[Our experience with surgical treatment of soft tissue neoplasms]. / Nash opyt khirurgicheskogo lecheniia opukholei miagkikh tkanei.

On the basis of the data on 650 cases of soft-tissue sarcoma, improvements to surgical treatment of these tumors have been made versus localization, local extension and histological pattern. Optimal size of area to be excized has been determined. Procedures for organ-saving surgery involving resection of nerves, vessels and underlying bones, in cases of locally-extended tumors, have been evolved. Optimal procedures for skin reconstruction have been suggested. The rationale has been given for indications to amputation. The 5-year survival in patients with soft-tissue sarcoma was 52,6%, while local recurrence incidence-23%.

[Direct angioscintigraphy of soft tissue sarcomas in outpatient diagnosis]. / Priamaia angiostsintigrafiia sarkom miagkikh tkanei v ambulatornoi diagnostike.

Direct angioscintigraphy was carried out in 80 patients suspected for soft-tissue tumors in the extremities. Relevant procedure, predictive value of the diagnostic test, relationship between scintigraphic patterns and those of tumor histology as well as factors adversely affecting examination results are discussed. The method was shown to be sufficiently accurate (0.79) and may find effective application in examination of outpatients.

[Clinical TNM classification of malignant soft tissue neoplasms]. / O klinicheskoi klassifikatsii zlokachestvennykh opukholei miagkikh tkanei po sisteme TNM.

A project for the classification of malignant soft tissue tumors according to the TNM system is suggested for a wide discussion. The classification takes into account the effect of some leading factors (histological type of a tumor, its size, the state of regional lymph nodes, the degree of the adjacent tissues infiltration) on the prognosis of this affection. Tumors staging is done through combining various grades of T, N, M criteria.

[Analysis of the reasons for the refusal of surgical treatment among esophageal cancer patients]. / Analiz prichin otkaza ot operativnogo lecheniia u bol'nykh rakom pishchevoda.

Data on 544 patients with esophageal cancer are reported. The main reasons of their refusing the radical treatment were as follows: 1) a considerable local tumor proliferation (31.8%); 2) senile age, concomitant diseases, a general poor condition of patients (25.6%); 3) the presence of distant metastases (11.4%); 4) location of a tumor in the jugular or upper thoracic esophagus for which palliative radiotherapy was performed, but in some cases a palliative surgery (9.7%); 5) fear of surgery (15.4%); 6) no reason (6.4%).

[The choice of the extent of the surgical intervention in patients with soft-tissue tumors of the trunk]. / Vybor ob''ema operativnogo vmeshatel'stva u bol'nykh s opukholiami miagkikh tkanei tulovishcha.

Data on 145 cases of soft-tissue tumor of the trunk were analysed. Tumor was located on the chest or back in 81 patients and deep in the anterior abdominal wall--in 64. When intramuscular sarcoma is removed, a 2-3-cm margin should be left around the palpable mass. Five-year survival in the entire group of patients with tumors of the chest and back was 59.4% +/- 2.4. Five out of ten cases with tumor of the abdominal wall survived over 5 years.

[The choice of the extent of the surgical intervention in patients with soft tissue sarcomas of the extremities]. / Vybor ob''ema operativnogo vmeshatel'stva u bol'nykh s sarkomami miagkikh tkanei konechnostei.

The analysis of data on 446 patients with soft tissue malignancies showed overall five-year survival rate to be 48.9%. The extent of tissue to be removed during sparing surgery is specified. In case of intramuscular location of tumor, it is enough to leave a 4-5-cm margin above and below the tumor border, as assessed by palpation. Indications for limb amputation at various levels were developed. Limb-sparing surgery could be employed on a larger scale if advances of modern plastic (skin, bone and vascular) surgery were adopted wider. A complex of rehabilitative measures was developed. Patients undergoing limb amputation need early prosthetics.

