Objective: To analyze literature data, assess prognostic factors, and evaluate the potential for implementing therapy in patients with the triple-negative subtype of the disease.
Materials and methods: Publications, reviews, large meta-analyses, and studies addressing this topic were used. A total of 23 sources were consulted to write this review.
Results: Analysis of available studies has shown that determining androgen receptor expression in breast cancer — particularly in the triple-negative subtype — could become a new direction in developing adjuvant therapy and improving patient prognosis.
Conclusion: Androgen receptor expression represents a promising therapeutic target in breast cancer. Its level may have both prognostic value and the potential to predict treatment response. Although conclusive clinical evidence for this role is still limited, the complex interaction of androgen receptors with key signaling pathways and their context-dependent functions in different molecular subtypes of breast cancer open up important avenues for research.
Keywords: breast cancer, prognostic factors, hormone therapy, androgens, receptor expression
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Introduction. The key proangiogenic factor VEGF is one of the important activators of tumor angiogenesis. The aim of the work – to analyze VEGF levels in the blood serum and tumor extracts of patients with ovarian cancer, taking into account the main clinical and morphological characteristics of the disease.
Materials and method. A total of 288 patients with ovarian neoplasms were examined, including: 119 with ovarian cancer (OC) at various stages of the disease, 16 with borderline ovarian tumors (borderline OT), 153 with benign ovarian tumors (benign OT) aged 18 to 82 years. The control group included 191 healthy women aged 18 to 79 years. The VEGF concentration was determined in blood serum and tumor lysates by the enzyme immunoassay using the Quantikine® “Human VEGF” reagent kits (R&D systems, USA) in accordance with the manufacturer’s instructions. Measurements were performed on a BEP 2000 Advance automated enzyme immunoassay analyzer (Siemens Healthcare Diagnostics, Germany).
Resuts. It was found that the median serum VEGF content in patients with OC was statistically signifi cantly higher (554 pg/ ml) than in the control (252 pg/ml) (p < 0.0001), BOC (273 pg/ml) (p < 0.0001) and BOC (286 pg/ml) (p < 0.0001). Serum VEGF levels did not differ between borderline OT, benign OT and the control. According to the ROC analysis, serum VEGF levels cannot serve as an independent marker in the diagnosis of OC. No relationship was found between VEGF levels and age in OC and borderline OT, but this reliable association was noted in the group of patients with benign OT. Multivariate analysis showed that an increase in serum VEGF in patients with ovarian tumors statistically signifi cantly reflected reproductive status (p = 0.0003) and the presence of abortions in the anamnesis (p = 0.02), but was not associated with the presence of childbirth in the anamnesis. No correlation was found between the content of VEGF and CA-125 in the blood serum of patients with OC, borderline OT, benign OT. No differences were found in the content of serum VEGF in OC and benign OT, taking into account their morphological type. In patients with ovarian tumors, reliably high concentrations of the marker were found in the serous type of neoplasm. Statistically signifi cantly higher median VEGF concentrations were found in patients with High grade tumors (690 pg/ml) than with Low grade tumors (558 pg/ml) (p = 0.036). Serum VEGF levels were signifi cantly associated with the detection of metastases in the greater omentum and iliac lymph nodes. It was noted that the median VEGF content was signifi cantly higher in OC lysates (363 pg/mg protein) compared to benign OT (12 pg/mg protein; p = 0.001) and did not differ from borderline OT (227 pg/mg protein). No correlation was found between VEGF levels in blood serum and tumor extracts in the three groups of patients; this dependence was noted only in wide spread stages III–IV OC. The median VEGF concentrations in ovarian tumor extracts did not depend on their histological type. A signifi cant decrease in the median VEGF content in tumor lysates of patients with stage IV OC (53 pg/mg protein) was noted, compared with stage I (494 pg/mg protein; p < 0.05). No signifi cant differences were found in the median VEGF content in tumor extracts of patients with OC depending on the degree of their differentiation.
Conclusion. The obtained data indicate a relationship between VEGF levels in the blood serum and extracts in the tumor of patients with OC with the clinical and morphological characteristics of the disease, which is of great practical and fundamental importance for characterizing the most aggressive tumor of the female reproductive system. These studies are ongoing to analyze their prognostic signifi cance.
Keywords: ovarian cancer, VEGF, blood serum, tumor extracts
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Background: anthracyclines are widely used in the treatment of recurrent ovarian cancer (ROC). However, randomized trials in this setting have primarily investigated pegylated liposomal doxorubicin (PLD), which is often limited in availability in clinical practice. Conventional doxorubicin may possess similar therapeutic effi cacy in the treatment of ROC.
