Objective. To assess the overall and disease-free survival rates in patients with EGFR-mutated lung adenocarcinoma, who underwent surgery after achieving the objective response to tyrosine kinase inhibitor (TKI) therapy.

Material and Methods. The overall and disease-free survival rates were analyzed in 18 patients with EGFR-positive lung adenocarcinoma, which was inoperable at presentation due to locally advanced disease or the evidence of distant metastasis. In accordance with the clinical standards, patients were recommended for TKI therapy. Surgical resection was performed after achieving the objective tumor response to TKI therapy. The control group included 23 patients with EGFR mutation-positive lung adenocarcinoma, who did not undergo surgery after receiving TKI therapy.

Results. The study revealed a statistically significant effect of surgical resection on the overall survival (OS) in patients with EGFR mutation-positive stage III–IV lung adenocarcinoma after response to TKI therapy (p=0.004). However, there was no statistically significant effect on the disease-free survival (DFS) (p=0.40). There was a tendency to increase in the median OS in patients of the study group (46 months) compared to that in patients of the control group (26 months). Surgery in the study group was characterized with some technical difficulties associated with severe fibrosis. However, this did not affect the duration of surgery and the volume of blood loss.

Conclusion. Tumor resection in patients with 

EGFR mutation-positive stage III–IV lung adenocarcinoma is feasible and safe, but requires highly qualified team surgeons in well-equipped medical centers. Our study revealed that the combination of EGFR-TKI and tumor resection provided better PFS and OS than EGFR-TKI alone. However, further studies are required.

The purpose of the study was to analyze rectal resection outcomes in patients with rectal cancer.

Material and Methods. A retrospective analysis of treatment outcomes of 251 patients with stage cT3–4aN0–2M0 rectal cancer, who underwent transperitoneal resections of the rectum with mesorectumectomy from 2015 to 2020, was carried out. The age of the patients ranged from 27 to 90 years. Considering the extent of rectal tumor spread, 143 (56.9 %) patients underwent neoadjuvant prolonged conformal radiation therapy or chemoradiotherapy.

Results. The failure of the colorectal anastomosis was observed in 11 (4.4 %) patients, repeated surgery was performed in 8 (72.7 %) patients (Grade C). During the follow-up, disease progression was detected in 58 (23.1 %) patients, tumor recurrence in the rectum occurred in 2 (0.8 %) patients, and distant metastases were found in 56 (22.3 %) patients. Statistical analysis showed that the parameters, such as the age, localization of the tumor in the rectum, tumor grade and T stage did not significantly affect the disease progression. A statistically significant relationship between the disease progression and pN2 stage was revealed. Patients with pN2 stage were 4.1 times more likely to have disease progression. The 75th percentile survival time was

51.2 months. Patients with pN2 stage had a 3.6-fold increase in the risk of lethal outcome.

Conclusion. The study demonstrated good oncological and surgical outcomes in the treatment of stage II–III rectal cancer with high survival rates. Resection of the rectum in patients with rectal cancer is a safe and predictable surgical procedure accompanied by a low incidence of anastomotic leaks and disease recurrence. The pN2 stage in rectal cancer patients significantly worsened the oncologic outcomes and survival of patients.

Peritoneal carcinomatosis is associated with poor prognosis in gastric cancer patients. Stage IV gastric cancer (GC) is diagnosed in 39.8 % of patients; local metastases without evidence of distant metastases occur only in 18–20 % of stage IV gastric cancer patients.

The purpose of the study was to estimate the efficacy of personalized chemotherapy in the combined modality treatment of patients with stage IV GC with peritoneal carcinomatosis.

Material and Methods. Cytoreductive surgery was performed in 70 patients with GC with peritoneal dissemination. The control group patients (n=35) received postoperative chemotherapy with the FOLFOX regimen. The study group patients (n=35) received personalized systemic and intraperitoneal chemotherapy based on the expression of chemosensitivity and resistance genes.

