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.

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.

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).

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.

Background. To date, the role of lymphadenectomy in stage I endometrial cancer has been relegated to the background in favor of sentinel lymph node biopsy. Taking into account the new data on the improved survival in patients at high risk of lymph node metastasis after pelvic and para-aortic lymphadenectomy and the tendency to upstaging in accordance with the new FIGO 2023 classification, the problem of performing para-aortic lymphadenectomy becomes relevant again.

The study objective: a comparative analysis of surgical accesses used in performing lumbar lymphadenectomy in endometrial cancer patients with an emphasis on the disadvantages and advantages of each surgical approach.

Material and Methods. Medical records of 122 endometrial cancer patients treated at the S. P. Botkin Moscow Medical Scientific Center were retrospectively analyzed. The study included patients undergoing pelvic and para-aortic lymphadenectomy, and hysterectomy through four surgical access methods: laparotomy (n=28), laparoscopic transabdominal (n=30), laparoscopic retroperitoneal (n=41) and robot-assisted retroperitoneal (n=23). The following parameters were compared between the subgroups: body mass index of patients, duration of surgery, number of removed pelvic and para-aortic lymph nodes, frequency of achieving III and IV levels of lymphadenectomy, frequency of intraand postoperative complications, length of hospital stay in the postoperative period, and frequency of transfers to intensive care unit.

Results. Compared with other subgroups, surgery performed via laparoscopic retroperitoneal access was characterized by the shortest duration of surgery, high frequency of achieving level IV lymphadenectomy and acceptable level of intraand postoperative complications.

Conclusion. Laparoscopic retroperitoneal access was found to have greatest advantageous in performing lumbar lymphadenectomy.

Background. Spread through air spaces (STAS) has long been considered a significant risk factor for local recurrence after segmental lung resection in patients with non-small cell lung cancer (NSCLC). Currently, the study of the biological significance of STAS, including its role in hematogenous metastasis of NSCLC, is relevant.

The aim of the study was to investigate the feasibility of predicting hematogenous metastasis in patients with NSCLC taking into account STAS. Surgical specimens from 88 patients with stage IA–IIIA NSCLC (T1–3N0–1M0), who were treated at the department of thoracic oncology of the Cancer Research Institute of Tomsk National Research Medical Center from 2014 to 2019, were evaluated. The patients underwent lobectomy or pulmonectomy with ipsilateral mediastinal lymph node dissection. Of these, 69 patients received adjuvant chemotherapy with carboplatin + paclitaxel. The tissue samples from the primary tumor, surrounding lung tissue, and all removed lymph nodes were examined. Histological and immunohistochemical studies were performed using standard methods. Only cases with adenocarcinoma and squamous cell carcinoma were included in the study. The follow-up period from the time of diagnosis was 5 years. The logistic regression method was used to construct mathematical models.

Results. Based on the assessment of clinical and morphological parameters, a mathematical model was developed to predict the feasibility of hematogenous metastasis only in patients with lung adenocarcinoma. Basic tumor parameters, such as TNM stage, differentiation grade, creeping type of structures, proliferative activity, and STAS were assessed. The reliability of the model was χ²=664.730; p<0.001; sensitivity and specificity were 99 % and 88 %, respectively. Without taking STAS into account, the model had a low level of specificity, not exceeding 60 %. It was not possible to construct an effective prognostic model for squamous cell carcinoma. Adjuvant chemotherapy did not affect the results obtained.

Conclusion. The study demonstrated a significant role of STAS in predicting the incidence of hematogenous metastasis in patients with lung adenocarcinoma. The study of the role of STAS in hematogenous metastasis is promising for understanding the mechanisms of this form of tumor progression.

Introduction. Bone tumors are heterogeneous group of skeletal neoplasms characterized by frequent recurrences, aggressive clinical course and low survival rates. The development of new treatment methods continues to pose pressing challenges. Radical intraoperative thermal ablation (RIT) using high-temperature exposure is emerging as a new and promising strategy for organ-preserving treatment. This study focuses on the effect of thermal ablation (TA) on tumors.

