Aim: to develop an algorithm for selecting the optimal surgical intervention for patients with metastatic colorectal cancer complicated by obstructive intestinal obstruction. Material and methods. The study is based on an analysis of the treatment outcomes of 202 patients with metastatic colorectal cancer complicated by obstructive intestinal obstruction. The patients were divided into two groups. Group 1 included 119 patients who underwent primary tumor removal as the first stage. Group 2 included 83 patients who underwent only symptomatic drainage surgery to relieve intestinal obstruction. Results. The one-year mortality rate was 37 patients (31.1%) in Group 1 and 51 (61.4%) in Group 2. Multivariate analysis identified predictors influencing the one-year mortality rate: the number of internal organs affected by metastases, albumin/globulin ratio, Krebs index, MCV index, and the planned targeted therapy regimen. Conclusion. Based on this analysis, a step-by-step decision-making algorithm was developed to determine the indications for primary tumor removal, and a computer program was created to calculate the one-year mortality risk in patients with metastatic colorectal cancer.

BACKGROUND: Surgical advances in breast cancer contribute to improving the postoperative quality of life. AIM: The study aimed to evaluate the short-term and long-term outcomes of breast-conserving surgery. METHODS: The study included the treatment outcomes reported for 194 patients diagnosed with breast cancer who had been admitted to the Samara Regional Clinical Cancer Hospital between 2011 and 2020. Group 1 (n = 96) included patients who had undergone conventional breast-conserving surgeries. For group 2 (n = 98), a modified approach, described as “Choosing the extent of surgery for patients diagnosed with breast cancer,” was used. This technique involved the placement of the lateral adipocutaneous flap in the axillary region, with the free edge positioned as close to the nervus thoracicus longus as possible. The analysis focused on operative time and intraoperative blood loss. The disease-free and overall survival probabilities were estimated using the Kaplan–Meyer method. The patients were also asked to complete the Breast-Q questionnaire prior to surgery and six months after the treatment. The statistical analysis was performed using the parametric (Student’s t test) and non-parametric (Mann–Whitney test, chi-squared test [χ2], and Fisher’s exact test) methods. The significance level was set at p 0.05. RESULTS: The short-term surgical outcomes were not significantly different between the groups. The mean operative time was 76.3 ± 23.3 minutes in group 1 and 65.5 ± 18.3 minutes in group 2 (p 0.001), with the intraoperative blood loss recorded at 53.1 ± 26.2 mL and 49.0 ± 14.3 mL, respectively (p = 0.18). Postoperatively, persistent non-infected seroma (14 days) was identified in 19 patients from group 1 and 7 patients from group 2 (p = 0.009). CONCLUSION: The proposed method provides a significant reduction in the incidence of complications, with long-term outcomes comparable to those observed in the conventional treatment group.

The number of diagnosed melanoma cases is increasing every year, and there is an urgent need for novel screening approaches that may help in the diagnosis and prognosis of melanoma. In this study we propose to utilize conventional Raman spectroscopy for the determination of Clark level of invasion. We collected spectral data from 59 melanoma samples and achieved accuracy of 75% for discrimination of I−II vs. III−V levels of invasion. This study is the first to explore the potential of spectral analysis, utilizing Raman scattering and autofluorescence techniques, for distinguishing melanoma tissues according to their invasion level. Analysis of spectral data was performed with the application of projection on latent structures and discriminant analysis. The most significant for the model is the spectrum bands, associated with autofluorescence. The most informative bands of the Raman component for the constructed discrimination of melanoma tissues by the degree of invasion are the bands of 1385 cm−1, 1445 cm−1, 1487 cm−1, 1565 cm−1, and 1695 cm−1, associated with the presence of pigments (melanin), protein components (e.g., amide bonds, collagen), and lipid structures. The proposed approach may be useful in fast screening analysis for the determination of the best treatment plan for the patient based solely on the analysis of Raman spectra.

