Aim: to identify patterns of lung cancer incidence in the population of the Republic of Tatarstan and its dependence on air pollution and the cyclicity of solar activity. Material and methods. The following data were used as initial data: data on lung cancer incidence available in the cancer registry of the Republican Clinical Oncology Dispensary of the Ministry of Health of the Republic of Tatarstan for the period from 2012 to 2021; data on emissions into the atmosphere and concentrations of carcinogens in the atmospheric air, available in the State reports “On the state of the natural environment of the Republic of Tatarstan” of the Ministry of Ecology and Natural Environment of the Republic of Tatarstan. Results. The study demonstrated a high degree of correlation between the comprehensive index of air pollution with carcinogens (IAPc) and the incidence of lung cancer in the population (r=0.79 at the level of α=0.05). To identify the relationship between the solar activity and the incidence of lung cancer, a statistical analysis of the long-term incidence rate of the population and the level of solar activity was carried out using the relative number of sunspots (Wolf number, W). The correlation factor between W and the incidence of lung cancer is significant at α=0.05, the value being r=0.72, which indicates a noticeable strength of the relationship between the studied indicators. Conclusion. Improving the monitoring system, monitoring the state of the external environment, and measures to prevent air pollution will help reduce the incidence of cancer, including lung cancer.

Abstract Introduction Colorectal cancer (CRC) with synchronous liver metastases remains a challenging issue in modern oncology. Minimally invasive simultaneous surgical interventions are increasingly recognized as an effective approach for treating this patient category. Objective To describe a clinical case of laparoscopic simultaneous surgery for rectal cancer with a solitary liver metastasis. Materials and Methods A 53-year-old male patient diagnosed with rectal cancer (T3N1M1, stage IV) and a solitary liver metastasis underwent treatment at the Republican Clinical Oncology Dispensary named after Professor M.Z. Sigal. The diagnostic stage included video colonoscopy, MRI, and contrast-enhanced CT, confirming locally advanced rectal cancer and a metastatic liver lesion in segment IV. The patient underwent a simultaneous nerve-sparing laparoscopic-assisted intraperitoneal resection of the rectum combined with left-sided hemihepatectomy, including resections of segments V and VIII of the right lobe of the liver. Results The surgery was performed successfully without intraoperative complications. Blood loss amounted to 350 mL during the liver resection stage and 30 mL during the rectal resection stage. The postoperative period was uneventful: early mobilization was achieved within 24 hours, and full recovery of motor activity occurred within 30 hours. The patient was discharged on postoperative day 11. Postoperative histological findings revealed high-grade rectal adenocarcinoma invading the submucosal and muscular layers with fat tissue involvement (pT3). No tumor cells were found in 14 examined regional lymph nodes. The liver lesion was identified as a metastatic adenocarcinoma of intestinal type, with tumor-free resection margins (pT3 N0 M1, stage IV). Conclusion This case demonstrates the effectiveness of laparoscopic access in performing simultaneous surgeries for CRC with synchronous liver metastases. Further research in this area will help better define the role of laparoscopy in simultaneous oncological surgeries.

BACKGROUND: Prognostic assessment of survival in patients with cancer is essential for guiding treatment strategies, particularly in gastric cancer, which is associated with high morbidity and mortality. AIM: The study aimed to evaluate the association between inflammatory response markers and survival outcomes in patients with gastric adenocarcinoma. MATERIAL AND METHODS: The study included 152 patients with histologically confirmed gastric adenocarcinoma. Patients were distributed by stage as follows: 25 (16.45%) with stage I, 25 (16.45%) with stage II, 34 (22.4%) with stage III, and 68 (44.7%) with stage IV disease. Inflammatory response parameters were collected, calculated, and evaluated. The resulting data were analyzed and compared to identify statistically significant associations with overall survival. The inflammatory response parameters included the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), as well as two specific indices, systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI), which reflect the activity of inflammatory response in cancer patients and may serve as additional independent prognostic factors. The Mann–Whitney U test was used for two-group comparisons and the Kruskal–Wallis test for comparisons across more than two groups. Spearman’s rank correlation coefficient was used to assess the relationship between inflammatory markers and overall survival. Statistical analysis was performed using MedCalc version 20.104. RESULTS: No significant associations were observed between inflammatory markers and patients’ age or sex. All inflammatory markers were significantly associated with overall survival (p 0.001 for NLR, PLR, SII, and SIRI; p = 0.013 for MLR). Elevated levels of these markers correlated with shorter overall survival and a higher probability of stage IV disease. CONCLUSION: Changes in hematologic markers reflecting systemic immune inflammation and inflammatory response are significantly correlate with survival outcomes in patients with gastric cancer.