Results. The median survival time (18.7 months) in the study group patients was higher than that in the control group and in studies described in the world literature (CRS + HIPEC). Personalized chemotherapy improved median progressionfree survival (PFS) by 4.6 months (29.1 %) and median overall survival (OS) by 6 months (32 %) compared to FOLFOX regimen chemotherapy. In the study group, the 1-, 2and 3-year survival rates were observed in 35 (100 %), 9 (27 %) and 1 (3 %) patients, respectively.

Conclusion. Personalized chemotherapy in the combined modality treatment can improve long-term treatment outcomes (longer median PFS and OS) in GC patients with peritoneal dissemination.

Aim to study the frequency of BRCA1/2 gene mutations , the efficacy of ovarian cancer therapy depending on the presence of BRCA1/2 mutations as well as the efficacy of olaparib maintenance therapy in BRCAassociated ovarian cancer.

Material and Methods. The retrospective analysis included 355 patients with high-grade, stage I–IV serous ovarian cancer. The examination for a mutation in the BRCA1/2 gene was carried out within the framework of the program “Improvement of molecular genetic diagnostics in the Russian Federation in order to increase the effectiveness of antitumor treatment”.

Results. Mutations in the BRCA1/2 genes were detected in 98 out of 355 (27.6 %) patients. Mutations of the BRCA1+ gene were detected in 62 out of 230 patients with ovarian cancer of stages IIIC–IV (27.0 %), the BRCA2 gene – in 9 out of 230 (3.9 %). In ovarian cancer of stages III–IV, BRCA gene mutations were absent in 159 of 230 (69.1 %) patients. The median time to progression in stages III–IV of the disease with a mutation in the BRCA1 gene was 22.0 months, in the BRCA2 gene – 27.0 months, in patients without mutations in the BRCA1/2 genes – 17.0 months, median life expectancy – 70.0; 65.0 and 45.0 months, respectively. Patients with serous ovarian carcinoma of high-grade I–IV stages with the presence of mutations in the BRCA1/2 genes were divided into two groups. The first group (6 out of 26 patients, 23.1 %) consisted of patients with stage IIIC–IV high-grade serous ovarian carcinoma, who received olaparib as maintenance therapy after the 1st line of chemotherapy, the second group (20 out of 26 patients, 76.9 %) were patients with stage I–IV high-grade serous ovarian carcinoma, who received olaparib in maintenance mode after 2 or more lines of chemotherapy.

Conclusion. The presence of BRCA1/2 gene mutations significantly increased the median life expectancy of patients with stage IIIC–IV serous ovarian cancer, and primary cytoreduction significantly improved both overall survival and survival to progression in this group of patients. Maintenance therapy with olaparib is more appropriate after the 1st line of treatment than after subsequent ones.

T cells expressing checkpoint receptors PD-1, TIM-3 etc., are potential targets for monoclonal antibody immunotherapy in multiple myeloma (MM). However, checkpoint expressing T cell compartment includes different subsets, and their dysregulation following anti-checkpoint therapy can lead to the development of adverse events.

The aim of this study was to evaluate activation markers – homeostatic cytokine receptors and transcription factors expressed by PD-1and TIM-3-positive T cells.

Material and Methods. Relative counts of circulating PD-1and/or TIM-3-positive and negative T cells expressing common ɣ-chain cytokine receptors CD25, CD122, CD127, phosphorylated STAT5, and transcription factor EOMES associated with T cell exhaustion were studied using flow cytometry in 17 healthy donors, 22 MM patients with remission and 7 MM patients with progressive disease.