Materials and Methods. A retrospective cohort study was conducted including patients who received chemotherapy for the first recurrence of high-grade serous or endometrioid ROC between 2014 and 2024 at the N. N. Blokhin National Medical Research Center of Oncology. Patients were stratifi ed into two groups based on the inclusion of doxorubicin in their treat ment regimen. The experimental group patients were treated with conventional doxorubicin (either as monotherapy or in combination with other antineoplastic agents), while the control group patients received other standard therapeutic options for recurrent ROC. The primary endpoint of the trial was progression-free survival (PFS). Cardinality matching (1:3 ratio) was employed to ensure group balance.
Results. Following the matching procedure, the fi nal study cohort consisted of 276 patients. Median PFS was 5.5 mo. in the doxorubicin group compared to 6.4 mo. in the control group; 1-year PFS rates were 16.4 % vs. 13.5 %, respectively (hazard Ratio [HR] 0.94; 95 % CI 0.71–1.26; p = 0.680). At 3 years overall survival (OS) rate was 29.8 % and 30.5 % in the control group (HR 0.94; 95 % CI 0.66–1.35; p = 0.739). Subgroup analysis revealed no signifi cant heterogeneity in treatment effi cacy across different patient subsets.
Conclusions: conventional doxorubicin demonstrates comparable effi cacy to other therapeutic options for recurrent ovarian cancer. The study results support the use of conventional doxorubicin as a viable treatment alternative for disease recurrence.
Keywords: ovarian cancer, recurrence, doxorubicin, PLD, bevacizumab, anthracyclines
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Introduction. Surgical staging, including pelvic and para-aortic lymphadenectomy, is standard treatment for early ovarian cancer (EOC). However, the signifi cance of lymph node dissection in terms of its impact on survival rates in patients with IA–IIA stage EOC remains a subject of debate. At the same time, lymphadenectomy is characterized by a higher incidence of postoperative complications.
Aim. To evaluate the immediate results of surgical treatment and the nature of complications in patients with early EOC (FIGO I–IIA) depending on whether retroperitoneal lymphadenectomy was performed or not. Materials and methods. A retrospective single-center study was conducted, including 367 patients who underwent surgery at the N. N. Blokhin National Medical Research Center of Oncology from 2010 to 2025. All patients were divided into two groups based on the presence of a lymphadenectomy stage. The main group consisted of 183 women who underwent systemic pelvic and para-aortic lymphadenectomy, while the control group included 184 patients without lymphadenectomy. Nonparametric statistical methods were used to analyze the data. The Matthew's correlation coeffi cient (Rm) was applied to study the relationship between phenomena represented by dichotomous variables.
Results. The average duration of surgery in the main group was 188 minutes (median 190 minutes), while in the control group it was 138 minutes (median 120 minutes; p < 0.001). The median intraoperative blood loss was 200 [100.0; 300.0] ml and 200.0 [100.0; 250.0] ml, respectively (p = 0.002). The incidence of intraoperative complications did not differ signifi cantly (3.3 % and 2.7 %; p > 0.1), however, postoperative complications were signifi cantly more frequent in patients with lymphadenectomy — 51 (27.8 %) and 11 (6.0 %) (Rm=0.246, p < 0.001). Complications from the lymphatic system were leading in the main group: lymphocele (n = 17, 9.3 %), lymphorrhea (n = 7, 3.8 %), and lower limb lymphostasis (n = 3, 1.6 %). Severe complications (grade III or higher according to Clavien–Dindo) were observed in 13 (7 %) patients in the main group and 2 (1 %) in the control group. Lymphadenectomy increased the risk of postoperative complications by 3.8 times. Discussion. The performance of lymphadenectomy is the main factor in the development of postoperative complications. Despite the low incidence of intraoperative complications, lymph node dissection signifi cantly increases the trauma of surgery and the duration of the surgical intervention.
Conclusion. Performing pelvic and paraaortic lymphadenectomy in patients with early stages of EOC statistically significantly increases the frequency of postoperative complications, the time of surgery and the volume of blood loss. The expediency of performing lymphadenectomy should be determined individually, considering the histological type of the tumor and other risk factors.
