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Background. Metastasis is a formidable complication of malignant neoplasms, with therapy not always effective in advanced malignancy. Metastasis is a multistep process involving the cancer cell detachment from primary tumour, intravasation, extravasation and invasion into the target organ. Early metastasis stages are well understood, whilst the impact of tumour microenvironment on the disease progression and advancement remains a matter of debate.Aim. An immunohistochemical study of the adaptive and reactive properties of greater omentum with metastatic involvement in ovarian cancer.Materials and methods. We examined greater omentum tissue samples from 40 patients with verifi ed stage 3a and b ovarian cancers. For light microscopy, samples were fi xed in 10 % formalin, dehydrated, paraffi n-embedded and stained with Mayer’s haematoxylin and eosin. Immunohistochemical assays used monoclonal antibodies against CD7, CD4, CD8, CD 68, VEGF, D2-40 and CD44 proteins. Statistical data analysis was performed with Statistica v. 7.0 soft ware.Results and discussion. Analyses of the greater omentum tissues revealed cases of leucocyte-bank encapsulation of metastatic foci. Higher CD7+ and CD8+ cell counts were observed in encapsulation, possibly influencing the greater omentum reactive and adaptive properties. Higher CD44-expressing cell counts were also detected in greater omentum samples lacking encapsulation. Angiogenesis marker-expressing cells (e.g., VEGF and CD34) predominated in greater omentum tissues lacking leucocyte-bank encapsulation of metastatic foci.Conclusion. Events in tumour microenvironment may be indicative of a preserved or reduced organ adaptivity, the latter facilitating disease progression.

Peritoneal carcinomatosis is viewed by many experts as a terminal illness with an unfavourable course and prognosis. Existing therapies are controversial and exhibit ambiguous efficacy. We review the current state of the art in therapy for peritoneal metastases of various origin and its historical background. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy compound the treatment of choice as achieving the highest survival rates. Palliative surgery and systemic chemotherapy are an alternative that proved even more aggressive and ineffective in comparative survival evaluations. Manifold studies and expert opinions exist on the efficacy and expedience of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in treatment of peritoneal carcinomatosis. Today, however, their routine use in everyday practice is hotly debated. Despite an evident progress in managing peritoneal metastases, a series of questions remain unsolved. Contentious research data, late diagnosis, low treatment efficacy in severe peritoneal dissemination, a limited applicability of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, all highlight the importance of inventing and developing novel methods for early high-accuracy diagnosis and careful selection of the treatment strategy. Fundamental knowledge of malignant metastasis underlies the choice of patient management and the innovative toolkit for prevention and treatment of peritoneal carcinomatosis.

Introduction. Neuroendocrine breast tumors represent a rare subtype of breast cancer, accounting for less than 1 % of all neuroendocrine neoplasms. Starting from their pathology definition, and going through their prevalence, prognosis and treatment, our knowledge is still really uncertain.Materials and methods. The article presents a rare clinical observation of a neuroendocrine breast tumor. A breast fibroadenoma was diagnosed at the initial diagnosis stage in a private clinic; after a surgical treatment and further morphological study, it was estimated: a diagnosis of Cancer in situ of the left breast T1N0M0, stage I. Next, 3D-conformal remote radiation therapy was performed on the area of the left breast.Results and discussion. After conducting positron emission tomography, multiple metastases were detected in the lymph nodes, bones, and liver. Additionally, micropreparations were consulted at the Federal Reference Center in St. Petersburg and at an independent third-party molecular biological laboratory in Germany (Munich). Given all the instrumental, molecular biological, histological and immunohistochemical studies of the patient, an individual regimen of drug therapy was selected.Conclusion. After 18 months of personalized drug therapy, we observed a positive trend and a significant decrease in metabolic activity according to positron emission tomography.

Peritoneal carcinomatosis (PC) is a global challenge of modern oncology representing the most unfavourable scenario in diverse-locality tumourisation. Despite certain attention by the oncological community, the management of PC patients is currently palliative, which weakly promotes research into the basic principles of this morbidity. This literature review attempts to comprehensively cover the PC problematic from a global perspective and presents a key evidence on the world schools of thought in this area. Briefly taking, peritoneal carcinomatosis is viewed today as a local process in the conventional implantation theory, which imposes a locoregional character on all current or emerging therapies, such as cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Their inadequate efficacy is largely due to pronounced gaps in our understanding of PC logistics and signalling. PSOGI is a key organisation for centralising the specialty effort in peritoneal carcinomatosis. Despite its global geography and approach to PC discussion, a multitude of scientific questions remain unanswered impeding the establishment of novel effective therapies. The seven countries that nurtured distinguished schools of thought in PC studies are the USA, UK, Japan, China, Italy, France and Germany. Taking peritoneal carcinomatosis in a global perspective, an insufficient attention to its problematic in Russia should be addressed. The founding and fostering of national PC institutions will benefit cancer patients and progress in oncological science.

