Introduction. Treatment of locally advanced laryngeal cancer is a complex problem and should be aimed at saving the organ. Chemoradiation therapy is ineffective in 30 % of cases. Oncological outcomes of surgical treatment are better than outcomes of conservative methods, but the patient loses the larynx. Therefore, organ-saving surgical intervention in the form of various types of extended resections of the larynx depending on the location of the tumor remains an important problem of clinical oncology.
Aim. To analyze the results of extended resections of the larynx as a method of organ-saving surgical treatment of patients with locally advanced and recurrent laryngeal cancer depending on tumor location, advancement, and previous treatment.
Materials and methods. The study included 67 patients with locally advanced and recurrent laryngeal cancer who underwent extended resections of the larynx using techniques developed at the N. N. Blokhin National Medical Research Center of Oncology with the aim of performing organ-saving treatment. Stages of performing various extended resections of the larynx depending on tumor location are presented. Retrospective analysis of data on 37 patients who were followed up for 5 or more years was performed, clinical progression of the disease is discussed, and 5‑year recurrence-free and overall survival are presented, as well as the results of functional and social rehabilitation of the patients.
Results. Between 2010 and 2025 at the N. N. Blokhin National Medical Research Center of Oncology, 67 patients with stage III–IVa cancer or tumor recurrence after previous unsuccessful treatment underwent various extended resections of the larynx depending on tumor location. After organ-saving surgical intervention, in all 67 patients rehabilitation of all functions of the organ with restoration of the separation biomechanics (between breathing and swallowing), breathing, vocalization was achieved at the level sufficient for social and labor rehabilitation. The five-year overall and disease-free survival rates were 89.2 and 87.1 %, respectively.
Conclusion. The obtained data demonstrate the effectiveness of extended resections of locally advanced and recurrent laryngeal cancer. After surgery, the patients are fully functionally and socially rehabilitated without compromising oncological results which are similar to the results of laryngectomy.

Introduction. Internation and Russian experience of surgical treatment of stage T1–2N0M0 laryngeal cancer in the form of endolaryngeal laser resection demonstrates good oncological and functional results. The problem of patient management in the postoperative period after these surgical interventions remains unsolved.
Aim. To determine rational tactics of postoperative management of patients with cancer of the voice box after microendolaryngeal laser resection.
Materials and methods. The study included 50 patients with squamous cell carcinoma of the voice box aged between 31 and 84 years who received treatment at the Head and Neck Oncology Division of the National Medical Research Center for Otorhinolaryngology between 2022 and 2025. All patients underwent surgical treatment – endolaryngeal laser resection. Depending on the resection volume, the patients were divided into 2 groups. Group 1 included 30 (60 %) patients with stage Tis–1aN0M0 laryngeal cancer who underwent type II–III cordectomy; group 2 included 20 (40 %) patients with stage T1b–3N0M0 laryngeal cancer who underwent type IV–VI cordectomy. Cordectomy volume was evaluated in accordance with the classification of the European Laryngological Society (ELS). At day 21–23, the patients were hospitalized again. Endoscopic evaluation of the postoperative wound, microdebrider procedure, histological examination of granulation tissue and bacteriologic examination of the material near the surgical area were performed.
Results. In group 2, increased production of dirty yellow exudate, thick fibrin layer on the wound surface, marked hyperemia and edema of the laryngeal mucosa, contamination of the surgical area (more frequent than in group 1) by highly pathogenic microorganisms with high titers were observed. Histological differences in granulation tissue between groups 1 and 2 show marked inflammation and tendency towards prolonged healing.
Conclusion. Taking into account the obtained data, an algorithm of postoperative management of patients was developed to decrease complication rate, the number of unsatisfactory functional results, and therefore decrease patient rehabilitation time.

