Aim: To investigate the impact of time of performance of delayed orchiectomy on overall survival of patients with advanced germ cell tumors of testicle who didn’t undergo surgery before starting of treatment.
Materials and methods: From 1986 to 2010 in the department of clinical pharmacology and chemotherapy 71 (4,8%) of 1486 patients underwent delayed orchiectomy. During the first course of chemotherapy (1st group) 39 (55%) patients underwent surgery, 21 (29,6%) patients - during 2nd -4th courses (2nd group), after the ending of chemotherapy – 11 (15,5%) patients (3rd group).
Results: Final histological investigation of the specimens revealed viable germ cell tumor in 25 (64,1%) patients in the 1st  group, in 10 (47,7%) patients in the 2nd group and no viable tumor in the 3rd group.
Conclusion: Performance of orchiectomy simultaneously with the removal of the other sites of the tumor after chemotherapy doesn’t impair survival.

Introduction: Metastases in the pancreas are very rare and amount 4.5% of all tumors of the pancreas. As a rule such tumors don’t have any specific symptoms and are diagnosed spontaneously. The most frequent metastasizing to the pancreas tumor is renal cell carcinoma, then in descending order – colorectal cancer, melanoma, sarcoma and lung cancer. Prognosis is based on the histology of the primary tumor and the stage of the disease.
Case reports: This article describes cases of metastases of renal cell carcinoma, colorectal cancer, lung cancer and locally advanced cases of gastric cancer and lymphoma.
Conclusion: In this article 10 cases of secondary tumors of the pancreas are presented which amounts 5,4% (10 of 184)of all tumors of the pancreas during this period. In 6 cases metastases are found and in 4 cases – local invasion. It is very important to provide differential diagnosis with primary tumors of the pancreas because treatment strategy may differ significantly. It is difficult to choose right treatment strategy in patients with such diagnosis due to its rarity.

Metastases of malignant tumors to the brain represent a severe manifestation of far gone oncological disease. Modern possibilities of combined treatment dictate the requirements for understanding the epidemiology, etiology, pathogenesis and morphology of brain metastases. It has been long observed that certain tumors: breast, lung, colon and kidney cancer and melanoma - are the most frequent origins of the brain metastases. However, other tumors, much less, but are also capable to metastasize to the CNS. In this paper, a detailed clinical and morphological investigation of the brain metastases from the origins different from the most common metastatic tumors of the brain is presented. Karnovskiy index before surgery and presence of non-brain metastases are significant criteria of the prognosis. Literature review is presented in this article.

High morbidity and mortality of gastric cancer in Russia determine relevance of developing of a national strategy for gastric cancer and preneoplastic diseases of the stomach screening, especially atrophic gastritis. Review of the literature shows that the best non-invasive method to identify individuals at high risk of gastric cancer are H. pylori serological tests and markers of pepsinogens atrophy. H. pylori eradication is the most promising strategy to reduce the incidence of gastric cancer.

This article presents the results of our observations of the treatment of patients with metastatic kidney cancer. Bevacizumab is used in combination with interferon-alpha (IFN-a) as a first-line treatment. The medicament belongs to the new generation group of drugs that block angiogenesis.
Aim: to determine the effectiveness and possible adverse effects of the treatment of renal cell carcinoma with the combination of bevacizumab and interferon-alpha.
Materials and methods: treatment was performed in 22 patients with distant metastases of renal cell carcinoma. Patients received therapy in the mode of bevacizumab 10 mg/kg intravenously every 14 days, and IFN-a-2A 3 million units subcutaneously 3 times a week. Blood test, serum biochemistry, coagulogram and analysis of urine were monitored every 2 weeks. Computed tomography of the chest, abdomen and pelvis was performed every 3 months.
Results: progression-free survival was 12 months, overall survival was 21 months (12-24 months). We identified adverse events during the treatment, in relation to which some patients had either temporarily cancel current treatment or to modify the dose (grade 3 (G3) was detected in 18% of patients).
Conclusion: after 24 months of treatment 14 patients (63%) had disease progression, 5 (22%) patients had stabilization of the disease and 3 patients (15%) had partial response to treatment. Our results (overall survival, progression-free survival, rate of side effects) are consistent with results of the treatment described in world literature. Side effects of the treatment are associated primarily with the use of low doses of IFN-alpha and there were practically no side effects of high severity, requiring special treatment or cancel of treatment. It allows to recommend bevacizumab and interferon-alpha in low doses as first-line combination therapy. Prevention of adverse effects of treatment allows to continue the ongoing targeted therapy.