Carcinogenesis research uncovers new pathogenesis links as vulnerable targets of effective antitumour therapies. Among the key mediators of immune response, cell proliferation, cell apoptosis and inflammation is transcription factor NF-κB. Misregulation of an NF-κB-dependent pathway is found in solid and haematopoietic tumour cells. One of the best known NF-κB functions is expression regulation of genes involved in the apoptosis inhibition or activation and survival in both intact and malignant cells. The NF-κB-mediated pathways’ involvement in carcinogenesis, angiogenesis and tumour resistance to chemo- and radiotherapies makes this factor a promising target for drug anti-cancer interventions. This review summarises evidence on the antitumour and anti-inflammatory activity of a high-potent and specific low molecular-weight NF-κB inhibitor, dehydroxymethylhepoxyquinomycin (DHMEQ), as a candidate therapeutic agent in treatment for variant malignancies.

Background. At the end of 2019, a new coronavirus infection emerged in the People’s Republic of China. On March 11, 2020, the World Health Organization announced the start of the COVID­19 pandemic. During 2018, 2068 patients with malignant neoplasms of the vulva were identified, with the majority of patients aged 75–79 years. Surgical treatment is currently the main treatment method for vulva cancer (VC) patients. According to most authors, surgical treatment is the only method providing good long­term results. One of the approaches to reducing the volume of surgical treatment in such patients is the selective biopsy of the sentinel lymph node (SLN).Aim. To apply the method of SLN biopsy in VC patients with the purpose of reducing the amount of surgical treatment and surgical complications, as well as shortening hospital stay in the context of the COVID­19 pandemic.Materials and methods. This paper presents the results of surgical treatment of 19 patients with malignant neoplasms of the vulva. All the patients were at risk for a complicated course of COVID­19 due to age and concomitant pathologies. In 13 cases, vulvectomy with SLN biopsy was performed. SLN biopsy was performed by radioisotope lymphoscintigraphy.Results and discussion.A decrease in the duration of hospital stay and the absence of surgical complications characteristic of lymphadenectomies were noted.Conclusion. Reducing the duration of hospital stay in the context of the COVID­19 pandemic is an urgent task. The method of SLN biopsy in patients with invasive squamous cell carcinoma of the vulva with T1A — T2 was found to be effective, allowing the amount of surgical treatment to be reduced. Vulvectomy accompanied by SLN biopsy is the surgical treatment of choice in the context of strict anti­epidemiological measures in the COVID­19 pandemic.

The aim of the study was to review the international experience in providing oncological care during the COVID-19 pandemic. A literature search was conducted across the Medline, Cochrane Library, Elibrary and PubMed databases to select publications dealing with various aspects reflecting the state and capacity of oncological care during the COVID-19 pandemic. The research sample included 44 articles meeting the selection criteria.The new coronavirus, known as SARS-Cov-, has become a worldwide threat and a serious health problem in 2020. The pandemic of this infection has had an impact on the management of cancer patients. According to studies conducted in China and the United States, patients with malignancies are at higher risk of severe COVID-19. This has led many oncologists to change their daily cancer treatment practices. An individual approach should be taken when considering the potential risk and beneficial effects of anticancer therapy in the population of cancer patients. A decision to delay the onset of cancer therapy should be made on an individual basis. Strict adherence to sanitary and epidemiological rules, as well as minimization of outpatient visits, can reduce the number of the infected and prevent the spread of the disease among cancer patients. Telemedicine consultations, which allow infectious exposures to be reduced, can be an option of choice.

The 2019 coronavirus infection (COVID-19) is a dangerous infectious disease proceeding as an acute respiratory viral infection with specific complications, which may include pneumonia leading to acute respiratory distress syndrome or respiratory failure with a high risk of death. The etiological agent of COVID-19 is a new coronavirus, referred to as Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). This new viral form is most likely to have appeared from zoonotic coronaviruses, such as SARS-CoV emerged in 2002. This article sets out to present a strategy for manag‑ ing neurosurgical patients, which was developed taking into account the experience of the Neurosurgery Department of the First Affiliated Hospital of Harbin Medical University in the prevention and control of pneumonia outbreaks caused by the new coronavirus. This strategy can be helpful for neurosurgeons in providing emergency care in the context of the COVID-19 pandemic in the Russian Federation.

