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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="other" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Tumors of female reproductive system</journal-id><journal-title-group><journal-title xml:lang="en">Tumors of female reproductive system</journal-title><trans-title-group xml:lang="ru"><trans-title>Опухоли женской репродуктивной системы</trans-title></trans-title-group></journal-title-group><issn publication-format="print">1994-4098</issn><issn publication-format="electronic">1999-8627</issn><publisher><publisher-name xml:lang="en">Publishing House ABV Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">509</article-id><article-id pub-id-type="doi">10.17650/1994-4098-2016-12-3-62-69</article-id><article-categories><subj-group subj-group-type="toc-heading"><subject>ГИНЕКОЛОГИЯ. ОБЗОР</subject></subj-group><subj-group subj-group-type="article-type"><subject></subject></subj-group></article-categories><title-group><article-title xml:lang="en">Optimizing the primary treatment of patients with advanced ovarian cancer</article-title><trans-title-group xml:lang="ru"><trans-title>Аспекты выбора первичного лечения больных распространенным раком яичников</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Nikogosyan</surname><given-names>S. O.</given-names></name><name xml:lang="ru"><surname>Никогосян</surname><given-names>С. О.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Department of Gynecology, </p><p>23 Kashirskoe Shosse, Moscow, 115478</p></bio><bio xml:lang="ru"><p>гинекологическое отделение,</p><p>115478, Москва, Каширское шоссе, 23</p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Kuznetsov</surname><given-names>V. V.</given-names></name><name xml:lang="ru"><surname>Кузнецов</surname><given-names>В. В.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Department of Gynecology, </p><p>23 Kashirskoe Shosse, Moscow, 115478</p></bio><bio xml:lang="ru"><p>гинекологическое отделение,</p><p>115478, Москва, Каширское шоссе, 23</p></bio><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Zagashtokov</surname><given-names>A. Z.</given-names></name><name xml:lang="ru"><surname>Загаштоков</surname><given-names>А. З.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Department of Gynecology, </p><p>23 Kashirskoe Shosse, Moscow, 115478</p></bio><bio xml:lang="ru"><p>гинекологическое отделение,</p><p>115478, Москва, Каширское шоссе, 23</p></bio><email>zagamedik@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Rumyantsev</surname><given-names>A. A.</given-names></name><name xml:lang="ru"><surname>Румянцев</surname><given-names>А. А.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Department of Gynecology, </p><p>23 Kashirskoe Shosse, Moscow, 115478</p></bio><bio xml:lang="ru"><p>гинекологическое отделение,</p><p>115478, Москва, Каширское шоссе, 23</p></bio><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">N.N. Blokhin Russian Cancer Research Center, Ministry of Health of Russia</institution></aff><aff><institution xml:lang="ru">ФГБУ «РОНЦ им. Н.Н. Блохина» Минздрава России</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2016-11-24" publication-format="electronic"><day>24</day><month>11</month><year>2016</year></pub-date><volume>12</volume><issue>3</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>62</fpage><lpage>69</lpage><history><date date-type="received" iso-8601-date="2016-11-24"><day>24</day><month>11</month><year>2016</year></date><date date-type="accepted" iso-8601-date="2016-11-24"><day>24</day><month>11</month><year>2016</year></date></history><permissions><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/></permissions><self-uri xlink:href="https://ojrs.abvpress.ru/ojrs/article/view/509">https://ojrs.abvpress.ru/ojrs/article/view/509</self-uri><abstract xml:lang="en"><p>In this article we analyzed the issues of optimizing the upfront debulking surgery for patients with advanced ovarian cancer. We reviewed the recent evidence highlighting the actual concerns of using neoadjuvant chemotherapy aiming to reduce the tumor burden and enhance the probability of optimal cytoreduction; the rates of complete and optimal cytoreduction. From the up-to-date point of view we designated the pros and cons of upfront and neoadjuvant chemotherapy, the major disadvantages of the only head-to-head comparison study of these approaches. Outlined the role lymphodissection and extended surgery for advanced ovarian cancer, including performance of small and large bowel, liver, spleen, peritoneum and diaphragm resections. We analyzed the existing risk factors of and prognostic models predicting the probability of optimal cytoreduction which allows the oncologists to select patients which will benefit from neoadjuvant chemotherapy and interval cytoreduction.</p></abstract><trans-abstract xml:lang="ru"><p>В статье рассмотрены вопросы выбора тактики лечения пациенток с диссеминированными формами рака яичников. Подробно оценена современная доказательная база, касающаяся преимуществ и недостатков выполнения хирургического лечения или неоадъювантной химиотерапии на 1-м этапе лечения в зависимости от функционального состояния больных и распространенности опухолевого процесса. Представлены данные литературы о частоте оптимальных циторедукций в различных странах мира и выживаемости больных в зависимости от размера остаточной опухоли после хирургического этапа лечения. Рассмотрена роль вы- полнения лимфодиссекции, а также комбинированных хирургических операций с резекцией тонкой и/или толстой кишки, печени, селезенки, брюшины и т.д. Проанализированы существующие факторы прогноза и прогностические модели, позволяющие выделить пациенток, которым на 1-м этапе лечения в силу низкой вероятности выполнения оптимальной циторедукции показано проведение неоадъювантной химиотерапии.</p></trans-abstract><kwd-group xml:lang="en"><kwd>advanced ovarian cancer</kwd><kwd>optimal cytoreduction</kwd><kwd>complete cytoreduction</kwd><kwd>neoadjuvant chemotherapy</kwd><kwd>interval cytoreduction</kwd><kwd>lymph node dissection</kwd><kwd>extended surgery</kwd><kwd>prognostic model</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>распространенный рак яичников</kwd><kwd>оптимальная циторедукция</kwd><kwd>полная циторедукция</kwd><kwd>неоадъювантная химио- терапия</kwd><kwd>интервальная циторедукция</kwd><kwd>лимфодиссекция</kwd><kwd>комбинированные операции</kwd><kwd>прогностическая модель</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><citation-alternatives><mixed-citation xml:lang="en">1. 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