The study of 581 patients with multiple primary malignant neoplasms of reproductive system including their genealogical data revealed that the risk of developing malignancies significantly increases in the presence of congenital defects of mismatch repair system. Mutations in mismatch repair genes (MSH2, MLH1 and MSH6) were detected in patients with multiple primary malignant tumors of the colon and reproductive system in 13 (37%) observations. It is feasible to perform DNA-diagnosis in patients with multiple primary cancers of the colon and endometrium starting with identification of mutation inMSH6 gene. All women with colorectal cancer, especially in cases where mutations in genes of mismatch repair system are present, should undergo simultaneous preventive surgery during preand menopause periods: hysterosalpingo-oophorectomy. The decision regarding the greater omentum should be based on each particular situation.
A 5-year survival of patients with Stage III colon cancer with prophylactic panhysterectomy in anamnesis was 83.3%, significantly higher than that of patients with Stage III colon cancer without panhysterectomy (69.3%) and than in colon cancer patients with metachronous ovarian metastases (42%). In families of patients with primary multiple malignant tumors (PMMT) of colon, endometrium and/or ovaries as well as in cases of accumulation in the same family of solitary tumors of the above locations it is necessary to carry out genetic testing to identify mutations in genes MSH2, MLH1, MSH6. Carriers of mutations in genes of mismatch repair MSH2, MLH1, MSH6 should be assumed to the high-risk group for the development of malignancies both PMMT of colon and organs of the female reproductive system and solitary tumors of the above locations. All women suffering from colon cancer, especially in the presence of mutations in genes of mismatch repair, in pre- and menopause should be undergone simultaneous prophylactic surgery: panhysterectomy. The question about the greater omentum should be decided situationally.
Diagnosting the correct disease stage plays an important role in predicting the individual, treatment planning and the preparation of an adequate program of medical rehabilitation. The Russian oncogynecology used several classifications: national, international clinical such as TNM and FIGO, International Classification of cancer (ICD-O) and the International histological classification (2003, Lyon). The leading factor in determining the prognosis and expertise, and the fate of the patient after treatment, is the stage of the disease, which is installed with the above-mentioned group of classifications.
Diagnosting the correct disease stage plays an important role in predicting the individual, treatment planning and the preparation of an adequate program of medical rehabilitation. The Russian oncogynecology used several classifications: national, international clinical such as TNM and FIGO, International Classification of cancer (ICD-O) and the International histological classification (2003, Lyon). The leading factor in determining the prognosis and expertise, and the fate of the patient after treatment, is the stage of the disease, which is installed with the above-mentioned group of classifications.
A major focus of the population health prevention are examinations carried out by the state, society and health. This is especially true for those branches of medicine, with high levels of morbidity and mortality such as oncology. The basic principles of clinical examination used in oncogynaecology are described in the paper.
A major focus of the population health prevention are examinations carried out by the state, society and health. This is especially true for those branches of medicine, with high levels of morbidity and mortality such as oncology. The basic principles of clinical examination used in oncogynaecology are described in the paper.
A state-, society-, public health-run follow-up of the population is one of the basic areas of disease prevention. This is particularly important for medicine sections with high morbidity and mortality rates, i. e. for oncology. The paper indicates the basic follow-up principles used in gynecological oncology.
Complex measurements of tumor markers help to improve the diagnosis of multiple primary neoplasms (MPN) significantly. For breast- ovarian MPN CA-125 was increased in 92.6 % and CA-153 — in 81.6 %. In patients with ovarian-colorectal MPN CA-125 was increased in 79.0 % and carcinoembryonic antigen — in 90.0 %.