Introduction. Kidney cancer remains an urgent problem in modern oncology. More than 200 thousand new cases of kidney cancer are diagnosed globally every year, with about 100 thousand patients dying. 15–17% of patients are diagnosed with stage IV kidney cancer. Arterial tumour embolization and nephrectomy are used as a palliative treatment.Aim. To evaluate the results of renal artery embolization in combined treatment of stage IV kidney cancer.Material and methods. The treatment results of 22 patients with stage IV kidney cancer are presented: 6 patients had metastases in the skeletal bones; 15 — metastases in the lungs; 1 — bilateral kidney damage. At the first stage, all patients underwent renal artery embolization. Subsequently, 6 patients received bisphosphonates and radiation therapy for metastases in the skeletal bones, 15 patients underwent operation followed by a targeted therapy with Sunitinib and Sorafenib), 1 patient with bilateral kidney damage underwent operation followed by a 2-year targeted therapy with Sorafenib.Results and discussion. Renal artery embolization was performed successfully without technical difficulties in all the patients. After embolization, hemostasis was achieved in all patients with hematuria (n = 14). Postembolization syndrome was noted in 13 patients with total renal artery embolization. 6 patients with metastases in the skeletal bones lived for 16.4 ± 2.1 months, the survival time of 15 patients who received renal artery embolization, nephrectomy and targeted therapy was 41.7 ± 15.3 months. Only one patient (bilateral kidney damage) has been under dynamic observation for the period of 10 years.Conclusion. Renal artery embolization is an effective and minimally invasive technical procedure that should be used in the combined treatment of patients with kidney cancer. The combined use of renal artery embolization and subsequent targeted therapy for kidney cancer provide new opportunities for stage IV combined treatment.

Introduction. Hepatocellular carcinoma (HCC) is the most common primary malignant neoplasm of the liver. During the early stages, HCC is asymptomatic, which makes X-ray examination a particularly important diagnostic tool. According to WHO data, the mortality rate from HCC was 782,000 in 2018. HCC is associated with a number of risk factors: a high viral load, liver cirrhosis, detected HBeAg and elevated serum HBsAg levels. Inhibitors of tyrosine kinase receptors increase the overall survival and progression-free survival rates in patients with metastatic HCC. In this article, we conduct an analysis of results of the REFLECT study obtained for Russian patients by the Republican Clinical Oncological Dispensary, Ufa.Materials and methods. The experimental group included 9 patients (52.9%) receiving Lenvatinib. The control group included 8 patients (47.1%)) underwent therapy with Sorafenib at a dose of 800 mg per day 7 (41.17%) patients had a history of chronic hepatitis, of which hepatitis B and chronic hepatitis C was confirmed in 6 and 1 cases, respectively.Results and discussion. Over the period from 2017 up to the present, progression-free survival was observed in three patients (17.6%), of which 2 and 1 received Lenvatinib and Sorafenib, respectively. Overall survival was 10.5 months. The median overall survival rate in the experimental and control groups was 9.8 and 11.2 months, respectively. These parameters are considered comparable, provided that the sample was small.Conclusions. The use of Lenvatinib demonstrated the efficacy comparable to that of Sorafenib in terms of the overall survival rate in patients with inoperable HCC. Lenvatinib allowed statistically and clinically significant improvement in the progression-free survival and time to progression to be achieved.

Oncology was officially acknowledged as a separate branch of medical science 75 years ago. Historically, it was landmarked by Order No. 323 of the People’s Commissariat for Health of the USSR of April 30, 1945 “On efforts to improve national oncology care”. This decision triggered deployment of a network of oncological institutions that covered almost the entire country in relatively short time and persists today. Aside to rapid revival of existing cancer institutions, new research centres for oncology and radiology, cancer dispensaries and rooms were being set up to gear universal and comprehensive case archival, due-time tumour diagnostics and vocational training, along with manifold other measures to contain cancer. A milestone event was the erection of the Oncological Society in 1954 by the Scientific Council Presidium of the USSR Ministry of Health. The Moscow and All-Union oncological societies contributed greatly to establishment of the Oncology Service and promoted the prestige of Soviet oncology, professional activity in the Union’s republics and overall effectiveness against cancer. Involvement of outstanding scientists, leading oncologists and healthcare decision makers in fostering the Oncology Service cannot be overstated. Today, a progress is made towards understanding the roots of cancer, supply of medical institutions with state-of-the-art equipment, implementation of effective diagnostic and therapy practices. Nevertheless, as yet timely remain further enhancement of preventive medicine, deployment of regional programs for cancer monitoring, education and higher-level professional training, remodelling of diagnostics and care in specialised oncological and primary medical institutions, creation of a unified system for prevention, earlier diagnosis and treatment of cancer.

