BACKGROUND: In recent decades, there has been an increase in the incidence of multiple malignancies. The incidence of this type of cancer ranges from 4.6 to 8.0 %. Subsequent tumors are detected between 1.5 and 42 years. The average interval between the primary and secondary processes is 6 years. More than 80 % of cases of primary multiple cancer (PMC) occur in people over 60 years of age.

AIM: To generalize the patterns of development of PMC associated with breast cancer (BC), and to predict risk factors.

METHODS: We retrospectively reviewed the medical records of 62 women with VUR, examined and treated at the Sverdlovsk Regional Oncology Center (Yekaterinburg) from 2020 to 2022. VUR associated with breast cancer was detected in 2 % of cases. Three women were excluded from the study according to the Warren–Gates criteria: two with metastases and one with mammary tuberculosis. The average time to secondary tumor detection was 5.4 years (range, 2 to 10 years). PMC was detected in the other breast in 29 % of cases, endometrial lesions were diagnosed in 17.7 % of patients, and malignant ovarian and renal neoplasms were diagnosed in 9.6 %. Disease progression in the form of metastases was observed in 14.5% of cases in patients over 55 years of age. Family history was a significant risk factor in 36 % of cases, gene mutations in 18.5 %, hormonal status in 49.4 %, obesity in 45.6 %, lymph node status in 48.4 %, previous treatment (chemotherapy or radiation therapy) in 5 %, and environmental factors in 24.5 %. A shallow learning neural network was used to predict risk factors for the development of PMC. The input data (diagnostic features) were converted to binary form: a value of “1” for a feature indicated its presence, a value of “0” indicated its absence. When training and testing the neural network, the target function was the time of secondary tumor onset and, in the presence of known breast cancer, also the time of progression.

RESULTS: The risk of developing PMC within 5 years with a sensitivity of 86%, a specificity of 100 %, and an AUC of 0.929 (AUC – area under the receiver operating characteristic curve) was observed in patients over 60 years of age with stage T1–2N1 disease and luminal B and luminal/HER2-positive breast cancer (HER2 – human epidermal growth factor receptor 2). The development of PMC more than 5 years after the primary process, with a sensitivity of 64 %, a specificity of 86 %, and an AUC of 0.714, is possible in patients under 60 years of age with the luminal B molecular subtype of breast cancer and a primary tumor with a malignancy grade of G2.

CONCLUSION: There is no consensus on the causes of PMC development (single tumors are not an exception). Increased survival after the onset of the first malignancy leads to an increased frequency of detection of second and subsequent tumors. Patients diagnosed with PMC, especially those with a strong family history and early onset of the disease, should be referred to a geneticist for consultation.

BACKGROUND: All three main methods are used to treat stomach cancer: surgical, medicinal, and radiation. Currently, in addition to classical chemotherapy, targeted drugs, including anti-HER2 therapy, are actively used as part of the drug treatment method. At the moment, monoclonal antibodies in Russia are registered only for the treatment of metastatic gastric cancer.

AIM: Comparison of the degree of pathomorphological response according to Mandard gastric tumor to adjuvant perioperative polychemotherapy in patients with the presence and absence of HER2 overexpression.

METHODS: The study groups consisted of patients with locally advanced gastric cancer who underwent perioperative chemotherapy (n = 31). The first group included patients with a lack of HER2 expression in tumor tissue (n = 28), the second group consisted of individuals with overexpression of HER2 (n = 3). In both groups, the degree of therapeutic pathomorphosis according to Mandard TRG (Mandard Tumor Regression Grade) after neoadjuvant chemotherapy on surgical material was compared.

RESULTS: In patients without HER2 expression in the tumor, more pronounced drug pathomorphosis was observed against the background of standard perioperative chemotherapy regimens. It can be assumed that in patients with overexpression of HER2 (3+), the use of standard regimens for perioperative chemotherapy is not effective enough. Overexpression of HER2 is an unfavorable prognosis factor and is associated with poorer overall survival and relapse-free survival. A patient with HER2 overexpression who received Trastuzumab in addition to chemotherapy demonstrated a more pronounced pathoformological response.

