Detailed, systematic review of the world literature data, including all aspects that reflect the impact of the COVID-19 pandemic on the oncological practice was conducted. The information sources were taken from Pubmed, MedLine, Scopus, Web of Science, and RSCI systems. The data from retrospective and prospective clinical trials have been analyzed. This review presents current data on the impact of COVID-19 on cancer patients, mortality and prognosis of cancer patients infected with COVID-19, treatment options for COVID-19, as well as the case report of the cancer patient with rare atypical COVID-19 course of disease. To date, the groups of increased risk of being infected with a new coronavirus have been identified. These groups include cancer patients. Despite the pandemic, treatment of cancer patients must be continued, since the presence of a tumor process does not allow the therapy to be delayed. The world cancer community is actively continuing to develop recommendations for optimal management of cancer patients in the context of the pandemic. The most relevant of them are described in this article.

The aim of the study was to assess the incidence and mortality rates of female reproductive system cancer in the Far Eastern Federal District over the last ten years (2008–2017).

Material and Methods. In our study we used statistical reports on the female reproductive system cancer incidence and mortality rates and 10-year follow-up data.

Results. In 2017, 25155 new cases of female reproductive system cancer were diagnosed in the Far Eastern Federal District (26.6 % higher than in 2008). A total of 128776 patients (2.1 % of the population of the region) were followed up. Over the study period, there has been increase in the number of patients with stage I–II breast cancer (+4.8 %), cervical cancer (+6.3 %), uterine body (+3.9 %) and ovarian cancer (+5.7 %), with simultaneous reduction in the number of patients with advanced stages, except ovarian cancer (+5.0 %). For the past 10 years, cancer incidence rates have been steadily increasing, while cancer mortality rates have been decreasing with the exception of cervical cancer (+13.7 %). Morphological confirmation of the diagnosis (over 90 %) exceeded the national average ones. The number of patients followed-up for 5 or more years appeared to be lower than the average values in Russia; however the 1-year mortality rates after diagnosis improved. Ovarian cancer remains the most deadly of the gynecological cancers (22.9–27.9 %).

Conclusion. Over the last ten years in the Far Eastern Federal District, in contrast to the overall decline in the mortality rates, there has been a steady increase in the incidence rates of female reproductive system cancer, except for cervical cancer. 

The impact of pathological complete response (pCR) on long-term treatment outcomes was analyzed in patients with locally advanced gastric cancer, who received prolonged neoadjuvant chemoradiotherapy.

Material and Methods. The study included 45 patients with locally advanced gastric cancer. Neoadjuvant hyperfractionated accelerated radiotherapy at a total dose of 45 Gy was given concurrently with capecitabine and oxaliplatin chemotherapy. There were more men than women. The median age of the patients was 62 years. Tumors were most commonly located in the upper (46 %) and middle (38 %) thirds of the stomach. Low-grade adenocarcinoma and signet-ring cell carcinoma were the most common (65 %). According to a comprehensive examination, including CT and laparoscopy, tumors which invaded the subserous layer of the stomach wall were diagnosed in 17 (37.8 %) patients, and tumors which penetrated the serous layer or surrounding structures were found in 28 (62.2 %) patients. Regional lymph node metastases were detected in 38 (84.4 %) cases.

Results. The absolute majority of patients underwent gastrectomy (43 patients, 96 %). Grade IaIb pathological response occurred in almost half of the patients (45.4 % of cases). Peritoneal metastases were found to be the most common mode of cancer dissemination; they were mostly observed in patients with poorly differentiated gastric cancer. Multivariate analysis revealed no effect of any of the factors characterizing the patient, tumor and completeness of treatment on the pathological response grade. However, a correlation between the clinical and morphological assessments of tumor regression was observed. In cases with complete or partial responses of the primary tumor and regional lymph nodes to chemoradiotherapy, 1aIb grades of pathological response were more frequently observed. It was also demonstrated a direct correlation between the pathological response grade and pathomorphological stage of the tumor (yp), as well as ypT and ypN categories. Analysis of long-term treatment outcomes showed that the overall and relapse-free 5-year survival rates were significantly higher in patients with 1a and Ib grades of pathological response. The overall 3-year survival rates were 70 ± 10 % and 41 ± 11 %, respectively (p=0.003). Multivariate analysis using the Cox regression model confirmed a statistically significant independent effect of the pathological response grade on the overall survival (p=0.015).

