Vol 71, No 6 (2025)
FROM THE EDITOR-IN-CHIEF
1225-1226
EDITORIALS
Assessing National Healthcare System Readiness for Value-Based Healthcare Models Implementation
Abstract
The oncology care system served as a case study to evaluate the Russian healthcare system’s preparedness for transitioning to value-based healthcare (VBHC) models. In 2024, a working group of leading oncologists and healthcare policy experts conducted a series of meetings focused on implementing VBHC projects within Russian oncology practice. Analysis of international experience and ICHOM consortium outcomes revealed consensus on the importance of incorporating patient-reported outcomes and experiences to enhance care quality. The experts comprehensively reviewed the criteria proposed by the ICHOM Participants reviewed ICHOM’s VBHC research criteria, discussing key metrics, their clinical relevance, and implementation feasibility within Russia’s healthcare context.
The meetings concluded with agreement on developing standardized VBHC methodologies for oncology and expanding educational initiatives for healthcare professionals and patients.
Proposals were made for further educational and organizational initiatives to raise awareness of VBHC principles among healthcare professionals and patients. Particular attention was given to identifying system-specific challenges in adopting value-based approaches in Russian oncology.
Problems in Oncology. 2025;71(6):1227-1237
1227-1237
Interlaboratory Quality Control of BRAF Mutation Testing: The Experience of the Russian Organization of Molecular Geneticists in Oncology and Oncohematology
Abstract
Tumors harboring BRAF V600 mutations demonstrate sensitivity to BRAF kinase inhibitors. Molecular genetic testing for this mutation represents an essential diagnostic component for cutaneous melanoma, colorectal, lung, and thyroid carcinomas, among other malignancies.
Reported BRAF mutation frequencies In Russian cutaneous melanoma patients range from 28 to 60 %, suggesting substantial interlaboratory variability in testing procedures.
Problems in Oncology. 2025;71(6):1238-1244
1238-1244
Flat-Detector Computed Tomography: Advancing Real-Time Neuronavigation for Stereotactic Brain Tumor Biopsy
Abstract
Stereotactic brain tumor biopsy (STB) currently relies on two primary navigation technologies: framebased and frameless systems. A significant limitation of both
approaches is the inability to visualize the target tumor and biopsy needle in real-time during needle insertion.
Problems in Oncology. 2025;71(6):1245-1259
1245-1259
STATISTICS
The State of Cancer Care in Russia: Gastric Cancer (C16). Prevalence, Data Registry Quality (Population Study)
Abstract
Gastric cancer (GC) is a malignant tumorar ising from the epithelium of the gastric mucosa that can develop in any stomach region. It most commonly metastasizes to the liver via the portal venous system, with potential dissemination to lungs, kidneys, brain, bones, and other organs.
This study utilizes data from Russia’s only population-based cancer registry (PCR) at the federal district level.
Problems in Oncology. 2025;71(6):1260-1270
1260-1270
Prevalence of Human Papillomavirus Infection and Cervical Pathology in Women with Different HIV Statuses
Abstract
Human papillomavirus (HPV) genotype distribution HIV-infected women shows both similarities and distinct differences compared to HIV-negative women. A global meta-analysis of 5,578 HIV-positive women across multiple continents demonstrated HPV monoinfection prevalence of 36.3 % and multiple-type infections in 11.9 % of cases. This population therefore represents a high-risk group for cervical cancer development, presenting a significant public health challenge.
Problems in Oncology. 2025;71(6):1271-1280
1271-1280
ORIGINAL ARTICLES Clinical research
A Single-Dose Pharmacokinetic and Bioequivalence Study of Generic and Original Aprepitant in Healthy Volunteers
Abstract
Chemotherapy-induced nausea and vomiting may lead to dehydration, malnutrition, and electrolyte imbalances, subsequently resulting in prolonged hospitalization and
treatment refusal by patients. The addition of aprepitant to chemotherapy regimens in adult patients has demonstrated high efficacy in reducing emetogenic potential.