Keywords: early ovarian cancer, complications, lymphadenectomy
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Modern advances in cervical cancer surgery make it possible to apply a personalized approach to the treatment of advanced stages and relapses of this disease. Although the problem remains poorly understood today, international professional communities prescribe a centralized approach to such problems patients by including them in clinical protocols. However, such studies are still extremely rare. Further data analysis is needed to fi nd out whether non-standard surgical interventions can be the method of choice in individual clinical cases with recurrent breast cancer, and thus be able to optimize the survival and quality of life of this category of patients. Therefore, it seemed appropriate and timely for us to present a clinical case of surgical treatment of relapse. Breast cancer in a patient with icroinvasive breast cancer after non-radical surgery in a non-specialized medical facility. The description of such observations is of great practical importance, since it allows us to accumulate experience and will contribute to the widespread implementation of such tactics in everyday practice.
Keywords: cervical cancer, relapses, personalized surgery
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Introduction. Vulvar cancer is a rare malignant neoplasm, ranking fourth among gynecologic oncology diseases. Surgical treatment remains the most effective method, but radical vulvectomy often leads to the development of postoperative complications, such as wound infection, tissue necrosis and vaginal stenosis, which signifi cantly reduces the quality of life of patients.
Material and methods. A retrospective analysis of 217 patients with vulvar cancer who underwent surgical treatment was performed. Complications were classifi ed depending on the extent of surgery, the method of wound defect closure and the presence of risk factors (diabetes mellitus, previous radiation therapy). Evaluation of vaginal stenosis included clinical and psychological tests. Early postoperative complications were detected in 28.1 % of patients, delayed ones — in 67.3 %. Stenosis of the vagina of II–III degree was diagnosed in 20.86 % of patients, accompanied by chronic pain syndrome, dysuric disorders and psychoemotional disorders. Three cases of severe stenosis that required surgical correction were analyzed in detail.
Results. Correction using displaced skin-fascial fl aps in surgical treatment of vaginal stenosis signifi cantly improved the quality of life in 3 operated patients: 6 months after surgery, pain syndrome and dysuric disorders disappeared in 100 % of cases.
Conclusions. Reconstructive plastic surgery is an effective method for the prevention and correction of postoperative complications after radical surgical interventions for vulvar cancer.
Keywords: vulvar cancer, radical vulvectomy, vaginal stenosis, reconstructive surgery
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Background. Endometrial cancer is one of the most common malignancies in women, which requires surgical treatment associated with irreversible disruption of reproductive function in young women, among who up to 70 % have not had previous pregnancies and childbirth. Conservative hormonal therapy at the initial stage of disease is a possible alternative. However, this approach has not yet been fully investigated, and published studies have shown oppositely directed results.
Objective of the study. The study was aimed at assessing the perinatal and oncological results of hormonal therapy for atypical endometrial hyperplasia (AEH) and G1 endometrial cancer (EC).
Materials and methods. The study included data on 114 patients. Statistical analysis was performed using the Student’s t-test, Mann-Whitney U-test, Kaplan-Meier method, and Cox-Mantel test.
Results. The patients were divided into 2 groups: (1) spontaneous pregnancy (n = 70) and (2) pregnancy after assisted reproductive technologies (ART) (n = 44). Treatment resulted in live birth in 75.7 % in group 1 and 79.5 % in group 2 (p = 0.631). The risk of recurrence after childbirth was 8.8 %; the median time to recurrence was 20 months; and the 3- and 5-year progression-free survival rates were 95 % and 92 %, respectively. The disease stage, the ART involvement, and pregnancy outcome did not correlate with worsening long-term treatment outcomes.
Conclusion. Hormonal therapy for AEH and early EC is an effective treatment option, which allows young women to realize their reproductive function without a signifi cant threat of worsening the oncological prognosis of the disease.
Keywords: atypical endometrial hyperplasia, endometrial cancer, hormonal therapy, assisted reproductive technologies, pregnancy outcomes, progression-free survival
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Due to the vastness of the presented material, the article is divided into two parts. The fi rst section provides literature data summarizing the features of the pathogenesis, prevalence and mechanism of occurrence of various types of oncological pain, as well as the author’s classifi cation of pain syndromes in oncogynecology. The clinic and diagnosis of pelvic pain are described separately, the characteristics of domestic painkillers for its pharmacotherapy are given, indications for prescribing drugs, dosage forms, single and daily doses for the treatment of severe and moderate pain, as well as contraindications and possible limitations are indicated. The presented material is supplemented by a description of cases from clinical practice.
Keywords: oncogynecology, pelvic pain in oncology, pharmacotherapy of pelvic pain, interventional methods of pelvic pain therapy
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