Conclusion. Grade IaIb pathological response was observed in almost half of the patients, who received neoadjuvant chemoradiotherapy for locally advanced gastric cancer. No clinical and morphological factors influencing the pathological response grade were found. A correlation between the clinical and morphological assessments of tumor regression was observed. Patients with Ia-Ib pathological response had significantly higher overall and disease-free survival rates. 

Glial cerebral tumors (GCT) are primary tumors of the central nervous system that develop from glial tissue. Despite the use of combination treatment, the overall median survival rate in patients with glioblastoma, the most malignant form of HCC, is low. MicroRNA is a large class of endogenous small RNA molecules that inhibit mRNA translation of target genes involved in the evolution of GCT. It was shown that miRNA-21 has antiapoptotic and invasive functions by means of silencing of the PTEN tumor suppressor. MicroRNA-128 can activate a number of genes that are responsible for the mechanisms of suppression of tumor growth. MicroRNA-342, modulating PAK4 gene expression, is involved in the control of tumor cell proliferation, invasion and apoptosis.

The aim of the work was to study the feasibility of using the assessment of miRNA-21, -128 and -342 expressions in the blood plasma and saliva of patients to monitor GCT progression or stabilization during combined modality treatment.

Material and Methods. The main group consisted of 56 patients with GCTs. (34 men and 22 women), aged 25 to 72 years (average age 48.5 years) GCTs. The control group consisted of 50 people (45 volunteers and 5 neurosurgical patients with extracerebral meningiomas). The study of miRNA-21, -128, and -342 expressions was carried out according to the semiquantitative StemLoopRealTime protocol, using small U6 RNA as a reference gene. Data was processed using the STATISTICA for Windows computer system.

Results. In 70 % of patients with disease progression assessed by magnetic resonance imaging, without progression in cerebral and focal neurological signs, the expression level of miRNA21 exceeded the control values both in blood plasma and saliva, and the expression levels of miRNA-128 and -342 were significantly reduced. In patients with GCT stabilization, the expression levels of miRNA-21, -128, and -342 did not go beyond the reference values. The diagnostic significance of miRNA-128, -342 for GCT was 69 %; therefore these miRNAs can be used in a clinical setting. Thus, the increased expression of miRNA-21 and decreased expressions of miRNA-128 and -342 in both blood plasma and saliva indicate cerebral glioma progression. 

Introduction. The development of inflammation is characterized by changes in blood hematology parameters and indices. Various inflammatory parameters are used to assess the inflammatory status (IS) during cancer treatment. Recent studies have revealed a relationship between tumor progression and the presence of chronic inflammation. Consequently, there have been many attempts to predict the risk of tumor recurrence and distant metastases, as well as patient’s survival assessing the various inflammatory markers. The relationship between IS parameters and lymph node metastasis remains poorly understood in non-small cell lung cancer (NSCLC).

Material and Methods. The prospective study included 35 patients with NSCLC (T1–4N0–2M0). Seventeen patients received 2–3 cycles of neoadjuvant chemotherapy (NAC). A leukocyte formula was determined in the peripheral blood and inflammatory indices, such as neutrophils to lymphocytes ratio (NLR), platelets to lymphocytes ratio (PLR), lymphocytes to monocytes ratio (LMR) and systemic immuno-inflammatory index (SII) were calculated. In addition, the concentrations of fibrinogen, C-reactive protein (CRP) and cortisol were evaluated.