In the Russian Federation, the prevalence of bladder cancer is increasing from year to year. Currently, the problem of urine drainage after radical cystectomy is urgent. The most optimal medical, social and psychological rehabilitation in such patients is provided by orthotopic plastic surgery of the bladder. At the same time, it is necessary to use the terminal sections of the ileum. The article presents overview data on the key points of the creation of the neobladder, historical information on the development of techniques for creating a urinary reservoir, various methods of creating neocystis from the ileum. Data on the advantages and disadvantages of certain techniques are presented.

Introduction. Recent studies have led to the conclusion that gender is an important factor influencing the prognosis of survival of patients with colorectal cancer. Aim. To analyze 5-year overall survival rates in patients with colorectal cancer of different sexes and in different age groups. Materials and methods . The study included 1593 patients, of whom 720 were men (45.2 %) and 873 women (54.8 %). Patients were divided into 3 age groups: under 50 years, 50–70 years and over 70. Overall survival rates were calculated, followed by comparison between groups of patients, taking into account gender and stage of the disease. Results . Analysis of treatment results taking into account a gender approach showed that the prognosis of the disease was most favorable in women. With approximately the same 5-year survival rate in men and women (54.9 and 52.7 %), this indicator correlated with the age of the patients and was significantly better than in men in the group of patients under 50 years of age. Conclusion . The identified gender and age characteristics in the development and course of colorectal cancer are relevant for oncologists when choosing diagnostic, treatment and rehabilitation strategies.

Relevance . Adenomatous colorectal polyps are associated with a high risk of developing a malignant tumor. They are considered precancerous conditions and can lead to the development of colorectal cancer. To date, colorectal cancer ranks third in the world in frequency of occurrence among all malignant neoplasms. Objective . Improving the results of diagnosis and surgical treatment of patients with colorectal adenomatous neoplasms by identifying development factors and identifying risk groups for this nosology. Materials and methods . Analysis of literary data. Results. Among the factors leading to the development of colorectal polyps, it is worth noting a genetic predisposition, so by immunoblotting, PCR sequencing of the entire exome in cases of patients with familial dentate polyposis, rare variants of the germ line in the WNK2 gene were identified. Functional studies have shown that variants of the WINK2 germ line affect protein function in the context of the MAPK pathway, a molecular trait of this disease. Also, in the course of many domestic and foreign randomized clinical trials, the following modifiable factors for the development of adenomatous colorectal polyps were identified. Conclusion. The study revealed the factors of development and recurrence of colorectal neoplasms and identified risk groups for this nosology. The study revealed low compliance of patients with respect to changes in certain living conditions (the use of ethyl alcohol and products containing it, tobacco smoking, both active and passive, the fight against obesity and inactivity), which leads to recurrence and increases the risks of malignancy of colorectal polyps.

With each passing day, medicine strives to become more personalized, centered directly on the patient. A significant aspect of this dynamic involves the consideration of patients' gender, which influences their physiology, the pathogenesis of developing diseases, and their response to treatment. Historically, most research has been conducted on male cells, male mice, and men, with women of childbearing age often excluded from studies for their safety. It was assumed that female cells were identical to male cells, leading medical research to be predominantly focused on male physiology. However, this approach was fundamentally flawed, as individuals of different sexes differ in terms of epidemiology, pathogenesis, clinical manifestations, disease progression, and responses to treatment. Knowledge of these gender-specific characteristics can aid clinicians in their patient management. This literature review aims to examine the peculiarities of cancer progression in men and women, specifically in the cases of stomach and colorectal cancer.