Background. Our previous studies have shown that postnatally formed lymph nodes (PNFLN) can serve as a source of biological signals activating antitumour immune reactions and suppressing the spread of metastatic malignant cells.Aim. To determine the expression of CD3, CD20, CD68 in native, sentinel and postnatally induced lymph nodes of the axillary zone in breast cancer.Materials and methods. The study involved an analysis of digitalized images of the immunohistochemical expression of a fixed panel of antibodies CD3, CD20, CD68. The expression levels were assessed quantitatively by counting the expressed cells in each studied node for four main structural and functional zones.Results and Discussion. The results of a comparative immunohistochemical study of native, sentinel and postnatally induced lymph nodes showed that the content of CD3, CD20, CD68 demonstrates fundamental differences in different lymph node structures.Сonclusions 1. In postnatally induced lymph nodes, compared to native and sentinel lymph nodes, the distinct expression of antibodies to the main immunocompetent cells, which realize key immune responses in the lymph node, can indicate an increased functional status of the newly formed lymph nodes. 2. The study demonstrated a high level of antigenic stimulation of T and B lymphocytes in postnatally induced lymph nodes, as well as indicated a possible role of macrophage cells in the stimulation of neolymphogenesis and the formation of new lymph nodes. 3. The study provides the basis for further research into postnatal induced lymph nodes in cancer patients.

Introduction. The incidence of ovarian cyst amounts to 5–17 % in postmenopausal women. Currently monitoring of or screening for ovarian cysts in menopausal patients is not regimented in the Russian Federation at all. This situation warrants a review.Materials and methods. In this paper the authors review retrospective and prospective studies concerning outcomes in patients with ovarian cysts in menopause published in the last 5 years. Results. The retrospective and prospective studies analysed show that the risk of malignancy of this type of benign neoplasm is low, on average 0.7%. The results of a large prospective study prove that there is no need for surgical treatment in 80% of patients.Discussion. There is now doubt that patients with this disorder should be followed up in accordance with an algorithm that clearly defines the criteria for surgical treatment and the follow up length. Surgical treatment should be indicated when there is at least one of the signs of an ovarian cyst: symptomatic, texture not smooth, over 50 mm in diameter, multilocular, bilateral. A positive CA-125 in combination with ultrasound, MRI and CT imaging make it possible to calculate the risk index with the use of a particular formula and determine the indications for a risk-reducing bilateral salpingo-oophorectomy. The follow up of BRCA1/2 mutation-free patients with a benign ovarian neoplasm should include a close step-by-step monitoring and all the necessary examinations performed in a timely manner.Conclusion. The risk of a malignant transformation of an ovarian cyst in menopause is rather low (about 0.7%); following up patients with simple ovarian cysts in menopause is possible and should be carried out in strict compliance with the algorithm; the preventive bilateral salpingo-oophorectomy in patients presenting no signs of ovarian pathology is indicated only for the high risk group (BRCA1/2 mutations confirmed or there is family history).

Introduction. Vulvar cancer belongs to the group of rare neoplasms and accounts for about 4% of all gynecological malignant tumours. One of the important barriers to the spread of the tumour cell population is the lymph nodes. Most oncologists recognize the existence of the so-called sentinel lymph nodes. A proper assessment of the status of this node makes it possible to predict the extent of the spread of cancer, which in turn secures a better surgical treatment outcome.Materials and methods. 87 patients with vulvar malignant neoplasms received surgical treatment in 2015-2018 at the Department of Oncogynecology of the Republican Oncology Center. Vulvectomy was performed on 19 patients with verified vulvar cancer; sentinel lymph node detection was employed. The methods used were the contrast lymphography and indirect intraoperative radioisotope lymphoscintigraphy. This resulted in the minimal number of postoperative complications recorded.Results. The scope of surgical treatment for vulvar cancer was optimized based on sentinel lymph node verification.Conclusions. Detection of sentinel lymph nodes in vulvar cancer is an effective method of planning for the scope of the surgery. Using this method reduces the number of postoperative complications. The reduction of the number of postoperative complications improves the patients’ quality of life.