Introduction. Soft tissue sarcomas (STS) are quite rare malignant tumors of mesenchymal origin. The incidence is up to 2% among all malignant neoplasms. In Russia, about 10,000 new cases of STS are registered annually. For a long time, the main treatment method for patients with soft tissue sarcomas of the extremities was amputation, which led to a decrease in quality of life and disability. Currently, thanks to a multidisciplinary approach, it has been possible to develop optimal tactics in the complex treatment of patients with this pathology. The modern view on the treatment of this group of patients involves drug therapy and adequate excision of the tumor, observing the ablastic principles. A necessary condition is that the distance from the palpable edge of the tumor should be 5-8 cm. Due to this indentation, the question arises of closing extensive post-resection soft tissue defects. This aspect creates certain difficulties in the treatment of patients with tumor localization, mainly in the distal parts, such as the hand and especially the foot. The purpose of this work is to analyze the experience of using revascularized flaps in the surgical treatment of patients with soft tissue sarcomas. The study was conducted at the Center of Oncology-Orthopedics of the Samara Regional Clinical Oncology Center.Object and methods. From 2020 to 2023, our observation included a group of patients of 10 people, 6 women and 4 men, ages from 29 to 64 years. Nosological types were: spindle cell sarcoma, liposarcoma, fibrosarcoma (pT1.2a-bN0M0, GI-III, IAB, IIA-B, stage III). All patients underwent surgical interventions, which included radical removal of the soft tissue tumor and the reconstructive stage of replacing the post-resection defect using revascularized flaps on microvascular anastomoses.Results. The main advantage of the reconstructive stage using microsurgical technology is the rapid restoration of the skin, replenishment of soft tissue deficits, including thickness, the strength of the flap to perform the supporting function, the absence of trophic disorders, the absence of joint contracture, restoration of limb function in the shortest possible time. The follow-up period was 3 years. During this time, the following were noted: relapse – 0, thrombosis of the microvascular anastomosis – 0, marginal necrosis of the flap – 1, joint contracture – 0. The relative disadvantages of using this technique include: the duration of the surgical intervention, the need for simultaneous work of several surgical teams, the constant improvement of the surgeon's manual and practical technique, the labor intensity of such operations and the mandatory availability of special optical equipment and suture material.Conclusion. The use of revascularized flaps in the surgical treatment of patients with soft tissue sarcomas makes it possible to radically remove the tumor and fully replace the post-resection defect, which in turn reduces the risk of relapses and promotes restoration of limb function with a good cosmetic result.

Aim – to study own experience of treating patients with testicular cancer, to assess the overall survival rates, as well as the risk factors affecting it. Material and methods. The study included 221 patients with a newly diagnosed testicular cancer in 2007–2022. All patients underwent orchifuniculectomy with subsequent chemotherapy. Kaplan – Meier survival curves were constructed to assess the time to death from any cause and to compare factors affecting mortality. Results. The 10-year overall survival rate was 83%. Patients with left-sided tumor localization had a poorer prognosis (p0.05). The 10-year overall survival rate was 89% for right-sided localization and 79% for left-sided localization. Stages T2 and T3 significantly worsened the overall survival prognosis. The 10-year overall survival rate was 92% for T1, 85% for T2, and 68% for T3. Survival rates were higher in the N0 and N1 groups than in the N1 and N2 groups (p0.05). The 10-year overall survival rate was 100% for N0, 93% for N1, 60% for N2, and 49% for N3. Patients with M1 stage had a worse prognosis for overall survival (p 0.05). The 10-year overall survival rate in rural residents (91%) was statistically significantly different from the survival rate in urban residents (82%) p 0.05. The overall survival rate in younger patients was 97%, while in men over 40 years of age it was 86% (p0.05). Conclusions. The stage of the disease, place of residence, age, and side of the lesion are statistically significant predictors of survival in patients with testicular cancer.

