The paper describes the state-of-the-art of surgical treatment in patients with neuroendocrine tumors of the lung. It considers their classification, morphological diagnosis, and the possibilities of their instrumental diagnosis. Distinctive clinical and morphological criteria for carcinoid, large-cell and small-cell neuroendocrine cancer of the lung are characterized.

Surgical treatment was performed in 286 patients with lung cancer. The final morphological study diagnosed typical and atypical carcinoid tumors in 258 (90.2%) and 28 (9.8%) patients, respectively. The central and peripheral tumor sites were established in 245 (85.7%) and 41 (14.3%) patients, respectively. According to disease stage, the patients were distributed as follows: Stage I in 166 patients, Stage II in 84, Stage III in 30, and Stage IV in 6. Five (1.7%) patients were found to have carcinoid syndrome: the tumor had the morphological structure of atypical and typical carcinoid tumors in 3 and 2 patients, respectively. One patient with typical carcinoid was observed to have carcinoid syndrome concurrent with the Itsenko-Cushing syndrome. Two patients with carcinoid syndrome were ascertained to have hepatic metastases; these patients were recognized to be inoperable. The basic type of surgical intervention for typical carcinoid tumors was an organ-saving operation: lobectomy, bilobectomy, reconstructive plastic surgery, precision removal, and segmental resection. Only 7 patients underwent endoscopic removal of typical carcinoid tumors. In atypical carcinoid tumors, the surgical volume depends on the specific features of the extent of a tumor and the presence or absence of metastases. Pneumonectomy with lymphadenectomy and lobectomy in combination with and without bronchial resection were performed in half the cases. The long-term results of radical surgical treatment in patients with bronchopulmonary carcinoid tumors suggest that these operations are warranted.

Quality of life (QL) was studied in 185 patients with stage III non-small cell lung cancer at the stages of multimodality treatment involving neoadjuvant chemotherapy with paclitaxel/carboplatin, radical surgery, and intraoperative radiotherapy (the single dose was 10 and 15 Gy) in the presence of gemzar or cisplatin radiosensitization. The EORTC QLQ-30 (version 3.0) and EORTC QLQ-LC13 questionnaires were used to estimate QL. The latter was shown to be determined by the performed courses of chemotherapy and the volume of surgical intervention. Neoadjuvant chemotherapy increases physical functioning (92.3±2.3%) and total health status (71.1±3.9%) versus the pretreatment values (81.4±3.3 and 61.8±4.1%, respectively). After surgical treatment, the functional parameters of QL depend on the volume of surgery: the results of pneumonectomy were worse (56.3±5.7) than those of lung resection (66.5±4.5%). Intraoperative radiotherapy in a single dose of 10 and 15 Gy, gemzar or cisplatin radiosensitization exerted no impact on QL indicators. The final stage of rehabilitation after multimodality treatment is performed at a 12-24-month interval.

A regimen was developed for the prevention of postoperative pyoinflammatory complications in patients with lung malignancies. Russian antioxidants and immunomodulators, such as laprot (L), ceruloplasmin (C), imunofan (I), and galavit (G), were used for corrective therapy. The trial was conducted in the randomized groups of patients: 24 patients were treated with a regimen of C+G, 31 received L+I, 28 patients had L+G, 18 had C+I; and 47 patients made up a control group. The study has demonstrated that corrective therapy, particularly that including the immunomodulator imunofan and the antioxidants ceruloplasmin or laprot, decreases the frequency and severity of postoperative pyoinflammatory complications.

Until the 1980s, primary hyperparathyroidism (HPT) was considered to be a rare disease. The ideas on its prevalence substantially changed after introduction of blood calcium and parathyroid hormone (PTH) tests into clinical practice.The patients admitted to cancer hospitals for the manifestations of HPT and osteodystrophy form a separate group. The paper describes problems in the differential diagnosis of parathyroid osteodystrophy with skeletal metastatic involvement and the tactic errors occurring in the treatment of this group of patients. Ultrasound study, hypercalcemia, and elevated PTH levels are shown to be of importance.