Results. NAC alone did not significantly change the parameters of patients’ IS. Lymph node metastases were associated with changes in parameters indicating the enhanced IS. In the group of patients who did not receive NAC, lymph node metastasis was associated with fibrinogen blood levels (cut-off value 5.35 g/L), PLR index value (cut-off value 7.18) and cortisol blood concentration (cut-off value 414 nmol/mL). The confidence level was χ2 =10.118; р=0.018. In the group of patients who received NAC, lymph node metastasis was associated with the leukocyte count (cut-off value 7.1×109 /L), PLR index value (cut-off value is 7.18) and CRP blood concentration (cut-off value is 8.5 mg/L). The confidence level was χ2 =8.193; р=0.042.

Conclusion. Risk of lymph node metastasis in NSCLC is associated with IS. Parameters of IS can be used to predict the risk of lymph node metastases. 

Understanding of the sequence of events that ensure invasiveness of malignant cells is important for prognostic purposes. The study of the cellular and molecular pathways in the metastatic process lays the foundation for further progress in the treatment of cancer patients.

Purpose: a comparative analysis of in vitro migration and invasion of human solid tumor cells isolated from primary and metastatic lesions.

Material and Methods. Cell cultures of skin melanoma (SM, n=29), renal cell cancer (RCC, n=2), colorectal cancer (CRC, n=1), soft tissue and bone sarcomas (STBS, n=39) isolated from solid human tumors were studied. Cell migration and invasion were assessed using xCelligence (ACEA Bioscience Inc., USA).

Results. All solid tumor cell cultures demonstrated in vitro invasive potential (IP), which was 73.79 % for RCC; 53.16 % for SM; 43.96 % for STBS and 5.16 % for CRC. The rates of migration and invasion (SlopeInv) in STBS cells were higher than those in SM cells (39.33 and 25.3 μm/h (p<0.05), 95.32 and 59.82е-3, respectively (p<0.05). The differences in IP values depending on the origin of STBC cells (primary tumor, relapse, and metastasis) were revealed: 18.11 ± 3.05 %, 25.75 ± 5.57 %, 52.97 ± 5.64 %, respectively (p<0.05). We found a correlation between migration and invasion parameters of solid tumor cells and the expression of factors ensuring their mobility and affecting other cellular components of the tumor microenvironment, including cells of the immune system.

Conclusion. The biologically «aggressive» phenotype of SM and STBS cells is associated with the expression of the cancer-testis genes, such as PRAME, PASD1, SSX1 and with the production of HB-EGF, IGFBP, PLGF, PECAM-1, FST, SCF, IL-8. These products can be considered as new targets for therapeutic technologies aimed at influencing metastatic disease. 

We studied the association between the presence of 2 or more stemness gene amplifications as well as copy number aberrations (CNAs) of WNT signaling genes in residual breast tumor and metastasis. WNT pathway genes associated with metastasis were identified.

Material and Methods. The study included 30 patients with breast cancer, who had 2 or more stemness gene amplifications in the residual tumor after neoadjuvant chemotherapy. Fifteen of the thirty patients developed hematogenous metastases; they constituted a group with metastases, the remaining 15 patients entered the second group without metastases. The tumor DNA was examined using a CytoScanHD Array microarray (Affymetrix, USA).

Results. By subtracting amplification and deletion frequencies in 852 cytobands between groups with metastases and without metastases, 21 cytobands were identified with the largest difference in deletion and amplification frequencies. They contain 19/150 of WNT genes (12 activators: SKP1, WNT8A, MAPK9, CCND3, FZD9, WNT8B, CCND1, PLCB2, PRKCB, FZD2, WNT3, WNT9B and 7 negative regulators: GSK3B, APC, CSNK2B, SFRP5, BTRC, TCF7L2, CSNK2A2). A point system was developed: when amplifying WNT-signaling activators or deletion of negative regulators, one point was added to the total score, and vice versa when deleting WNT-signaling activators or amplification of negative regulators, one point was taken from the total amount. It was shown that 93% (14/15) of patients with metastases had a total score higher than 0, while 93% (14/15) of patients without metastases had a total score of zero or less than zero. The differences between the groups were statistically significant according to the two-sided Fisher test with a high level of confidence probability (p=0.000003) and the log-rank test (p=0.00004) when assessing non-metastatic survival by the Kaplan-Mayer method.