Problems in Oncology. 2025;71(6):1281-1288
1281-1288
ORCHIDEA: A Retrospective Study of Patient Demographics, Clinical Characteristics, and Adjuvant Therapy Patterns in Stage II–III HR+/HER2– Breast Cancer Within Routine Clinical Practice
Abstract
Patients with stage II–III hormone receptor-positive, HER2-negative breast cancer (HR+/HER2- BC) maintain a persistent risk of recurrence for many years despite comprehensive treatment. Identifying risk factors enables adjuvant hormone therapy intensification and recurrence prevention.
Problems in Oncology. 2025;71(6):1289-1300
1289-1300
Comparative Analysis of Standard and Split-Dose Cisplatin in Neoadjuvant Chemotherapy for Bladder Cancer
Abstract
Cisplatin-based neoadjuvant chemotherapy (NACT) prior to radical cystectomy (RC) reduces mortality from tumor progression by 33% and achieves complete pathological response (pCR) in one-third of patients. However, the comparative efficacy of different cisplatin dosing regimens remains understudied.
Problems in Oncology. 2025;71(6):1301-1312
1301-1312
1313-1323
Transoral management of oral cancer with variable depth of invasion
Abstract
Aim. To retrospectively analyze the oncologic outcomes of transoral surgery for oral cavity squamous cell carcinoma based on primary tumor depth of invasion (DOI). Materials and Methods. We analyzed 122 patients (30- 80 years; mean age 57.8 ± 10.2 years) with tongue and floor of mouth squamous cell carcinoma (DOI ≤ 20 mm). Patients were stratified by DOI: Group 1 (1-5 mm, n = 35), Group 2 (6- 10 mm, n = 55), and Group 3 (11-20 mm, n = 32). Outcomes were assessed through local/regional recurrence rates, locoregional control, distant metastasis incidence, second primary tumors, and Kaplan-Meier overall survival. Statistical analysis utilized log-rank tests for survival comparisons and Fisher’sexact test for categorical variables. Results. Median follow-upwas 39.5 months (range: 4-134). Local/regional recurrence rates were: Group 1 (6 %/6 %), Group 2 (7 %/16 %), Group 3 (19 %/19 %). Locoregional control rates were 89 %, 84 %, and 69 % respectively. Distant metastasis rates were 3 %, 9 %, and 12 % (all non-significant). Second primary tumors developed in 14 patients (11.4 %), predominantly oral (6 cases, 4.9 %). Five-year overall survival was 80.8 %, 65.9 %, and 37.1 % (p = 0.031). Group 3 demonstrated more advanced disease and higher adjuvant radiotherapy utilization. Conclusion. Transoral surgery demonstrates excellent oncologic safety for lesions with DOI ≤ 10 mm. While outcomes deteriorate with increasing DOI beyond this threshold, the specific relationship between surgical approach and recurrence requires further investigation.
Problems in Oncology. 2025;71(6):1324-1331
1324-1331
Diagnostic Potential of a Multisensor Gas Analysis System and Artificial Intelligence for Upper Respiratory Tract Cancer. A Single-Center Study Results
Abstract
Exhaled breath analysis represents a promising non-invasive approach for diagnosing laryngeal, oral cavity, and pharyngeal cancers. This method is based on the premisethat ca ncer cel l metabolism differs from healthy cells, resultingin the production of specific volatile organic compounds.
Problems in Oncology. 2025;71(6):1332-1339
1332-1339
Exosomal Proteasome Levels as a Potential Biomarker for Differentiating Mastopathy from Breast Cancer via Liquid Biopsy
Abstract
Introduction. Breast cancer (BC) remains the most prevalent malignancy among women worldwide. Limitations in mammography and ultrasound sensitivity, combined with the absence of reliable biomarkers for distinguishing benign from malignant breast lesions, frequently result in unnecessary biopsies and patient distress. Aim. To quantify 20S proteasome levels within blood-derived exosomes from patients with mastopathy and BC. Materials and Methods. The study included blood samples from clinically healthy women (n = 20), patients with diffuse dyshormonal breast dysplasia (n = 20), and BC patients (T1N0M0, n = 20). Exosomes were isolated from plasma and whole blood via ultracentrifugation and characterized using flow cytometry and nanoparticle tracking analysis. Following comprehensive exosomal protein profiling, 20S proteasome levels were quantified through Western blot analysis. levels were quantified through Western blot analysis. Results. 20S proteasomes within exosomes demonstrated neither chymotrypsin-like nor caspase-like enzymatic activity. However, their expression levels were significantly elevated in both plasma and whole blood exosomes from BC patients, with whole blood exosomes showing higher concentrations than plasma-derived exosomes. These findings suggest BC progression involves intercellular transfer of 20S proteasome subunits via blood exosomes from donor to recipient cells. Conclusion. Quantification of 20S proteasome levels in circulating exosomes shows potential for differentiating between benign and malignant breast diseases.
