PURPOSE The 2-year Russian oncology residency focuses on diagnosis and treatment of malignancies but lacks evidence-based medicine (EBM) and patient communication skills (PCS) training. To overcome these educational disparities, the 5-year national program, the Higher School of Oncology (HSO), involving Russian expatriate physicians trained in the United States was established. METHODS A retrospective study was conducted. Highly motivated oncology residents were enrolled in the program through the three-step selection process. US-trained Russian expatriate physicians acted as mentors. EBM skills were taught through weekly online journal clubs and clinical case presentations. PCS training included live seminars and simulations after journal clubs. EBM knowledge was assessed using Fresno test among newly enrolled and postgraduate year (PGY) 2-5 HSO residents. PCS were evaluated via simulation exam including two clinical scenarios (maximum score 100 each) among 17 PGY2 HSO residents and seven non-HSO trainees. RESULTS Overall, 54 residents were enrolled over 5 years (8-13 annually); four were released from the program. The mean age was 24 ± 1 years, and 56% were females. Median scores of Fresno test were significantly higher among PGY 2-4 HSO residents compared with newly enrolled participants: 111 (IQR, 71-128) versus 68 (IQR, 42-84), P = .042; moreover, performance correlated with year of program participation (rs = 0.5; P < .0001). PCS assessment score was significantly higher among HSO residents than non-HSO trainees: 71 (IQR, 58-84) versus 15 (IQR, 10-30) for scenario number 1 ( P < .0001) and 78 (IQR, 71-85) versus 22 (IQR, 4-58) for scenario number 2 ( P = .005), respectively. CONCLUSION The involvement of Western-trained expatriates in remote education improves EBM and PCS among oncology trainees from their home country. This strategy can be useful in overcoming global medical education disparities in other specialties and in countries facing similar challenges.

Цель исследования-представить клинический случай очень редкой злокачественной опухоли-хондросаркомы трахеи. В англоязычной медицинской литературе описано всего 18 случаев этого заболевания. Материалы и методы. Мужчина, 74 лет, обратился за медицинской помощью к оториноларингологу в августе 2011 г. в связи с осиплостью голоса, наблюдавшейся в течение 3 лет и постепенно усиливавшейся. Диагностирована миксоидная хондросаркома. Результаты. В сентябре 2011 г. проведена тиреоидэктомия с циркулярной резекцией трахеи на уровне 2-го кольца и наложением трахеального анастомоза. Объем операции обусловлен наличием в правой доле щитовидной железы узлового новообразования с инвазией в перстневидный хрящ гортани и 1-е кольцо трахеи. С ноября по декабрь 2011 г. пациент проходил курс адъювантной дистанционной конформной лучевой терапии в суммарной дозе 50 Гр в режиме 5 / 2 с разовой дозой 2 Гр. Безрецидивный период длился 3 года 9 мес. В сентябре 2015 г. в проекции правой пластинки щитовидного хряща гортани выявлено узловое новообразование диаметром 24 мм с экзофитным компонентом, расцененное как рецидив хондросаркомы. В мае 2016 г. выполнена ларингэктомия. Края резекции были без признаков опухолевого роста (R0). На данный момент длительность ремиссии составляет 2 года 9 мес. Заключение. Клинический случай демонстрирует успешное комбинированное лечение пациента с хондросаркомой трахеи с длительной ремиссией после радикального лечения рецидива.

Introduction. Currently thyroid nodules are a widespread problem in clinical oncology and head and neck cancer, malignant focal lesions constitute more than 15-20 %. Accurate diagnosis is very important and determines treatment, as well as the volume of surgical intervention. Objective-determination of the diagnostic value of the method of contrast-enhanced ultrasound in the diagnosis of thyroid cancer. Reference materials were the results of the histological study of surgical specimens. Method. Performed a retrospective analysis of medical records of 42 patients who underwent surgery at the surgical department of head and neck tumors on the verified thyroid cancer in the N.N. Petrov Research Institute of Oncology at the Ministry of Health of Russia. The number of female patients was 36 persons (85.5 %), the number of men was 6 people (14.5 %). The average age of patients among men was 55.5 years, women-46 years. All patients underwent surgical treatment in the amount of extirpation of the thyroid gland-16 patients (37.5 %), hemithyroidectomy-26 patients (62.5 %). Results. The sensitivity of ultrasound with contrast in the diagnosis of cancer of the thyroid gland was 94.11 %, specificity was 87.5 %, diagnostic accuracy-92.8 %. Conclusions. The technique of ultrasound nodules thyroid with intravenous contrast enhancement has an excellent diagnostic properties, allowing to identify and verify thyroid cancer is 8 % more accurately in comparison with standard ultrasound technique.

