given-names>N. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бабышкина Наталия Николаевна - доктор медицинских наук, старший научный сотрудник лаборатории молекулярной онкологии и иммунологии, Научно-исследовательский институт онкологии, Томский национальный исследовательский медицинский центр РАН; доцент кафедры биохимии и молекулярной биологии с курсом клинической лабораторной диагностики, ФГБОУ ВО «Сибирский ГМУ» Минздрава России. SPINкод: 2738-9275. Researcher ID (WOS): A-7526-2012. Author ID (Scopus): 26641099700.</p><p>634009, Томск, пер. Кооперативный, 5; 634050, Томск, Московский тракт, 2</p></bio><bio xml:lang="en"><p>Natalia N. Babyshkina - MD, DSc, Senior Researcher, Laboratory of Molecular Oncology and Immunology, Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences; Associate Professor, Department of Biochemistry and Molecular Biology with a course in clinical laboratory diagnostics, Siberian State Medical University of the Ministry of Health of Russia (Tomsk, Russia). Researcher ID (WOS): A-7526-2012. Author ID (Scopus): 26641099700.</p><p>5, Kooperativny St., Tomsk, 634009; 2, Moskovsky trakt, Tomsk, 634050</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3009-2404</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дронова</surname><given-names>Т. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Dronova</surname><given-names>T. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дронова Татьяна Анатольевна - младший научный сотрудник лаборатории молекулярной онкологии и иммуноонкологии, Научно-исследовательский институт онкологии, SPIN-код: 3516-2517. Researcher ID (WOS): R-5952-2016. Author ID (Scopus): 6602971247.</p><p>634009, Томск, пер. Кооперативный, 5</p></bio><bio xml:lang="en"><p>Tatyana A. Dronova - MD, Junior Researcher, Laboratory of Molecular Oncology and Immunology, Cancer Research Institute. Researcher ID (WOS): R-5952-2016. Author ID (Scopus): 6602971247.</p><p>5, Kooperativny St., Tomsk, 634009</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2060-4840</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Пономарева</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Ponomareva</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Пономарева Анастасия Алексеевна - кандидат биологических наук, научный сотрудник лаборатории молекулярной онкологии и иммунологии, Научно-исследовательский институт онкологии, SPIN-код: 3185-5606. Researcher ID (WOS): D-8734-2012. Author ID (Scopus): 37116096000.</p><p>634009, Томск, пер. Кооперативный, 5</p></bio><bio xml:lang="en"><p>Anastasia A. Ponomareva - PhD, Researcher, Laboratory of Molecular Oncology and Immunology, Cancer Research Institute, Researcher ID (WOS): D-8734-2012. Author ID (Scopus): 37116096000.</p><p>5, Kooperativny St., Tomsk, 634009</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5758-7330</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ларионова</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Larionova</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ларионова Ирина Валерьевна - кандидат медицинских наук, старший научный сотрудник лаборатории молекулярной терапии рака, Научно-исследовательский институт онкологии, SPIN-код: 6272-8422. Researcher ID (WOS): R-2391-2017. Author ID (Scopus): 56862097400.</p><p>634009, Томск, пер. Кооперативный, 5</p></bio><bio xml:lang="en"><p>Irina V. Larionova - MD, PhD, Senior Researcher, Laboratory of Molecular Cancer Therapy, Cancer Research Institute, Researcher ID (WOS): R-2391-2017. Author ID (Scopus): 56862097400.</p><p>5, Kooperativny St., Tomsk, 634009</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9468-1980</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Паталяк</surname><given-names>С. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Patalyak</surname><given-names>S. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Паталяк Станислав Викторович - кандидат медицинских наук, заведующий отделением системной и персонализированной терапии опухолей, Научно-исследовательский институт онкологии, SPIN-код: 8497-1750. Researcher ID (WOS): D-2358-2012. Author ID (Scopus): 56324415300.</p><p>634009, Томск, пер. Кооперативный, 5</p></bio><bio xml:lang="en"><p>Stanislav V. Patalyak - MD, PhD, Head of the Department of Systemic and Personalized Tumor Therapy, Cancer Research Institute, Researcher ID (WOS): D-2358-2012. Author ID (Scopus): 56324415300.</p><p>5, Kooperativny St., Tomsk, 634009</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4595-4177</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Юнусова</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Yunusova</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Юнусова Наталья Валерьевна - доктор медицинских наук, главный научный сотрудник лаборатории биохимии опухолей, Научно-исследовательский институт онкологии, Томский национальный исследовательский медицинский центр РАН; профессор кафедры биохимии и молекулярной биологии с курсом клинической лабораторной диагностики, ФГБОУ ВО «Сибирский ГМУ» Минздрава России. SPIN-код: 35131888. Researcher ID (WOS): C-9275-2012. Author ID (Scopus): 8354141400.</p><p>634009, Томск, пер. Кооперативный, 5; 634050, Томск, Московский тракт, 2</p></bio><bio xml:lang="en"><p>Natalia V. Yunusova - MD, DSc, Chief Researcher, Laboratory of Tumor Biochemistry, Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences; Professor, Department of Biochemistry and Molecular Biology with Clinical Laboratory Diagnostics, Siberian State Medical University of the Ministry of Health of Russia. Researcher ID (WOS): C-9275-2012. Author ID (Scopus): 8354141400.