Thyroid cancer is one of the most common endocrine malignancies worldwide. Surgical resection remains the standard care; however, minimally invasive approaches are increasingly being investigated for patients with low-risk cases, particularly papillary thyroid microcarcinoma (PTMC). This review summarizes current evidence on the use of radiofrequency ablation (RFA) in the management of differentiated thyroid carcinoma, with a primary focus on papillary thyroid carcinoma. 27 key publications were analyzed, including international guidelines, meta-analyses, and prospective and retrospective studies. Available data indicate that RFA achieves local tumor control and recurrence-free survival rates comparable to those of surgical management in appropriately selected low-risk patients, while significantly reducing procedure-related morbidity and preserving thyroid function. The technique demonstrates particular efficacy in patients with solitary tumors of up to 1 cm (T1aN0M0) without evidence of metastasis. This review provides a comprehensive evaluation of accumulated clinical data, direct comparison between RFA and thyroid surgery, and an analysis of long-term outcomes as reflected in major guidelines from 2022–2025. Current evidence suggests that RFA represents an emerging organ-preserving strategy that maintains oncologic efficacy in low-risk papillary thyroid carcinoma. Further randomized trials are required to define its role within standardized treatment algorithms.
This article discusses the need for nutritional support during radiation and chemoradiation therapy as a mandatory component of clinical nurse support. Nutritional support is a mandatory component of comprehensive therapy and can be recommended at all stages of a patient’s progression. Continuity of rational treatment and dietary management, balanced in nutritional and energy value, is essential for the successful treatment of patients with tumors, such as those of the head and neck.
Рак молочной железы остаётся ведущей причиной онкологической заболеваемости и смертности среди женщин в мире и особенно в Российской Федерации, где наблюдается тенденция к «омоложению» заболевания. Несмотря на доказанную эффективность маммографического скрининга, данный метод имеет существенные ограничения, включая вариабельность чувствительности, субъективность интерпретации и дефицит кадров. В последние годы активно развиваются технологии искусственного интеллекта, способные повысить точность и эффективность диагностики. В настоящей статье представлен анализ современных подходов к скринингу и диагностике рака молочной железы с акцентом на интеграцию систем искусственного интеллекта в клиническую практику. На основе обзора эпидемиологических данных, нормативно-правовой базы и результатов пилотных проектов в России (включая Самарскую область) показано, что алгоритмы на основе сверточных нейронных сетей обеспечивают чувствительность до 96%, снижают нагрузку на специалистов и повышают стандартизацию заключений. Обсуждаются организационные, этические и регуляторные аспекты широкого внедрения искусственного интеллекта в онкологический скрининг. Делается вывод о перспективности гибридных диагностических моделей, сочетающих машинное обучение и клинический опыт врача.
Objective. To evaluate long-term outcomes of surgical treatment in patients with locally advanced renal cell carcinoma and to identify clinicopathological factors associated with overall and recurrence-free survival. Materials and Methods. A retrospective cohort study enrolled 97 patients with stage T3a-cN0M0G1–3 renal cell carcinoma who underwent surgery at the Samara Regional Clinical Oncology Dispensary between 2016 and 2017. Clinical, morphological, and metabolic parameters were analyzed. Survival was estimated using the Kaplan–Meier method with log-rank testing for between-group comparisons. Results. Five-year overall survival was 78% and recurrence-free survival was 86%. Statistically significant adverse prognostic factors for both endpoints included: tumor size greater than 7 cm, poor differentiation (G3), tumor thrombus (particularly with inferior vena cava extension), grade III obesity, diabetes mellitus, and anemia. Patient age and side of lesion had no significant effect on prognosis; grade I–II obesity did not worsen survival outcomes. Conclusion. Risk stratification in locally advanced renal cell carcinoma should incorporate not only tumor morphology (size, grade, thrombus extension) but also the patient's metabolic profile (grade III obesity, diabetes, anemia). The identified factors may serve as a basis for individualized postoperative surveillance planning.
Background. A Russian phase IV observational study was initiated to evaluate the efficacy and safety of lenvatinib with pembrolizumab (Len-Pembro) in patients with advanced renal cell carcinoma (RCC) receiving therapy in real-world practice. This article is based on the results of the third analysis conducted with a median follow-up of 23.1 months and reflects data on the efficacy and safety of Len-Pembro in Russian patients. Aim. To evaluate the real-world efficacy and safety of Len-Pembro in patients with advanced RCC with a median follow-up increased to 23.1 months. The primary outcome of the study was progression-free survival (PFS), the secondary outcomes included overall survival (OS), progression-free survival on next-line therapy (PFS2), objective response rate (ORR), duration of response, as well as safety. Materials and methods. The study included data from 165 patients with verified advanced RCC who received Len-Pembro at 36 centers in the Russian Federation from February 05, 2018 to July 30, 2025. The median age was 60 (20–76) years, and 70.3% of the participants were male. Most patients (74.6%) presented with Karnofsky performance score of ≥80%, metachronous metastases (50.9%) of clear cell RCC (93.3%) in 1 organ (75.2%), and had not received any anticancer treatment (91.0%). The IMDC favorable prognosis group included 40 (24.2%), intermediate – 92 (55.8%), and unfavorable prognosis – 33 (20.0%) patients. The median follow-up reached 23.1 (0.5–72.9) months. A total of 110 (66.7%) patients completed Len-Pembro therapy, and 51 (30.9%) patients received next-line treatment. Results. Median PFS reached 25.8 (95% confidence interval – CI 17.0–34.5) months, 23-month PFS – 52.6%; median OS was 39.9 (95% CI 26.9–52.8) months, 23-month OS – 73.1%; median PFS2 was 33.2 (95% CI 23.4–41.1) months, 23-month PFS2 – 66.9%. The ORR was 49.1%, including 3.0% of complete responses, and the disease control rate was 89.1%. The median duration of response reached 29.7 (95% CI 24.9–34.6) months. The incidence of any adverse events (AEs) was 78.8%, severe AEs occurred in 29.1%, fatal AES – in 1.2%, immune-related AEs – 17.0%, severe immune-related AEs – 6.7%. Conclusion. In real-world practice, with increased follow-up duration, the values of PFS, OS, and PFS2 were comparable to those obtained in the registrational study, with a lower ORR and a satisfactory safety profile of the combination of Len-Pembro in advanced RCC.