CONCLUSION: In patients with overexpression of HER2 in gastric tumors, the pathomorphological response is much worse than in patients with negative receptors for human epidermal growth factor 2. When an operable stomach cancer without distant metastases of the targeted drug Trastuzumab is added to the standard perioperative chemotherapy regimen, a more pronounced pathomorphosis according to Mandard is observed, which entails a more favorable prognosis.

BACKGROUND: Ovarian transposition is a surgical method aimed at preserving ovarian function in reproductive-age women undergoing pelvic radiotherapy. However, in the era of assisted reproductive technologies and fertility preservation strategies, the actual effectiveness of this procedure in maintaining reproductive potential remains controversial.

AIM: To evaluate oncological, hormonal, and reproductive outcomes of ovarian transposition in patients with cervical cancer based on regional clinical experience.

METHODS: A retrospective multicenter study included 118 patients with cervical cancer who underwent ovarian transposition between 2000 and 2025. The median age was 34 years (range 22–42). Patients were divided into two groups according to disease stage and treatment strategy. Oncological outcomes, ovarian hormonal function (folliclestimulating and luteinizing hormones levels, estradiol levels and antral follicle count), and reproductive outcomes were assessed.

RESULTS: Disease recurrence was detected in 13 (11 %) patients. Metastases to transposed ovaries occurred in 3 (2.5 %) cases. Preservation of ovarian function was observed in 59% of patients. Radiotherapy and age over 42 years were identified as significant risk factors for ovarian function decline (p <0.05). Consultation with reproductive specialists was recorded in 35 (30 %) patients. Transabdominal oocyte retrieval was performed in 10 (8.5 %) patients, with successful oocyte retrieval in 5 (4.2 %) cases. Pregnancy occurred in 3 (2.5 %) patients, and live birth was achieved in 2 cases (1.7 %).

CONCLUSION: Ovarian transposition allows preservation of hormonal function in a proportion of cervical cancer patients; however, its impact on reproductive outcomes remains limited. In the modern era of oncofertility, ovarian transposition should be considered as part of a comprehensive fertility preservation strategy that includes ovarian reserve assessment and discussion of oocyte or ovarian tissue cryopreservation prior to treatment.

Robotic surgery (RS) is considered a stage in the evolution of minimally invasive procedures. Despite the increasing adoption of RS, challenges remain regarding outcome reproducibility, pronounced operator dependence, learning curves, and technological and organizational constraints, which underscores the need to further develop the “digital layer” of surgery and to apply artificial intelligence (AI) for intraoperative data analysis. A systematic literature review was conducted using Russianand English-language keywords related to RS and AI. The review summarizes key directions of AI integration into robot-assisted procedures, most commonly implemented as modules for surgical video and instrument kinematic analysis, including computer vision, phase and task recognition, extraction of objective performance metrics, automated skill assessment and training support, predictive modeling of selected postoperative course parameters, and elements of partial automation of subtasks while maintaining the primacy of clinical oversight. The interpretation of published results is limited by heterogeneity in datasets and evaluation protocols, as well as differences in annotation strategies, performance metrics, and validation approaches, which complicates crossstudy comparisons and model transferability across institutions. Clinical implementation of AI is further associated with requirements for data privacy and security, cyber-resilience, model transparency, and regulatory accountability.

In clinical practice and scientific literature, very few cases of long-term and consistent therapy of patients with muscleinvasive progressive bladder cancer have been described. The article presents a clinical case of a patient with combined chemo-surgical treatment of bladder cancer pT3aN0M0G3, stage III. A year after radical cystprostatectomy, progression was diagnosed, which required 4 courses of chemotherapy with gemcitabine and cisplatin and subsequent therapy in the maintenance phase with the immuno-oncological drug avelumab. A total of 53 injections were performed and therapy is currently ongoing.

Adenoid cystic carcinoma of the minor salivary glands is a rare and aggressive form of malignant neoplasms characterized by hidden growth, rapid perineural advancement, tendency to develop local recurrences and distant metastases. This pathology is mostly seen in white women aged 50–60 years and is mostly localized in the sinonasal area and oral cavity.

The article presents clinical cases of treatment of patients with adenoid cystic carcinoma of the sinonasal area and adenoid cystic carcinoma of the hard palate. Efficacy of off-label therapy as salvage therapy and an attempt to prolong life in incurable patients is demonstrated. Etiopathogenesis of this tumor is being investigated, and new treatment strategies are being developed, including targeted therapies.