Introduction. Melanoma skin is a tumor with a high metastatic potential. Often, its lymphogenous spread is realized in the first place. That is why the assessment of the state of the regional zones of lymph drainage is a prognostically significant aspect of the diagnosis of this disease.  

The study objective – to estimate the possible predictive value of the results of preoperative lymphoscintigraphy for multiple regional lymph node involvement in clinically localized cutaneous melanoma.

Materials and methods. The study involved 89 patients with clinically localized cutaneous melanoma who underwent  sentinel lymph node biopsyand regional lymphadennectomy. Morphological findings were compared with the results of preoperative lymphoscintigraphy.  

Results. In this paper, quantitative data such as the number of lymphatic drainage areas, the number of sentinel lymph  nodes in one anatomic region and their combination were considered.  

Conclusion. It was impossible to determine unambiguously the number of involved lymph nodes. However, the lymphoscintigraphic findings were suggestive of a higher risk for multiple lymph node involvement in patients with several accumulation zones and several lymphatic drainage areas.

Introduction. The evolution of rapid prototyping technologies, novel high-precision metalworking equipment, and prompt implementation of additive technologies into practice have significantly expanded the possibilities of producing new  biomechanical structures. Therefore, the development of novel methods and approaches ensuring rapid and highly effective designing and manufacturing of individual implants is highly relevant.  

Objective – to develop a technology that allows rapid design and manufacturing of implants for maxillofacial surgery.  

Results. In this study, we analyzed the technology of rapid design and production of individual jaw implants based on computed tomography data, which reduced the duration of surgery by ~50 % (from 3–4 h to 2–2.5 h) and allowed one-stage surgery. We achieved high toughness of implants and excluded the risk of fatigue destruction of a biome chanical structure due to increased cyclic loads.  

Conclusion. Rapid production of individual jaw implants described in this article ensured high productivity of the pro cess of producing individual biomechanical structures and helped to restore the original contour of the patient’s face with significant lesions to the mandibular bone.

Introduction. Giant cell tumor refers to tumors with an uncertain malignancy potential, has a locally aggressive  course. Intra-focal resections performed for a giant cell tumor of long tubular bones are accompanied by the development of relapse in 30–46 % of cases. The combination of pathogenetic therapy with surgical intervention makes it  possible to reduce the frequency of relapses in operable tumors after marginal and intra-focal resections, and in inoperable tumors to provide local control and relieve pain.  

Objective – to analyze the results of combined treatment of patients with giant cell bone tumor.  

Materials and methods. In the conditions of Republican Clinical Oncological Dispensary of the Ministry of Health  of the Republic of Tatarstan, 13 patients aged 20 to 63 years are in the process of combined treatment of a giant cell  tumor. As of November 2021, 7 patients have completed treatment.

Results. Among the 7 patients who completed treatment, 6 people were operated on (1 patient refused surgery).  In 5 patients, intra-focal resection of the tumor with osteoinductive material “BoneMedic-S” was performed, in 1 patient with a giant cell tumor of the sciatic bone, resection of the sciatic bone was performed without reconstruction.  1 patient with a widespread tumor (sacral lesion) receives supportive treatment.  

Conclusion. The combined approach in the treatment of giant-cell bone tumor allows performing a functional-saving, organpreserving surgical intervention, significantly reducing the risk of tumor recurrence and its malignant transformation.

Introduction. Currently, the achievements of oncological hip replacement play an important role in the treatment  and rehabilitation of patients with a tumor lesion of the proximal femur.  

The study objective – to evaluate the effectiveness of the use of the acetabulum component with double mobility  in oncological hip replacement.  