AIM: to highlight modern methods of assessing the viability of the intestinal wall. MATERIALS AND METHODS: the search was made using electronic databases. We explored multiple sources, including, but not limited to, monographs, journal articles, books and websites. RESULTS: despite recent advances in scientific methods and technologies, currently the visual method remains the most popular for assessing the viability of the intestinal wall, which includes parameters such as color of the intestinal wall, peristalsis, and arterial pulsation. CONCLUSION: it would be fair to conclude that such methods as hyperspectral imaging, multimodal coherent tomography provide greater flexibility and details on the intestinal viability. However, further research is needed to determine their value in clinical practice. To the date, the most studied and applied method is fluorescent angiography, which allows to assess the viability of the intestine for most of its length.

Ovarian cancer is the sixth most common cancer in women. The overall 5-year survival rate for ovarian cancer is approximately 40% due to the fact that most cases are diagnosed at late stages. Detection of ovarian cancer at the earliest possible stages is a public health priority. The article provides a review of existing scientific data regarding the early detection and screening of ovarian cancer, based on an analysis of publications in international electronic databases. Screening strategies are most effective for detecting diseases in their early stages, but at the moment there is no standard instrumental method that could be recommended as a screening examination for detecting ovarian cancer at an early stage. In this regard, most researchers have switched to the field of biomarkers and their combinations. Currently, more than 200 tumor markers, which are produced with varying intensity in ovarian cancer, have been proposed, but only two of them, CA-125 and HE4, have been tested in clinical experience. The article highlights the role of new tumor markers, multimarker panels, longitudinal algorithms in the early diagnosis of ovarian cancer. Most of the studies on the early diagnosis of ovarian cancer is aimed at searching for new biomarkers or developing multimodal algorithms that include both tumor markers, free deoxyribonucleic acid, and ultrasound of the pelvic organs. However, there are still no convincing data on mortality reduction based on randomized controlled trials, which stops doctors from including one or another strategy for the early diagnosis of ovarian cancer in national protocols and/or recommendations as a screening examination.

Colorectal cancer (CRC) is one of the main problems of modern oncology due to the high incidence and significant mortality in Russia and other countries. This disease can be considered as a marker of the socio-economic development of the regions. In this regard, it is relevant to study the quantitative and qualitative assessment of environmental factors and, above all, air, on the risk of CRC in the conditions of the active influence of human activities on the environment. Purpose of the study — to determine patterns of formation of the incidence of colorectal cancer in the population of a large industrial region, depending on air pollution. Material and methods. To achieve this goal, the incidence of CRC was studied in a large industrial region — the Republic of Tatarstan (RT), depending on the level of air pollution. Results. Analysis of the study shows that a high incidence of colorectal cancer was found in Kazan, as well as in 11 municipal districts of the Republic of Tatarstan. A strong upward trend in the incidence of colorectal cancer was observed in Kazan and Naberezhnye Chelny, as well as in 10 municipal districts of the Republic of Tatarstan. A significant effect of harmful emissions into the atmosphere on the incidence of malignant neoplasms of the rectum and colon has been established. Conclusion. Studies conducted in the Republic of Tatarstan on the dependence of the incidence of CRC on the complex effects of polluted atmospheric air confirm the position on the formation of a high level of incidence of this pathology in an unfavorable environmental situation.

Relapses in the anastomosis region are one cause of the unfavourable remote results in the treatment of the colorectal cancer. This is connected with the fact that the tumor boundaries determined by palpation and visually do not always coincide with true ones. The tumor infiltration in some cases is found only in urgent planned examination. In this connection in cancer revealing, its localization, its spreading degr^ are of importance. The use of the reverse transillumn national endoscopy during gives the operation such possibility.