Introduction. The question of the advisability of neoadjuvant chemotherapy (NACT) in patients with oral cavity squamous cell carcinoma is still controversial.
Aim. To identify a group of patients at high risk of progression and death from the oral cavity squamous cell carcinoma, with resectable stages, and to determine the effectiveness of docetaxel and cisplatin (TP) NACT patients with high-risk oral cavity squamous cell carcinoma.
Materials and methods. At the 1^st stage of our study, we retrospectively analyzed the data of 98 patients and determine that the NACT for patients with oral cavity squamous cell carcinoma, with 3 or more factors of an unfavorable prognosis (peripheral blood parameters indicating the presence of systemic inflammation, reduced level of infiltration of tumor structures by CD8‑tumor infiltrating lymphocytes and low expression of programmed death-ligand 1 (PD-L1) on tumor and immune cells) significantly reduces the risk of death and disease progression: hazard ratio 0.33; 95 % confidence interval 0.13–0.86; p = 0.0231. In 2^nd part of study we assessed the effectiveness of 3 cycles of NACT with docetaxel + cisplatin in 24 patients with 4 or more unfavorable prognosis factors.
Results. Objective response rate after 3 cycles of NACT was 66.7 % (16 / 24): 1 / 24 (4.2 %) patient had complete response, and 15 / 24 (62.5 %) patients had a partial response. NACT allowed achieving disease control rate in a significant majority of patients – 23 / 24 (95.9 %) (p <0.001). The medians of overall survival and progression-free survival weren’t reached at the time of the data cutoff (with a median follow-up of 56.5 months).
Conclusion. Our study allows to conclude that it is necessary in real clinical practice to identify patients with oral cavity squamous cell carcinoma with high-risk of progression and death in order to prescribe them NACT before surgery to increase the effectiveness of treatment and reduce the risk of progression and.

Introduction. The function of drains in thyroid surgery has long been a matter of discussion, with the possible advantages of avoiding complications being weighed against the risks and discomfort they could cause. By examining not only what is medically effective but also what actually benefits the patient’s recovery and well-being.
Aim. To assess the importance of the drainage with the thyroidectomy operations.
Materials and methods. A retrospective study was conducted over four years and included 148 patients that had thyroid surgery without using a drain. The ultrasound was used preoperatively in classifying the thyroid pathologies and the sizes of the gland and postoperatively in assessment and treatment of surgical site collection. The hospital stay, post-operative complications related to surgical drainage, and the way of dealing with them for each patient were recorded.
Results. The types of goiter were 8 diffuse, 68 multinodular, and 72 solitary thyroid nodule that were treated by different types of thyroidectomies without drainage (25 by subtotal thyroidectomy (16.8 %), 12 by total lobectomy and isthmesctomy (8.1 %) and 111 by total thyroidectomy (75 %)). There were no operation site collections in 94 % of the cases; 9 cases only had developed post-operative collection, and all were resolved by simple needle aspiration.
Conclusion. There is no role for the drain with thyroid surgery, and thyroidectomies can be considered a day case surgery.

Introduction. In Russia, cancer of the oral mucosa is diagnosed in more than 9500 patients every year. In 65–70 % of cases, the disease is diagnosed at stages III–IV. Despite the use of combination treatment, prognosis in patients with stage III and IVA oral mucosa cancer remains unfavorable. Neoadjuvant chemotherapy is considered a strategy to decrease the risk of distant metastasis, decrease tumor volume, and affect the status of surgical resection margins.
Aim. To evaluate the results of using revascularized flaps in patients with resectable stage III and IVA cancer of the oral mucosa who received neoadjuvant chemotherapy.
Materials and methods. Retrospective analysis of data of 41 patients who underwent surgery in 2020–2023 at the Republican Clinical Oncological Dispensary (Ufa) was performed. All patients underwent R0 resection with subsequent defect reconstruction using revascularized flaps. Two groups were compared: primary patients (n = 31) and patients who received neoadjuvant therapy per the DCF (docetaxel, cisplatin, 5‑fluorouracil) (n = 10) scheme.
Results. Overall rate of complications in the groups of primary patients and patients receiving neoadjuvant therapy per the DCF scheme was 16.1 and 20 %, respectively (p = 0.398), however the rate of flap loss was significantly higher in patients who underwent neoadjuvant chemotherapy: 40 % versus 9.7 % (p = 0.047). Recurrence rate in the neoadjuvant chemotherapy group was 10 %, in the group without neoadjuvant therapy it was 38.7 % (p = 0.129).
Conclusion. Neoadjuvant chemotherapy can be associated with higher risk of microvascular complications and flap loss but it decreases the recurrence rate. Therefore, further search for the optimal treatment strategy for patients with cancer of the oral mucosa is necessary.