The investigators conducted a preclinical study of the antitumor efficacy of the combined use of an Oxycobalamin-lio (Ox-lio) + Efiter acid-based binary catalytic system (BCS) with radiation and chemoradiation therapy. The incorporation of the BCS Ox-lio + ascorbic acid (Aa), which was used as independent antitumor agents, into a chemoradiation therapy regimen, was shown to lead to biologically important tumor growth suppression throughout the observation and to promote the potentiated therapeutic effect of radiation/chemotherapy. The therapeutic effectiveness of the Ox-lio + Aa BCS used as a modifier is higher than the Efiter + Ac BCS, which seems to be due to its detoxifying activity. The findings suggest the expediency of a clinical trial of the Ox-lio + Ac BCS as a modifier of medical treatments in patients with malignancies.

Experimental animals (sheep) underwent radiofrequency thermal ablation (RFTA) of iliac bones (spongy bones) for 2, 4, 6, 8, 10, and 12 minutes, followed by a histological study. There was bone necrosis in all the radiofrequency wave exposure periods (2 to 12 minutes), the fragments of osseous structures in the RFTA periods of 10 to 12 minutes showed obvious signs of coagulation necrosis with carbonization. The radius of bone necrosis varied from 15 to 20 mm under 2-6-min hyperthermia and 8-12-min thermal ablation. The findings show that 4-6-min RFTA exposure was sufficient for malignancies not exceeding 3 cm in diameter and the time of hyperthermia for bone metastases must be 8-10 minutes.

The level of a serological marker for squamous cell carcinomas (SCC) was studied in patients with primary, remitting, and relapsing esophageal SCC (ESCC). The levels of SCC antigen (SCCA) increased from Stage I to Stage IV (from 0.8±0.3 to 1.7±0.3 ng/ml, so as the percentage of patients with elevated SCCA (from 20 to 60%, respectively). In remission, the values of SCCA were within the upper normal range in all the patients. The diagnostic sensitivity of SCCA in relapse was similar to that in primary SCC (38/9 and 39.8%, respectively). The proportion of SCCA-positive cases was higher in patients with low- and moderate-grade tumors than in those with high-grade tumors (54.1 and 21.4% of cases, respectively). The mean level of SCCA slightly rose after invasive diagnostic procedures. Hence, this group of patients should undergo serum SCCA tests before and 3-4 days after invasive diagnostic procedures. For the monitoring of the efficiency of treatment and preclinical detection of relapses, it is expedient to use SCCA as a serological marker in 30-40% of all patients with primary ESCC and in approximately 50% of patients with low- and moderate-grade SCC.

The paper presents historical data on the emergence of medical services of otorhinolaryngology, dentistry, and head and neck tumors. It gives the names of their pioneers, such as laryngologists, ear specialists, and oncologists who operate patients with head and neck tumors. The setting-up of head and neck tumor services in the USSR is described.

The paper considers the state-of-the-art of the problem of lung carcinoids. Particular emphasis is laid on the treatment of patients with typical carcinoid tumors. Most patients undergo organ-saving bronchoplastic procedures, including isolated bronchial resection with interbronchial anastomosis and preservation of the whole lung parenchyma. The paper describes a case of the rare operation to make polybronchial anastomosis.

The paper describes a case of giant neuroendocrine tumor of the mediastinum. In the authors' opinion, medical treatments are not indicated in patients with this size of the tumor and its morphological structure. Surgery is the method of choice in treating these patients.

The paper reviews the literature concerning the surgical treatment of patients with non-small-cell lung cancer. It describes the historical aspects of development of lung surgery and the views about mediastinal lymphadenectomy. The long-term results of treatment in this group of patients are given in terms of tumor stage and morphological structure. The major and additional prognostic factors influencing 5-year survival after surgical treatment are identified and specified.