[Pattern of lymphogenic metastasizing of soft tissue malignant tumors]. / Osobennosti limfogennogo metastazirovaniia zlokachestvennykh opukholei miagkikh tkanei.

The examination performed indicated metastases in regional lymph nodes in 34 (7.5%) of 453 patients with soft tissue malignancies. The presence of metastases aggravates considerably the prognosis: a 5-year survival was 6.6%. Great risk of metastatic proliferation is especially characteristic of rhabdomyosarcoma, non-classifiable blastoma and synovial sarcoma. Primary tumors develop metastases more frequently than recurrent ones. The probability of lymphogenic spread of metastases is the higher the larger the tumor size in young individuals, and also with skin involvement. Tumor infiltration of bones does not result in an increased percentage of lymphogenic metastasization. The proximity of a tumor to regional lymph nodes is not inherent in a higher risk of their metastatic involvement.

[Angioscanning in the diagnosis of tumors of the soft tissues of the extremities]. / Angioskennirovanie v diagnostike opukholei miagkikh tkanei konechnostei

The results of radioisotope scanning in 70 patients with tumors and nontumor lesions of soft tissues of the extremities are presented. It was found that angioscanning with macroalbumin-iodine-131 (MAA-J-131) allows visualization of malignant tumors of soft tissues.

[Medical care for patients with cancer of the upper thoracic segment of the esophagus]. / Lechebnaia pomoshch' bol'nym rakom verkhnegrudnogo otdela pishchevoda.

Out of 350 hospitalized cases of esophageal carcinoma in the upper thoracic segment, stage III-IV tumors were identified in 82.8%. A retarded seeking of medical advice was chiefly responsible for the advancement of tumors. Radical surgery was performed in 32 (9.1%) patients only. The percentage of radically-treated cases could have been greater, if there had been fewer refusals to operate and to be operated on both on the part of patients and doctors who would object to surgery on the grounds of concomitant pathology or the patient's age. Radiotherapy, used in 197 (72.7%) patients as a sole method of treatment, was followed by remission in 68%.

[Role of radiation therapy in the combined treatment of soft tissue liposarcomas]. / Rol' luchevoi terapii v kombinirovannom lechenii liposarkom miagkikh tkanei.

The end results of surgical and combination (radiation + surgery) treatment of 85 patients with liposarcoma are compared. The 5-year survival rate following combination therapy proved to be much higher than after surgery (84 and 53.4%, respectively). Application of radiation improves the results for treatment of all histological types of tumor, polymorphocellular liposarcoma included. Indications of standard and concentrated dose-fractionated radiation should be determined by the size of tumor.

[Treatment of patients with soft tissue neoplasms]. / Lechebnaia pomoshch' bol'nym zlokachestvennymi opukholiami miagkikh tkanei.

The methods of treatment of 1,410 cases of soft tissue sarcoma were compared. Tumor was less than 5 cm only in 19.4% of patients admitted to the hospital by the beginning of treatment. Radical surgery was performed in 65.3% of cases, it still remaining the major procedure of treatment. Application of combined (surgery + radiation) treatment is increasingly used, every fourth patient (25.1%) being given this therapy. The percentage of radically-treated cases of soft tissue sarcoma may be raised by 15% unless patients refuse to be operated on.

[Angioscanning in the diagnosis of breast neoplasms]. / Angioskennirovanie v diagnostike opukholei molochnoi zhelezy

Angioscanning with macroalbumin J131 was performed in 30 patients with different mammary gland diseases (breast cancer--in 22, breast sarcoma--in 1, cystic fibroadenomatosis--in 6 and one patients without any breast pathology). Twenty eight of thirty patients were subjected to surgery, and the diagnosis was supported histologically. Injection of macroalbumin J131 in the subclavian artery enabled the authors to visualize malignant neoplasms, located mainly in the external quadrants of the mammary gland. The least size of the tumor, revealed by angioscanning, was 1.5 cm in diameter. The method of isotope injection directly in the subclavian artery, employed by the authors, may be recommended for patients, whose primary tumor is localized in the external half of the gland and in the axillary process.