Objective of the Study to assess the impact of TA (using the RIT method) on the viability of tumor cells.

Material and Methods. The study included 8 patients with bone tumors. Tumors underwent TA at a temperature of 60 °C for 30 minutes ex vivo. Apoptosis was studied in tumor tissue samples before and after TA. Apoptosis was assessed using two methods: flow cytometry and the TUNEL assay.

Results. The TA procedure developed by our scientific group represents a promising organ-preserving approach for treating malignant bone tumors. A temperature regime of 60 °C for 30 minutes was effective in initiating tumor cells death. This was confirmed by two independent methods – flow cytometry and TUNEL assay – which demonstrated a significant increase in the number of apoptotic cells immediately following the procedure and a notable rise in the number of cells exhibiting signs of late apoptosis one hour post thermal ablation. Therefore, the collected data confirm a pronounced antitumor effect immediately after implementing RIT.

Conclusion. The findings confirm that RIT is a viable organ-preserving method for treating bone tumors, meriting further investigation to expand its application in clinical practice.

Introduction. Chemotherapy remains a cornerstone treatment for most non-Hodgkin lymphoma (NHL) patients, yet it is frequently associated with significant adverse effects that compromise their quality of life. Emerging evidence highlights that genetic factors, particularly single nucleotide polymorphisms (SNPs), play a critical role in determining individual variability in treatment responses and susceptibility to drug-related complications.

Aim of this study: to identify SNPs associated with chemotherapy-induced adverse events in NHL through advanced bioinformatics approaches, enabling personalized therapeutic strategies to mitigate risks.

Material abd Methods. This study leveraged the PharmGKB database to identify SNPs associated with Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone. SNPs meeting inclusion criteria (Level of Evidence 1A-3, p<0.01) were prioritized for functional impact analysis using PolyPhen-2 scores. Data extraction and computational analysis utilized SNPnexus, HaploReg v4.2, Ensembl Genome Browser (GRCh37), and PharmGKB. The methodology employed a descriptive approach, relying exclusively on secondary data sources.

Results. This study identified 11 SNPs that may be important for hematological toxicity, liver damage, and nausea risk. These genes are SLC22A16, GSTP1, NAT2, ATM, ABCB1, CYP2B6, XRCC1, ERCC1, MUTYH PIK3R2, and PNPLA3. In terms of priority and risk, the most significant variants were rs738409 (PNPLA3), rs12210538 (SLC22A16), rs2229109 (ABCB1), and rs56022120 (PIK3R2). The distribution of SNP alleles is more common in European populations than in Asians or Africans.

Conclusion. For the first time, we found SNPs that indicate an increase in drug side effects. These SNPs rs738409, rs12210538, rs2229109 and rs56022120 increase the severity of NHL patients during chemotherapy. In order to ensure that these biomarkers can be used in clinical practice and to support the creation of precision medicine strategies, additional clinical validation is needed.

The purpose of the study was a comprehensive analysis of molecular genetic changes in tumor and normal tissues of patients with colorectal cancer using whole-genome sequencing to identify de novo mutations, microsatellite instability patterns, and mutational signatures associated with tumor development.

Material and Methods. A single-time cross-sectional study was conducted in the Kaliningrad region. Colorectal cancer samples were analyzed using whole-genome next-generation sequencing (WGS). The human reference genome GRCh38.p14 was used for read mapping. Bioinformatic analysis of signatures was conducted separately for each patient. 71 pairs of samples were sequenced: complete genomes of tumor biopsies and DNA isolated from blood samples for 71 patients. The average age among the analyzed patients was 69 years, with a median of 71 years.

Results. Genetic alterations associated with tumor development and progression, as well as potential therapeutic targets were identified. Using the Oncovar database, 151 driver mutations were detected in 62 patients. Using the CIVIC database, 70 marker mutations were found in 45 patients. It was found that the most common driver mutations in the study cohort were mutations in the KRAS gene (KRAS:G35T, KRAS:G35A, KRAS:G38A), associated with tumor resistance to Panitumumab and Cetuximab. The frequency of the most common driver mutations in the study cohort was low, indicating high heterogeneity of colorectal cancer. Analysis of the tumor mutational burden (TMB) revealed a high average value of 5.5, suggesting a significant potential of immunotherapy in colorectal cancer treatment. In the studied population, the mutational signatures SBS1, SBS5, and SBS39 were the most common.