Conclusion. Nineteen WNT signaling genes were identified. Copy number aberrations of these genes in combination with stemness gene amplifications in residual tumors were associated with metastasis. A new highly effective prognostic factor for breast cancer was identified. 

Objective: to detect new molecular genetic markers and therapeutic targets in retroperitoneal myxoid liposarcoma.

Material and Methods. DNA samples isolated from tumor tissue and obtained from formalinfixed paraffin-embedded (FFPE) slides were used. DNA was extracted using the GeneRead DNA FFPE Kit (50) (Qiagen). High-throughput next generation sequencing (NGS) using the GeneReader Actionable Insights Tumor Panel (GRTP – 101X) on the QCI Analyzer version 1.1 platform (Qiagen) was used for molecular genetic analysis of 12 genes involved in carcinogenesis: KRAS, NRAS, KIT, BRAF, PDGFRA, ALK, EGFR, ERBB2, PIK3CA, ERBB3, ESR1, RAF1.

Results. Targeted sequencing of retroperitoneal extra-organ myxoid liposarcoma demonstrated genetic heterogeneity. Our study was the first to describe mutations and polymorphic variants in genes, such as EGFR, PIK3CA, ALK, BRAF, ERBB2 / 3, ESR1, KIT, PDGFRA in myxoid liposarcoma.

Conclusion. This study demonstrated a wide range of molecular genetic rearrangements in retroperitoneal extra-organ myxoid liposarcoma. Synonymous mutations in the EGFR (Q787Q) and PDGFRA (P567P) genes were detected in all cases (100 %). Missense mutations in the ERBB2 gene (P1170A) and synonymous mutations in the ALK (G845G) and BRAF genes were identified in 75 % of cases. Missense mutation in the PIK3CA gene (I391M) was detected in 25 % of cases. The gene polymorphisms presented in this paper are most likely involved in the carcinogenesis of retroperitoneal myxoid liposarcoma. Further studies with larger patient groups and multivariate analysis of long-term treatment results are required. 

One of the factors of variability of malignant neoplasms is the loss of heterozygosity (LOH). The biological meaning of LOH, in relation to carcinogenesis, is associated with the inactivation of heterozygous loci of pathogenetically significant genes. Thus, the aim of this work was to study BRCA1/2 LOH in breast tumors.

Material and Methods. The study included 122 patients with stage IIAIIIC breast cancer. DNA was isolated from 122 biopsy samples of tumor tissue using the QIAamp DNA mini Kit (Qiagen, Germany). To assess the status of LOH, microarray analysis was performed on high-density DNA chips from Affymetrix CytoScanTM HD Array. To process the results of microchipping, we used the Chromosome Analysis Suite 3.3 program (Affymetrix, USA).

Results. The loss of heterozygosity in the BRCA1 gene was found to be associated with response to NAC. It was shown that in 59 patients LOH in the BRCA1gene was associated with an objective response to treatment (p=0.005). The presence of LOH in the studied genes was associated with a favorable prognosis. The 5-year non-metastatic survival rates were 75 % and 100 % in patients with LOH in the BRCA1 and BRCA2 genes, respectively (log-rank test: p=0.003 and p=0.05, respectively).

Conclusion. The phenomenon of LOH in the BRCA1/2 genes was shown to be associated with response to NACT. BRCA1/2. Further studies are needed to evaluate the frequency of BRCA1/2 LOH after NAC for choosing and changing treatment tactics. 

Introduction. Hypoxia in tumor growth contributes to mitochondrial dysfunction and exacerbates oxidative stress in the immortalized cell. The objective of the study was to investigate the molecular mechanisms of the effects of N-acetylcysteine on redox regulation of tumor cell apoptosis under hypoxia.

Material and Methods. P19 cells (mouse teratocarcinoma) cultured under hypoxia served as the material for the study. The redox status was modulated with N-acetylcysteine in the final concentration of 5 mM. The level of reactive oxygen species, concentration of calcium ions, transmembrane potential and the number of CD95-, CD120- and Annexin V-positive cells were determined by flow cytometry. The concentration of glutathione system components as well as the levels of protein SH groups and protein carbonyl derivatives were measured by spectrophotometry.

