On the basis of the Department of Oncogynecology together with the pathoanatomical department of the N.N. Petrov Research Institute of Oncology conducted a comparative assessment of age-related features of endometrial cancer. The study included 309 patients, which were divided into two groups: group 1 - from 50 to 69 years (n = 150), group 2 - 70 years and older (n = 159). The article presents a comparative assessment of treatment, morphological characteristics of the tumor and the prevalence of the tumor process in two age groups, as well as the long-term results of treatment.

Background. More than 80 % of cases ovarian cancer are detected at stage III–IV. One of the most important predictive factors is the cytoreductive surgery without residual tumor.   Aim. To determine the selection criteria for cytoreductive surgery in the advanced ovarian cancer patients.   Materials and methods. The study included 190 primary IIB–IV stage ovarian cancer patients who underwent surgical treatment in the oncogynecological department of the N. N. Petrov NMRC on Oncology in the period from August 2017 to August 2020. All patients underwent pelvic magnetic resonance imaging, chest and abdominal computed tomography, and diagnostic laparoscopy. Assessment of the peritoneal carcinomatosis index (PCI) was performed according to P. Sugarbaker. The outcome of cytoreductive surgery was determined by the size of the residual tumor: complete – without a macroscopically detectable tumor, optimal – residual tumor ≤1 cm, suboptimal – residual tumor ≥1 cm.   Results. The complete or optimal cytoreduction achieved in 72.6 % of cases (48.9 % (93 / 190) and 23.7 % (45 / 190), respectively), suboptimal in 22 % (42 / 190) of cases, 5 % (10 / 190) only a diagnostic laparoscopy due to the initial underestimation of the tumor dissemination. In the entire sample PCI value ranged from 0 to 35 points, the median was 4 points (2; 11). In the group of optimal cytoreductions PCI ranged from 0 to 19 points, median – 3 points (2; 6), in the group of suboptimal from 5 to 35 points, median – 19.5 points (15; 23) (p < 0.0001, Mann–Whitney test). No optimal cytoreduction was performed in PCI >20 points. The optimal cut-off PCI point was 9.5 points (sensitivity 92.1 %, specificity 86.2 %, overall accuracy 87.4 %), if PCI ≤ 9 points – the operation will be hypothetically optimal, if PCI ≥ 10 then hypothetically suboptimal. The main cause of non-optimal interventions (n = 52) were: diffuse carcinomatosis of the small bowel and its mesentery – 73 % (38 / 52), carcinomatosis of the hepatoduodenal zone – 9 % (5 / 52) and a total of 16 % (9 / 52) were other non-resectable tumors (paraaortal, intrathoracic lymph nodes, invasion of the pancreas or pleura, lung metastases). Radiation diagnostic and intraoperative revision were comparable in 60.5 % (115 / 190) of cases. The sensitivity of radiological diagnostic methods in detecting of the small intestine lesions was 23.7 %, the specificity was 90 %, while for laparoscopic diagnostics, the sensitivity in detecting of the small intestine lesions was 93.3 %, and the specificity was 100 %. In assessing of carcinomatosis of the hepatoduodenal zone, the advantage belongs to radiation diagnostic methods: the sensitivity of computed tomography was 66.7 %, the specificity was 97 %, while the sensitivity of diagnostic laparoscopy was 0 %.   Conclusions. Determination of a high score in assessing the index of peritoneal carcinomatosis, detection of damage to the hepatoduodenal zone, diagnosed mainly by radiation imaging methods, detection of diffuse lesions of the small intestine, determined mainly by laparoscopic diagnosis reduces the frequency of suboptimal cytoreductive operations from 67 % to 13 %.

The study included 160 patients with advanced ovarian cancer (OC) who underwent combined treatment from January 2000 to January 2013 at the N.N. Petrov Research Institute of Oncology. Compared to non-mutated patients, BRCA-positive patients were characterized by a longer platinum-free interval (BFI) (14 months [95% CI 9.6-36.4 months] versus 8 months [95% Ci 4.8-12.4 months]; P = 0.006), with the largest median of the BFI were established using the CAP scheme - 33.5 months versus 12 months using the TCbP scheme. Half of patients with a mutation in the BRCA1 gene (20/40 (50%)) had an isolated recurrence in the pelvic area versus 35/120 (29.2%) of patients without mutations (p = 0.00001). The progression of distant foci in the first recurrence of the disease in patients with mutations was significantly lower (15/40 (37.5%) versus 84/120 (70%), p = 0.00001). In addition 85% of recurrences in BRCA-positive patients were platinum-sensitive. Only the age of patients with advanced OC was an independent prognostic factor of BFI since the start of treatment (p = 0.00001).

On the basis of the Departments of Oncogynecology and Radiology of the N.N. Petrov Research Institute of Oncology there was performed a comparative analysis of the results of detection of the sentinel lymph node using a fluorescent method with Indocyanine Green (ICG) and a radioisotope method with 99m-labeled colloidal radiopharmaceutical in endometrial cancer patients undergoing laparoscopic hysterectomy with lymphadenectomy from June 2016 to December 2016. The study included 19 patients with early endometrial cancer. Specificity and sensitivity of methods of radiation diagnostics (ultrasound and MRI) in the detection of metastatic involvement of pelvic lymph nodes are also presented.