Introduction. In foreign literature, a number of authors identify such anatomical structures as tubular salivary glands, which, when exposed to radiation, lead to the development of xerostomia. There are still ongoing discussions regarding this discovery and the importance of tubular salivary glands for practical medicine as a risk organ during radiation therapy. Aim. To study the morphological characteristics of the tubular glands of the nasopharynx on cadaveric material. Materials and methods. At the Samara Regional Bureau of Forensic Medicine in the simulation center, material was collected from areas of the posterior surface of the nasopharynx and histological examination of the cadaveric material was carried out. Macroscopic and microscopic examination of the autopsy material was carried out. To perform the study, autopsy fragments were subjected to alcohol wiring and embedded in paraffin blocks. Then, 3–4 transverse sections, 5–7 μm thick, were made from each block, followed by staining with hematoxylin and eosin. Results. Macroscopic and histological examination of nasopharyngeal autopsy specimens from 3 cadavers (2 fragments from each), selected randomly, showed that all 6 studied fragments correspond in structure to glandular structures and contain myoepithelial cells. Conclusions. Conducting a morphological study after autopsy confirmed the presence of glandular tissue near the tubal ridge along the posterior wall of the nasopharynx, which refers to the salivary glands.

Background. Anti-PD-1 immunotherapy (IT) is the standard of care for patients with metastatic melanoma. However, in the real world, IT is effective only in a fraction of patients. The lack of valid prognostic factors for various immunotherapy agents warrants a comprehensive and advanced study of this topic. Aim. To improve the outcomes of the first-line therapy for disseminated melanoma based on identifying immunohistochemical predictors of IT efficacy. Materials and methods. Data from 130 patients who were treated with immune checkpoint inhibitors nivolumab or prolgolimab in the first-line therapy for disseminated melanoma between 2017 and 2024 were analyzed. Results. The expression of PD-L110 on tumor cells was found to be a predictor of effective therapy: in the nivolumab group, the 2-year disease-free survival (DFS) with PD-L1 level 10% was high at 79% (95% confidence interval – CI 61–100); the 1-year DFS was 89% (95% CI 78–100) compared to 17% (95% CI 3.2–88) with a lower level of PD-L1 expression (p0.0001). In the prolgolimab group, the 2-year DFS with PD-L110% was also high at 78% (p0.0001; CI 54–100), the 1-year DFS was 94% (95% CI 84–100) compared to 35% (95% CI 17–73) with a lower level of PD-L1 expression (p0.0001). A less severe course of the disease was observed in patients with both peritumoral and intratumoral locations versus those with only peritumoral locations of the immune infiltrate. The study of the presence and form of lymphoid infiltration of the tumor showed the following direct relationship: in the nivolumab group, the 2-year DFS was 94% (95% CI 83–100) compared to 8.3% (95% CI 1.3–54), in the prolgolimab group, the 1-year DFS was 82% (95% CI 68–100) compared to 15% (95% CI 2.6–86); p0.0001. It was found that the predominance of CD8+ over CD4+ is associated with better results of IT: in the nivolumab group, the 2-year DFS was 87% (95% CI 74–100) compared to 19% (95% CI 4–91) in the absence of CD8+ predominance over CD4+; in the prolgolimab group, the 2-year DFS was 73% (95% CI 51–100) in patients with CD8+ predominance over CD4+ (p=0.0001). In patients without CD8 predominance over CD4, 2-year DFS was not achieved. The one-year DFS was 85% (95% CI 70–100) and 25% (95% CI 8.4–76), respectively; p=0.0001. Conclusion. The results of the study suggest that immunohistochemical characteristics such as a PD-L1 expression level 10%, the simultaneous presence of peri- and intratumoral lymphoid infiltration of the tumor, the ratio of the intensity of lymphoid infiltration with tumor-infiltrating lymphocytes (TILs), and the predominance of CD8+ over CD4+ can be considered predictors of IT efficacy with nivolumab and prolgolimab.