Results. The use of N-acetylcysteine under hypoxic conditions was accompanied by the increased total glutathione concentration and protein SH groups levels, decreased levels of Са2+ ions, proteinbound glutathione and protein carbonyl derivatives, as well as the production of reactive oxygen species and more appropriate functioning of P19 cells mitochondria. N-acetylcysteine contributed to the development of additional resistance of P19 cells to apoptosis under hypoxia.

Conclusion. The alteration in the state of the glutathione system under hypoxia influences the changes in tumor cell metabolism on the whole and promotes formation of additional mechanisms to escape apoptosis. 

Introduction. Thrombotic complications caused by the tumor and consequences of its treatment are the leading causes of death in cancer patients. The development of a model for the pathology of hemostasis, in particular the excessive pathological clot formation, in the laboratory animals receiving antitumor agents, could help find new pharmacological methods for correcting hemostatic disorders.

The purpose of the study was to study the effect of cisplatin on the blood coagulation system in mice and rats.

Results. An experiment using outbred mice showed that the levels of PT-INR and aPTT were decreased and the level of fibrinogen was increased on day 10 after administration of cisplatin in the maximum tolerated dose of 10 mg/kg. A significant decrease in the PT-INR and aPTT levels was observed on day 15 after cisplatin injection only in female mice. The cisplatin injection at a dose of 4 mg/kg resulted in a decrease in the PT-INR, and aPTT levels and an increase in fibrinogen concentration on day 10. In rats, a significant decrease in the PT and aPTT levels was observed in both females and males on day 15 after cisplatin injection.

Conclusion. A change in the PT and NIR, aPTT levels towards decrease and fibrinogen concentration towards increase indicates the initiation of thrombus formation. 

The purpose of the study was to comparatively assess the endoscopic plastic or nitinol stenting in patients with unresectable adenocarcinoma of the pancreatic head, who subsequently received systemic chemotherapy.

Material and Methods. Between 2014 and 2018, 64 patients underwent retrograde stenting followed by chemotherapy. All patients were divided into 2 groups. Group I consisted of 21 patients, who underwent nitinol stent implantation. Group II comprised 43 patients, who underwent plastic stent implantation.

Results. The technical success was 91.3 % in group I and 93.5 % in group II (р=0.324); clinical success was 95.2 % in group I and 90.6 % in group II (р=0.218). Complications according to the Clavien–Dindo classification in group I patients: Grade II in 2 (9.5 %), Grade III in 1 (4.5 %), and Grade IV 2 in (9.5 %). In group II patients, these complications were as follows: Grade II in 4 (9.3 %), Grade III in 4 (9.3 %), and Grade IV in 1 (2.3 %). The median duration of chemotherapy was 127.3 days. Stent dysfunction was observed in 5 (23.8 %) patients of group I and in 24 (55.8 %) patients of group II (р=0.026). The median time of stent patency was 108 ± 5.2 days in group I and 64 ± 4.3 days in group II (р=0.034). In group I patients, the median survival time was 100 days in 5 patients, 120 days in 9 patients, and 150 days in 5 patients. Two patients are alive. In group II patients, the median survival time was 100 days in 10, 120 days in 16, and 150 days in 13. Five patients are alive.

Conclusion. Based on the results obtained, it is advisable to recommend the use of nitinol stents for resolving obstructive jaundice in patients with unresectable ductal adenocarcinoma of the pancreatic head, who are scheduled to undergo chemotherapy. 

The purpose of the study was to analyze the existing methodological approaches to the experimental testing of resistance to chemotherapy and assess the prospects for their further application.

Material and Methods. We analyzed publications regarding the experimental testing of tumor resistance to chemotherapy available in the databases, such as SciVerse Scopus (748), PubMed (1727), Web of Science (1025), RSCI (125). To obtain fulltext publications, the electronic resources of Research Gate, RSCI, CyberLenink were used. Forty-two modern publications (2012–19) including 18 articles of the founders of the methods analyzed in the review were cited.