Materials and methods. Our prospective study included 108 patients operated in the Department of Bone Oncology  of the R.R. Vreden National Medical Research Center of Traumatology and Orthopedics, Ministry of Health of Russia  for a tumor lesion of the proximal femur in the period from 2014 to 2019.  There were 65 (60.2 %) women, 43 (39.8 %) men. The median age was 52.1 years. Primary malignant bone tumors were  identified in 19 (17.6 %) cases; benign aggressive and tumor-like diseases in 18 (16.6 %) cases; metastatic lesion  in 71 (65.8 %) cases.  Patients operated with bipolar heads were included in Group 1B – 53 (49 %). The 2D Group included 55 (51 %) patients  operated with the use of the acetabulum component with dual mobility.  Classification and analysis of complications was carried out according to the international system International Society  of Limb Salvage 2014 (ISOLS 2014). The functional result was evaluated using the international Musculoskeletal Tumor  Society (MSTS) system and the Harris Orthopedic scale (Harris Hip Score) in terms of 3, 6 and 12 months.  

Results. The total number of complications detected during the follow-up period from 2014 to 2020 was 13 (12 %) cases.  Type I complications (ISOLS 2014) were represented by dislocation of the endoprosthesis – subtype IA, which was detected in 7 (6.4 %) patients operated with bipolar heads. There were no cases of dislocation of the endoprosthesis  in the group operated with the use of double mobility (p = 0.006).  We were able to identify a statistically significantly better functional result in patients operated with using of double  mobility at all follow-up periods, both on the MSTS scale and on the Harris scale (p = 0.004).  The five-year survival rate for aggressive benign tumors and tumor-like diseases was 92 %; for malignant primary tumors – 82 %; in patients with secondary bone lesions – 60 %.  

Conclusion. Today, oncological hip replacement, is still lags behind in functional results from primary standard hip arthroplasty, and the number of complications is still several times higher. We consider that one of the solutions of this  problem, is a wider use of acetabulum components with dual mobility in oncoortopedic practice.

Background. Standard treatment for hormone receptor-positive breast cancer includes long-term hormone therapy.  However, treatment efficacy varies even in homogeneous groups of patients. Tamoxifen is metabolized in the liver,  resulting in the production of endoxifen, its active metabolite. Cytochromes P450 (CYP2D6, etc.) play a major role  in converting tamoxifen to endoxifen. The CYP2D6 gene is extremely polymorphic and has more than 100 alleles that  can encode normal, high, and low metabolic activity or be inactive. Thus, patients can be divided into three groups according to the presence or absence of CYP2D6 gene polymorphisms, namely slow, intermediate, and rapid metabolizers.  

Objective – to analyze the long-term results of complex treatment of patients with early breast cancer depending  on the variability of the polymorphism of the CYP2D6 gene.  

Materials and methods. We analyzed the frequency of 3 main polymorphisms in the CYP2D6 gene among 89 patients with  hormone receptor-positive stage I–II breast cancer who received tamoxifen at a dose of 20 mg/day as adjuvant hormone  therapy for 6 months to 9 years. Homozygous carriers of wild-type CYP2D6 allele were assigned to the group of patients  with unchanged (normal) metabolism (Group 1) (wt CYP2D6) (n = 64), whereas homozygous and heterozygous carriers  of non-functional CYP2D6 alleles were included into the group of patients with slow metabolism (Group 2) (n = 25).  

Results. Disease progression was observed in 21 (23.6 %) patients with primary operable hormone receptor-positive  breast cancer, including 10 women from Group 1 (15.6 %) and 11 women from Group 2 (44 %); the difference between  them was statistically significant (p <0.05). Disease progression after combination therapy without chemotherapy was  registered in 8 (22.9 %) patients, including 2 (5.8 %) patients with normal metabolism and 6 patients (17.1 %) with  slow metabolism (р <0.05). Ten-year relapse-free survival rate was 85.9 % in Group 1 and 63.6 % in Group 2 (р = 0.02).  We found no significant difference in overall survival rates between the two groups, which confirmed the results  of other studies.  

Conclusion. The assessment of metabolic activity and its impact on the efficacy of combination treatment for breast  cancer is a promising method; however, it requires further research in this area.