Conclusion. The identified diversity of genomic changes may be associated with DNA replication errors, exposure to external factors, and genetic predisposition. The pattern of mutational signatures was very similar among all patients in the studied samples, suggesting a single mutagenic factor is involved in the development of colorectal cancer in all patients.

Background. Interleukin-10 (IL-10) regulates immune responses and has been linked to cancer development. Polymorphisms in the IL-10 gene, such as rs1800872 and rs1800896, may affect cancer susceptibility. No previous study has examined the association between these variants and cervical cancer in Quetta, Pakistan, which this study aims to address.

Aims. This study aimed to investigate the association between IL-10 gene polymorphisms (rs1800872 and rs1800896) and cervical cancer susceptibility among women in Quetta, Pakistan, and to determine the prevalence and risk factors contributing to cervical cancer in this population.

Material and Methods. A total of 50 patients diagnosed with cervical cancer and 50 individuals without any health issues were selected for the case-control analysis. Data was collected for retrospective analysis using a pre-designed data collection form. Demographic information and blood samples were collected from participants with explicit consent. The DNA was extracted using an organic approach, and genotyping was performed using the TETRA primer ARMS-PCR technique. The data analysis was conducted using multinomial logistic regression with a 95 % confidence interval, utilizing the SPSS software.

Results. The study demonstrated no significant association between IL-10 gene polymorphisms (rs1800872 and rs1800896) and cervical cancer among the population of Quetta City. Statistically significant relationships were found between cervical cancer and smoking, lack of exercise, menarche, and usage of oral contraceptive medications.

Conclusion. This study confirms no association between IL-10 gene polymorphisms (rs1800872 and rs1800896) and cervical cancer in Quetta. Furthermore, a lack of awareness regarding cervical cancer poses a significant obstacle to its effective care at the individual level in Pakistan.

Background. There is limited data on the effectiveness of immune checkpoint inhibitors (ICIs) in third-line therapy for metastatic gastric cancer.

The aim of the study was to compare progression-free survival (PFS) and overall survival (OS) in patients with metastatic gastric cancer receiving third-line immunotherapy or chemotherapy.

Material and Methods. In third-line treatment for metastatic gastric cancer, the long-term outcomes (PFS and OS) of ICI (n=93) or chemotherapy (n=77) were retrospectively evaluated. The study group comprised 170 patients; 63.4 % were males and 53.2 % were females. The median age was 65.5 and 63.7 years in ICN and chemotherapy groups, respectively. ECOG 2 was 22.6 % and 16.9 %, respectively. The ICI group had worse PFS in second-line therapy (2.8 and 4.8 months, p=0.0014), and fewer patients continued treatment after progression (14 % and 39 %, p=0.002). In the chemotherapy group, 80 % of patients received ICIs in fourthand later lines of treatment.

Results. The analysis showed that PFS was better in the chemotherapy group than in the ICI group (4.3 vs 2.4 months, p=0.12, HR 1.28, 95 % CI 0.94–1.76), OS was also better in the chemotherapy group than in the ICI group (7.8 vs 4.8 months, p=0.064, HR 1.35, 95 %CI 0.98–1.85). The influence of the CPS level (0–9/unknown and ≥10) in the ICI group was not found: PFS 2.1 and 2.4 months (p=0.75), OS 4.1 and 4.4 months (p=0.62). When comparing PFS and OS in patients with MSI/dMMR who received ICI (n=6) and chemotherapy (n=5), no benefits of using ICT was shown (PFS 3.4 and 9.7 months, p=0.75, and OS 11.9 and 13.0 months, p=0.56). During the first follow-up, disease stabilization was observed in 26 % and 44.2 % of patients, respectively (p=0.015 %).