Results. The review discusses the characteristics of the main methods for assessing the resistance / sensitivity of tumor cells obtained from biopsy / surgical specimens to various chemotherapy drugs in vitro in monolayer and suspension cultures, in the form of spheroids, histo and organocultures, as well as in vivo xenografts of tumors in immunodeficient mice. During testing, the proliferative and metabolic activities as well as the level of cell death were considered as the main evaluated characteristics of tumor cells. The main indicators were the intensity of DNA synthesis, the level of protein or ATP in the cell, the activity of NADH-dehydrogenases, the level of apoptosis, and the integrity of cell structures. The advantages and disadvantages of the described methods, as well as the prospects for their further application were discussed.

Conclusion. Over the past half century of using the experimental testing of tumor cell resistance in order to personalize chemotherapeutic treatment, the evolution of methodological approaches was based on the increase in their safety and sensitivity through the use of fluorescent compounds. The general vector for improving experiments on the personalization of tumor chemotherapy is aimed at approximating the experimental conditions to the processes occurring in the human body. Each of these methods has its own range of predictive power and, if used properly, can provide a useful guide for treatment. 

The object of the study was to analyze radionuclide detection techniques for in vivo animal imaging. Material and Methods. A total of 49 publications available from Scopus, Web of Science, Google Scholar eLIBRARY and Pubmed and published between 2013 and 2019 were reviewed. Results. The nuclear medicine techniques, such as positron emission tomography (PET) and single photon emission computed tomography (SPECT) are the most suitable imaging modalities for in vivo animal imaging. Besides traditional radiopharmaceuticals, such as [18F]-FDG and [⁹⁹mTc]-MDP, the new radiolabeled tracers, such as [⁹⁹mTc]-3PRGD2, [ ⁹⁹mTc]-HisoDGR targeted to integrin, [¹⁸F]- tetrafluoroborate, labeled antibodies and others have been used for the noninvasive detection of tumors and for monitoring their response to treatment in mice and rats. 111In and 89Zr –labeled monoclonal antibodies are used to evaluate the expression level of many receptors such as EGFR, HER-2 and others in different tumors. PET imaging has demonstrated a good efficacy in tumor hypoxia imaging with [⁶⁴Cu]-ATSM, [¹⁸F]-FMISO. PET and SPECT can also be used for early evaluation of anticancer therapy response. Nuclear imaging techniques may assist in the vivo assessment of DNA damage (doubleand single-strand brakes) as well as apoptosis intensity in tumor and normal tissues. [99mTc]- duramycin is the most commonly used tracer for imaging of apoptosis. Changes in tumor cell proliferation in response to anticancer therapy can be assessed by PET imaging with [¹⁸F]-FLT. Conclusion. Nuclear medicine offers a unique means to study cancer biology in vivo and to optimize cancer therapy. 

Purpose of the study: to review available data on the role and significance of GATA3, FOXA1 and ELF5 transcription factors in the pathogenesis, progression and therapy resistance of breast cancer.

Material and Methods. The Medline and PubMed databases were used to identify all studies that evaluated the structure, functional parameters and participation of the studied transcription factors in the pathogenesis of breast cancer. More than 180 publications were analyzed, of which 76 were included into the review.

Results. The review shows that molecular genetic studies in relation to transcription factors and subsequent comparison of the obtained results with various clinical and morphological characteristics of breast cancer are of great importance. The review also demonstrates the inconsistency of the available data regarding clinical significance in assessing the prognosis of the disease and the sensitivity of the tumor to hormone therapy.

Conclusion. The study of the expression parameters of GATA3, FOXA1, and ELF5 transcription factors, as well as their relationship with tumor progression mechanisms will increase the reliability of immunomorphological studies, most likely suggesting the efficiency of hormone therapy. Therefore, the results of this study can help to plan adequate treatment tactics and predict outcomes in patients with breast cancer. 

Purpose of the study was to provide medical oncologists and surgeons specializing in the treatment of pancreatic cancer patients with the most recent information on the importance and role of chemotherapy in the treatment of patients with resectable and borderline resectable pancreatic cancer.