Introduction. Malignant tumors of the oropharyngeal area hold a significant place in overall oncological morbidity. In most cases, they are diagnosed at later stages which worsens treatment prognosis. One of the key factors of late diagnosis is low oncological awareness of dentists. The absence of a streamlined action algorithm for suspicions of malignant process, as well as insufficient knowledge on principles of dental management of oncological patients, are also significant problems. The observed trend towards an increase in malignant tumors of the mouth morbidity and mortality determines the necessity analyzing their risk factors and developing strategies for prevention, early diagnosis, and improved treatment of this pathology.
Aim. To analyze the questionnaire answers from dentists and determination of future strategies for development of dental management of oncological patients.
Materials and methods. Between 2023 and 2024, at the Department of General and Clinical Dentistry named after V. S. Dmitrieva of the Peoples’ Friendship University of Russia, anonymous survey of dentists of all specialties on the problems of oncological awareness and dental management of patients with malignant tumors of the oropharyngeal area was performed. The questionnaire included 15 questions aimed at evaluation of doctors» competence in the areas of diagnosis, dental treatment and management tactics of patients with oncological diseases.
Results. Results of the survey showed that the majority of responders are aware of clinical manifestations of oncological diseases. Many of the surveyed doctors admitted to gaps in knowledge relating to early diagnosis and methods of treatment of this pathology. Additionally, non-compliance with diagnosis timelines and patient routing in cases of suspected malignant tumors were found.
Conclusion. Results of the survey of dentists on the problems of oncological awareness and dental management of patients with malignant tumors showed that the knowledge of the majority of specialists is insufficient. This demonstrates the necessity of improving educational programs, including at the level of postgraduate education, as a part of interdisciplinary approach to improving the quality of treatment of oncological diseases.