Aim to find the main causes of the lateral conical defects formation in obese patients after radical mastectomy for breast cancer. Material and methods. We analysed prospectively 82 breast cancer patients with various degrees of obesity. The patients were randomized into two groups. In the main group (43 patients), the original RME method (RU patent No. 2748639, dated May 28, 2021) was used; in the control group (39 patients), the standard RME method was applied. Results. The use of a standard elliptical incision for RME in obese patients leads to the formation of lateral conical defects, the frequency of which reaches 74%. There is a high correlation between the frequency of formation of lateral conical defects in radical mastectomy with expansion of the breast base (Spearman index 0.85 (p0.05), chest circumference (Spearman index 0.92(p0.05), fat pedicle thickness (Spearman index 0.94 (p 0.05) and degree of mammoptosis (Spearman index 0.98 (p 0.05).

The cancerous situation in Tatarstan Republic, in particular, the data on the disease incidence, mortality are estimated. The data on the content of some toxic substances in environment are analyzed. The necessity of studying the role of anthropogenous factors in population health formation is emphasized. The use of geochemical investigation methods in medicine is necessary to solve the topical problem to reveal the relation between environmental pollution and growth of the malignant tumor incidence.

The purpose of the study: to develop an expert system based on the construction of a «decision tree» for predicting the 5-year survival rate of patients with colorectal cancer.Material and Methods. T he study included 654 patients with colorectal cancer (CRC) who were treated from 2013 to 2015, including 434 men and 220 women. The average age of patients was 64,1 ± 10,2 years. All patients underwent genetic analysis for the presence of a mutation in the K-ras gene from the primary tumor.Results. For the Republic of Tatarstan, there are regional features of mutation of the K-ras gene: the frequency of mutations in tumors in men was less frequent (20.3 %) than in women (37.7 %), in patients of Slavic nationality, mutations were slightly more frequent – 39 % than in Tatars – 21 %. The gender approach to assessing long-term treatment results showed that in men with colorectal cancer, the most favorable treatment results were observed in patients with tumors in stage T1–2N0M0, regardless of the differentiation of the tumor and its mutational status. Low-grade tumors with any T should be considered prognostically unfavorable in men, with the presence of regional metastases and mutation of the K-ras gene, even in the absence of distant metastases: no patient lived 5 years. Based on the construction of a «decision tree», the most favorable treatment results were observed in female patients with tumors in stage T1–2–3N0M0 at the age of 70 years (5-year survival rate of 90 %), with tumors T1–2N0M0 at the age of 70 years (5-year survival rate of 81.8 %), regardless of the tumor differentiation and its mutational status. Tumors of any differentiation are prognostically unfavorable for women of the T3–4N0 stage with the presence of distant metastases (6 % of patients lived 5 years) and lowdifferentiated stage T4N0M0 tumors (5-year survival rate of 8 %).Conclusion. G ender- and age-associated features of the development and course of CRC are relevant for oncologists to choose effective diagnostic and therapeutic measures.

Aim. To conduct a comparative analysis of the microbiome of biopsies of a tumor and normal intestinal epithelium of patients diagnosed with colorectal cancer and to identify of functional activities of the obtained bacterial isolates that affect the development of the tumor. Methods. The study included 50 patients with malignant neoplasms of the colon: 36 men and 24 women. The mean age of the patients was 64.110.2 years. To analyze the microbiota of the biopsies, DNA samples were obtained from the tissue of the unaffected colon mucosa and tumor of the patients. Bacterial 16S rRNA genes fragments were amplified using bar-coded primer bakt_341f. Metagenomic next-generation sequencing was performed using the MiSeq platform (Illumina, USA). The obtained data were processed by bioinformatic methods using the QIIME package. Recognition of microorganisms depending on the morphotype and gram staining of the microflora was carried out using combination differential media and biochemical tests. Statistical analysis was carried out using Microsoft Excel, Service Pack 2 for Office XP, Statistica 6.0 (StatSoft). A comparative analysis was performed with the Student's t-test and the MannWhitney test in case of unmet conditions of validity. Alpha diversity of bacterial communities was quantified by the Shannon diversity index and the UniFrac distance for beta diversity analysis. Results. In patients with colorectal cancer, 5 bacterial phyla were isolated, the predominant of which were Firmicutes and Bacteroidetes, while the content of Actinobacteria was low. In addition, a higher number of representatives of Fusobacteria was observed in the tumor tissue compared to the tissue of a healthy mucosa, at a distance of 5 centimeters proximal to the tumor. The results of this study indicate that the microbiome of a tumor and a healthy mucosa fundamentally differ from each other not only in morphotype and gram staining but also in antagonistic, hemolytic and ribonucleolytic activities. Conclusion. Colonization of the tumor by dominant aggressive Gram-negative bacteria leads to significant changes in the tumor microbiome composition compared with normal mucosa, whose representatives are displaced from the damaged epithelium by more aggressive strains.

