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Purpose. Determination of thyroid hormones (TH) and cortisol levels in blood in patients with breast cancer (BC) without previously detected endocrine pathology in the anamnesis.Patients and methods. Twenty-five primary luminal A breast cancer patients before and aſter surgical removal of the tumour and 25 breast cancer patients with secondary metastatic brain lesions were examined. The levels of total and free forms of TH (T4, FT4, T3 FT3) and cortisol were determined in serum by RIA method.Results. Before treatment in all patients with breast cancer the level of T3 was decreased 1.3 times and FT3 was increased 1.3 times (p < 0.05) against the background of normal TTH content. In 80 % of patients, blood cortisol concentration was 2 times higher than normal, and in 16 % of patients, T4 level was 1.8 times higher than normal (p < 0.05). Aſter tumour removal, FT3 levels in all patients and cortisol levels in 40 % of patients did not differ from normal. T4 content in 40 % of patients, and T3 and TTH in 28 % of women were above normal. A distinctive feature of patients with brain metastases of breast cancer was low T4 and cortisol levels in 36 % of patients against the background of low T3 levels.Conclusions. Euthyroid sick syndrome was detected in all patients with BC: low serum T3 levels against the background of normal serum levels of TTH. Patients with primary BC were characterized by high concentrations of FT3 and cortisol, which could promote proliferation of malignant cells and decrease antitumour immunity. The condition of 1/3 of patients with brain metastases was aggravated by low levels of T4 and cortisol which could indicate the depletion of the main regulatory systems and an unfavorable disease prognosis.

Purpose of the study. To represent the results of a two-stage surgical treatment in patients with extensive pelvic bone defects.Materials and methods. Data on 7 patients who underwent surgery for pelvic and sacrum tumors at the National Medical Research Centre for Oncology from 2016 up to 2020 are presented. The average age of the patients was 36 years. Patients with massive tumors that required a major resection of the posterior pelvis and the formation of an extensive bone defect requiring reconstruction with massive allografts and implants were selected for the study. 5 patients underwent different variations of sacrectomies with the resection of the iliac bones; 2 patients – interiliac-abdominal resections. For all these patients, surgical treatment was split into 2 stages.Results. At the first stage we performed: 5 surgical interventions (total or extended sacrectomy at L5–S1 with lumbar-iliac bilateral stabilization with an 8‑screw pedicle system) in patients with sacral tumors. In 2 cases, an interilio-abdominal resection with the defect replacement with cement articulating spacer. Intraoperative blood loss on average was 1.8L. We used autohemotransfusion to compensate the intraoperative blood loss.The 2nd (reconstructive) stage was completed on average after 3 months. The reconstructive stage was not accompanied by major trauma in all patients. The average blood loss was approximately 800 ml. There were no complications after the reconstructive surgical stage.Conclusion. The described two-stage technique allowed to avoid severe infectious complications requiring removal of implants and grafts in all patients. Adequate spinal pelvic stabilization and/or spacing of the defect contributed to early functional rehabilitation of patients and the continuation of adequate adjuvant therapy in the interstage period. The delaying of the reconstruction allowed to reduce the duration and invasiveness of the main intervention without affecting the final result of treatment.

The objective was to evaluate the levels of neurotrophins in the brain of mice with urokinase (uPA) gene knockout, carriers of B16/F10 melanoma developing in presence of comorbid pathology – chronic neurogenic pain (CNP).Methods and materials. The study included female mice of two strains: С57ВL/6 (n=40) and C57BL/6-PlautmI.IBug-ThisPlau6FDhu/GFDhu (n=28). In the main groups, CNP was created by the bilateral sciatic nerve ligation, with В16/F10 melanoma transplanted under the skin of the back 2 weeks after. The comparison groups included sham operated animals with melanoma transplantation, the control groups – sham operated animals and animals with CNP. Mice were decapitated on day 21 of the tumor growth, and the brain levels of brain neurotrophic factor (BDNF); nerve growth factor (NGF), neurotrophins 3 (NT3) and 4 (NT4) were studied by ELISA.Results. The brain of mice with uPA gene knockout demonstrated higher levels of NT3 (by 1.3 times (p=0.0146)), NT4 (by 2.6 times) and NGF-β (by 1.9 times (p=0.0021)) and lower BDNF (by 1.7 times (p=0.0203)), compared to mice without knockout. Cerebral reduction of NGF-β was a nonspecific brain response to CNP and neoplastic growth in female mice, enhanced in the combination of the pathological factors. Greater stimulation of subcutaneous melanoma growth in female mice with uPA knockout under the influence of CNP combined with a 2-fold decrease in levels of NT3 and BDNF in the brain, along with 2.2 times higher cerebral levels of NGF-β, compared to female mice without knockout.Conclusions. In female mice with uPA gene knockout compared to mice without knockout, we revealed background differences and other dynamics of neurotrophin levels in the brain at melanoma growth both alone and in combination with comorbid pathology – CNP.

Objective: to evaluate the frequency of axillary lymph node metastasis (detected at routine pathomorphological examination) in order to determine the group of patients who do not require lymph node surgery.Materials and methods. We analyzed medical records of 485 patients with breast cancer and no signs (either clinical or instrumental) of regional lymph node involvement who underwent surgery at the first stage of their treatment.Results and conclusion. In patients with cN0 cancer, only the size of primary tumor ≤1 cm was found to be a significant factor indicating that regional lymph nodes are not involved (in addition to palpation, ultrasound, mammography, and spiral x-ray computed tomography of the chest). In patients with сТ1c cancer, the majority of standard immunohistochemical markers cannot yet be used as predictors of regional lymph node involvement. However, tumor differentiation grade G1 is rather an exclusion, which in combination with the size of the primary tumor сТ1c can also be considered as a significant prognostic factor.

A procedure for drainage-free radical mastectomy is proposed, which can significantly reduce not only the incidence of postoperative lymphorrhea (from 10 to 4.2%), but also its average duration (from 9 to 4 days). No postoperative wound complications accelerate healing and accordingly decrease the length of bed rest. This determines the economic benefits of the proposed procedure and makes it possible to continue combined or complex treatment.