RADIATION AND CHEMORADIATION THERAPY FOR I STAGE INTERMEDIATE AND HIGH/INTERMEDIATE ENDOMETRIAL CANCER - DESCRIPTIVE ANALYSIS. / PROMENEVA TA KhIMIOPROMENEVA TERAPIIa U LIKUVANNI RAKU ENDOMETRIIa I STADIÏ PROMIZhNOÏ TA VYSOKOÏ GRUP RYZYKU -DESKRYPTYVNYI ANALIZ.

INTRODUCTION: Endometrial cancer ranks the third place in prevalence among all cancers in Ukraine. The surgicaltreatment and subsequent adjuvant treatment is planned according to the patient's risk group. The choice of radi-ation therapy and the need to add chemotherapy determines the level of recurrence-free survival. OBJECTIVE: The aim of the study was to analyze the database of treated patients in National Cancer Institute, with Istage endometrial cancer intermediate and high-intermediate group; determination of the most frequent choice ofradiation treatment in accordance with the risk group of patients with a hysterectomy with salpingo-oophorectomyfor further observation and evaluation of diseasefree survival. MATERIALS AND METHODS: Retrospective was analysed 245 patients with high and intermediate risk groups with stageI endometrial cancer. The exclusion criteria were: low-risk patients, stages II-IV and non-endometrioid histologi-cal variant. RESULTS: According to the analysis, there were 122/245 (49.8 %) patients of high risk group, 123/245 (50.2 %) ofintermediate risk group. High-risk patients underwent external beam therapy and brychytherapy, supplemented bychemotherapy in 5.8 % of cases (7 patients), brachytherapy with external beam therapy was performed in 58.2 % ofcases (71 patients), brachytherapy - in 8.1 % of cases (10 patients), external beam therapy was performed in 27.9 %cases. Intermediate and high-intermediate risk patients were distributed as follows: brachytherapy was performedin 41.5 % of cases (51 patients), brachytherapy with external beam therapy - 54.5 % (67 patients), external beamtherapy was performed in 5 patients. CONCLUSION: Brachytherapy is available for patients with intermediate risk endometrial cancer and external beamtherapy with possible addition of brachytherapy is recommended for high-intermediate and high-risk groups, espe-cially in patients with lymphatic vascular involvement. All patients are monitored for further assessment of recur-rence-free survival.

Features of recurrence of endometrioid type endometrial cancer of I stage.

The aim of this study was to determine the rates of recurrences of stage I endometrial cancer (EC) and features of their localization depending on the clinical and pathological characteristics of the tumor and methods of patients' treatment. PATIENTS AND METHODS: The study included 968 patients with stage I endometrioid EC, who underwent surgical treatment in the Department of Oncogynecology of the National Cancer Institute in 2015-2019. Surveillance of patients lasted from January 2015 to December 2020, with a minimum follow-up period of 1 year from the date of surgery. Adjuvant radiation or chemotherapy was performed depending on the clinical and pathological characteristics of the EC case. RESULTS: During the follow-up period, recurrences were observed in 7.0% of cases and were most often found in stage IC of low differentiation grade. It was found that during surgical treatment without adjuvant therapy relapses occurred in 12-36 months after the start of treatment, with adjuvant radiation therapy - in 6-18 months, and with adjuvant chemotherapy - in 32-60 months. Recurrences most often occurred in patients with EC who underwent surgical treatment in combination with chemotherapy (p < 0.05). The lowest number of recurrences was recorded among patients who underwent surgery as an only treatment. The best 5-year survival rate was observed in the group of patients with surgical treatment (93%), and the worst - in the patients treated with combination of surgery and chemotherapy (57%). In patients without recurrences, the survival rate after treatment was 97%, while in patients diagnosed with relapses, the survival rate was 65%. CONCLUSION: Despite the predominantly favorable course of EC stage I, some patients develop relapses. The rate and localization of recurrences depend on the histological structure of the tumor and treatment regimens of the EC patients.

Expression of chemokine receptor CXCR4 in tumor cells and content of CXCL12+-fibroblasts in endometrioid carcinoma of endometrium.

BACKGROUND: The expression of the CXCL12 chemokine and its receptor CXCR4 in the stromal component of the tumor plays an important role in tumor cell migration, proliferation, inhibition of apoptosis and determination of invasive and metastatic potential of malignant neoplasms of various genesis. The significance of CXCL12 and CXCR4 expression in endometrial tumor cells for cancer progression is not fully understood. AIM: To evaluate the content of CXCL12+-fibroblasts and expression of CXCL12 and CXCR4 in endometrial cancer cells, depending on the tumor stage. MATERIALS AND METHODS: Surgical material of 45 patients with endometrioid carcinoma of the endometrium (ECE) of the stages I-II and III was studied using morphological and immunohistochemical methods. RESULTS: In ECE of stage I-II CXCR4 expression was lower (43.3 ± 4.2%) while CXCL12 expression was higher (33.6 ± 2.4%) compared with the corresponding indices​​ in ECE of stage III (63.6 ± 3.5%, 24.5 ± 1.9%, respectively, p < 0.05). In ECE of stage III, high expression of CXCR4 (> Me) and low CXCL12 (< Me) was observed in 80% of samples; these tumors invaded more than 1/2 of the myometrium. There was a positive correlation between the depth of tumor invasion in the myometrium and the presence of metastases and CXCR4 expression in tumor cells (R = 0.5 and R = 0.4, respectively, p < 0.05) and the negative correlation with the expression of CXCL12 (R = -0.6 and R = -0.3, respectively, p < 0.05). In tumors that deeply invaded the myometrium, a high number of the CXCL12+-fibroblasts (> Me) (14.9 ± 1.3%) was detected. CONCLUSION: The obtained data reflect the communication of the immunosuppressive factor of the tumor microenvironment, i.e. CXCL12+-fibroblasts and CXCR4 expressing tumor cells. We suggest that the aggressiveness of ECE is determined by the combined effect of these two factors.