The current state of medicine, the integration of data and analytical methods allow us to measure the quality of medical care with numerical values. For understanding what and how to measure in oncology we are using cancer registries. They have become a very powerful tool in the study of cancer. In this study, we analyzed the main performance indicators of the Scientific and Research Institute for Pediatric Oncology and Hematology by using the possibilities of hospital based cancer registry (HBCR). The study showed that HBCR is essential for assessing the quality of care for cancer patients.

Background. To investigate the role of BRAF mutation in the prognosis of skin melanoma. Patients and methods. 114 patients with skin melanoma in a stage of progression after previous surgical treatment were included in the study. Depending on the results of a molecular genetic test for the presence of a BRAF mutant, the patients were divided into 2 groups - with the mutant gene and the wild type. All patients had noted by time to progression of the disease since the initial treatment of the skin melanoma. By using a statistical program, we studied the factors that influenced on time to progression, and the role of the BRAF gene mutation on relapse-free period. Results. There was no significant effect of BRAF V600-mutant on the duration of the relapse-free period in skin melanoma patients and on the nature of the first recurrence of the disease. At the same time, the study found out that the mutation in the BRAF gene was more characteristic to the younger age group - patients under the age of 50 years (p = 0.002). Conclusions. The frequency of BRAF V600-mutant was 67.5% of cases. The absence of the effect in BRAF V600 mutation-positive melanoma was confirmed by stratification according to the stages of the disease, and it was also shown that the mutation did not significantly affect the nature of disease progression. The results of our study did not provide grounds to consider the BRAF mutant melanoma to be a predictive factor in association with aggressiveness of the skin melanoma.

Currently, the complex treatment of malignant neoplasms of various localizations is used perfusion technology more commonly. We performed the analysis of literature on the use of perfusion chemotherapy in the treatment of tumors. The basic physical principles of delivering a chemotherapy drug (CP) to tumor tissues were considered, and it was noted that to ensure the effectiveness of this process, it is necessary to overcome high vascular resistance, high pressure of interstitial fluid and fibrous stroma around the tumor. It presented the factors contributing to the increase in CP in interstitial tissue, including ischemic vasodilation, low viscosity of injected fluids and bolus drug delivery. It is noted that when applying the method of intraarterial perfusion, the pressure of fluid flow increases, this causes the «leaching» of the intravascular protein in the interstitium, CP does not undergo reabsorption in the venous section, and the tumor is completely retained by the tissue. It is indicated that further study of the physicochemical principles of the application of this method will contribute to a significant increase in the survival rate of cancer patients in whom conservative treatment methods prove ineffective.

Breast sarcomas are rare heterogeneous tumors in breast and the optimal treatment for them is still under discussion. Patients and methods. We retrospectively reviewed 51 patients with BS between 1999 and 2017 in N.N. Blochin Russian Cancer Research Center Ministry of Health of the Russian Federation. Results. Five-year recurrence-free survival and OS rate were 37.5% and 56.2%, respectively. With median follow-up of 86.4 months, 43.14% patients (22/51) were found with local recurrence and metastasis. 93.33% of all distant metastases and 80% of all relapses were found in patients with stage III disease and G3 with only surgical treatment. Also, 84.61% of all separated metastases were detected in patients in the group with more malignant tumor subtypes (malignant fibrous histiocytoma, spindle cell sarcoma) with surgical treatment only. Conclusion. The combined approach is necessary in the treatment of high-grade sarcomas, taking into account the morphological and immunohistochemical parameters of the tumor. Disease stage and local recurrence were indicated as unfavorable prognostic factors. Surgery remains crucial treatment for breast sarcomas. Mastectomy is not routinely necessary if clear margin could be achieved by local excision.

Studying quality of life and its factors as well as the impact of quality of life on the outcomes of treatment and postoperative rehabilitation is important due to significant progress in the treatment of patients with primary and metastatic bone tumor. This study continues series of works of the authors in this area. The study is devoted to reveal relationship between the main parameters of quality of life and survival in patients with bone tumors. The data of psychological study in 50 patients with bone tumors were compiled. The EORTC QLQ-C30 (Quality of Life Questionnaire Core-30) and BM-22 (additional module) were used to study the main parameters of quality of life. Patient survival was calculated using Kaplan-Meier method. According the results, higher quality of life among patients with bone tumors correlates with better survival, while decreased quality of life in patients, manifested in the somatization of negative emotional experiences, is associated with a lower level of survival. In accordance with the results obtained in the framework of a multidisciplinary approach to the treatment and rehabilitation of patients with bone tumors, the main directions of psychological assistance in the oncoortopedic clinic are done.

Aesthetic appearance and restoration of the vital functions of the upper jaw is one of the main criteria when performing operations in reconstructive and maxillofacial surgery. Tumor of the upper jaw is a rare disease; therefore, there is no «gold standard» for reconstruction of defects after the performed maxillectomy. When choosing the type of flap to restore the resected area of the upper jaw, we rest on a complex of factors, based on which we carry out the tactics of individual selection of the flap depending on the size and type of defect, patient’s age, presence/absence of concomitant diseases in anamnesis, as well as the prospects for the rehabilitation period. This article will discuss the main indications for the use of a flap of scapula angle, its advantages compared with other types of autografts, the possibility of a rehabilitation period, the subsequent implantation of osteointegrated implants.

The utility of ICG fluorescent lymphography is very common among SLN detection. This method is used to evaluate different diseases including skin melanoma, stomach cancer, cervical carcinoma and penile cancer. Our research is focused on using ICG lympphography for breast cancer treatment. Aim of research. Evaluation of the possibility of ICG lymphography method usage for SLN detection while breast cancer treatment. Methods and data. 200 I-II-A-B breast cancer deceased previously supervised and conducted combined and/or complex therapy including reconstructive plastic surgery were made operations. The first group of patients was performed an SLN biopsy, a modified radical mastectomy ± reconstruction or organ-sparing surgery and axillary lymphadenectomy leveled I-II. The second group of patients was performed an SNLB, mastectomy ± reconstruction or organ-sparing operation. Results of the research. Major diagnostic characteristics of the method: frequency of SLN finding is 98-100%. False negative result: 3.4-9%. While monitoring the patients for 36 months there was received no evidence of local-regional metastasis. Conclusion. According to the diagnostic characteristics of fluorescent lymphography is not inferior to the international standard with radioisotope tracer. The importance of the method of fluorescent lymphography for the clinical practice of an oncosurgeons is extremely high.