Background. The two-year Russian oncology residency focuses on the diagnosis and treatment of malignancies but lacks evidence-based medicine (EBM) and communication skills training. To overcome these educational disparities, the 5-year national program, the Higher School of Oncology (HSO), involving Russian expatriate physician trained in the United States medicine was established. The study aim was to assess the efficacy of HSO. Methods. A retrospective cohort study was conducted. Highly motivated oncology residents were enrolled in the program through the 3-step selection process. United States trained Russian expatriate physicians acted as mentors. EBM skills were taught through weekly online journal clubs and clinical case presentations. Patient communication training included annual live seminars and simulations after journal clubs. EBM knowledge was assessed using the Fresno test among newly enrolled residents and PGY2-5 HSO residents. Communication skills were evaluated via simulation exam including two clinical scenarios (maximum score 100 for each) between 17 PGY2 HSO residents and 7 non-HSO young oncologists.Results. Overall, 54 residents were enrolled for 5 years (8-13 annually); 4 (7%) were terminated. The mean participant age was 24±1 years and 30 (56%) were females. Mean participant medical school GPA was 4.8±0.2 (max 5.0). The specialties distributed as follows: 33% surgical oncologists, 46% medical oncologists, 6% radiology oncologists, 6% pediatric oncologists, and 9% oncology pathologists. The median scores of the Fresno test were significantly higher among PGY 2-4 HSO residents compared to just enrolled participants: 111 (IQR: 71-128) vs 68 (IQR: 42-84), p=0.042. Fresno test performance correlated with the year of participation in the program (rs=0.5, p<0.0001). Communication skills assessment score was significantly higher among HSO residents than in non-HSO young oncologists: 71 (IQR: 58-84) vs 15 (IQR: 10-30) for scenario #1 (p<0.0001), and 78 (IQR: 71-85) vs 22 (IQR: 4-58) for scenario #2 (p=0.005), respectively.Conclusion. The involvement of Western-trained expatriates in remote education improves EBM and patient communication skills among young oncologists from their home country. This strategy can be useful in overcoming global medical education disparities in other specialties and in countries facing similar challenges.

e18037 Background: Elective neck dissection remains the standard treatment for cN0 oral cancer due to the high incidence of occult lymph node (LN) metastases. Sentinel lymph node biopsy (SNB) might be a less morbid alternative to neck dissection. Diagnostic value of SLNB depends on the number of sampled LNs. We aimed to compare the diagnostic features of SNB and RGEND in patients with T1-2N0 oral tongue cancer. Methods: A prospective study was conducted in patients with cT1-2N0M0 oral tongue squamous cell carcinoma treated between January 2016 and December 2020. The procedure included SLNB ollowed by immediate extent ipsilateral neck dissection. SLNB included accumulated radiotracer LNs, which located close to the primary tumor. RGEND included LNs accumulated radiotracer with all LNs located at the same level. Pathology assessment was performed and diagnostic characteristics were compared between SLNB and RGEND. Results: A total of 38 patients were enrolled. The mean age was 55.7±13,1. Twenty-four patients had unilateral lymph flow and 14 had bilateral. Sentinel LNs were located at levels IIa-III. Occult metastases were found in 15,8% (n = 6) of patients. The median number of LNs in the sample was 3 (IQR: 1-5). The sensitivities of SLNB and RGEND were 50% (95%CI: 15.7 - 84.3) and 100% (95%CI: 54.7-100), respectively, p-value = 0.001. Specificity was similar among groups: 100% (95%CI: 88-100) and 100% (95%CI: 89.1-100. SLNB had accuracy of 89.5% (95%CI: 77.2 - 97), and RGEND 100% (95% CI: 90.7-100), p-value = 0.001. Positive predictive value (PPV) was similar among groups. Negative predictive value (NPV) was 88.2% (95% CI: 78.9 - 93.7) in SLNB and 100% (95%CI: 91-100) in RGEND groups. p-value = 0.001. Conclusions: SLNB and RGEND have high rates of specificity, accuracy, PPV, and NPV, regardless of sampling size. RGEND has the highest sensitivity in patients with cT1-2N0 oral tongue cancer.