Material and Methods. Pubmed and COSMIC databases were used for literature search. Reports of the executive authorities in the field of Health Care of the Russian Federation, as well as worldwide data regarding morbidity and mortality of patients with pancreatic cancer were analyzed. The data of retrospective and prospective clinical trials were studied.

Results. Based on the analysis of the most recent publications, the authors provided data on modern approaches to the treatment of operable pancreatic cancer.

Conclusion. The data presented in the article summarize results of recent clinical trials. This will allow oncologists to choose the most correct and personalized tactics for the management of patients with resectable and borderline resectable pancreatic cancer. 

The purpose of the study was to undertake a systematic literature review regarding the role of cytoreductive surgery in treatment of recurrent ovarian cancer, as well as to summarize available data on various current studies and estimate indications for secondary cytoreduction in recurrent ovarian cancer with isolated lymph node involvement.

Material and Methods. The search for relevant sources was carried out in PubMed, Gynecol Oncol, Medline, NCCN, Elibrary systems; publications were included from January 2006 up to March 2019. Of the 87 studies found, 26 were used to write a systematic review.

Results. Ovarian cancer (OC) remains the leading cause of death from gynecological cancer. The initial treatment for IC-IV stages of OC includes surgical cytoreduction followed by platinum-containing chemotherapy. The best outcomes are observed in patients, in whom complete cytoreduction has been achieved. Despite this fact, most patients develop relapses and the 5-year survival rate is about 30 %. The frequency of lymph node involvement in patients with recurrent OC is not reliably known; isolated lymph node recurrence is reported to occur in 5–32 % of patients. To date, the problem regarding the extent of lymph node dissection in treatment of OC recurrence is still unsolved. In our paper we review the available data concerning the role of secondary cytoreductive surgery for isolated lymph node recurrence of ovarian cancer.

Conclusion. Isolated lymph node recurrence of ovarian cancer may indicate a more favorable prognosis and has a less aggressive pattern of OC relapse. The role of secondary cytoreduction in this context is not fully understood, but this category of patients may be one of the most suitable for surgical treatment of ovarian cancer recurrence. 

Background. Ewing’s sarcoma is one of the most common musculoskeletal cancers in children and adolescents. Extremely aggressive clinical course of Ewing’s sarcoma makes a successful treatment of this tumor difficult. Despite a comprehensive multidisciplinary approach to the treatment of this cancer, including chemotherapy, surgery and radiation therapy, rapid tumor progression, recurrence and resistance to chemotherapy are still common.

Our purpose was to present the results of a personalized approach to multidisciplinary combination treatment for musculoskeletal cancer involving polychemotherapy, 3D conformal radiation therapy and modern surgical technologies.

Description of the clinical case. A female patient presented to Rostov Research Institute of Oncology complaining of a tumor and moderate pain in soft tissues of the left iliac region, left lower extremity, and lameness when walking. After complete examination, the patient was diagnosed with Ewing’s sarcoma of the left ilium with lung metastases (Т3N0M1). The patient received 6 cycles of neoadjuvant chemotherapy according to EURO EWING 2008 protocol; tumor progression and lung metastasis were registered. Two cycles of second-line chemotherapy were performed; by the decision of the doctors’ council, the first stage of surgical treatment was performed: resection of the left ilium and the defect replacement with a temporary cement spacer. In the postoperative period, the patient underwent 8 cycles of adjuvant chemotherapy, external beam radiation therapy to the lungs (12 Gy total dose) and the primary tumor (46 iGy total dose), and 12 cycles of supporting therapy. A delayed second reconstructive stage of surgical treatment involved removal of a temporary cement spacer and implantation of an individual pelvic stability system. The patient was followed-up for 25 months after the combination treatment, had no complaints, and was able to ambulate without assistance; the motor function of the left hip joint was fully preserved. 

Conclusion. The use of non-standard high-technology approaches to surgical treatment of unfavorably localized Ewing’s Sarcoma in combination with chemo-radiation therapy allows patients with advanced tumors to achieve satisfactory results and good quality of life.