Results. T cells expressing PD-1 and/or TIM-3 inhibitory checkpoint receptors in MM patients consisted of CD25+EOMESactivated cells, CD4+CD25+CD127-FOXP3+ regulatory T cells (Treg), CD4+CD25-EOMES+ dysfunctional cells. CD25+ T cells from healthy donors and MM patients, regardless of the expression of the studied checkpoint receptors, were EOMES-negative. No such association was found for CD122 and CD127 cytokine receptors. EOMES is a marker of T cell exhaustion for CD4+ T cells, but not for CD8+ T cells, in which it is more associated with activation. The proportion of CD4+ Tregs among circulating PD-1+ and TIM-3+ T cells was relatively low. A higher content of cytokine receptors in the population of TIM-3+ T cells may indicate the predominant involvement of TIM-3 in the control of homeostatic proliferation of mature T cells under lymphopenic conditions, while the expression of PD-1 may be more associated with the regulation of activation through T cell receptor. PD-1+ and/or TIM-3+ levels of activated, dysfunctional, and regulatory T cells can potentially be used to predict the safety and efficacy of targeted immunotherapy.

The management of cerebral glioma (CG) remains challenging. Recently, methods based on the study of the expression levels of miRNAs in blood plasma have proven to be promising. The volume of tumor tissue is known to correlate with increased expression levels of microRNA-21 and -210. MicroRNA-15, -16, -34, -126 and -342 are involved in the regulation of tumor proliferative potential, and microRNA-128 is involved in the regulation of metabolic activity.

The aim of the study was to evaluate the extended protocol for assessing the expression of microRNA-15, -16, -21, -34, -126, -128, -210, and -342 in the plasma and saliva of CG patients.

Material and Methods. The study group consisted of 24 patients with supratentorial glioma (8 men and 16 women aged 41 to 71 years, mean age: 56 years). The control group consisted of 30 volunteers. MicroRNA expression was studied in plasma and saliva according to the StemLoop-RealTime protocol, using fluorescently labeled samples with small miRNA U6 as a reference gene. Statistical analysis was carried out using nonparametric methods.

Results. The lack of CG stabilization and the most probable progression of the tumor with a poor prognosis was related to an increase in microRNA-21 and -210 expression levels and decrease in microRNA-128 expression and at least four of microRNA 15, -16, -34, -126, and -342. Stabilization of CG with a high probability of progression was associated with an increase in microRNA-21 or microRNA210 expression levels, decrease in no more than three of microRNA-15, -16, -34, -126, -342 expression levels as well as decrease in microRNA-128 expression. Stabilization of the tumor with a low probability of progression was associated with a decrease in the expression of microRNA-21 and -210 and in no more than one of miRNA-15, -16, -34, -126, -342 below the reference level, with a simultaneous increase in miRNA-128 expression.

Conclusion. The determination of microRNA expression in blood plasma and saliva can be one of the important criteria for assessing the prognosis of CG.

Background. Ischemic stroke is one of the most frequent causes of postoperative death in patients with thoracoabdominal malignant tumors. The role of molecular genetic factors of cardiovascular risk in the development of this complication in cancer patients has not yet been studied properly. The identification of genetic determinants of arterial thrombosis will allow predicting an increased risk of ischemic stroke and will create the possibility of pathogenetically justified prevention among carriers of genetic markers of thrombophilia.

Aim. To compare the frequency of carriage of procoagulant mutations in the genes of the hemostasis system in cancer patients who have suffered an ischemic stroke and in cancer patients without concomitant cardiovascular diseases.

Material and Methods. The non-randomized observational pilot research included 105 patients with thoracoabdominal tumors treated at the Thoracoabdominal Department of N. N. Blokhin National Research Center of Oncology during the period 2018–2019. The study group (n=24) consisted of patients with a history of ischemic stroke or perioperative stroke. The control group (n=81) included patients without concomitant cardiovascular diseases, including a family history. The real time polymerase chain reaction technique was used to determine the gene polymorphisms of blood coagulation.

Results. We found a statistically significant difference in the frequency of carriage of the heterozygous variant (GA) mutation of the F2 gene (c2=6,881, p=0,009), homozygous mutation (TT) of the of the ITGA2 gene (c2=15,724, p<0,001), the heterozygous variant (TC) mutation of the ITGB3 gene (c2=3,861, p=0,05) as well as the general frequency of genetic aberrations in these genes between patients with thoracoabdominal malignant tumors, who had ischemic stroke and patients with thoracoabdominal malignant tumors without cardiovascular pathology.