Introduction. This article presents data on the manifestations of changes in the microenvironment of the peritoneal cavity in patients with carcinomatosis, expressed by the mineralization of the peritoneum, which in turn leads to functional changes in drainage of the peritoneal cavity.Materials and methods. We examined autopsy tissue of the peritoneum with symptoms of carcinomatosis and intact peritoneum using comparative scanning electron microscopy.Results and discussion. The study of the ultrastructure of peritoneum in patients with PC, revealed the phenomenon of SLL mineralization. The resulting elemental composition profile showed a high content of Ca, P, Na.Conclusions. 1. Carcinomatosis is not a local, but rather a systemic process. Determining the role of mineralization in carcinomatosis is of fundamental importance in carcinogenesis. 2. The serous membranes mineralization in patients with carcinomatosis can become a new treatment target, the impact on which may increase life expectancy and improve the quality of life. 3. The serous membranes demineralization can serve as a part of a combination treatment that includes the subsequent endolymphatic anti-tumour drug therapy.

In clause results endovascular methods of treatment of 70 patients with tumoral defeats of a liver of men 47 (67,1 %), women 23 (32,9 %), from them are presented: a primary cancer of a liver 42 (60 %) cases, metastatic defeats of a liver 28 (40 %). Chemo-infusions a hepatic artery it is executed at 50 patients, from them at a primary cancer of a liver at 32 (45,7 %) by patients, at metastatic defeats of a liver at 18 (25,7 %) patients. At 20 patients it is lead chemo-embolisations a hepatic artery, from them at a primary cancer of a liver 10 (17,1 %) by patients, at metastatic defeats of a liver 8 (11,4 %) patients. Data obtained by us have shown efficiency chemo-infusions a hepatic artery at a primary cancer of a liver at 19 (45,2 %) to patients with high quality of a life that enables wider application of a technique for rendering special treatment of this complex category of patients. Results chemo-embolisations a hepatic artery at a primary cancer of a liver also encourage, as after 1 procedure gives stabilization of process and improves quality of a life of patients.

The article generalizes the results of treating patients with IV stage stomach cancer according to the South-Kazakhstan regional oncological clinic data during 2003-2007yy. During this period 100 patients were operated, 49 (49 %) patients had a citoreductive subtotal resection of stomach, 31 (31%) patient had citoreductive gastrectomy and 20 (20%) patients had citoreductive proximal resection of stomach. The percentage of postoperative death is 13%. Sixty-one (61%) patients received system polychemotherapy. After a citoreductive resection relapses have arisen at 15,6 % of patients, among them 9,3% of patients after citoreductive distal resections, and 6,2 % of patients after proximal resections of stomach. Three-year survival rate after distal subtotal resection is authentically 3,3 times higher than after gastrectomy and 3,8 times higher than proximal resections. After distal subtotal resection of stomach 6,1% of patients lived during five years, they received about 4 rates of system chemotherapy.

This article presents an overview and results of treatment of malignant neoplasms of the liver hepatic artery chemoembolization methods in 141 patients. The analysis of the results of this method of treatment.

The article presents the results of the study depending survival of patients with breast cancer (BC) stage IIIb degree from neolymphangiogenesis . The results show that the higher the degree neolymphangiogenesis on the level lymphangion at the drainage area “sentinel“ lymph node, the more pronounced local compensatory and protective reactions of the organism affecting the duration of life in breast cancer.

The transcription factor NF-kB plays a key role in various physiological processes such as immune response, cell proliferation, cell apoptosis and inflammation. Controlling the transcriptional activity of a number of genes responsible for different ways of inflammatory processes and of malignant, NF-kB is involved in a wide range of diseases. Special attention deserves part signalnych paths controlled NF-kB, in carcinogenesis, angiogenesis, including tumor and stability to chemotherapy and radiotherapy. The combination of cancer and inflammatory processes involving constitutive activation of NF-kB, making it a promising target for pharmacological intervention aimed at cancer therapy.

This article describes the results of scanning electron microscopy in cancer. For the first time visualized the cancer cells migrated via directly serous-lymphatic hatches on the surface peritoneum. Shown the similar results of studies of Japanese scientists, but selected the differences in the mechanisms of this process, in particular in the direction of movement of cancer cells. From data analysis results of quantitative and anatomical evaluation of serous lymph hatches diaphragmatic peritoneum we selected their functional classes. Investigation results have important applied value in oncology.