BACKGROUND: Diagnosis and treatment of patients with colorectal cancer is a multidisciplinary task. The transition to a new edition of clinical guidelines for the treatment of colorectal cancer in 2024, while maintaining the routine approach to MR staging of malignant neoplasms of this localization, reduces the level of continuity between medical specialists. AIM: To improve the quality and completeness of MR diagnostics of malignant neoplasms of the rectum to ensure continuity and improve the multidisciplinary approach. MATERIALS AND METHODS: A retrospective analysis of the completeness of compliance with the parameters of TNM 8 (2017) and the MRI subclassification T3 of rectal cancer was carried out on 137 MRI scans of the pelvic organs and protocols with conclusions to them. Based on the results of the analysis, educational training and a conclusion template for radiologists were developed and conducted, after which the MR images were re-evaluated. Before and after the training, the most fully evaluated MRI scans by radiologists were provided to medical experts to form a “second opinion”. The results obtained made it possible to calculate the absolute and relative number of consensuses (coinciding in all parameters of the conclusions) and to identify cases of rectal cancer restaging that require changes in treatment tactics. RESULTS: Before the educational training, only 11% of MRI scans and their reports met the requirements of the modern protocol. After the training, 78% of the images were completed in compliance with all requirements. Particular difficulties and the majority of “discrepancies” in conclusions arose when determining the depth of tumor invasion into the mesorectal tissue; measuring the distance from the tumor and/or affected lymph node to the mesorectal fascia or edge of the levator ani muscle and identifying signs of extramural vascular invasion. It was not possible to achieve complete consensus in all cases on these parameters. CONCLUSION: The analysis of MRI scans of the pelvic organs, the development and implementation of educational training to improve the interpretation of medical images, made it possible to significantly improve the staging of rectal cancer and ensure proper continuity in the implementation of a multidisciplinary approach.

The paper is devoted to the identification of skin tumors and interpretation of their component composition based on multidimensional analysis of Raman scattering spectral data and dermoscopic images. The dataset contains 65 samples of malignant melanomas, 107 seborrheic keratoses, and 166 nevi. The multivariate curve resolution alternating least squares analysis was performed for the Raman spectra to extract spectral profiles of main skin components and their composition. The obtained biochemical profiles of skin neoplasms were analyzed by the gradient boosting method. Dermoscopic image analysis was performed using a convolutional neural network with modified Visual Geometry Group 16-layer model architecture. Joint analysis of component and spatial features was carried out using logistic regression of the predicted values of a model based on Raman spectra and a model based on image analysis. As a result, a binary model for the classification of malignant melanoma and pigmented benign neoplasms was constructed, showing an area under the receiver operating characteristic of 0.94 (0.90−0.98) with 95% confidence interval. Combining spatial and Raman spectra derived component features makes it possible to increase the efficiency of diagnosing skin cancer.