</p><p>5, Kooperativny St., Tomsk, 634009; 2, Moskovsky trakt, Tomsk, 634050</p></bio><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Научно-исследовательский институт онкологии, Томский национальный исследовательский медицинский центр Российской академии наук</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Научно-исследовательский институт онкологии, Томский национальный исследовательский медицинский центр Российской академии наук; ФГБОУ ВО «Сибирский государственный медицинский университет» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences; Siberian State Medical University of the Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>04</day><month>08</month><year>2025</year></pub-date><volume>24</volume><issue>3</issue><fpage>5</fpage><lpage>14</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Добродеев А.Ю., Костромицкий Д.Н., Афанасьев С.Г., Тарасова А.С., Бабышкина Н.Н., Дронова Т.А., Пономарева А.А., Ларионова И.В., Паталяк С.В., Юнусова Н.В., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Добродеев А.Ю., Костромицкий Д.Н., Афанасьев С.Г., Тарасова А.С., Бабышкина Н.Н., Дронова Т.А., Пономарева А.А., Ларионова И.В., Паталяк С.В., Юнусова Н.В.</copyright-holder><copyright-holder xml:lang="en">Dobrodeev A.Y., Kostromitsky D.N., Afanasyev S.G., Tarasova A.S., Babyshkina N.N., Dronova T.A., Ponomareva A.A., Larionova I.V., Patalyak S.V., Yunusova N.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.siboncoj.ru/jour/article/view/3659">https://www.siboncoj.ru/jour/article/view/3659</self-uri><abstract><p>Цель исследования – анализ показателей 2-летней выживаемости больных колоректальным раком (КРР) с синхронными метастазами в печень после комбинированного лечения с периоперационной химиотерапией.</p><sec><title>Материал и методы</title><p>Материал и методы. Проведено пилотное проспективное исследование, в котором 30 больных КРР с исходно резектабельными метастазами в печень получили комбинированное лечение, включающее 3 курса неоадъювантной химиотерапии FOLFOXIRI в сочетании с цетуксимабом или бевацизумабом (в зависимости от мутационного статуса генов семейства RAS), радикальное хирургическое лечение и 3 курса адъювантной химиотерапии FOLFOXIRI. Анализ 2-летних результатов комбинированного лечения больных КРР с синхронным метастатическим поражением печени представлен с учетом основных клинико-морфологических характеристик опухолевого процесса.</p></sec><sec><title>Результаты</title><p>Результаты. В течение 2-летнего периода наблюдения прогрессирование выявлено у 7 (23,3 %) больных, включая метастатическое поражение печени – 4 (13,3 %) и множественные метастазы в легкие – 3 (10 %). Рецидивов в зоне резекции кишки и печени не было. От прогрессирования заболевания умер 1 (3,3 %) больной. Двухлетняя безрецидивная и общая выживаемость составила 76,7 и 96,7 % соответственно. У больных с распространенностью первичной опухоли урТ4 выживаемость была значимо ниже относительно больных с урТ3 – 44,4 и 88,2 % соответственно (р=0,015). При отсутствии метастазов в лимфатических узлах ypN0 выживаемость составила 100 %, а при ypN2 достоверно снижалась до 50 % (р=0,016). Выживаемость больных при наличии 1–3 метастазов в печени достигла 94,1 %, при 7–11 метастазах была значимо ниже – 50 % (р=0,02).</p></sec><sec><title>Заключение</title><p>Заключение. Периоперационная химиотерапия у больных КРР с исходно резектабельными синхронными метастазами в печень обеспечивает обнадеживающие показатели 2-летней выживаемости, которая находится в прямой зависимости от распространенности опухолевого процесса.</p></sec></abstract><trans-abstract xml:lang="en"><p>The purpose of the study was to analyze the 2-year survival rates in colorectal cancer (CRC) patients with synchronous liver metastases after combined modality treatment including perioperative chemotherapy.</p><sec><title>Material and Methods</title><p>Material and Methods. A pilot prospective study included 30 colorectal cancer patients with initially resectable liver metastases, who received combined modality treatment including 3 courses of neoadjuvant chemotherapy with FOLFOXIRI in combination with cetuximab or bevacizumab (depending on the mutational status of the RAS family genes), radical surgery and 3 courses of adjuvant chemotherapy with FOLFOXIRI. The 2-year survival rates in colorectal cancer with synchronous liver metastases were analyzed on the basis of the main clinical and morphological characteristics of the tumor.</p></sec><sec><title>Results</title><p>Results. Within 2-years of follow-up, disease progression occurred in 7 (23.3 %) patients, including liver metastases in 4 (13.3 %) and multiple lung metastases in 3 (10 %) patients. There were no relapses in the area of intestinal and liver resection. One patient (3.3 %) died from disease progression. The 2-year recurrence-free and overall survival rates were 76.7 % and 96.7 %, respectively. The survival rate was significantly lower in patients with урТ4 primary tumor than in patients with урT3 tumor (44.4 % and 88.2 %, respectively, p=0.015). In patients without lymph node metastases ypN0, the survival rate was 100 %, and in patients with ypN2, the survival rate decreased to 50 % (p=0.016). The survival rate reached 94.1 % in patients with 1–3 liver metastases, and it was 50 % in patients with 7–11 metastases (p=0.02).</p></sec><sec><title>Conclusion</title><p>Conclusion. Perioperative chemotherapy in CRC patients with initially resectable synchronous liver metastases provides encouraging 2-year survival rates, which are directly dependent on the extent of the tumor.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>колоректальный рак</kwd><kwd>метастазы в печень</kwd><kwd>периоперационная химиотерапия</kwd><kwd>таргетная терапия</kwd><kwd>выживаемость</kwd></kwd-group><kwd-group xml:lang="en"><kwd>colorectal cancer</kwd><kwd>liver metastases</kwd><kwd>perioperative chemotherapy</kwd><kwd>targeted therapy</kwd><kwd>survival</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Xi Y., Xu P. Global colorectal cancer burden in 2020 and projections to 2040. 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