Conclusion. The use of ICT in third-line treatment for metastatic gastric cancer was inferior to standard treatment regimens in terms of PFS and OS (regardless of CPS level and presence of MSI). Given the risks of rapid progression in ICI-treated patients, the presence of a small subgroup of patients (no more than 10 %) who benefit from classical treatment approaches with long follow-up periods, it is necessary to continue the search for factors associated with the effectiveness of ICI.

Background. Esophageal cancer (EC) is one of the most aggressive gastrointestinal malignancies with a poor prognosis. The standard treatment for thoracic EC involves chemoradiotherapy (CRT). For localized tumors, a multimodal approach, including neoadjuvant chemoradiotherapy followed by surgery, is considered optimal. This approach can improve long-term treatment outcomes and provide better local control. The CROSS regimen is a commonly used chemoradiotherapy regimen for EC in Europe and Russia.

Objective: to evaluate the effectiveness of chemoradiotherapy with the CROSS regimen administered both preoperatively and alone, as well as to assess long-term overall and recurrence-free survival rates.

Material and Methods. This retrospective study included patients with stage I–III thoracic esophageal cancer treated at the Ulyanovsk Regional Clinical Oncology Center from January 1, 2019, to December 31, 2023. A total of 94 patients began chemoradiotherapy in the CROSS regimen. The final analysis included 80 (85.1 %) patients who completed the entire treatment program. Data collection was performed according to a unified protocol.

Results. The rate of complete pathological response (TRG 1) was 10/26 (38.5 %). The 1-year overall survival rates in patients undergoing surgery and in patients not undergoing surgery were 83.3 % and 71.7 %, respectively. The 3-year overall survival rates in patients undergoing surgery and in patients not undergoing surgery were 58.3 % and 50.9 %, respectively. The 1-year and 3-year recurrence-free survival rates were higher in patients who received CRT followed by surgery compared to those who received CRT alone (76.9 % versus 63.5 % and 53.9 % versus 44.2 %).

Conclusion. Chemoradiotherapy with the CROSS regimen was shown to achieve a complete response in more than a third of EC patients. Survival rates were higher in patients undergoing a three-modality approach.

The development of effective, highly sensitive and highly specific approaches to early detection of colorectal cancer is the basis for the timely use of various targeted interventions that can effectively solve patients’ problems, minimizing the impact on their quality of life. Endoscopic diagnostic and therapeutic techniques continue to play a critical role in improving cancer outcomes and are continually being reviewed and improved to increase detection rates of colorectal cancer.

The aim of the study was to analyze and summarize the current scientific literature describing promising developments in early diagnosis and treatment of colorectal cancer, as well as to describe a case report demonstrating the importance of high-quality diagnostics for selecting a therapeutic strategy for colorectal cancer.

Material and Methods. The literature search was conducted in Pubmed, Google Scholar, and Elibrary.ru databases, focusing on articles published between 2016 and 2025, using the key words “colorectal cancer”, “colorectal cancer”, “CT-colonography”, “colonoscopy”. Priority was given to the studies describing the improvement of screening tools for detecting colorectal neoplasia. Of the 100 publications, 41 were selected for this review.

Results. Precise optical diagnosis of colorectal polyps, including the ability to predict polyp histology in real time during colonoscopy, appears to be the most promising approach for detecting even small colorectal lesions. This approach can potentially allow for the abandonment of forceps biopsy reducing the incidence of misdiagnosis (as demonstrated in the described case report).

Conclusion. To develop strategies for improving early detection and treatment of colorectal cancer, it is necessary to take into account the fact that the human, diagnostic and therapeutic potential in different regions of Russia varies significantly. Researchers should prioritize developing their own diagnostic experience, removing economic barriers to effective colorectal cancer detection, and developing rational ways to improve therapeutic approaches within regional health care settings.

Background. Colorectal cancer (CRC) remains a major global health concern both in Russia and worldwide. According to WHO data, CRC ranks as the third most common cancer and has a tendency to increase both morbidity and mortality. According to 2022 data, CRC is the fifth most common malignancy and the second leading cause of cancer death in Russia. Acute colorectal obstruction (ACRO) is one of the most frequent and threatening complications of CRC, necessitating urgent treatment. Colonic stenting is a modern minimally invasive alternative to emergency surgery for ACRO. However, a detailed analysis and systematization of the accumulated data are required to assess its efficacy and safety as well as the variability of long-term results and the risk of complications.