BACKGROUND: Improving the strategy of surgical treatment of breast cancer is an important and urgent task for a physician at the present stage. АIM: To evaluate the immediate results and quality of life indicators of patients using the two-stage reconstruction technique with symmetrizing operations. MATERIAL AND METHODS: The retrospective study included the results of treatment of 126 patients with a diagnosis of breast cancer in the Samara Regional Clinical Oncology Dispensary in the period 2018–2022. Patients of the comparison group (n=72) underwent two-stage reconstruction with an expander, 54 patients of the main group — two-stage reconstruction with the performance of a symmetrizing operation. Patients from the comparison group and the main group were comparable in age, disease stage, biological subtypes of the tumor. Before the operation, at an appointment with an oncologist, the quality of life indicators’ assessment of patients of both groups was performed using the SF-36 questionnaire (which did not differ statistically significantly), then these parameters were assessed 6 months after the operation. Statistical processing of the obtained results was carried out using parametric (Student's t-test) and nonparametric (Mann–Whitney test, χ2 test and Fisher's exact test) methods. The significance criterion in the study was p 0.05. RESULTS: The immediate results of surgical treatment in the compared groups did not differ statistically significantly: the average operation time in the control and main groups was 125±25 and 153±33 min, respectively (p=0.874); intraoperative blood loss reached 50±17 and 65±21 ml (p=0.347); the duration of postoperative lymphorrhea was 12±4 and 14±3 days (p=0.621); postoperative bed-day was 12±2 and 13±3 days (p=0.541), respectively. According to the scale of physical condition, social functioning, psychological health and vital activity, assessed by patients using the SF-36 questionnaire by means of a survey, after 6 months, women who underwent two-stage reconstruction with symmetry surgery had a statistically significant advantage: in the control group, according to the scale of physical condition — 47.51±10.72 points, in the main group — 72.34±12.63 points (p=0.041); according to the scale of social functioning — 42.42±19.81 and 78.12±14.23 points (p=0.003); according to the scale of mental health — 44.31±21.32 and 81.42±8.81 points (p=0.008); according to the vital activity scale — 59.12±13.57 and 65.21±18.24 points (p=0.026), respectively. CONCLUSION: Patients of the main group 6 months after the symmetrizing operation have better quality of life indicators compared to the comparison group.

Introduction. Recent decades indicate a significant increase in the incidence of skin cancer. Aim. To upgrade the specialized device and to improve the quality of skin neoplasm diagnostics. Materials and methods. The study mainly involved the method of non-invasive differential diagnostics of skin neoplasms. The method relies upon optical research methods, including Raman spectroscopy, a spectroscopic technique. A 10-year study, conducted by the Department of Oncology, the Samara Regional Clinical Oncology Dispensary (SOKOD), included more than 500 observations. The study used samples of various skin neoplasms obtained during surgical treatment of patients. Experimental tests provided a certain spectrum of various benign and malignant human skin neoplasms, including melanoma. Results. A series of experimental tests resulted in an experimental setup that is absolutely safe to use. Discussion. The study involved comparison of individual characteristics of the Raman spectra, obtained in the examination of neoplasm and healthy skin for each patient, thereby individualizing the method. The study revealed a high accuracy rate of 92% (with sensitivity of 89%, specificity of 93%), thus minimizing risks of false negative results, which is essential for mass examination. Conclusion. Since the proposed device setup does not require consumable products and different reagents, the method is marked with lower time costs and maintenance burden. Raman spectroscopy obtains a significant potential, thus, can be widely used for skin neoplasms in various medical and preventive institutions.

Aim – assessment of the effectiveness of complex therapy to reduce the development of early cardiovascular complications. Materials and methods. Information from medical histories and outpatient follow-up cards of 139 patients with invasive breast cancer was analyzed: in the G.V. Bondar Republican Cancer Center 64 patients (main and control groups); as an additional comparison group, the study included 75 patients of the Samara Regional Clinical Oncology Dispensary. Patients in the control group (33 people) and the Samara Regional Clinical Oncology Dispensary group (75 people) received standard therapy (RUSSCO, recommendations, 2023): doxorubicin 60 mg/m2 IV on day 1 + cyclophosphamide 600 mg/m2 IV on day 1 Day 4 – 4 courses. In 31 patients of the main observation group, in addition to similar drug treatment, in order to prevent the development of early cardiovascular complications, the method was used, which included 7 courses before the start of 1 cycle of chemotherapy + 3 courses of interval normobaric hypoxic therapy (INHT) before the start of each subsequent cycle of chemotherapy. Results. When analyzing the total effectiveness of treatment between the groups of patients, statistically significant differences were obtained: the control and main groups were compared (χ2=5.4, p=0.03), the group of the Samara Regional Clinical Oncology Dispensary group and the main group (χ2=3.45, p=0.076). Conclusions. Hypoxic therapy significantly affects the quality of life of patients. For all indicators reflecting quality of life, traditional treatment was inferior to combination drug therapy with INHT.