Conclusion. Based on the results of the genotyping of factors associated with a high thrombogenic risk, a statistically significant difference in the frequency of occurrence of polymorphisms of hemostasis system genes F2, ITGA2, ITGB3 was revealed between patients with thoracoabdominal malignant tumors, who had ischemic stroke and those without cardiovascular diseases. The role of the genetic factor in the development of ischemic stroke in cancer patients requires further study.

Background. Lymph node metastasis in breast cancer is not only a variant of cancer progression, but is also associated with the development of hematogenous metastases. The LIMCH1 protein is involved in the mesenchymal type of migration due to the activation of non-muscle myosin IIA.

The objective of the study was to investigate the association of different LIMCH1 protein expression variants with lymph node metastasis.

Material and Methods. The retrospective study included 53 patients with invasive breast carcinoma of no special type. The study group included all molecular genetic types (luminal A, luminal B, HER2-positive and triple negative). The median age of the patients was 55.4 ± 14 years. According to the TNM classification, patients had stage T1–3N0–3M0 breast cancer. The patients did not receive preoperative chemotherapy. The expression of the LIMCH1 protein in tumor cells was assessed using immunohistochemistry. Anti-LIMCH1Prestige (HPA004184, Sigma Aldrich, Germany) and anti-LIMCH1-C-term (SAB2700402, Sigma Aldrich, Germany) antibodies were used.

Results. Lymph node metastases were more frequent in patients with LIMCH1 protein expression in tumor cells. This is true for cytoplasmic expression of the LIMCH1 protein detected by the CH domain, but not for submembrane expression or expression of the LIMCH1 protein detected by the LIM domain, regardless of localization in the cell. This phenomenon was not associated with the morphological heterogeneity of breast cancer. The most unfavorable factor for worse metastasis-free survival is the combination of the presence of lymph node metastases and cytoplasmic expression of the LIMCH1 protein detected by the CH domain.

Conclusion. The development of synchronous lymph node metastases in breast cancer is associated with the presence of cytoplasmic expression of the LIMCH1 protein detected by the CH domain in the primary tumor tissue.

Purpose of the study: development of in vitro laboratory models to evaluate quality parameters and specific efficacy of dendritic cell vaccine (DCV).

Material and Methods. Biological samples of malignant tumor patients treated with autologous dendritic cell vaccine (DC) were included into the study. Immature DCs (n=46) and mature DCs (n=56) were used to induce proliferation of antigen-specific T lymphocytes (n=227). Autologous tumor cells from skin melanoma (n=10) or sarcoma (n=8) patients in the xCELLigence® assay system were used to study the in vitro antitumor cytotoxic activity of generated CTLs (n=18). The secretion of cytokines and cytolytic proteins was studied by multiplex analysis. The subpopulation composition of effector T-lymphocytes was determined by flow cytometry.

Results. We revealed that mature DCs (CD83+CD1a-) had a high expression of antigen presenting molecules (HLA-DR) and those providing migration of DCs into lymph nodes (CCR7) as well as costimulatory molecules CD80 and CD86 as compared to immature DCs (CD83-CD1a+). Induction of mature DCs was found to stimulate an increase in the relative content of proliferating T cells compared with stimulation of immature DCs (p<0.001) and specific PTA+ tumor lysate (p<0.001). When studying cytotoxic activity of effector T-lymphocytes, we developed 2D in vitro models using xCELLigence® analytical system and revealed 2 types of interaction: 1) in vitro model № 1 – decrease in cell index (CI) of autologous tumor cell culture in the presence of activated effector T lymphocytes; 2) in vitro model № 2 – no change in CI of autologous tumor cell culture when co-cultured with activated effector T cells compared to control (72 h observation). The results demonstrated cytotoxic activity of antigen-specific T lymphocytes due to high content of terminally differentiated cytotoxic T lymphocytes (TEMRA), GrB-producing CTLs, and cytokine secretion profile.