[Treatment of lung metastasis in patients with soft-tissue sarcoma]. / Lechenie legochnykh metastazov u bol'nykh sarkomami miagkikh tkanei.

The study group included 104 patients with soft-tissue sarcoma and metastases into the lung, treated at the Institute Clinic in 1960-1992. Surgery for lung metastasis was given to 10 and chemotherapy-to 48 patients; the remaining 48 cases received treatment for symptoms only. Overall 5-year survival was 13.5% (after surgery-30.0%; chemotherapy-19.1%). All the 46 patients treated for symptoms died within two years after detection of lung metastasis. Chemotherapy proved effective in the treatment of multiple metastasis when detected shortly after removal of the first lesion.

[Combined treatment of soft tissue sarcoma]. / Kombinirovannoe lechenie sarkom miagkikh tkanei.

The five-year results of surgical and combined (irradiation + operation) treatment of 451 patients with sarcoma of the soft tissues are analysed with due account for the principal prognostic factors. It is shown that the survival of patients may be prolonged if the operation is supplemented by irradiation. Comparison of three variants of combined treatment showed the advantages of combined treatment with subsequent postoperative irradiation. Radiotherapy does not increase the number of postoperative complications.

[Treatment of soft tissue sarcomas of the leg]. / Lechenie sarkom miagkikh tkanei nizhnikh konechnostei.

An analysis of data of 548 patients with different diseases of soft tissues of lower extremities after using a complex of diagnostic measures (clinical, radionuclide data, thermography, puncture, biopsy) has shown that the number of erroneous conclusions may be minimized to 2%. Modern advances of plastic surgery can widen indications for preserving operations in malignant tumors of soft tissues of lower extremities without prejudice to the main principle of oncology concerning its fascial character. Combined treatment can also improve the results.

[Comparative analysis of clinical data on pigmented villonodular synovitis and sarcoma of the soft tissues of the legs]. / Sravnitel'nyi analiz klinicheskikh dannykh pigmentnogo vorsinchato-uzelkovogo sinovita i sarkom miagkikh tkanei nizhnikh konechnostei.

Pigmentary villonodular synovitis was isolated in an independent nosological unit in 1941. A comparative analysis of data on 278 patients with soft tissue sarcomas of lower extremities (262 observations) and pigmentary villonodular synovitis (16 observations) is presented. Clinico-historical data, results of instrumental methods of examination evidence the absence of any definite symptoms of these diseases. Findings of punctures are most informative.

[Erros in diagnosis of esophageal cancer]. / Oshibki v diagnostike raka pishchevoda

The authors' personal observations reported illustrate difficulties in establishing the proper diagnosis of esophageal pseudotumors. From the complex of modern diagnostic methods roentgenological and fibroesophagoscopic methods with subsequent cytologic and histological assay proved to be mostly effective. Taking into account the degree of the risk of pseudotumor lesions due to their possible malignant transformation in negative cytologic and pathomorphological findings a diagnostic thoracotomy seems to be largely recommended.

[The treatment and prosthesis after an interilioabdominal amputation for sarcomas of the bones and soft tissues]. / Lechenie i protezirovanie posle mezhpodvzdoshno-briushnoi amputatsii po povodu sarkom kostei i miagkikh tkanei.

According to data of the Research Institute of Oncology named after N. N. Petrov, progress was achieved in treatment of patients who were subject to interilioabdominal amputation for malignant tumors. Five years survival after such operations was 19.7 +/- 3.4%. The prosthesis for patients subjected to interilioabdominal amputations was developed in Research Institute of Prosthesis (Saint Petersburg). It was successfully used in 11 patients in the age from 8 to 51 years. The original construction of the prosthesis gives the patients possibility to walk without crutches, move along staircases with 25-cm-high footsteps and to use urban transport.