Problems in Oncology. 2025;71(6):1340-1350
1340-1350
Comparative Diagnostic Performance of Multiparametric Ultrasound Versus Contrast-Enhanced Computed Tomography the Differential Diagnosis of Focal Liver Lesions in Colorectal Cancer
Abstract
Introduction. Liver metastasis represents a critical prognostic determinant in colorectal cancer (CRC). Precise imaging characterization of focal liver lesions directly impacts staging accuracy, treatment planning, and the need for additional diagnostic procedures. While various radiological modalities yield distinct imaging patterns that enable confident lesion characterization without further studies, the effect of chemotherapy on these patterns and their diagnostic specificity remains understudied. Aim. To compare the diagnostic yield of specific imaging features for focal liver lesions using grayscale ultrasound (US), contrast-enhanced ultrasound (CEUS), and contrast-enhanced computed tomography (CECT) in patients with CRC. computed tomography (CECT) in patients with CRC. Materials and Methods. This prospective study included 35 CRC patients (12 chemotherapy-naïve, 23 post-chemotherapy). All participants underwent comprehensive imaging evaluation comprising B-mode US, CEUS, and multiphase CECT. Imaging analysis focused on lesion characterization and identification of specific enhancement patterns enabling definitive lesion classification. Results. CEUS demonstrated superior performance in detecting specific diagnostic features compared to both grayscale US and CECT. Notably, CEUS maintained high pattern specificity in the post-chemotherapy cohort, while CECT specificity declined to 86 %. Conclusion. CEUS provides optimal diagnostic yield for characterizing focal liver lesions while maintaining consistent performance post-chemotherapy. Standardized contrast enhancement patterns enable reliable metastasis-benign differentiation. Chemotherapy does not reduce the diagnostic effectiveness of CEUS, whereas with CT the specificity of patterns decreases. CEUS can serve as a first-line modality for lesion verification after initial US detection and as a valuable alternative to CT in cases of diagnostic uncertainty or contraindications to CT.
Problems in Oncology. 2025;71(6):1351-1361
1351-1361
CT Arteriography in Patients with Liver Metastases from Colorectal Cancer Following Systemic Drug Therapy
Abstract
Introduction. Colorectal cancer ranks third in global cancer incidence. Liver metastases are present in 25 % of patients at initial diagnosis and develop in 50 % of patients following resection of the primary tumor. Aim. To develop and evaluate a CT arteriography protocol for diagnosing colorectal cancer liver metastases following chemotherapy. chemotherapy. Materials and Methods. Seven patients with colorectal cancer and liver metastases after neoadjuvant chemotherapy were included. All patients underwent CT arteriography with intra-arterial administration of 40 mliodinated contrast medium (300−320 mgiodine/ml) at 2 ml/s. Scanning was performed in two phases: arterial (22 seconds post-injection; n = 7) and portal venous (33−38 seconds; n = 6). Imaging assessment included capillary phase enhancement, metastasis visualization, peripheral rim enhancement, and severity of transient hepatic attenuation differences (THAD). Results. Nineteen liver metastases were identified. Capillary phase enhancement was achieved in 4/7 patients (57 %) at 22 seconds and all 6 patients (100 %) at 33−38 seconds. Hypervascular rim enhancement was visualized in 15 non-calcified metastases (100 %) during both phases with consistent intensity. THAD was observed in allpa- tients at 22 seconds, with reduced severity at 33−38 seconds. Conclusion. The proposed CT arteriography technique provides 100 % visualization of peripheral rim enhancement in non-calcified colorectal liver metastases after chemotherapy. The 33−38 second scan timing is preferred due to consistent capillary phase achievement and reduced perfusion artifacts while maintaining diagnostic rim enhancement quality.
