Background. According to some studies, nutrient deficiencies reach an over-70% prevalence in ovarian cancer, among other gynaecological malignancies, thus constituting an important risk factor for postoperative mortality, surgical complications and longer hospital stays. Therefore, effective nutrient deficiency correction methods are warranted to improve the ovarian cancer outcomes, especially in patients following radical surgical interventions. New systematic evidence emerges in literature on the impact of such novel methods on the critical status of variant-category patients. Meanwhile, such evidence bears a recommendatory value only, with no current standard or protocol assumed for nutrient deficiency management. This issue presently remains open and requires careful research and analysis.Materials and methods. The clinical case demonstrates the efficacy of nutrient deficiency correction in an ovarian cancer patient following an individualised radical surgery.Results and discussion. The energy supplied on day 1 was >42%, >83% on day 3, and the target values had been achieved by day 7 of intensive therapy. The nutrient deficiency marker dynamics revealed the growth of transferrin, triglycerides and peripheral blood lymphocyte counts as early as by day 3 post-surgery. Albumin was the latest to respond, increasing only on day 7.Conclusion. The introduction of novel nutrition strategies and knowledge of their impact depend on further high-quality research, especially prospective studies, incorporating a greater homogeneity of intervention types and clinical outcomes, as well as wider sampling of female ovarian cancer.
Introduction. Malignant tumors dominate in the picture of disability and mortality worldwide. One of the most frequent and dangerous comorbid conditions is kidney injury. At the same time, the most unfavorable incidence of acute kidney injury is recorded in multiple myeloma, leukemia, lymphoma and kidney and/or liver cancer and malignant ovarian neoplasms. In this regard, of vital importance is the choice of tactics in the prevention of thrombosis and thromboembolic complications, as well as the individual approach to of the anticoagulant therapy regimen during renal replacement therapy sessions, depending on the underlying disease and the state of the hemostatic system. Aim. To evaluate the effect of calcium citrate veno-venous hemodiafi ltration sessions on the hemostatic system of a patient with progressive organ dysfunctions associated with malignant ovarian neoplasm. Materials and methods. The methodology involved literature review and a case study to assess the effect of veno-venous hemodiafi ltration on hemostasis. Results and discussion. The clinical case was assessed in terms of P-selectin (CD62), which characterizes platelet activation processes. It should be noted that in this patient, the expression of P-selectin increased with each session of renal replacement therapy, while the platelet aggregation values remained at the level of the lower thresholds, which indicates a low probability of coagulation initiation. However, due to aggressive regulation of ovarian cancer by the hemostatic system in the form of production of inflammatory mediators, microvesicles, tissue factor expression and endothelial activation, attention should be paid to the molecular aspects of platelet activation in renal replacement therapy with regional citrate coagulation. Conclusion. The widespread use of extracorporeal detoxification methods is an independent risk factor not only for bleeding events, but may potentially contribute to thrombosis and thromboembolic complications, which requires a further detailed study of molecular mechanisms of hemostasis regulation by tumor and clinical evaluation of various anticoagulation methods.
Background. Ovarian cancer ranks 5th in the structure of female oncological mortality in the Russian Federation, with a first-year post-diagnosis rate of almost 35%. In 75% cases, ovarian cancer is diagnosed at stages III—IV. The disease usually represents as peritoneal carcinomatosis regarded as an advanced form that demands attention, which renders the issue highly relevant. We present a literature review and analysis of combined treatment outcomes in ovarian cancer patients hospitalised at the Kuvatov Republican Clinical Hospital within period 2020—2021.Materials and methods. The article reviews foreign and national scientific literature, as well as reports the case data on 18 patients diagnosed with ovarian cancer and treated at the Department of Oncology of the Kuvatov Republican Clinical Hospital within period 2020—2021.Results and discussion. A complete cytoreductive surgery was performed in 100% cases. In cohort I, mean operation time was 256 vs. 364 min, mean intraoperative blood loss — 1200 vs. 1050 mL, mean hospital stay — 14.6 vs. 18.7 bed-days. Postoperative complications were 16.7 vs. 50% in cohort I vs. II. A 30-day mortality rate was 0 vs. 16.6% in cohort I vs. II. The monitoring and enrolment of patients currently continues.Conclusion. A HIPEC procedure is not a radical measure and can only achieve a maximum efficacy if coupled with a complete cytoreduction. The treatment of stage III—IV ovarian cancer patients in a concurrent combined approach is promising and requires further in-depth research and a more robust statistics.
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