Aim of the study: to conduct a systematic analysis of the data available in modern literature on efficacy, safety and long-term results of colonic stenting as a method of ACRO treatment in patients with CRC.

Material and Methods. Scientific publications from PubMed, Scopus, Web of Science, eLibrary, CyberLeninka databases published over the last 10 years, as well as data from the World Health Organization (WHO) and specialized oncology portals on the topic of the study were analyzed.

Results. The literature review demonstrated that colorectal stenting is an effective minimally invasive strategy for the ACRO treatment in CRC patients, allowing in some cases to avoid emergency surgery or to be used as a “bridge” to planned surgery. The technique has been found to be associated with a certain spectrum of complications arising both during surgery and in the postoperative period (e.g. perforation, stent migration, reobstruction). Significant variability in long-term outcomes was observed, highlighting the lack of uniformity and the need for further standardisation of indications and technique.

Conclusion. Colorectal stenting is an important and effective method for the treatment of ACRO caused by CRC, offering significant advantages over emergency surgery for a certain category of patients. However, the presence of complications and the ambiguity of long-term outcomes require further study of this technique, improvement of patient selection criteria, technical aspects of stenting, and development of clear patient management algorithms to improve treatment outcomes.

The objective of the study: to identify current strategies, achievements, and challenges in developing HER2-targeted therapeutic conjugates and assess clinical outcomes of therapies based on them.

Material and Methods. A total of 247 publications over the past 7 years were analyzed. Finally, 60 were selected for the review. The sources were searched in Scopus (n=35), PubMed (n=321) and WOS (n=91) databases. Electronic resources, such as PubMed Central (PMC), ScienceDirect and ResearchGate were used to obtain the full-text articles.

Results. The therapeutic potential of HER2-targeted conjugates has been confirmed in clinical trials for drugs, such as trastuzumab emtansine (T-DM1, Kadcyla®) and trastuzumab deruxtecan (T-DXd, Enhertu®). The development of new HER2-targeted conjugates involves several approaches to improve drug characteristics and therapeutic efficacy: increasing binding affinity to the target, simultaneous blocking of two HER2 domains, various mechanisms of cytotoxic effects on tumor cells (inhibition of tubulin, RNA polymerase II, and DNA topoisomerase I), enhancing the ratio of cytotoxic agents per antibody molecule and improving the conjugate stability in the bloodstream. Trastuzumab duocarmazine (SYD985), disitamab vedotin (RC48, Aidixi®), zanidatamab zovodotin (ZW49), ARX788 and MRG002 are all currently being studied in clinical trials.

Conclusion. Improvements in the design and understanding of drug-tumor interactions contribute to new clinical advances that may provide not only a survival advantage over traditional therapy, but also significantly improve the quality of life of patients with HER2-positive tumors.

Background. Pancreatic cancer (PC) is an aggressive malignancy with a high mortality rate. Pancreatic ductal adenocarcinoma constitutes approximately 90 % of pancreatic cancers, and is frequently diagnosed at an advanced stage. The disease is distinguished by the presence of tumor micrometastasis prior to the onset of clinical symptoms, as well as rapid progression. There are currently no effective screening methods for the disease.

Aim of the study: analysis of available literature data about susceptibility genes and molecular mechanisms of PC.

Material and methods. The search for relevant sources was performed in the PubMed (NCBI), Elibrary, GoogleScholar, publications from January 2000 to December 2024 were included. Of the 959 papers analyzed, 60 were used to write the review, 27 of which were published in the last five years.

Results. Approximately 10 % of pancreatic adenocarcinoma patients are carriers of germinal pathogenic variants that cause an increased risk of PC. These variants predominantly occur in DNA damage repair genes. Tumor cells undergo complex multistep genetic alterations, and the accumulation of these changes facilitates the activation of various oncogenes that contribute to the progression of PC. Research in the field of molecular genetics makes it possible to identify groups of patients with certain genetic alterations who need to be prescribed targeted drugs.