Conclusion. Requirements for the quality of personalized autologous DCs, including control of immunophenotypic characteristics were developed, and functional activity of Tlymphocytes during induction of mature vaccine DCs was evaluated. A laboratory procedure was developed for quantitative assessment of cytotoxic activity of antigen-specific T-lymphocytes against autologous tumor using the xCELLigence® analytical system, thus allowing for personalized monitoring and predicting the effectiveness of DСV treatment.

Aim: to study changes in the activities of purine nucleotide degradation enzymes – adenosine deaminase (ADA) and xanthine oxidase (XO) in patients with rectum cancer (RC).

Material and Methods. The activity of purine nucleotide degradation enzymes was studied in blood plasma and tissue homogenates: tumor tissue and normal rectal mucosa in 70 patients with stage I–IV RC. The histological type of RC was adenocarcinoma. The levels of ADA and XO activities were measured using spectrophotometry.

Results. The activity of ADA and XO in blood serum of RC patients was significantly higher than that of healthy people. A significant increase in the activity of ADA and XO in tumor tissue compared to normal tissue was also found. The relationship between the activities of the enzymes of purine catabolism in blood plasma and tissues were revealed. An increase in purine catabolism depending on the stage of RC was found.

Conclusion. The increased ADA and XO activities indicated the enhanced purine catabolism not only in malignant transformation, but also in tumor progression.

Itroduction. Gastric cancer incidence and mortality rates remain very high worldwide, including the Russian Federation. More than 50 % of gastric cancers are locally advanced at presentation [1]. Perioperative or adjuvant chemotherapy is a standard treatment for gastric cancer patients. The use of neoadjuvant chemoradiotherapy is considered very promising.

Material and Methods. We present the analysis of the results of surgical treatment of cancer of the stomach and gastrooesophageal junction after various options of neoadjuvant therapy: chemotherapy, chemoradiotherapy, and their combinations. The experience of the Medical Radiological Research Centre (MRRC), including 5 clinical prospective studies and one randomized multicenter clinical trial, was analyzed. A total of 237 patients with histologically proven locally advanced cancer of the stomach and gastro-oesophageal junction were included into the study. Of these patients, 202 received neoadjuvant therapy. Our treatment outcomes were compared with those of randomized trials published over the last 15 years.

Results. Of 202 patients who received neoadjuvant therapy, 190 (94 %) underwent surgery (R0 resection: 184 patients). In the early postoperative period, complications were observed in 62 patients (32.6 %). Re-surgery was performed in 11 (5.8 %) patients. Postoperative mortality was 1.6 % (3 patients). Multicenter randomized studies and meta-analyses, as well as the long-term experience of MRRC, have shown that neoadjuvant therapy does not increase the number of postoperative complications and mortality, increases the rate of R0 resections and improves long-term treatment outcomes in patients with resectable locally advanced cancer of the stomach and gastro-oesophageal junction.

Conclusion. Analysis of long-term clinical studies conducted at the MRRC as well as the treatment results published by other authors show that in some cases neoadjuvant therapy can lead to soft tissue changes in a surgical area and may complicate surgical management; however, it does not have a negative impact on the rates of postoperative complications and mortality.

The aim of this study was to determine the most effective approach to the treatment of patients with continuous growth of brain glioma.

Material and Methods. The study included 200 patients with progression of primary brain glioma, who were treated at the Chelyabinsk Regional Center of Oncology and Nuclear Medicine in the period from 2001 to 2021. The average age of patients was 47.86 ± 11.47 years. The ratio of men to women was 1:1. The continuous growth of high-grade glioma was detected in 125 cases. The progression of lowgrade glioma was observed in 40 patients. Transformation of low-grade glioma into high-grade glioma was found in 35 patients. Re-surgery was performed in 92 patients. Repeated radiation therapy was given to 140 patients. Chemotherapy as the method of choice was administered to 60 patients.

