The significance of the study is associated with the high level of the morbidity rate of colorectal cancer, generous amount of patients with the 4th stage and the necessity of the research of palliative surgical treatment. A retrospective analysis of 364 cases with metastatic colorectal cancer included 58 patients with palliative colon resection and 306 patients with bypass anastomosis and unloading stoma. Evaluated parameters are the frequency of postoperative complications, postoperative mortality rate, median survival and one-year survival. In the group of palliative resections the frequency of postoperative complications and postoperative mortality rate were 32.7% and 20.6%, in the group of symptomatic operations the same results were 12.1% and 8.8%. Median survival, one-year survival in the group of palliative resections are longer than in the group of symptomatic operations - 10.0 and 5.1 months, 37.0% and 18.3%, respectively (p < 0.05). However, after stratification of studied subgroups according to the sign of the presence or absence of post-operative chemotherapy the survival were shown to be higher in patients with chemotherapy and hardly depended on fact of the removal of the primary tumor. To our opinion the high rate of postoperative complications and the postoperative mortality rate after palliative resections of the colon can be corrected by more precise determination of indications to their performance in emergency surgery. The improvement in survival indices is associated with the execution of postoperative adjuvant chemotherapy.
Background. Breast cancer is the most common cancer and the leading cause of cancer death in women worldwide. The presence of an unfavorable molecular biological subtype significantly worsens the prognosis, making it necessary to individualize treatment strategy for each patient.The aim of the study was to demonstrate the achievement of long-term remission in the treatment of metastatic triple-negative breast cancer. Case description. A 42-year-old patient presented to Ryazan Oncologic Dispensary in October 2006 with complaints of lump in her left breast. She was diagnosed with stage cT2N0M0 triple-negative carcinoma of the left breast. She underwent radical mastectomy for left breast cancer (October, 2006). Disease progression (metastases to lungs and mediastinal lymph nodes) occurred in June 2009. The patient received 6 courses of polychemotherapy according to the FAC regimen with a favorable response. In February 2011, the patient was found to have metastatic lesion in the brain, which was surgically removed in March, 2011. She received metronome chemotherapy. Recurrence of brain metastasis occurred 6 months after chemotherapy. The patient received external beam radiation therapy, which resulted in tumor regression, and metronomic chemotherapy was continued with a positive effect. The patient was followed up for 6 years with no evidence of disease progression. In July 2019, the follow-up examination revealed stage cT2N0M0 triple-negative cancer in the right breast. The patient underwent radical mastectomy for the right breast and 8 courses of adjuvant polychemotherapy (4 courses of AC + 4 courses of paclitaxel). The patient is alive with no signs of disease progression.Conclusion. This clinical case demonstrated personalized approach to the treatment of patients with triple-negative breast cancer. Fifteen years had passed since the detection of the primary tumor. During this time, the disease progressed three times, and breast cancer was diagnosed on the opposite side. Combined modality treatment including chemotherapy, surgery and radiotherapy allowed satisfactory results to be achieved. The patient is still alive with no signs of disease progression.
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