Conclusion. This article provides an overview of current understanding of the genetic predisposition to PC. The functional/clinical significance of proteins involved in the pathogenesis of the disease was described. Genetic alterations of PC were discussed.

The aim of the study was to summarize current trends in developing photodynamic therapy strategies for osteogenic sarcoma.

Material and Methods. We searched and analyzed 153 publications available from MedLine, Scopus, WoS and RSCI databases over the past 7 years. Of these, 60 were included in the review.

Results. Traditional methods of treating malignant bone tumors, such as surgery, chemotherapy and radiation therapy, have significant disadvantages, including complications, serious side effects and low efficacy. Instead, nanoparticles represent a new platform for the treatment and diagnosis of malignant bone tumors. Recent studies have shown that nanoparticles can be used to treat and diagnose various types of bone tumors, including osteogenic sarcoma. This is due to their unique structure, ability to efficiently deliver drugs, and bioavailability. In addition, the surface of nanoparticles can be modified with various molecules or materials, allowing them to acquire unique properties. For example, nanoparticles can be loaded with chemotherapeutic drugs or genes, allowing their release to be controlled and precisely targeted to osteosarcoma. Nanoparticles can also be used for photodynamic therapy. In addition, the incorporation of contrast agents or fluorescent probes into nanoparticles can improve imaging capabilities and monitor the treatment process in real time. This not only makes it possible to evaluate the effectiveness of photodynamic therapy, but also to adjust the treatment plan to achieve the best results for each patient.

Conclusion. Multifunctional nanoparticles are a promising tool for an individual approach to the treatment of osteogenic sarcoma using photodynamic therapy and improving the prognosis for patients.

Fertility preservation in women of reproductive age with ovarian cancer is still challenging. The ovarian-sparing surgery may increase the risk of recurrence. The direct involvement of the ovary in the tumor process significantly limits the ability to implement the most effective fertility preservation methods. For example, ovarian stimulation and ovarian cortex cryopreservation are absolutely contraindicated due to the risk of tumor cell contamination. In such cases, the only feasible fertility preservation method may be OTO-IVM (Ovarian Tissue Oocyte In Vitro Maturation), which involves retrieving immature oocytes from ovarian tissue removed during surgery and subsequent in vitro maturation.

Clinical Case Description. We present a case of successful pregnancy achieved through comprehensive, multidisciplinary fertility preservation. A 30-year-old patient with a recurrent borderline ovarian tumor in her only remaining ovary underwent surgery with uterine preservation and removal of the affected ovary. From the tumor-involved ovary, 22 cumulus-oocyte complexes were obtained. Following OTO-IVM, 12 metaphase II oocytes were obtained and fertilized via intracytoplasmic sperm injection (ICSI) that resulted in 3 blastocyst-stage embryos, which were cryopreserved. Cyclic hormone replacement therapy was administered to the patient. Nine months later, one embryo was thawed and transferred into the uterine cavity. Currently, an ongoing 20-week pregnancy has been confirmed.

Conclusion. The OTO-IVM method holds significant value as a fertility preservation technique for patients with ovarian cancer, making childbirth achievable. Further research is needed to refine the method, optimize protocols, and define clear indications and contraindications for its application.

Background. Disseminated peritoneal leiomyomatosis (DPL) is a rare disease of mesenchymal origin that is characterized by the presence of multiple benign myomatous tumors proliferated along the surface of the peritoneum, omentum and other soft tissues of the abdominal cavity and / or pelvis. Despite the benign morphological characteristics, DPL is known for its tendency for recurrence or malignancy. In addition, clinical manifestations of these tumors resemble peritoneal carcinomatosis, therefore, imaging investigations are important to accurately diagnose and treat lesions Currently, due to the rarity of DPL, there are no conventional guidelines for the diagnosis and treatment of this disease. The purpose of this study was to present a case report of a female patient with hormonally sensitive recurrent DPL following laparoscopic myomectomy to improve the algorithms for managing this disease.