Results. The median overall survival (OS) time was 36 months. The 1and 2-year survival rates were 96.0 % and 59.4 %, respectively. The method-specific overall survival time was 15 months. There was a tendency towards an increase in OS in all subgroups of patients who underwent re-surgery. The highest method-specific overall survival rates were observed in patients who received stereotactic radiation therapy (STRT) and combined photon-neutron therapy (CPNT): 23 and 47 months in patients with high-grade glioma and 60 and 72 months in patients with continuous growth of low-grade glioma, respectively (p>0.05). In patients with the transformation of low-grade glioma into high-grade glioma, the method-specific OS was higher in patients who received combination of chemotherapy and radiation therapy compared to those who received chemotherapy or radiation therapy alone: 32, 12, and 24 months, respectively (p>0.05).

Conclusion. Repeated surgery is the optimal treatment approach for patients with continuous growth of primary brain glioma. In cases with repeated radiotherapy courses, CPNT or STRT can be the methods of choice. Treatment of patients with transformation of low-grade gliomas into high-grade gliomas should include repeated course of chemoradiotherapy.

Objective of the study: To review worldwide literature data on the efficacy of combined modality treatment including intraoperative radiation therapy (IORT) in patients with operable breast cancer (BC).

Material and Мethods. Of 110 publications (2000–2021) available from Scopus, Pubmed, Elibrary and other databases, using the key “breast cancer”, “local recurrence”, “intraoperative radiotherapy” and “radiation technique”, 45 were included in the literature review.

Results. Radiotherapy is of paramount importance in the organpreserving treatment of breast cancer, as numerous randomised studies have shown that the use of postoperative radiotherapy dramatically reduces the number of locoregional recurrences. The use of IORT as an effective method of relapse prevention compared to standard postoperative adjuvant radiotherapy is an important trend in radiation oncology.

Conclusion. The use of IORT in combination treatment modality for operable breast cancer should be differentiated and based on clinical and morphological prognostic factors. Different molecular subtypes of breast cancer are characterized by significant differences in pathogenesis and response to therapy. Further studies on the effectiveness of IORT are required to identify a group of patients with absolute indications for the use of IORT.

Purpose. To reflect the current understanding of the frequency, molecular mechanisms, and means of overcoming alopecia in cancer patients, taking into account the fundamental data of recent years on the physiology of the hair follicle and the pharmacological profile of the toxicity of anticancer drugs.

Material and Methods. A literature search using Medline, Pubmed, etc. databases was carried out. More than 200 publications devoted to the study of alopecia were found, of which 42 were included in this review.

Results. Chemotherapy-induced hair loss is a common adverse effect in cancer patients undergoing treatment. The frequency and molecular mechanism of the development of alopecia are related to the pharmacological features of the drug-based treatments, initial nutritional premorbid status, and predisposing polymorphisms of genes involved in drug conversion and excretion. Focal or diffuse alopecia may be the first sign of malignant growth within the paraneoplastic syndrome, primary or metastatic malignancies of the scalp, or be a manifestation of nutritional insufficiency. Baldness negatively affects the psycho-emotional state of patients, exacerbating depressive disorders, anxiety, reducing self-esteem and adherence to treatment. Thus, prevention or rapid overcoming of alopecia can significantly improve the quality of life of cancer patients. The use of scalp cooling or ‘cold caps’ is proven to be an effective way of combating chemotherapy-induced hair loss.

Conclusion. Further studies are needed to prevent and treat alopecia in cancer patients.

Objective. To present the available data regarding the tolerance of immune checkpoint inhibitors (ICIs) in cancer patients with concurrent HIV.

Material and Methods. A literature search was conducted in the electronic databases PubMed, Cochrane Library and UpToDate up to February 2022.

Results. The article outlines the background and experience of using ICIs for the treatment of malignant tumors in patients with concomitant HIV infection.

Conclusions. Until recently, the presence of chronic infections, including HIV infection, was one of the key contraindications for prescribing immunotherapy. However, the recent scientific publications demonstrate the efficacy and good tolerability of ICIs in cancer patients with concurrent HIV. Future prospective clinical trials will help to predetermine the potential of immunotherapy in clinical practice in this patients.