Improvement of the multidisciplinary approach to the treatment of rectal cancer over recent years has led to the fact that in specialized high-volume oncology clinics it is possible to achieve a complete pathomorphological response to neoadjuvant therapy in a third of patients. The emergence of new knowledge about the development of tumor complete response and the accumulation of clinical experience opens up possibility for the wider use of an organ-sparing approach. Undoubtedly, making such a critical strategic decision requires reliable and effective tools for complete response predicting. This review is devoted to methods for assessing tumor response in patients diagnosed with rectal cancer. A look at the problem is presented from the perspective of modern methods of medical imaging, molecular and genetic studies, the study of the characteristics of the immune response, and a new look at clinical data. New data can form the basis for new patient selection algorithms for personalized treatment protocols for rectal cancer, thereby improving long-term results and quality of life for patients.

В данной статье рассматриваются инновационные методы обучения студентов и молодых онкологов, которые внедряются в ВУЗах РФ. Целью является обобщение текущих изменений в дидактике в России для использования инновационных методов обучения молодых врачей. В статье раскрыты актуальные проблемы внедрения, развития и использования в учебном процессе инновационных методов обучения.

Aim to compare the results of vacuum aspiration biopsy (VAB) and sectoral resection in the treatment of benign breast tumors. Material and methods.During the study we compared the results of treatment in two groups of patients. The main group included 50 patients (mean age 54.830.934 years) who underwent VAB, the control group comprised 55 patients (mean age 55.7041.998 years) who underwent sectoral resection. Before the surgery, a tumor biopsy was performed with the following cytological and histological examination. The diagnosis of fibroadenoma was predominant. After the operation, a histological analysis of the received preparations was done. We assessed the immediate postoperative results, such as: blood loss, operation time, intensity of pain syndrome, bed-day number, quality of life after the operation. Results.The duration of surgery was significantly lower in patients with VAB than in patients with sectoral resection (p=0.000). The blood loss after surgery did not differ significantly (p=0.921) and did not exceed 10 ml in both groups. The groups under study were comparable according to the results of the histological examination (Student's t-test was 0.501, p=0.651). In each group, the pain syndrome was assessed in the postoperative period according to a 10-point pain scale after 3 hours, 8 hours, 24 hours, 3 days, 5 days and 10 days after surgical intervention. In the VAB group, the scores were significantly lower, p=0.000. The average number of bed-days in patients of the control group was 10.322.814, in the main group 1 day, the difference was statistically significant (p=0.000). The frequency of possible complications (hematoma, seroma, infection, deformity of the mammary gland, residual masses after removal) was significantly lower (p=0.013) in patients of the main group. When assessing the life quality of patients after surgery with the MOS SF-36 questionnaire, we found that the indicators were significantly higher in patients of the VAB group (Psychological Health Scale p=0.008, Social Functioning Scale p=0.003, Physical Condition Scale p=0.041).

