Most patients had bone malignancies 223 (86,7%) and 34 (13,2%) patients had benign bone lesions. Knee implants were made in 181 (70,4%), shoulder implants in 24 (9,3%), hip joint implants in 38 (14,8%), elbow implants in 4 (1,6%) cases. Total replacement of the upper arm was made in 1 (0,4%), total replacement of the thigh bone in 8 (3,1%) and replacement of the femoral diaphysis in 1 (0,4%) cases. Postoperative events included surgical complications (16, 6.2%), purulent inflammations 32 (12,5%), orthopedic complications 17 (6,6%). Local recurrence was detected in 25 (9,8%) cases.

III степени анаплазии) рекомендовано сочетание хирургического лечения и химиотерапии.Chondrosarcoma is the second commonest bone malignancy. Choice of treatment strategy depends upon the disease course: from slow, rather favorable to rapid, aggressive, with early hematogenic metastasis. The paper analyses experience in the chondrosarcoma treatment gained at the N.N.Blokhin CRC over the last three decades (296 cases). Surgery alone was given to 274 cases. Preservation surgical procedures were performed in 61,3% of cases. Surgery was limited to nonradical procedures in neoplastic involvement of ischial and pubic bones or a clavicle due to topographic peculiarities and technical difficulties. Recurrence rate was 33,9%, mean time to recurrence being 21.4±2.8 months. The overall 5and 10year survival rates after chemotherapy alone were 69% and 56%, respectively. 22 patients with stage 2 chondrosarcoma received surgical treatment plus adjuvant or neoadjuvant chemotherapy. The 5-year survival was 47,4%. Radical surgery is indicated in low-grade chondrosarcoma. Treatment consisting of surgery and chemotherapy is recommended in highgrade chondrosarcomas (mesenchymal, undifferentiated chondrosarcomas, chondrosarcoma with grade III anaplasia).

The Russian Cancer Research Center has experience in diagnosing and treating more than 800 patients with osteosarcoma who have been treated at the Clinic of General Oncology since 1952. Survival rates were no more than 10% before the 1970s when the only treatment was surgical. The use of adjuvant chemotherapy after radical surgery has increased survival up to 45-60%. In 1982 to 1986, a protocol involving intraarterial chemotherapy with adriamycin, 90 mg/m2, radiation therapy in a dose of 40 Gy, preserving surgery, and adjuvant chemotherapy was used to improve local and regional guidance. Survival was 55-60%. The high incidence of purulent complications prompted us to do away with radiation therapy. A protocol of neoadjuvant therapy that implies preoperative intraarterial monotherapy with cisplatin, 120-150 mg/m2, adriamycin, 90 mg/m2 or large-dose methotrexate (8-10 g/m2) was implemented in 1986 to 1998. The best results were achieved only in patients with complete tumor necrosis, among whom survival being over 70%. Preserving surgery following ineffective chemotherapy caused a high incidence of local relapses (30%). The second line of chemotherapy did not greatly improve prognosis when a histological response was slight. Complete tumor necrosis was noted only 10% of more than 150 patients so survival in the whole group was 40%. In 1998, a new protocol was initiated to improve immediate and late outcomes. Preoperatively, 3-4 sessions with adriamycin, 90 mg/m2 and cisplatin, 120 mg/m2, are performed. Postoperatively, 3 or 4 sessions of chemotherapy with the same drugs are made if there is a marked therapeutical pathomorphism. If a response is weak, 6 sessions with ethoposide, 100 mg/m2 and iphosphamide, 1.8 g/m2 during 1-5 days are given. This study has covered just 30 patients. The rate of a full histological responses has increased by 4 times. In every second patient, an amputable tumor could be made a resectable one. The proportion of candidates for preserving surgery has increased up to 90%. Intensified chemotherapy increased the incidence of severe adverse effects, primarily degrees 3-4 hematological toxicity reaching 40%. At the turn of centuries, osteosarcoma is a highly promising curable disease. The survivals of 65-70% and satisfactory functional results can be achieved only at highly specialized centers.

The paper discusses the effect of indomethacin, leukinferon as well as their combined effect on blood thromboxane B2 (TxB2) level in 40 endometrial cancer patients in the perioperative period. Perioperative treatment with indomethacin was followed by a significant decrease in blood TxB2 level before surgery and in the postoperative period. Treatment with leukinferon exerted similar effect which, however, was less pronounced than that of indomethacin. The effect was most apparent when the two drugs were combined. The influence of indomethacin and leukinferon on metabolism of arachidonic acid in tumor cells and those of the immune system of endometrial cancer patients are discussed as well possible role of eicosanoids in the pathogenetic mechanism of growth and dissemination of reproductive tumors.

The perioperative influence of leukinferon, indomethacin and their combination on the blood plasma level of thromboxane B2 (TxB2), platelet aggregation ability and humoral and cellular immunity has been assessed in 40 endometrial cancer patients. It has been found that the perioperative use of indomethacin diminishes the blood plasma level of TxB2 and platelet aggregation ability. Leukinferon did not affect substantially the parameters. However, the combination of leukinferon with indomethacin causes a more stable reduction in platelet aggregation and TxB2 level than the use of indomethacin alone. The use of these drugs and their combination prevented postoperative immune suppression in the endometrial cancer patients. However, leukinferon alone or its combination with indomethacin were more effective than the use of indomethacin alone. Possible mechanisms of indomethacin and leukinferon effect on tumor cell metabolism of arachidonic acid and possible role of eicosanoids in the pathogenetic mechanisms of tumor growth and metastasis dissemination are discussed.

Beta-endorphin release was studied in 40 patients after surgery for thyroid cancer or after femoral amputation due to malignant malformations in bones and soft tissues of the lower extremities. In thyroid surgery beta-endorphin release was more marked under neuroleptanalgesia than under combined electroanesthesia. A correlation between beta-endorphin and ACTH levels has been established. It indicates a stress nature of neuropeptide release. In patients with femoral amputation an increased beta-endorphin release was not observed. Possible mechanisms of beta-endorphin level elevation are discussed in terms of modern concepts of pain modulation.