Problems in Oncology. 2025;71(6):1362-1369
1362-1369
ORIGINAL ARTICLES Experimental research
Extracellular Vesicle and DNA Aptamer-Based Targeted Delivery System for Doxorubicin to Ovarian Cancer Cells
Abstract
The efficacy of systemic cytostatic therapy for oncological diseases, including ovarian cancer, is limited by toxic effects on healthy tissues. The development of target ed drug delivery technologies for anticancer agents represen tsan urgent priority. A promising strategy involves creating innovative delivery systems based on extracellular nanovesicles(ENVs) modi fied with DNA aptamers.
Problems in Oncology. 2025;71(6):1370-1380
1370-1380
In vitro and in vivo Evaluation of Three-Component Nanosystem for Photodynamic Therapy Containing Selenium Nanoparticles with Cellulose Graft Copolymer and Radachlorine
Abstract
Aim. The purpose of this study presents a comparative evaluation of a modified Radachlorin formulation for photodynamic therapy using an innovative hybrid tri-component nanosystem (HTN) incorporating selenium nanoparticles and a cellulosic graft copolymer. Materials and Methods. Patient-derived solid tumor cell lines included bladder cancer (587 BlCan TVV), lung cancer (1014 LC PNS), and skin melanoma (929 mel SVU). BAL- B/cmice (48 female, 28 male) were inoculated with Ehrlich carcinoma and ACATOL colon adenocarcinoma. Real-time cell analysis was performed using the xCELLigence system. Photosensitizers (HTN and Radachlorin) were administered at concentrations equivalent to 5 and 20 μg/mL Radachlorin. Cellular responses were quantified using the cell index parameter. In vivo, photosensitizers were administered intravenously (5 mg/ kgRadachlorin equivalent) when tumors reached 10±1 mm. Photoactivation employed 662 nmlaser irradiation at 5 J/cm² (24h post-incubation for cells) and 300 J/cm² (6h post-injection for tumors). Results. Both photosensitizers demonstrated no dark toxicity in tumor cell cultures. Laser activation induced significant cell death (sharp cell index decrease). Concentration-dependent proliferation inhibition was observed in bladder cancer and melanoma cultures, while lung cancer cells exhibited regrowth capacity. Cellular responses to photodynamic treatment were consistent between Radachlorin and HTN, with lung cancer cells showing relative resistance to both agents. In vivo studies revealed comparable efficacy between HTN and Radachlorin across tumor models, with ACATOL adenocarcinoma demonstrating lower sensitivity. Ehrlich carcinoma-bearing mice showed statistically significant survival improvement. Complete responses were observed in one female mouse with Ehrlich carcinoma and one with ACATOL adenocarcinoma using the selenium-containing nanosystem as a photosensitizer, though without statistical significance versus Radachlorin. Conclusion. The investigated hybrid selenium-polymer nanosystem shows significant promise for fluorescence-guided diagnosis and photodynamic therapy applications in oncology.