BACKGROUND: Surgery is the only treatment option for tumors of the head and tail. To date, the most optimal operations used for tumors of the head of the pancreas are gastro-pancreatoduodenal resection, and for tumors of the tail — distal subtotal resection of the pancreas and splenectomy. The main access for these operations is median laparotomy. In our article, we analyze the surgical interventions that have been performed for pancreatic cancer in our center, Samara Regional Clinical Oncological Dispensary. AIM: Analysis of surgical interventions for pancreatic cancer in the Samara Regional Clinical Oncological Dispensary to assess the immediate and long-term results of surgical treatment. METHODS: This article presents the results of treatment of 236 patients with pancreatic cancer in the Department of abdominal Oncology of the Samara Regional Clinical Oncology Dispensary from 2018 to 2023. Most patients underwent surgical interventions, including choledochal stenting, bile duct drainage, and cholecystostomy. In inoperable or unresectable processes, palliative surgery was performed, such as the formation of cholecystoenteroanastomosis and gastroenteroanastomosis. Most of the patients underwent radical surgery, and some of them were preceded by neoadjuvant polychemotherapy. In the postoperative period, various reconstruction methods were performed, including the formation of pancreato-gastro-anastomosis and pancreatoejunoanastomosis. Combined operations were also performed in some patients with tumor invasion of adjacent organs. RESULTS: The medical records of 99 patients who underwent radical surgery were examined. 30 of them had significant clinical complications according to the Clavien–Dindo classification and included pancreatic fistula, failure of pancreatoejunoanastomosis, failure of pancreato-gastro-anastomosis and subhepatic abscess. All patients underwent laparotomy, sanitation and drainage of the abdominal cavity, and continued treatment in intensive care units. Some patients required a relaparotomy to stop intra-abdominal erosive bleeding. The mortality rate was 12.02%, the cause of death in some cases was the failure of pancreatoenteroanastomosis together with pancreatic fistula and cardiopulmonary insufficiency caused by pulmonary embolism. The patients were divided into four groups depending on the operation performed. Mortality after distal subtotal pancreatic resection was 2.02%, after. CONCLUSION: Surgical intervention is the main method of treating pancreatic cancer. Radical surgery is a key factor that affects the prognosis of the disease. However, the lack of verification of pancreatic cancer before admission to the hospital does not allow chemotherapy to be performed in the mode of preoperative treatment for a common form of the disease. In about 70% of patients, the syndrome of mechanical jaundice becomes the first manifestation of the disease, which requires additional methods of diagnosis and treatment. The complexity of the operation lies in the proximity of the pancreas to vascular structures. Most patients are already inoperable at the time of diagnosis confirmation due to the spread of the tumor process. Due to the technical complexity of operations, the high number of complications and high postoperative mortality, treatment of pancreatic cancer should be carried out in large specialized centers. The treatment of the disease requires interdisciplinary cooperation to achieve optimal diagnosis.

Aim to propose a schematic design of a new prototype having a potential for mass production and use in medical institutions for routine diagnostics of skin neoplasms. Material and methods. The study included more than 600 patients with various skin neoplasms. We studied the samples of various skin neoplasms obtained after surgical treatment in the departments of the Samara Regional Clinical Oncology Center. For this purpose, we used the proposed original experimental device for Raman laser spectroscopy. The received signal was processed with a designed algorithm using artificial intelligence. Results. The proposed diagnostic method reached the 89% sensitivity and 93% specificity proving to be effective. As a result, we have substantiated the technological possibility of creating a portable cost-saving spectroscopic technique with a neural network classifier. The device allows to perform preliminary diagnostics without the involvement of a specialist doctor and is devoid of subjective analysis criteria.

