Surgical oncology department No. 1

The department provides surgical, chemotherapy and rehabilitation care to patients with:

• malignant neoplasms of the skin;
• malignant neoplasms of the breast;

malignant neoplasms of the soft tissues;

• malignant neoplasms of the lymphatic tissue.
• malignant neoplasms of the urinary system in women;
• malignant neoplasms of the genitourinary system in men.

Surgical care is also provided to patients with benign neoplasms of the breast and soft tissues.

The department’s doctors see patients and carry out pre-admission examinations in room 226 of the outpatient clinic, according to the doctors’ appointment schedule.

Patients with urologic cancers are examined in room 232 of the outpatient clinic. Urologic oncology patients are seen by the urologists A. D. Volkohon and A. Ye. Sirobaba.

If cancer is suspected and the examination cannot be done on an outpatient basis, patients are admitted to the department. Patients are examined using the equipment and diagnostic facilities of the outpatient clinic and the diagnostic imaging department. In some cases, certain examinations are carried out at healthcare facilities and diagnostic centers in the city and the region.

For every cancer patient, treatment is prescribed by a multidisciplinary tumor board made up of a surgical oncologist, a radiation oncologist and a medical oncologist. Other specialists join the board when necessary.

The department has mastered percutaneous core needle biopsy of tumors of the breast, soft tissues, liver and retroperitoneal space. In diagnosing tumors of the genitourinary system, transurethral biopsy of bladder tumors and ultrasound-guided multifocal prostate biopsy are widely used.

For stomach cancer, the standard operations in the department are distal subtotal gastric resection, gastrectomy and gastroenterostomy. Surgery is performed through an abdominal approach with D2 lymph node dissection; combined operations are performed when necessary. Diagnostic (staging) laparoscopy is mandatory at the start of treatment, and in most cases preoperative polychemotherapy (4–6 cycles) is given.

For tumors of the colon and rectum, standard operations are performed: right and left hemicolectomy, transverse colon resection, sigmoid colon resection, anterior resection of the rectum, abdominoanal resection of the rectum, abdominoperineal resection of the rectum, reconstructive operations to restore passage through the colon and rectum, and symptomatic operations. The use of circular staplers in the surgical treatment of rectal tumors has significantly increased the proportion of sphincter-preserving operations. For metastatic and locally advanced colorectal cancer, intra-arterial chemotherapy is used. In recent years, laparoscopic methods have been increasingly used in surgical treatment.

In the treatment of malignant breast tumors, depending on the stage of the disease and prognostic factors, the following operations are performed: radical mastectomy

(Patey, Halsted, Madden), subcutaneous radical mastectomy, radical breast resection with assessment of resection margins, quadrantectomy with regional lymph node dissection and assessment of resection margins, simple mastectomy and lumpectomy. Oncoplastic and augmentation techniques are widely used. A central venous port is placed for long-term polychemotherapy.

Patients with malignant neoplasms or suspected malignant neoplasms are admitted for planned treatment after pre-admission examination in line with the protocols of medical care for the relevant tumor site. If certain examinations cannot be done on an outpatient basis, the patient may be admitted to the department for further examination and subsequent treatment.

Patients with benign neoplasms are admitted for planned treatment after pre-admission examination.

Required examinations for patients with benign neoplasms:

• Complete blood count;
• Blood glucose test;
• PTI (prothrombin index), blood clotting time;
• Microprecipitation reaction with inactivated serum (syphilis test);
• Viral hepatitis testing;
• Urinalysis;
• Stool test for helminth eggs;
• Fluorography (within the last year);
• Gynecologist’s examination (for women);
• Urologist’s examination (for men over 40).

Indications and procedure for referring patients to the State Institution “National Cancer Institute of Ukraine”:

• Patients with malignant neoplasms are referred to the National Cancer Institute of Ukraine for consultative and highly specialized diagnostic and treatment care using modern technologies.

Indications for referral to the National Cancer Institute of Ukraine:

• the patient’s wish;
• difficult cases of differential diagnosis and treatment of malignant tumors;
• significant comorbidities (in the subcompensated stage);
• inability to provide diagnosis and treatment according to the standards.

Contraindications for referral to the National Cancer Institute of Ukraine:

• severe general condition;
• acute conditions requiring emergency care;
• infectious diseases: acute, or chronic in the active form; parasitic diseases: pediculosis, scabies and others;
• comorbidities in a state of functional decompensation;
• mental illnesses (endogenous depression, schizophrenia);
• emotional instability, negative attitude toward examination and treatment;
• alcohol or drug dependence.