Problems in Oncology. 2025;71(6):1381-1388
1381-1388
PRACTICES OF ONCOLOGICAL INSTITUTIONS
Comparative Efficacy of Anastrozole, Letrozole, and Fulvestrant as Endocrine Partners Combined with CDK4/6 Inhibitors in Patients with HR+/HER2– Metastatic Breast Cancer: A Real-World Evidence from the Stavropol Regional Clinical Oncology Center
Abstract
Introduction. Combining CDK4/6 inhibitors with various м endocrine partners is a key therapeutic strategy in clinical prac- - tice, enabling treatment personalization and improved outcomes с for patients with HR+/HER2– metastatic breast cancer (MBC). - Aim. To evaluate the comparative effectiveness of different - endocrine therapy regimens combined with CDK4/6 inhibitors о using real-world data from the Stavropol Regional Clinical Oncology Center. - Materials and Methods. This retrospective analysis inыcluded 83 patients with HR+/HER2– MBC who received ribo- - ciclib (n = 42, 51 %) or palbociclib (n = 41, 49 %) in combiбnation with anastrozole, letrozole, or fulvestrant between April м 2019 and April 2024. Treatment efficacy was assessed through ь relapse-free survival (RFS) analysis using the Kaplan-Meier й method, with curve comparisons evaluated by log-rank test. Results. Anastrozole demonstrated significantly superior survival compared to letrozole (p < 0.001), while showing no statistically significant difference from fulvestrant (p = 0.168). The median RFS was not reached in the anastrozole group, both in the overall population and ribociclib subgroup. Letrozole showed more modest outcomes with median RFS of 5 months in the ribociclib group and 3-6 months in the palbociclib group. Comparative analysis revealed statistically significant advantages for ribociclib over palbociclib when combined with fulvestrant (p = 0.019), demonstrating median RFS of 22 months versus 10 months, respectively. Conclusion. These findings highlight the need for further research to optimize HR+/HER2– MBC treatment strategies, considering individual patient characteristics and complex clinical scenarios.
Problems in Oncology. 2025;71(6):1389-1402
1389-1402
Minimally Invasive Restorative Surgery for Low-Lying Rectal Carcinoma Patients
Abstract
Introduction. To preserve natural defecation and improve quality of life in patients with distal rectal cancer, sphincter-preserving techniques including low anterior resection (LAR) and intersphincteric resection (ISR) have been developed and implemented in surgical practice. Aim. To evaluate short-term outcomes and demonstrate the feasibility of laparoscopic LAR/ISR with natural orifice specimen extraction (NOSE) and double-layer hand-sewn coloanal anastomosis without diverting stoma. Materials and Methods. From February 2023 to March 2025, weretrospectively analyzed nine patients with distal rectal cancer (≤ 7 cmfrom anal verge) who underwent laparoscopic LAR/ISR with coloanal anastomosis without protective stoma. Results. All 9 (100 %) patients underwent laparoscopic surgery. D2 lymph node dissection was performed in 2 (22.2%) patients, and D3 in 7 (77,8 %) of cases. Internal sphincter resection was performed in 5 (55,6 %) of cases. According to macroscopic assessment, median distal clearance was 2 cm (IQR 1-2.5 cm). Specimen extraction was transanal (NOSE) in 8 (88.9 %) patients and via minilaparotomy in 1 (11.1 %) of cases. All patients received double-layer hand-sewn coloanal anastomosis (end-to-end: 6 (66.7 %); side-to-end: 3 (33.3 %)). Median operative time was 240 minutes (IQR 164-428), with median blood loss of 100 mL (IQR 50-200). Pathological assessment showed complete mesorectal excision (Quirke G3) in all in all 9 (100 %) cases with negative lateral, distal and proximal resection margins. Early postoperative complications (Clavien-Dindo I-II) occurred in 2 (22.2 %) patients. Median hospital stay was 8 days (IQR 7-12). Conclusion. Laparoscopic LAR/ISR with NOSE and stoma-free coloanal anastomosis is safe and anatomically preserving. This approach is justified in selected, motivated patients without significant comorbidities who are committed to postoperative rehabilitation for functional recovery.
Problems in Oncology. 2025;71(6):1403-1413
1403-1413
Clinical application of active aspiration fluid biopsy for pancreatic neoplasia diagnosis in oncology practice
Abstract
Introduction. Differential diagnosis of pancreatic cystic neoplasms (PCNs) presents a significant clinical challenge due to their structural heterogeneity. Pancreatic juice represents a highly specific biological medium of particular interest, containing both cellular components and potential molecular biomarkers. We present a novel technique — Active Duodenal Aspiration Biopsy (DAB) — enabling collection of pancreatic juice-bile mixtures for diagnostic analysis. Aim. To evaluate the efficacy of this original DAB technique when integrated with standard diagnostic modalities across different levels of oncology care institutions. Materials and Methods. Patients with inconclusive standard diagnostic workups underwent DAB procedures. Aspirates were analyzed cytologically and through carcinoembryonic antigen (CEA) level quantification. Results. In a case series of six patients with various pancreatic cystic neoplasms, DAB demonstrated feasibility and diagnostic utility when combined with conventional verification methods. CEA levels and cytological findings from DAB aspirates enabled precise diagnosis and informed treatment strategy modifications. Conclusion. This preliminary experience indicates DAB is both safe and effective. The technique is applicable across outpatient and inpatient oncology settings and shows potential for improving early pancreatic cancer detection.
