Introduction: Patients with lung cancer receive treatment according to National Cancer Comprehensive Network (NCCN) standards. However, disease recurrence is reported in about 30% of patients during the first five years. Our study aimed to establish independent predictors of lung cancer recurrence. Material and methods: 104 patients with definitive treatment for nonsmall-cell lung carcinoma receiving standard adjuvant chemotherapy in the period 2014-2018 in our cancer center were retrospectively reviewed. The prognostic significance of five routine immunohistochemical (IHC) markers was examined. Results: During the follow-up period disease recurrence occurred in 42 (40.4%) of the 104 enrolled patients. The median recurrence-free survival was 56.3 months, range 4-84.0 months (95% CI = 46.866-65.683). The recurrence-free survival rate was 58.8%. The frequencies of locoregional recurrence, lung recurrence, kidney, bone, lymph nodes of the neck, liver, and brain recurrence were 23.8%,

According to GLOBOCAN 2.2 data a million of new cases of lung cancer and 1.8 million of deaths from this pathology were registered in the world in 2020. Every tenth patient with suspected malignancy was diagnosed with lung cancer, and death of every fifth of them was caused by it. Aim. To analyze the trend of the spreading of lung cancer among the population of Sumy region and Ukraine, as well as compare it with global indicators for the period of 2011-2020. Methods. The data from The Global Cancer Statistics (GLOBOCAN) and National Cancer Register of Ukraine were used. GLOBOCAN helped to evaluate global trends, while National Cancer Register of Ukraine helped to evaluate lung cancer statistics among residents of Ukraine and Sumy region. Results. The incidence rate of lung cancer among residents of Sumy region during the observed period was 24% higher than the average rate in Ukraine. Among women population prevalence of lung cancer in Sumy region exceeds the Ukrainian average rate by almost 19%. The incidence rate in the districts in general corresponded to the average indicators in the region. But it is possible to identify areas with the highest incidence rate (Burynskyi, Lebedynskyi, Glukhovskyi), as well as areas with the smallest rate (Seredyna-Budskyi, Trostyanetskyi, Shostkinskyi, Konotopskyi). The indicators of the Burynskyi district exceed the Ukraine nationwide indicators by 2.2 times, and the regional by 1.7 times. According to GLOBOCAN data lung cancer was the most common malignancy in 10 world regions over the past decade: Central and Eastern Europe, Eastern Asia, Southern Europe, North America, Western Europe, Micronesia / Polynesia, Western Asia, Northern Europe, Australia / New Zealand, and Southeast Asia. If we compare 2012 and 2020, a significant reduction in the incidence of lung cancer was observed only in North America. On the contrary, the negative dynamics was observed in Micronesia / Polynesia, and especially by West Asia, where the indicators in 2020 were more than 2 times higher than in 2012. Diagnose of lung cancer in women was mainly recorded in North America, Northern Europe and Australia / New Zealand. In addition, in North America incidence rate for woman were almost the same as in men. In Northern Europe and Australia / New Zealand they were only slightly smaller than in men. The incidence among women in Western Asia, Central and Eastern Europe, on the other hand, is several times lower than among men. In Ukraine, the incidence of lung cancer among women is about 5 times lower than the incidence among men. The incidence rate in Ukraine in 2020 corresponded to the indicators of Eastern Europe (29.5 versus 30.3 per 100 000 population, respectively). There is no significant downward trend in morbidity over the past 10 years. Conclusions. The incidence rate of lung cancer among residents of the Sumy region for the period from 2011 to 2020 significantly exceeded the average Ukrainian indicators. The situation in Ukraine was fully consistent with the data presented in GLOBOCAN for the countries of Eastern Europe. The countries of this region, along with North America, East Asia and Western Europe, occupied the leading positions in the incidence rate of lung cancer among both men and women. Country with the highest prevalence of malignant lung tumors among men is Turkey, while among women is Hungary. The downward trend in the incidence rate was observed only in high-income countries. For developing countries where smoking is still gaining, the peak of the incidence rate has not been reached yet. Ukraine also belongs to such countries.

Gastrointestinal stromal tumors (GIST) are one of the most common mesenchymal tumors that originate from the intestinal cells of Cajal. The most common localization of GIST is the gastrointestinal tract, however, extragastrointestinal forms are sometimes found. Most GISTs are small in size, which most often does not exceed 5 - 8 cm in maximum dimension. This article describes the case of a patient with a non-metastatic giant tumor of the stomach without any clinical manifestations. The tumor was localized in the abdominal cavity, occupying almost all of it, squeezing and displacing the surrounding organs. Due to the cystic-solid structure, its gigantic size and intimate adherence to the surrounding organs, it was not possible to carry out an accurate differential diagnosis before surgery. Intraoperative imaging of the tumor, further histological and immunohistochemical (CD117, CD34, S100, CD45, PanCK; Ki-67) studies made possible to establish the diagnosis of gastric GIST T4N0M0 stage II. Based on the data obtained, despite the gigantic size, the prognosis of the disease was considered favorable (low mitotic index, no metastasis). During the period of clinical observation, within 1.5 years after surgery, no relapse or disease progression was recorded, which indicates a favorable prognosis for the patient.

Lung cancer is one of the main causes of death from malignant neoplasm all around the world. For the purpose of personalized treatment immunohistochemical determination of specific proteins (biomarkers) presence in tissues and biological fluids is needed. Today management of patients with lung cancer is directly associated with determination of genes mutations: EGFR, ALK, ROS1 and rate of PD-L1 receptors expression. Depending on the PD-L1 expression level blockers of these receptors can be used as the first, supportive and second / third line therapy. As the first line of therapy for patients with high expression level of PD-L1 (≥ 50 % TPS) Pemblizomab is recommended, while for patients with moderate levels (PD-L1 1 – 49% TPS) PD-L1 blockers can be used only as a second / third line of therapy. In numerous clinical trials efficiency and safety of Pemrolizumab, Nivolumab and Atezolizumab have been proved. Testing of Avelumab, Durvalumab, as well as combined drugs – Ipilimumab and Tremilimumb are still going on.