The research of surgical material including a primary breast tumor, lymphatic basins with lymph nodes revealed the fact of neo-lymphatic genesis of breast cancer patients. Evidentiary basis of the genetic lymphoid re-forming is made with the use of modern biological technologies. Inflammatory chemokines’ expression profile and their receptors in newly formed lymph nodes during breast cancer were analyzed. The analysis revealed an increase in CCL16, XCR1, CYFIP2, TNFSF14 genes and a decrease in CXCL5 and CXCL12 chemokines’ ligands in newly formed lymph nodes .The data got are of a great scientific importance.

The lymph circulatory bed of the axillary area, peripheral lymph structure and its flow properties of 78 breast cancer patients were studied. Such factors as total protein, albumin, globulin, fibrinogen, bilirubin, cholesterol, urea, creatinine, glucose, sodium and potassium were defined to estimate the lymph structure influence on its viscosity. The research proved that during breast cancer both the quantity of sentinel afferent lymph nodes and their diameter increases. Neo-lymphatic angiogenesis is a prognosis factor for IIIB breast cancer stage.

The article summarizes the experience of academic and pedagogical leading of universities in Russia to train specialists of new formation in oncology, in accordance with the challenges of modern society and the needs of the modernized health. There are prospects and the possibility of the introduction of advanced educational technology in health professional education on the basis of the competence approach. The modern model of continuing professional development is implemented in the departments of oncology leading Russian universities.

The article proves indications and represents methods and late results of the surgery of 200 resectable stomach cancer patients. The treatment includes perioperative chemotherapy, neoajuvant intraarterial regional chemotherapy and trans-arterial chemoembolization of the hepatic artery in the presence of liver metastasis. The combined modality treatment shows visible improvement of short-term and late treatment results when applying the above-described methods.

Previously, we designed DTCM-glutarimide as a novel anti-inflammatory agent inhibiting macrophage activation. It also showed anti-inflammatory activity in vivo. In the present research, we evaluated the anti-metastatic activity of this agent using mouse melanoma B16-F10 cells. DTCM-glutarimide inhibited the cellular invasion in the Matrigel chamber assay, lowering matrix metalloproteinase 9 (MMP9) expression. It also induced anoikis rather than apoptosis in polyHEMA-coated plates. It increased Bax and decreased Bcl-XL expressions, and activated p53 lowereing the MDM2 expression. Thus, DTCM-glutarimide was found to inhibit cellular invasion and to induce anoikis in B16-F10 cells. It is non-toxic, and easily prepared, therefore, is considered to be a new candidate of anti-metastasis agent.

Many studies show that there are blood composition changes in the development of malignances. Nonetheless, to study changes inchemical composition of peripheral lymph is also an urgent problem. This paper presents the results of studying the biochemical composition of peripheral lymph in 78 patients after mastectomy or breast resection in different breast stages. The study estimated the peripheral lymph concentrations of the following indicators: total protein, albumin, globulin, fibrinogen, bilirubin, cholesterol, urea, creatinine, glucose, sodi- um, potassium, alanine aminotransferase and aspartate aminotransferase, and alkaline phosphatase. The findings suggest that considerable peripheral lymph changes occur in cancer patients, which shows the need for timely diagnosis and correction.

The study was undertaken to improve breast cancer (BC) staging by the criterion N ex vivo, by applying the up-to-date ultrasound and microsurgical technologies. A LySonix 3000® with PulseSelectTM system was used to expose lymph nodes and vessels. Axillary adipose tissue classically exposed was examined in 70 patients with Stages II-III BC. Lymph vessels and nodes were separated by the sonolipodestruction technique. The findings permit sonolipodestruction to be used for ex vivo total lymph dissection for BC as a method that improves its N-staging. Sonolymphodissection opens up fresh opportunities for studying the anatomic structure of the lymphatic apparatus.

The results of a comprehensive evaluation and treatment of background and pre-cancerous cervical cancer of women were studied (n = 1022). There is the complex assessment of social and obstetric gynecological risk factors for cervical intraepithelial neoplasia and cervical cancer. A system for optimizing diagnostic, therapeutic, preventive and rehabilitative measures, taking into account the differentiated approach to the choice of treatment, follow-up in the near and long-term postoperative period. An individual approach to the selection of organ presentation or radical treatment using new technologies of surgical treatment are identified. Application of the developed system enabled a statistically significantly improve the results of treatment of background and precancerous cervical disease.