Background. Distant organ tumor dissemination is a major cause of breast cancer-related deaths. Breast cancer can metastasize to several organs, and the most frequent metastatic sites include the bones, lungs and liver. There is a question what factors can influence the direction of spread of tumor cells to a particular organ.

Material and Methods. We summarized the data available in the world literature on methods for prediction of the localization of distant metastases in breast cancer patients.

Results. We divided the factors associated with the localization of distant metastases into two main groups: clinicopathological parameters of breast cancer patients and molecular features of tumor microenvironment and tumor cells (primary tumor and circulating tumor cells) or its derivates – exosomes. From our point of view, the most powerful clinicopathological factor predicting the distant metastasis site is a molecular subtype of primary tumor. We can conclude that luminal (HR+/HER2-) tumors are often characterized by single metastases and bones are the most common metastatic site, while TNBC and HER2-enriched tumors often metastasize to multiple sites, most commonly brain and liver. However, several authors did not reveal these associations in their studies. It likely indicates the existence of other factors that significantly affect the organotropism of metastasis. Numerous studies demonstrate the association of different molecules expressed on tumor cells with organotropic metastasis. However, these data are very fragmentary and rather contradictory.

Conclusion. The found associations are common to all participants of metastatic cascade, but remains unclear which factors are essential and crucial in determining the direction of metastasis.

Introduction. Radiation therapy (RT) has been widely used since the 1970s in the treatment of Hodgkin’s lymphoma. RT increases the risk of secondary malignancies and heart disease including coronary artery disease, noncoronary atherosclerotic valvular disease, valvular dysfunction, pericardial disease and radiation induced vasculopathy.

Case Presentation. We describe a case of a patient with 4 secondary malignancies due to previous RT including parotid mucoepidermoid carcinoma, breast multicentric infiltrating ducta, thyroid papillary microcarcinoma with follicular pattern and lung adenocarcinoma that later presented with severe constrictive pericarditis, which led to an emergency pericardiectomy – all of these were complications of her previous radiotherapy. She received a prompt diagnosis and treatment.

\Discussion. Radiation-induced vascular disease (RIVD) occurs due to endothelial injury following RT; patients have up to 3–4 fold increase in risk of myocardial infarction due to CAD, therefore screening of CAD with a CT coronary angiography is recommended to begin 5 years after receiving RT in patients 45 and older and 10 years after RT in patients <45 years old. Radiation induced secondary malignancies (RISM) are seen in 17–19 % of cases and the risk increases by time since last RT session. Many factors contribute to the risk severity of developing RISM such as age of radiation, dosage and size of the area irradiated, and radiation technique. Lung and breast cancer are the most common forms of second malignancy. A prompt screening, diagnosis and treatment of the RT complications are vital and should be prioritized in every control.

Background. Surgery for non-organ malignant retroperitoneal tumors poses a serious challenge. Long-term asymptomatic course of the disease leads to a delayed diagnosis, when tumors can reach massive size with potential involvement of adjacent organs and critical structures. In most cases, nephrectomy is often required during resection of retroperitoneal sarcomas. Recently, there has been growing interest in nephronsaving surgery for large retroperitoneal tumors.

Description of the clinical case. A 70-year-old patient was admitted to Irkutsk Regional Cancer Center with right-sided giant primary retroperitoneal tumor and grade 1 hydronephrosis of solitary right kidney. The patient underwent extended resection of primary retroperitoneal tumor with right-sided hemicolectomy and nephradrenalectomy. Extracorporeal resection of the solitary kidney was then performed. After obtaining negative kidney smears (imprints), the kidney was replanted in the pool of right iliac vessels. No complications were observed in the postoperative period. Histopathology examination revealed was welldifferentiated liposarcoma. On follow-up examination 38 months after surgery, there were no signs of local tumor recurrence, and renal function was satisfactory.

Conclusion. Extracorporeal resection of the kidney with heterotopic replantation is an effective nephron-saving method in surgery for primary retroperitoneal sarcomas. The patient’s solitary kidney with primary retroperitoneal sarcoma is an absolute indication for kidney’s saving, including the use of transplant technologies.