Problems in Oncology. 2025;71(6):1414-1422
1414-1422
CLINICAL CASE
Successful Management of Nasal Cavity and Paranasal Sinus Neuroendocrine Carcinoma with Upper Airway Obstruction During Pregnancy: A Case Report
Abstract
Introduction. Sinonasal neuroendocrine carcinoma is a rare neoplasm with an incidence of 0.2–0.8 %, characterized by an aggressive clinical course. Theco-occurrence of this malignancy with pregnancy has been reported only in isolated clinical cases to date. Case Description. We present a case of stage IV (cT4aN3M0) neuroendocrine carcinoma of the ethmoid bone in a 26-year-old pregnant patient who achieved a complete objective response following EP chemotherapy. Conclusion. The management of malignant neoplasms during pregnancy represents a significant challenge in contemporary oncology, particularly given the increasing incidence of cancer diagnoses during gestation, including rare morphological subtypes.
Problems in Oncology. 2025;71(6):1423-1427
1423-1427
Primary Multiple Malignant Peripheral Nerve Sheath Tumors with Hematogenous and Lymphatic Metastases in Neurofibromatosis Type 1: A Case Report
Abstract
Introduction. Malignant peripheral nerve sheath tumor (MPNST) is a neuroectodermal sarcoma with an incidence of 5−9 %. Approximately 25−50 % of MPNST cases are associated with neurofibromatosis type 1 (NF1). Case Description. A patient presented to the Oncology Research Institute at the Tomsk National Medical Research Center in 2009 with a painless mass on the posterior right thigh. Diagnostic evaluation confirmed a grade 2 MPNST of the soft tissues. The patient underwent wide local excision with intraoperative radiation therapy (12 Gy). Clinical findings — including multiple neurofibromas along the sciatic nerve and café-au-lait spots — established a diagnosis of NF1. Local recurrence occurred three years postoperatively, requiringre-excision with IORT (15 Gy). In 2014, a solitary lung metastasis was resected via atypical lower lobectomy, followed by adjuvant chemotherapy. One year later, the patient presented with gastric bleeding secondary to a new tumor, requiring gastrectomy with D2 lymphadenectomy. Histopathological examination revealed a multinodular conglomerate extensively involving the gastric wall with serosal extension (without adjacent organ invasion) and metastatic perigastric lymph node involvement, consistent with metachronous grade 3 MPNST with metastatic involvement of one lymph node. Disease progression manifested as peritoneal metastases and ascites in January 2016, leading to patient mortality two months later. Conclusion. MPNST associated with NF1 represents a rare, highly aggressive malignancy with poor prognosis. Key characteristics include high local recurrence rates and metastatic potential via both hematogenous and lymphatic pathways.
Problems in Oncology. 2025;71(6):1428-1434
1428-1434
REVIEWS
DNA Homologous Recombination Repair Gene Mutations in Prostate Cancer: Predictive Significance and Role in Hereditary Predisposition
Abstract
The advent of next-generation sequencing has enabled comprehensive molecular profiling of prostate cancer (PC), revealing a high prevalence of DNA repair gene deficiencies—particularly in homologous recombination repair (HRR) pathway components in tumors of this localization. HRR gene analysis has gained critical importance following the clinical introduction of poly(ADP-ribose) polymerase inhibitors (PARP inhibitors) for metastatic castration-resistant prostate cancer. These agents are approved for tumors with BRCA1/2 mutations and other HRR gene alterations. While the predictive significance of BRCA1/2 defects is well-established, the clinical benefit of PARP inhibition in cases with other HRR abnormalities remains controversial. Beyond therapy personalization, HRR genetic testing facilitates identification of hereditary PC syndromes. This review characterizes the clinical implications of mutations across the HRR pathway.
