Brain metastases are an unfavourable manifestation of renal cell cancer. Currently, we have limited understanding of the tumour and immune biology of brain metastases and resistance factors to systemic therapy. The optimal approach to comprehensive treatment of brain metastases in renal cancer remains unclear. That is why it is important to search for additional prognostic factors in this category of patients.
The aim of the study was to analyse prognostic predictors in patients with renal cancer metastases to the brain affecting survival rates.
Materials and methods. We retrospectively analysed the data of 56 patients with brain metastases of RCC treated at the Moscow City Oncological Hospital No. 62 in Moscow and the City Clinical Oncological Dispensary (St. Petersburg) from 2006 to 2022, with a median follow-up of 45,6 months. 48 (85,7%) men prevailed in the study. Solitary brain metastases were detected in 19 (33,9%), and more than 2 metastases in 21 (37,5%). Intermediate and poor prognosis according to IMDC was established in 21 (37,5%) and 25 (44,6%), respectively, with low-differentiated tumours in the primary kidney tumour detected in 28 (50%) patients. Radiation therapy was given to 32 (57,1%) and metastasectomy to 33 (58,9%) patients. The study investigated clinical and morphological prognostic factors influencing survival rates in patients with brain metastases of RCC. Statistical analysis was performed using Statistica 10.0 software packages (StatSoft, USA) by constructing Kaplan-Meier curves and survival tables, building a mathematical model of survival.
Results. The 3- and 5-year OS in patients with brain metastases of RCC (n=56) was 43% and 22%, respectively, with a median OS of 22,3 months. In single factor analysis in patients with renal cancer brain metastases, ECOG status (p=0,0047), number of brain metastases (p<0,001), liver metastases (p=0,028), IMDC prognosis (p=0,024), nephrectomy (p<0,001) and radiotherapy (p=0,05) were found to have a negative impact on survival rates. In multivariate analysis, gender (p<0,001), ECOG status (p<0,001), degree of tumour differentiation (p=0,001), type and number of brain metastases (p<0,001), IMDC prognosis (p<0,001), metastases to lung (p<0,001), bone (p<0,001), liver (p=0,001) and lymph nodes (p<0,001), as well as nephrectomy (p=0,001) and radiotherapy (p<0,001) were additional predictors affecting AE rates in patients with brain metastases of RCC.
Conclusion. In our study, sex, ECOG status, tumour differentiation, type and number of brain metastases, IMDC prognosis, metastases to lung, bone, liver and lymph nodes, as well as nephrectomy and radiotherapy were additional independent prognostic factors affecting OS in patients with brain metastases of RCC. 

Aggressive soft tissue angiomyxoma in the pelvic region (AAM — Aggressive angiomyxoma) is an extremely rare neoplasm that develops mainly in women of reproductive age. AAM can occur at any age with a characteristic solid infiltrative growth type. AAM is described as benign neoplasms with intermediate malignant potential, since the development of local recurrence is possible. In three cases, distant metastasis of AAM has been described. Radical surgery is the main method of treatment. Hormone therapy is used before surgery with a high risk of performing highly traumatic intervention, after non-radical surgical treatment of AAM, the risk of relapse, inoperable AAM.

Bladder cancer is one of the most common malignant tumors of the urinary system, with global annual incidence rates exceeding 573,000 cases and a mortality rate of approximately 212,000. In recent years, there has been an increase in the incidence among young adults (under 40 years of age), accounting for 5–10% of all diagnosed cancer cases. In this group, the disease often progresses aggressively due to late diagnosis, and patients face long-term consequences of specialized treatment, including impaired fertility and reduced quality of life. The article presents a clinical case of treating localized bladder cancer in a young patient, discussing the challenges of diagnosis, treatment selection, and long-term follow-up, while emphasizing the need for a personalized approach.

Radiotherapy-induced angiosarcoma (RIAS) of the breast is a rare but aggressive complication of radiation therapy that develops in patients following breast cancer treatment. This malignancy is characterized by a poor prognosis due to delayed diagnosis, rapid tumor progression, and the limited effectiveness of current treatment modalities. The aim of this study is to review modern approaches in the diagnosis and management of RIAS and to present a clinical case of a patient who developed RIAS several years following breast cancer treatment. Despite radical surgical resection, this case demonstrated rapid recurrence and resistance to therapy, highlighting the challenges in management. The presented case emphasizes the need for an individualized approach and further research to optimize treatment strategies.

Studies of drugs from the group of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors as first-line therapy are currently not limited to the group of patients with metastatic luminal Her2-negative (ER+/HER2-) breast cancer. A number of preclinical and clinical studies have demonstrated the potential of CDK4/6 inhibitors in the treatment of HER2-positive breast cancer with positive expression of hormone receptors («triple-positive» subtype). However, in these studies, CDK4/6 inhibitors were used together with monoclonal antibodies (Trastuzumab, Pertuzumab). This article presents a case of using a combination of an aromatase inhibitor and a CDK4/6 inhibitor without chemotherapy and monoclonal antibody (MAB) drugs as a first-line treatment for metastatic Her2-positive breast cancer in the St. Petersburg City Clinical Oncology Dispensary.

Neuroendocrine tumors (NETs) include heterogeneous neoplasms that can be functional or symptomatically active (functioning) or non-functioning. The overall incidence of NETs is growing faster than the incidence of all human malignancies. NETs are the second most common gastrointestinal cancers, characterized by frequent liver metastasis, which is a major factor affecting the quality of life and significant survival of patients. Cytoreductive treatment of liver metastases (NELM) is the method of choice aimed at ensuring prolongation of patient survival and improving control of hormonal symptoms resistant to conservative therapy. Surgical resection of metastases is indicated in patients with well-differentiated (G1/G2) tumors, while its feasibility and complexity in severity dictate the degree of liver involvement. As a result of advances in surgical techniques in recent years, 1- and 2-stage or repeat liver resections are performed safely and effectively by surgeons with the treatment of NETs. The wide range of interventional radiological treatments for NELM with limitations requires reasons, which is the basis for adjunctive or alternative surgery. In general, liver-directed therapies can precede the administration of systemic molecular targeted agents and chemotherapy for patients with metastatic stage and severe liver disease, which leads to the fact that patients continue to be treated only with somatostatin analogues (SAA). Cytoreductive surgery of NETs is not limited to liver metastases, but is also used in peritoneal carcinomatosis. The large variability of clinical manifestations and the prevalence of the tumor process determine the need for an individual regimen for each patient within the framework of the MDT. In this article, we discuss the surgical approach to metastatic small bowel NETs: primary tumor, liver metastases and peritoneal carcinomatosis.