Genetic Features of Tongue Cancer Recurrence in Young Adults.

To identify genetic alterations associated with tongue cancer recurrence in young adults, whole exome sequencing of the primary tumor, recurrence, and whole blood samples from young patients with tongue cancer was performed. A frameshift mutation in the TP53 gene was detected in the primary tumor and recurrence tumor tissue. A mutation in the EPHB6 gene was detected in the recurrence and was absent in the primary tumor. In addition, the primary tumor and recurrence tongue cancer tissue harbored amplification of the 20p13 region containing C20orf96, DEFB125, DEFB126, DEFB127, DEFB128, DEFB129, DEFB132, and ZCCHC3 genes. Thus, genetic alterations have been identified that are associated with tongue cancer recurrence in young adults.

[Oropharyngeal cancer: the aspects of surgical treatment].

The objective of the present study was to estimate the effectiveness of chemoradiotherapy and surgical treatment of the patients presenting with oropharyngeal cancer depending on the character of the tumorigenic process, the intensity of radiotherapy, and time of the surgical intervention. The study included 47 patients who underwent routine clinical examination, endoscopic study, contrast-enhanced computed tomography, magnetic resonance imaging, and evaluation of oropharyngeal conditions under general anesthesia. It was shown that the mode of surgical approach (largely median mandibulotomy) is of primary importance for the surgical intervention in the oropharyngeal region and its plastic reconstruction. The surgical intervention on the regional lymph collector following chemotherapy for oropharyngeal cancer with the excellent clinical effect was performed 2 months after the persisting tumorigenic process in cervical lymph nodes had been confirmed. In the patients with operable metastases of squamous- cell carcinoma in the cervical lymph nodes and the absence of the identified primary site of the neoplastic growth, the surgical intervention was followed by dynamic observations. In the case of discovery of the primary oropharyngeal tumour, the course of radical chemotherapy was prescribed. It is concluded that precise evaluation of the extent of the tumour is indispensable for the targeted choice of the patients with recurrent oropharyngeal cancer for the surgical treatment.

[Cryoradiation therapy of the patients presenting with locally advanced auricular skin cancer].

The objective of the present work was to improve the efficacy of treatment of locally advanced auricular skin cancer with the use of the newly proposed combined method including cryogenic and radiotherapy. The choice of the optimal temporal and thermal parameters of combined cryoradiotherapy was based on the results of previous experimental and theoretical investigations. Each radiation treatment session was immediately preceded by local cooling of the tumour down to 0°C - minus 5°C with a nitrogen vapour. Radiotherapy was performed with the use of either photon or electron radiation at a single local dose of 2 Gy-2.25 Gy (the total cumulative dose 64 Gy-68 Gy). As many as 14 patients presenting with locally advanced auricular skin cancer received combined cryogenic and radiotherapy; 10 of them had basal cell carcinoma and 4 squamous cell carcinoma. In all these cases, the treatment resulted in the complete regression of the tumours. Further observation during a follow-up period from 2 to 14 years in duration demonstrated that only two patients developed tumour relapses. These secondary neoplasms were successfully treated by cryodestruction (n=1) and surgical ablation (n=1). The proposed cryoradiotherapy made it possible to preserve the anatomical relief of the auricle and the auditory passage with good aesthetic and functional outcomes.

[Comparison of methods of reconstructive vascular and microvascular surgery used in management of tumors].

Choice of procedure of treatment of defects of reconstructive surgery for locally advanced tumors is discussed. Part 1 deals with use of autovenous vessels and synthetic prosthetics for management of chief artery defects, while Part 2--with bone, soft tissue and skin defects as well as combination defects. Experience with application of free grafts and flaps in microvascular anastomosis is evaluated and relevant recommendations are given.

[Reconstructive surgery and organ-sparing methods in the treatment of patients with laryngeal and oral cavity tumors]. / Rekonstruktivnye operatsii i organosokhraniaiushchie metody lecheniia u bol'nykh opukholiami gortani i polosti rta.