Problems in Oncology. 2025;71(6):1435-1444
1435-1444
Preoperative Differential Diagnosis of Uterine Sarcomas: Current Considerations and Challenges
Abstract
Introduction. Uterine mesenchymal tumors represent a significant proportion of oncogynecological malignancies. Accurate preoperative differential diagnosis is critical for determining optimal patient management strategies, as misdiagnosis frequently leads to non-radical treatment, subsequently reducing survival rates and increasing risks of local recurrence or metastasis. Current challenges in clinical assessment, including the absence of specific diagnostic criteria and low preoperative verification rates, underscore the need for novel diagnostic tools in this field. Aim. To analyze current domestic and international literature on preoperative differential diagnosis of uterine mesenchymal tumors. Materials and Methods. We conducted a systematic literature review using PubMed/MEDLINE, UpToDate, e-Library, Scopus, and professional society resources (ESUR, ACR, ESGO, NCCN) from 2014–2024. Full-text studies and reviews addressing clinical presentation, laboratory findings, and imaging approaches for uterine mesenchymal tumors were included and analyzed. о - Results. This review synthesizes current diagnosticap- - proaches and identifies persistent challenges in uterine mesеenchymal tumor evaluation. Given the lack of validated bio- - markers and complexities in pathological verification, imaging - modalities combined with clinical data emerge as fundamental й for preoperative differentiation and treatment planning. - Conclusion. The morphological heterogeneity of uterine mesenchymal tumors continues to present significant diagnostic challenges, necessitating further research to develop improved diagnostic algorithms and optimize patient management strategies.
Problems in Oncology. 2025;71(6):1445-1460
1445-1460
Texture Analysis of MR Imaging for Hepatocellular Cancer Diagnosis: Reality and Prospects (Literature Review)
Abstract
This literature review synthesizes current evidence on MRI-based diagnostic methods for hepatocellular carcinoma (HCC). It defines the core principles of texture analysis, details its technical methodology, and discusses its clinical prerequisites. The article provides a comprehensive overview of texture analysis applications in oncology, supported by illustrative examples from personal archives. The discussion focuses on its role in predicting tumor histological grade, disease prognosis, and differentiation from hypervascular liver lesions (hepatocellular adenoma, focal nodular hyperplasia, hemangioma), metastases and regenerative/dysplastic nodules. The potential of texture analysis in assessing molecular-genetic characteristics and microvascular invasion is also critically examined. Key limitations, current barriers to clinical translation, and further prospects for its application are systematically evaluated.
Problems in Oncology. 2025;71(6):1461-1476
1461-1476
Cryoablation for Primary and Metastatic Lung Tumors: A Contemporary Perspective
Abstract
Malignant lung tumors represent a significant challenge in contemporary oncology. Lung cancer remains the leading cause of cancer-related mortality globally, while pulmonary metastases develop in 20−45 % of all cancer patients. Despite advances in multimodal cancer therapy, there remains a compelling need for novel treatment approaches, as conventional methods are either unsuitable for certain patients or demonstrate limited efficacy in specific clinical scenarios. This comprehensive literature review examines key studies on cryoablation for both primary and metastatic lung tumors, focusing on its applications for local disease control, palliation, and symptomatic management. The analysis encompasses technical methodologies, observed and anticipated complications with corresponding management strategies, and selected aspects of cryoimmunology. Current evidence indicates cryoablation is a safe and feasible modality for both cytoreductive and palliative purposes, particularly for patients ineligible for surgery or radiation therapy. Emerging cryoimmunology research presents promising avenues for investigating synergistic effects between cryoablation and modern immuno-oncological agents. Important limitations of existing studies include low evidence levels and absence of direct comparisons with other local therapies, preventing definitive conclusions regarding its comparative effectiveness and oncological outcomes.
Problems in Oncology. 2025;71(6):1477-1489
1477-1489
ANNIVERSARIES
Anniversaries
Problems in Oncology. 2025;71(6):1490-1491
1490-1491