Objective: to study the expression of anti-apoptotic protein survivin and its gene BIRC5 in primary breast carcinoma as a potential predictive and prognostic marker.

Materials and methods. Using immunohistochemical methods and real-time polymerase chain reaction 67 samples (biopsy) of the primary breast carcinoma were studied for the presence of expression of survivin protein and its gene BIRC5.

Results. Expression of survivin was determined in 47 (70.15 %) mammary carcinoma samples. Expression of survivin was most often determined in medium and high grade ductal carcinoma (G2–G3), and was associated with lymphovenous stromal invasion in most cases. Expression of survivin protein correlated with the expression of HER2/neu. In 59.6 % of cases survivin was expressed in tumors with a low Ki-67 index. Most often, survivin was expressed in luminal A and luminal B molecular-biological tumor subtypes. Real-time polymerase chain reaction determined the expression of BIRC5 gene in all 67 carcinoma samples. The level of normalized expression of BIRC5 gene significantly moderately correlated with the expression of its product – survivin protein (r = 0.704, p <0.01) and slightly correlated with the expression of oncoprotein HER2/neu (r = –0.285, p <0.05). The median follow-up was 40 months. Overall survival of patients without survivin expression in primary tumor was 100 %, overall survival of patients with survivin expression was 77.16 % (range 74.6–80.1 %) (p = 0.041), relapse-free survival was 100 % and 71.9 % (range 70.1–74.2 %) respectively (p = 0.037). The ratio of progression risks in the survivin expression group was 10.6 (95 % confidence interval 0.85–132.2) (p = 0.041).

Conclusion. Expression of the protein survivin and its gene BIRC5 is an independent adverse prognostic factor and can be used as a predictive and prognostic marker.

Background. A new strategy of breast cancer management is required for effective disease prevention and control. Immunotherapy is one of promising options.

Objective: to evaluate the effect of immunoadjuvant polyoxidonium on pathmorphological changes in breast tumors.

Materials and methods. The study was performed in 75 patients with breast cancer: 50 patients received polyoxidonium in a neoadjuvant regimen (main group), 25 patients did not receive polyoxidonium (control group). Polyoxidonium at a dose of 12 mg was administered intramuscularly 1 time per day on the days 1, 2, 3, 5 and 7 before surgery; on the day 8, radical mastectomy was performed in patients of both groups, followed by histological examination and determination of the grade of therapeutic pathomorphosis of the tumor.

Results. The proportion of cases with grade I therapeutic pathomorphosis was 58 %, grade II therapeutic pathomorphosis – 6 %. Pathomorphosis in metastatic lymph nodes was observed in 22.7 % of cases.

Conclusion. The anti-tumor effect of polyoxidonium was confirmed on the basis of the induction of pathomorphosis of the tumor tissue of breast cancer.

The article considers the modern methods of diagnosis and treatment of primary operable breast cancer depending on molecular biological profile of the tumor.

Genital bleeding poses a serious threat to patients with progressive locally advanced malignant tumors. Surgical treatment is often impossible in these patients; therefore, to achieve reliable hemostasis, the patients should undergo embolization of vessels feeding the tumor. Good results have been achieved by selective catheterization of pelvic arteries using chemoembolization with HepaSphere microspheres (Biosphere Medical, France) delivering the therapeutic agent to the tumor. Hydrophilicity of microspheres loaded with cytostatics and their biological compatibility with tissues ensure long-term therapeutic effect by controlling tumor growth. Pronounced hemostatic and antitumor effects of this treatment method have been confirmed by a morphological study. This study analyzes 38 patients that underwent chemoembolization with HepaSpheres loaded with doxorubicin or irinotecan, which allowed surgery and further treatment.

Objective: to assess the efficacy of fluorescence sentinel lymph node (SLN) detection with indocyanine green (ICG) in patients with cervical cancer.

Materials and methods. We analyzed the results of examination and treatment in 80 patients with morphologically verified stage IA1–IIA1 cervical cancer. All patients underwent laparoscopic surgery with fluorescence SLN detection with ICG using a high-resolution infrared camera.

