Vol 6, No 2 (2016)

Metastatic neck lymph nodes in massive lesion of their tissue with tumor cells are accompanied by extracapsular extension to the adjacent structures in a number of cases. The greatest problem in clinical oncology is when even extended radical neck dissection fails to completely remove tumor tissue that is macroscopically detectable after surgical resection. In this situation, there is a continued growth of tissue mass that is left on the neck. Thus, the unresectable extracapsular spread of neck lymph node metastases to the adjacent tissues reduces the duration of life in the patients and worsens its quality.

The basis for this investigation is clinical observations of patients who have been operated on at the Nizhny Novgorod Regional Clinical Oncology Dispensary (Hospital Two) in the period 2005 to 2016. Histologically, the tumors were squamous cell carcinomas. In this period, there have been 24 Crile operations (radical neck dissection) that are cytoreductive. A primary tumor has been (n = 15) or has not been (n = 9) previously excised. The extracapsular spread of metastatic lymph nodes corresponded to levels IIa, IIb, and III. Cytoreductive cervical lymphadenectomy with the pectoralis musculocutaneous flap covering an unresectable tumor for extracapsular unresectable squamous cell carcinoma metastasizing to the neck lymph nodes should be considered the operation of recovery. This type of surgery is warranted, as tumor mass reduction by eliminating the source of intoxication allows further antitumor treatment (radiotherapy or chemotherapy or their combination) that is contraindicated in patients with tumor lysis in the neck. When the cause of death is the exceedingly continued growth of an unresectable component of radio- and chemoresistant variants of tumor tissue on the neck, the covering of the component with a pectoralis major flap delays a fatal outcome in incurable patients to improve a number of quality-of-life indicators.

Lung cancer is mostly common occurring oncological disease in the developed countries. Currently lung cancers are subdivided into nonsmall-cell (adenocarcinoma, large-cell, squamous cell) and small-cell. The difference in the clinical and morphological picture leads to the necessity of choosing therapeutic approaches to patients of various groups.

Lung cancer should be referred to encephalotropic diseases since metastatic lesion of the central nervous system is sufficiently common complication. Successes of complex treatment of primary tumor result in increase of total longlivety currently ther is ageing of patients suffering lung cancer. These factors increase the risk of metastatic lesions of the brain.

Interest to the problem of neurosurgical treatment of patients suffering lung cancer is determined by frequency of lesion, varicosity of morphological variants of the disease, requiring various algorithms of treatment and diagnosis.

The main role of neurosurgical intervention in cerebral metastases of lung cancer consist in creation of the paled of carrying out combined therapy. Ideally, a neurosurgical operation should be carried out with clearcut observance of oncological principles of ablasty.

Adequate comprehensive approach to treatment or patients with cerebral metastases of various forms of lung cancer with the developed of optimal tactics of and stages of treatment would make it possible to increase duration and quality of life of patients.

Профессору Рубену Ильичу Азизяну – 55 лет.