BACKGROUND: This article offers detailed information about the surgical treatment of pancreatic cancer, based on the experience of the abdominal department of Samara Regional Clinical Oncological Dispensary (Samara, Russian Federation). This allows readers to familiarize themselves with the achievements and innovations in this field, to get information about constantly improving surgical methods and their effectiveness. Such information can help not only patients, but also medical professionals, including surgeons, to improve the quality and effectiveness of operations. The article also includes an overview of the main methods of diagnosing pancreatic cancer, which can help specialists identify the disease at an early stage and improve their working methods. It provides up-to-date information on the diagnosis, treatment and prognosis of pancreatic cancer, which can help improve treatment outcomes and prolong the survival of patients suffering from this disease. AIM: Analysis of the state of oncological care for patients with pancreatic cancer in the Samara region over the past 5 years. METHODS: The results of treatment of 236 patients with pancreatic cancer operated in the department of abdominal oncology of the Samara Regional Clinical Oncology Dispensary in the period from 2018 were studied. RESULTS: According to the results of treatment, pancreatic cancer stage IA was established in 9.74% of patients (n=23), stage IV — in 5.89% (n=14), stage IIA — 12.71% (n=30), stage IIB — in 12.71% (n=30); stage III — in 23.30% (n=55), stage IV — in 35.59% (n=84) of patients. Of the 76 patients with initially unresectable tumors, 12 received neoadjuvant chemotherapy according to the FOLFIRINOX scheme, which allowed them to perform radical surgery. The average age of the patients was 62.2 years. The overall survival rate in the entire group of patients was 20 months. It is interesting to note that in the group of patients with stage III, the 1-year survival rate was 20.53%, which is lower than in the group of patients with stage IV (25.59%). Most likely, this is due to postoperative complications and mortality in patients with stage III who underwent radical treatment (while patients with stage IV underwent gentle palliative surgery). CONCLUSIONS: Pancreatic cancer is a complex disease that requires an interdisciplinary approach to achieve the necessary diagnosis and develop optimal treatment tactics. Radical surgery is disabling, but remains the only treatment option for pancreatic cancer, which determines the patient’s life prognosis. The results of gastropancreatoduodenal resection are characterized by a significant frequency of postoperative complications (34.38%), with a high rate of postoperative mortality (20.93%). Unsatisfactory results of surgical treatment of pancreatic cancer indicate the need to develop more effective methods of complex treatment. The lack of verification of pancreatic cancer at the prehospital stage in the majority of patients (84.6%) does not allow chemotherapy treatment in the neoadjuvant mode for locally advanced forms, which dooms patients to diagnostic surgery. As a result, valuable time is lost, which calls into question the well-being of such patients. The development of new, more effective diagnostic methods at the outpatient stage will solve this problem.

Background. Breast cancer in many cases becomes the main cause of deterioration in the quality of life of patients due to the presence of severe postoperative asymmetry.Аim. To compare immediate and long-term results, quality of life indicators and cost-effectiveness in the treatment of patients diagnosed with breast cancer using an endoprosthesis and lipofilling reconstruction. Material and methods. A prospective study of the treatment results of 72 patients diagnosed with breast cancer was carried out. Patients in the control group (n=40) underwent subcutaneous mastectomy with endoprosthesis plastics. Patients of the main group (n=32) underwent subcutaneous mastectomy with primary reconstruction by lipofilling. The calculation of indicators characterizing the efficiency of the use of hospital beds of a medical institution was carried out, the number of cases and days of temporary disability was calculated, an analysis of economic costs was made based on the tariff for a completed case of treatment of the disease. All statistical analyzes were performed using the Statistica 10.0 software. The study established a significance test of p 0.05. Results. In the compared groups, the immediate results of surgical treatment did not differ statistically significantly (p=0.973), while the quality of life in patients after subcutaneous mastectomy with plastic lipofilling was significantly higher on the social functioning scale (0.004) than after reconstruction with the use of an endoprosthesis. When using the method of reconstruction with the use of lipofilling, it was possible to statistically significantly reduce the length of stay of patients in the hospital. Conclusion. The use of lipofilling as a new method of reconstruction in patients diagnosed with breast cancer allows maintaining significantly high quality of life indicators on the scale of social functioning in comparison with the group of patients who underwent reconstruction with an endoprosthesis, and also makes it possible to significantly reduce the economic costs of treating patients.

In Samara region colorectal cancer has taken a leading position in the structure of the incidence of oncological diseases in recent years. The aim of the study is to optimize preventive work in the region aimed at preventing the development of colorectal cancer and improving the detection of this disease at early stages. Material and methods. In addition to the activities provided by the program of dispanserisation of the adult population, the oncological service of the region proposed a number of organizational solutions: the program «Men’s health» was introduced, the target audience of which was men 40-60 years old; the programs of examinations at manufactures and offices of the region, carried out by the regional center of pathology associated with the profession, have been optimized; active educational activities are carried out by the department of medical prevention of the regional oncological center. Results. The introduced approaches allowed increasing the coverage of the population with preventive examinations and increasing the number of patients with diagnosed colon polyps. Extremely important is the work aimed at shaping the ideology and motivation of the population to actively maintain health.