Some advances have been recently made to improve survival rates among patients with common advanced larynx and oropharyngeal cancer. In this connection, it is essential to improve the quality of such patients' life. A total 382 patients with Degrees III-IV laryngeal and oral cancers were followed up. New approaches to treating these patients by combining various radiation, chemoradiation and surgical treatments, as well wide application of various primary plastic surgeries have yielded good functional and cosmetic results in most patients.

[Differential diagnosis of B-cell lymphoma rich in T cells and peripheral T-cell lymphomas]. / O differentsial'noi diagnostike B-kletochnoi limfomy, bogatoi T-kletkami, i perifericheskikh T-kletochnykh limfom.

Clinicomorphological analysis of T-cell-rich B-cell lymphoma in a 50-year-old female and literature data revealed objective difficulties in morphological diagnosis using cytological and histological methods. Large number of epithelioid histiocytes and tumor cells polymorphism resembled Lennert's lymphoma (peripheral T-cell lymphoma). Immunohistochemical study confirmed B-cell origin of tumor cells and large number of reactive T-cells. It is suggested that it would be more correctly to use the term "Lennert-like areas" in such cases with subsequent immunohistochemical study.

[Purulent complications in the surgical treatment of patients with mouth cancer and their prevention]. / Gnoinye oslozheneniia pri khirurgicheskom lechenii bol'nykh rakov polosti rta i ikh profilaktika.

Local purulent complications after surgical operations for mouth cancer were recorded in 49 (61.3 per cent) out of 80 cases and were mainly due to associations of 2 or more pathogens. The analysis of the factors influencing the development of the complications showed that there was no reliable increase in the number of the complications in the patients subjected at the first stage to the treatment with various antitumor agents: 17 (53.1 per cent) events in the group of the patients subjected to radiotherapy in a total focal dose of 40 Gy, 8 (72.7 per cent) events in the group of the patients subjected to radiotherapy in a dose of more than 60 Gy, 13 (59.1 per cent) events in the group of the patients treated with antitumor drugs and 8 (66.7 per cent) events in the group of the patients operated at the first stage of the treatment. The incidence of osteomyelitis was significantly higher in the group of the patients subjected to radiotherapy before the operation: 13 (30.2 per cent) events vs. 2 (5.4 per cent) in the group of the patients not subjected to radiotherapy. With increasing of the radiation dose, the incidence of osteomyelitis as well increased: 8 (25.0 per cent) osteomyelitis events in the group of the patients subjected to radiotherapy in a dose of 40 Gy and 5 (45.5 per cent) events in the group of the patients subjected to radiotherapy in a dose of more than 60 Gy. The method of osteosynthesis of the lower maxilla with titanium miniplates was also of great importance. The use of various schemes for antibiotic prophylaxis of wound infection in such patients was equally efficient.

[Results of organ-preserving and reconstructive surgery of the mandible in patients with cancer of the oral cavity]. / Rezul'taty organosokhraniaiushchikh i rekonstruktivnykh operatsii na nizhnei cheliusti u bol'nykh rakom polosti rta.

Surgery is the basic procedure of combined therapy for locally-advanced carcinoma of the oral mucosa. It is intended to excise involved mucosa and soft tissues of the oral cavity and to resect the mandible. Rim resection (55) produces good functional and cosmetic results and was followed by 5-year survival in 76.4%. Due to median mandibulotomy (24), optimal access was provided to tumor involving the whole tongue and sitting at the back of the oral cavity (5-year survival--58.3%). Postoperative complication incidence was significantly lowered when titanium miniplates were used for mandibular arch reconstruction. When these miniplates and osteomyocutaneous flaps were used for mandibular reconstruction, following segmental resection, good cosmetic and functional results were recorded in 5 out of 8 cases (5-year survival--75%).

[Choice of the optimal variant of plastic surgery in head and neck tumors]. / Vybor optimal'nogo varianta plastiki pri opukholiakh golovy i shei.

Indications for planning primary and delayed operations for head and neck tumors have been evolved on the basis of our 15-year experience with 667 reconstructive surgeries (550 patients) 425 of which (77%) were conducted in one stage.