Results. SLNs were detected in 78 out of 80 patients (97.5 %); the rate of bilateral SLN detection was 80.0 % (64 out of 80). SLNs were not identified in 2 patients only (2.5 %). The majority of SLNs (99 out of 176; 56.28 %) were located in the internal group of lymph nodes, near to the common iliac artery bifurcation. Eleven out of 80 patients (13.75 %) were found to have pelvic lymph node metastasis. SLN metastatic lesions were observed in 10 out of 80 patients (12.5 %), whereas only one participant had non-SLN metastasis. Therefore, the sensitivity of the fluorescence method with ICG was 98.75 %.

Conclusion. Fluorescence SLN mapping with ICG in patients with stage IA1–IIA1 cervical cancer is an effective diagnostic method allowing SLN topical diagnosis, intraoperative restaging, and correction of the treatment strategy.

Objective: to analyze treatment outcomes in patients with stage IIA–IIIB cervical cancer.

Materials and methods. The study included 278 women with stage IIA–IIIB cervical cancer. Study participants were divided into 2 groups. Group 1 comprised 165 patients who received chemoradiotherapy + surgery (radical hysterectomy). Patients in group 2 received standard radiotherapy.

Results. Patients receiving combination therapy demonstrated better overall and relapse-free survival compared to those receiving standard treatment.

Conclusion. Both publications of other authors and our own results suggest high efficacy and safety of combination therapy for stage IIA–IIIB cervical cancer.

Objective: to assess the efficacy of dose-intensive platinum-containing neoadjuvant chemotherapy in patients with FIGO stage IB2–IIB locally advanced cervical cancer.

Materials and methods. We evaluated the efficacy and toxicity of 3 cycles of intravenous dose-intensive neoadjuvant chemotherapy with either AP regimen (cisplatin 75 mg/m2 and doxorubicin 35 mg/m2) or TP regimen (cisplatin 60 mg/m2 and paclitaxel 60 mg/m2).

Results. The study included 105 patients (75 in the AP group and 30 in the TP group) aged between 27 and 63 years (mean age 44 years) with primary verified cervical cancer (T1–2B0–2Nx–0M0). Surgery was performed in 66 patients (88 %) from the AP group and 24 patients (80 %) from the TP group. Six patients (8 %) receiving AP regimen and 1 patient (3.3 %) receiving TP regimen developed disease progression. Four women (2.8 %) from the AP group developed relapses, whereas none of the patients from the TP group had relapses. Dose-intensive chemotherapy did not cause any significant complications at both chemotherapeutic and surgical stages. Our findings suggest that dose-intensive neoadjuvant chemotherapy is an effective method with an objective response rate of 84 % (63 cases) and 56.7 % (17 cases) in groups AP and TP respectively. Fifty-nine patients (78.7 %) receiving AP regimen had pathological response; of them, 7 participants (9.4 %) demonstrated pathological complete response (ypCR). In the TP group, 19 patients (63.3 %) had pathological response and 4 patients (13.4 %) had pathological complete response. Median follow-up time was 16.7 months (range: 3–29 months) in the AP group and 9.1 months (range: 2.8–12.7 months) in the TP group.

Conclusion. Dose-intensive neoadjuvant chemotherapy can be considered as an alternative to standard treatment of locally advanced cervical cancer; however, further studies are needed due to the small sample size in this study.

This article reviews the concept of sentinel lymph node biopsy in patients with endometrial cancer. This technique is becoming increasingly appreciated and was included into the latest standards of surgical treatment for gynecological cancers. Sentinel lymph node mapping is a reliable and highly specific (100 %) method, which can be used for determining the indications for adjuvant therapy in addition to a detailed pathomorphological examination that should include immunohistochemical testing and ultrastaging.

Lymphatic cysts, also known as lymphocele, are one of the most common complications after pelvic and paraaortic lymph node dissection in patients with gynecological cancers. Despite the high incidence of this complication, no specific guidelines on the diagnosis and treatment of lymphocele have been developed so far. This article analyzes the incidence of lymphatic cysts, risk factors, and currently available options for their diagnosis and treatment.