The article presents a clinical observation of a patient with ovarian cancer, stage IIIA according to FIGO (International Federation of Obstetrics and Gynecology), after completing the first-line combination therapy for whom we determined the risk of recurrence using a special software. The early prediction of the ovarian cancer relapse was based on calculated ARRNO index (Assessment of Risk of Relapse of Neoplasm of Ovary). As initial data the following characteristics were inserted into the program: disease stage according to FIGO, tumor differentiation stage (Grade), hystotype, state of residual tissue on ultrasound examination after the treatment, levels of СА-125 before the treatment, levels of НЕ-4 after the treatment. The ARRNO software calculated the individual risk of relapse in 3 limits: low (0 - 0,39), moderate (0,40 - 0,85) and high (0,86 - 1,0). Conclusion. The special software for assessing the risk of relapse of ovarian neoplasm proved to be simple to operate and allowed to predict the relapse with high probability.

Objective - to identify the gender-specific features of modeling the prognosis of treatment outcomes for patients with colorectal cancer (CRC). Materials and methods. The study included 654 patients with colorectal cancer (CRC) who were treated from 2013 to 2015, of which 434 were men, 220 were women. The average age of the patients was 64.1±10.2 years. All patients underwent genetic analysis for the presence of a mutation in the KRAS gene from the primary tumor. Results. The gender approach to assessing the long-term results of treatment of patients with CRC showed that in men with colorectal cancer, the most favorable treatment results were observed in patients with tumors in stage T 1-2 N0 M0, regardless of the differentiation of the tumor and its mutational status. In men, poorly differentiated tumors with any T, with the presence of regional metastases and a mutation of the KRAS gene, even in the absence of distant metastases, should be considered prognostically unfavorable: not a single patient lived for 5 years. In women, based on the decision tree analysis, the most favorable treatment results were observed in patients with tumors in the stage T 1-2-3 N0 M0 under the age of 70 years (five-year survival rate of 90%), with tumors T 1-2 N0 M0 - over the age of 70 years (five-year survival of 81.8%), regardless of the differentiation of the tumor and its mutational status. Tumors of any differentiation of the T3-4 N0 stage with the presence of distant metastases (5% of patients lived for 5 years) and poorly differentiated T4N0M0 tumors (five-year survival of 8%) are prognostically unfavorable for women. Conclusion. The study of gender and age-related features of the development and course of CRC is relevant for oncologists to select effective diagnostic, therapeutic and rehabilitation measures.

Цель – выявить специфические гендерные особенности моделирования прогноза результатов лечения больных колоректальным раком (КРР). Материал и методы. В исследование включены 654 пациента с колоректальным раком, находившиеся на лечении с 2013 по 2015 годы, из них мужчин – 434 человека, женщин – 220 человек. Средний возраст больных составлял 64,1±10,2 года. Всем пациентам проведен генетический анализ на наличие мутации в гене K-ras из первичной опухоли. Результаты. Гендерный подход к оценке отдаленных результатов лечения больных КРР показал, что у мужчин, больных колоректальным раком, наиболее благоприятные результаты лечения наблюдаются у пациентов с опухолями в стадии T1-2 N0 M0 независимо от дифференцировки опухоли и ее мутационного статуса. Прогностически неблагоприятным следует считать у мужчин низкодифференцированные опухоли с любым Т, с наличием регионарных метастазов и мутацией гена K-ras, даже при отсутствии отдаленных метастазов: 5 лет не прожил ни один пациент. У женщин на основе построения дерева решений наиболее благоприятные результаты лечения наблюдаются с опухолями в стадии T1-2-3 N0 M0 в возрасте до 70 лет (пятилетняя выживаемость 90%), с опухолями T1-2 N0 M0 – в возрасте старше 70 лет (пятилетняя выживаемость 81,8%) независимо от дифференцировки опухоли и ее мутационного статуса. Прогностически неблагоприятными для женщин являются опухоли любой дифференцировки стадии Т3-4 N0 с наличием отдаленных метастазов (5 лет прожили 6% пациентов) и низкодифференцированные опухоли Т4 N0 M0 (пятилетняя выживаемость 8%). Заключение. Исследование гендерно- и возраст-ассо-циированных особенностей развития и течения КРР актуально для онкологов при выборе эффективных диагностических, лечебных и реабилитационных мероприятий.