Material and Methods. The patient with DPL was treated at N.A. Lopatkin Research Institute of Urology and Interventional Radiology, a branch of the National Medical Research Center of Radiology of the Russian Ministry of Health, DPL. To determine the extent of the tumor and the appropriate treatment tactics for the patient, an extensive differential diagnostic search involving various imaging techniques was performed. The patient underwent diagnostic laparoscopy with urgent morphological examination to finally determine the extent of surgery and achieve the maximum cytoreduction. A subsequent planned morphological examination revealed the presence of estrogen and progesterone receptors within the tumor cells, that was the reason for prescribing hormonal therapy and careful follow-up for the patient.

Conclusion. Study and demonstration of rare clinical cases expands the horizons and understanding of the nature of the disease. Our case report and literature review demonstrated that leiomyoma cells are prone to implantation dissemination.

Thymoma is a tumor originating from the epithelial cells of the thymus. In cases when complete removal of the tumor is not possible due to its local spread, induction therapy, including chemotherapy, radiotherapy, or chemoradiotherapy, is administered to improve respectability.

Case presentation. We present a case of a 41-year-old male who was diagnosed with IVA type B3 thymoma (cT3N0M1a) in March 2022. Computed tomography (18.02.22) revealed a tumor in the anterior mediastinum measuring 12.0×8.0×14.5 cm with spread to the right lung and pericardium, compression of large vessels; single nodular lesions along the pleura. From 19.03.22 to 26.05.22, 4 cycles of polychemotherapy with CAP were administered. From 9.08.22 to 24.11.22, 6 cycles of chemotherapy with etoposide + cisplatin were administered. Stable disease was observed. In January, 2023, the patient visited A. Tsyb MRRC for a consultation with oncologists. Surgery was not considered as a suitable treatment option due to the spread of the disease, and radiation therapy was recommended. From 16.02.23 to 3.04.23, a conformal external beam radiation therapy was delivered to a mediastinal tumor to a total dose of 60 Gy. The treatment was well tolerated. A control examination showed tumor size reduction meaning the tumor can be surgically removed. Considering positive response to radiation therapy, satisfactory performance status and age of the patient, a decision to perform surgery was made. On September 15, 2023 the mediastinal tumor was removed with pericardial resection and its reconstruction, upper and middle lobectomy, and precision removal of parietal pleural lesions. A follow-up examination (October 2024) revealed disease progression with the appearance of nodular lesions along the diaphragmatic pleura on the right. Chemotherapy with pemetrexed was administered. Currently, the performance status of the patient is satisfactory and he is socially active.

Conclusion. Induction chemotherapy and radiotherapy for locally advanced unresectable thymoma can increase the feasibility of achieving complete tumor resection, thus improving treatment outcomes. The rarity of these tumors and the lack of standard approaches to the treatment of locally advanced thymic carcinomas determine the relevance of the problem and the need to make an optimal decision on treatment tactics in each specific clinical case.

Background. Peritoneal mesothelioma is a rare, high invasive and aggressive malignant tumor that arises from the mesothelial cells lining the abdominal cavity. Surgery is a primary treatment method for mesothelioma. It allows the removal of macroscopically visible tumor masses, which are often resistant to conventional drug therapy. However, the necessity and appropriateness of a surgical approach should be assessed individually, taking into account the histological subtype of the tumor, the extent of its spread and the presence of associated risk factors. Current research shows that the best long-term results are achieved with a multimodal treatment approach, which may include a combination of surgery, chemotherapy, and radiotherapy. This comprehensive approach allows for more effective management of the disease and improved quality of life of patients.

Case report. We present a clinical case of a 59year-old female patient with peritoneal mesothelioma. The patient underwent surgery with intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) using cisplatin and doxorubicin. During a 12-month follow-up, there were no signs of disease progression, which indicates the high effectiveness of the applied approach.

Conclusion. The use of cytoreductive surgery and HIPEC demonstrated positive effects in the treatment of peritoneal mesothelioma.