Vol 1, No 1 (2012)

Preoperative staging by digital examination, endorectal ultrasound and magnetic resonance imaging (MRI) allows an assessment of the risk of local recurrence after surgery alone. The successful management of rectal cancer requires a multidisciplinary approach, with treatment decisions based on precise patient evaluations. Chemoradiotherapy (CRT) is associated with reduction of tumor size and downstaging.
The aim of this study is to assess how often complete clinical response is achieved after eoadjuvant CRT and its concordance with pathologic complete response.
Results. Patients with biopsy-proven, locally advanced rectal cancer (T3, T4) were treated by CRT followed by radical surgery. Tumors were re-assessed after 8 weeks from CRT completion using MRI and endoscopic examination. The results of examination were compared
with the final histopathologic status.
Conclusions. Neoadjuvant CRT leads to significant tumor regression and in some patients there is complete disappearance of neoplasm. MRI combining with colonoscopic findings is a useful tool to evaluate these features.

Objective of this study is investigation of effectiveness of electromiostimulation of anal sphincter for incontinence treatment after sphincter saving surgery for distal rectal cancer.
Materials and methods. 54 patients after ultra-low anterior resection with hand-sewn coloanal anastomosis performed between end of 2008 till February of 2010 entered the trial. All patients received preoperative radiotherapy.
Results. All patients showed marked improvement in continence (according to Wexner scale) and higher quality of life after electromiostimulation (by FIQL score).
Conclusion. Electromiostimulation of anal sphincter for patients after ultra-low anterior resection is effective and allows improvement of functional results and accelerate social rehabilitation of this group of patients.

The aim of investigation is the optimization of surgical treatment of patients with locally advanced rectal cancer with the involvement of posterior wall of urinary bladder.
Materials and methods. The basis of investigation is the analysis of results of combined treatment of 67 patients with locally advanced rectal cancer involving triangle and cervix of urinary bladder. Radical operations of different volume were carried out in the department of common surgery during a period from 2000 till 2010. All patients had Т3–4N0–2M0 rectal cancer. Following types of surgery have been performed:
1. Ultra-low anterior resection with coloanal anastomosis or abdomino-perineal excision combined with resection of 2/3 of urinary bladder — main group (44 patients);
2. Pelvic exenteration — control group (23 patients).
Results. The application of combined surgical intervention with the resection of posterior wall of urinary bladder didn’t lead to the increased post operative complications rate, which were diagnosed in 1 (2.27 %) of 44 patients in the main group. The patients, which had the operative
treatment in the volume of pelvic exenteration (control group), had a complication rate of 4.34 % (1 patient). In both cases, pelvic abscess of with a favorable outcome took place.
Three-year disease-free survival rate in main investigated group was 55.3 %, in control group (23 patients) — 74 %.
Conclusion. The investigation showed that pelvic exenteration for locally advanced rectal cancer involving posterior wall of the bladder is not always justified. We consider, that it’s more reasonable to save even small part of urinary bladder for the better patients rehabilitation.

Bevacizumab in combination with standard chemotherapy (CT) in 1st line metastatic colorectal cancer (mCRC) settings prolongs median overall survival to 20,3 months. Data of observational cohort programs suggests that bevacizumab therapy beyond disease progression, in combination with several CT regimens prolongs median overall survival till 31,8 month. Authors presents their own experience of prolonged bevacizumab therapy in mCRC patient.

15 февраля 2012 г. исполнилось 60 лет заместителю директора по научной работе Научно-исследовательского института клинической онкологии ФГБУ РОНЦ им. Н.Н. Блохина РАМН,
доктору медицинских наук, профессору, члену-корреспонденту РАМН, лауреату премии Правительства РФ в области науки и техники Борису Ивановичу Долгушину