Introduction. The Bethesda System for Reporting Thyroid Cytopathology allows to standardize interpretation of fine needle aspiration biopsy of thyroid nodules with assessment of suspected malignancy risk. Analysis of prognostic significance of cytological data, using the Bethesda System as an example, is necessary for determination of tumor process aggressiveness and possibility of development of recurrences.
Aim. To study prognostic significance of the Bethesda System for Reporting Thyroid Cytopathology in recurrent thyroid carcinoma.
Materials and methods. Results of examinations and surgical interventions performed at the Altai Regional Oncological Dispensary (Barnaul) during a 3-year period in 503 patients (423 women (84.1 %) and 80 (15.9 %) men) with thyroid carcinoma are analyzed. In 440 patients, thyroid carcinoma in surgical material was found for the first time (R0 – primary patients); in 63 patients, disease recurrence was diagnosed (R1 – presence of recurrence). At the time of surgery, median patient age was 51 years (interquartile range 40–62 years). The inclusion criterion for the study was morphologically confirmed diagnosis of thyroid carcinoma; the exclusion criterion was the absence of cytological examination per the Bethesda System in patients with recurrent carcinoma. Data from medical records, disease histories and cancer registry were evaluated taking into account clinical and anamnestic characteristics of a special classifier for determination of risk factors of disease recurrence. Data processing was performed using Microsoft Excel software. At the preoperative stage, in primary patients, results of ultrasound and cytological examination of the fine needle aspiration biopsy of thyroid nodules were analyzed. Results of cytological examination per the Bethesda System were considered as an independent risk factor of recurrence. Orange Data Mining (version 3.3.37.0) and RStudio (version 4.3.1) software were used for data analysis. Distributions of quantitative variables were evaluated using the Kolmogorov–Smirnov and Shapiro–Wilk tests. Normal distribution hypothesis was rejected at p <0.20 for Kolmogorov–Smirnov test and at p <0.05 for Shapiro–Wilk test.
Results. According to the data, median time to recurrence was 2 years (Q₁–Q₃ – 1–6 years), minimal time to its development was 1 year, maximal – 20 years. 1-year recurrence-free survival was 100 %, 3-year was 91 %, 5-year was 86 %, 10-year was 59 %, 15-year was 25 %. Mean time to recurrence in 50 % of patients was 9.8 ± 0.9 years. Risk of recurrence of thyroid carcinoma of category IV per the Bethesda System was 3.623 times (72.4 %) lower compared to category III (hazard ratio 0.276; 95 % confidence interval 0.110–0.691; p = 0.006). Recurrence-free survival in patients with thyroid carcinoma of category VI per the Bethesda System was significantly higher (р = 0003 and p < 0.001) than in patients with category III and IV cytopathology.
Conclusion. Cytological conclusion of category III per the Bethesda System is 2.755 times more common in recurrence group than of category VI. Category VI cytopathology, 88.7 % of which are papillary thyroid carcinoma with conclusive cell signs, is characterized by relatively low risk of recurrence. Cytologic conclusion of categories III and IV per the Bethesda System is an unfavorable prognostic factor in preoperative diagnostics due to undetermined interpretation of the pathology. These categories are commonly observed in patients with more aggressive disease progression.

This review discusses the problem of safe, controlled myoplegia during anesthesia in patients with tumors of the maxillofacial area. Anatomical features of this category of patients affecting the permeability of the upper respiratory tract during standard induction of anesthesia are considered. Modern drugs for myoplegia and neuromuscular block reversal are presented. As an illustration, 2 clinical cases of using sugammadex for fast cessation of myorelaxant action in an emergency situation are described. Modern guidelines on safe use of myorelaxants and their antagonists for anesthesia in planned surgeries in maxillofacial oncological surgery are presented.

Post-radiation hypothyroidism is a common complication of treatment of head and neck tumors: its incidence is 6–50 %. Even subclinical hypothyroidism is associated with such cardiovascular diseases as ischemic heart disease and myocardial infarction. This pathology can significantly affect both quality of life and lifespan of patients who underwent radiation therapy.
The article presents results of studies on identification of predictors of post-radiation hypothyroidism, as well as clinical cases demonstrating results of radiation therapy in head and neck cancer treatment.

Laryngeal cancer occupies the leading place among malignant tumors of the ENT organs. The main approach to the treatment of advanced forms of this disease remains laryngectomy, leading to the loss of vocal function and reduced quality of life of patients.
The article presents the possibilities of modern methods of reconstructive surgery aimed at restoration of the lost functions after laryngectomy. A clinical case of successful restoration of swallowing and speech functions in a patient who after organ preservation treatment and recurrence underwent laryngectomy with subsequent reconstruction of the pharynx with a free jejunal flap is described. Thus, pharyngeal reconstruction with free jejunal flap is an effective method of social rehabilitation of patients after laryngectomy, especially when organ preserving approaches are ineffective.

Pancreatic cancer is one of the most aggressive types of oncological diseases and is often accompanied by various complications including malnutrition. Despite significant successes in the treatment of pancreatic cancer, late diagnosis, aggressive progression and resistance to traditional therapy methods complicate its treatment.
The article presents the causes, consequences and ways to correct malnutrition in patients with this malignant neoplasm, as well as a clinical case demonstrating the importance of nutritional deficiency screening and timely nutritional support in patients with pancreatic cancer during antitumor treatment.