Цель – разработать алгоритм оценки индивидуального риска рецидивирования рака яичников. Материал и методы. Был проведен ретроспективный анализ результатов лечения пациентов с диагнозом «рак яичников» за период 2010–2015 гг. Проанализированы данные 1103 пациентов, из которых рецидив рака яичников был регистрирован у 907 пациентов (средний возраст: 58,7±12; межквартильный размах: 50–68 лет), а за наблюдаемый период рецидивов не было у 196 пациентов (средний возраст: 63,1±13,6; межквартильный размах: 53–74 года). На первом этапе исследования был выполнен однофакторный анализ прогностических факторов рецидивирования рака яичников, на втором этапе – анализ бинарной регрессии. В результате анализа была разработана окончательная формула оценки риска рецидивирования, которую мы назвали «индекс оценки риска рецидивирования рака яичников». Результаты исследования. С помощью бинарной регрессии из изначально определенных 12 факторов были отобраны следующие 6, которые вошли в окончательную формулу расчета риска: стадия, гистотип, степень дифференцировки (Grade) опухоли, результаты УЗИ после химиотерапии, уровни СА 125 до начала комбинированной терапии, уровни НЕ 4 после комбинированной терапии. В зависимости от значения индекса риска рецидивирования рака яичников риск рецидивирования разделяется на низкий (0–0,39), умеренный (0,40–0,85) и высокий (0,86–1,0). Заключение. Разработанный нами индекс риска рецидивирования рака яичников обладает высокой чувствительностью и специфичностью и позволяет стратифицировать пациентов в группы высокого, умеренного и низкого риска. Интегрирование последнего в план динамического наблюдения пациентов после окончания терапии первой линии позволяет корректировать план динамического наблюдения и своевременно предпринимать лечебно-профилактические меры против рецидива рака яичников.

Objectives - to develop an algorithm for assessing the individual risk of ovarian cancer recurrence. Material and methods. A retrospective analysis of the results of treatment of patients with ovarian cancer in the period 2010-2015 was carried out. Finally, data of 1103 patients was reinvestigated, ovarian cancer relapse was registered in 907 patients (mean age: 58.7+12 years; interquartile range: 50-68 years). 196 patients with ovarian cancer did not have relapse for the mentioned time period (mean age: 63.1 + 13.6 years; interquartile range: 53-74 years). In the first stage of investigation, a unifactorial analysis of prognostic factors of ovarian cancer relapse was carried out. In the second stage, the most significant factors were analyzed with the aid of binary regression. As a result, a final formula of the assessment of individual risk of ovarian cancer relapse was developed, which we have named ARRNO (Algorithm of the Assessment of Risk of Relapse of Neoplasm of Ovary). Results. From 12 prognostic factors, we selected 6 ones with the aid of binary regression: stage, hystotype, tumor differentiation grade, results of post-chemotherapy ultrasound examination, CA 125 pretreatment levels, HE4 post-treatment levels. The final ARRNO score was developed on the basis of binary regression formula. Depending on the value of ARRNO score the risk could be divided into low (0.00- 0.39), moderate (0.40-0.85) and high (0.86-1.00). Conclusion. The algorithm of the risk assessment of recurrence of ovarian cancer has a high sensitivity and specificity and allows for stratification of patients into groups of high, moderate and low risk. Integration of the ARRNO in the follow-up plan of ovarian cancer patients, after accomplishment of the first-line therapy, could enhance the treatment planning and timely prevention.