Relevance: GLOBOCAN estimates 1.9 million new cases of colorectal cancer (CRC) and 935,000 deaths from CRC in 2020. CRC accounts for every tenth cancer case or death from cancer. According to the Oncological Service of the Republic of Kazakhstan (RK), in 2019, CRC ranked 5th in incidence and mortality among all cancers. With a survival time of more than five years, one of the main criteria that determine the condition of patients and the effectiveness of treatment is their quality of life (QOL). Understanding QOL parameters is essential to assess the full impact of the disease on an individual, family, and community. The purpose of the study was to analyze the quality-of-life indicators in patients with colorectal cancer and validate a Kazakh variant of the EORTC QLQ-CR-2 questionnaire in RK. Results: The QOL of patients with CRC globally is relatively low in its physical, mental, social, and clinical aspects. The most important factors affecting the QOL are sexual dysfunction, body dissatisfaction in ostomy patients, chronic recurrent diarrhea, symptoms of distress, and high fatigue. The patient’s lifestyle, age, gender, stage of the disease, and psycho-emotional status all affect the QOL of patients with CRC. It should also be noted that CRC survivors who have been physically active report a better QOL than those who were not physically active. Conclusion: The fact that no study has been conducted in the RK for the QOL of patients with CRC necessitates a study to understand the QOL parameters in patients with CRC using the Kazakh version of the EORTC QLQ-CR-2 questionnaire. We plan to conduct such a study in the near future within the framework of grant funding for young scientists IRN AP09058432 KN MES RK and publish the results

Introduction: Differentiated thyroid cancer (DTC) is characterized by a favorable prognosis in most cases. However, the development of radioiodine refractoriness significantly worsens the disease course, limits the effectiveness of standard therapy, and is associated with an increased risk of progression. In this regard, the search for molecular genetic markers that allow early identification of patients at high risk of developing an aggressive radioiodine-refractory phenotype is a relevant area of research. Integration of molecular and clinical-pathological characteristics of the tumor may improve the accuracy of risk stratification and contribute to personalization of treatment strategy. Objective: To evaluate the relationship between molecular genetic alterations, including BRAF and TERT promoter mutations, and clinical-pathological characteristics of radioiodine-refractory differentiated thyroid cancer. Materials and Methods: A retrospective single-center study was conducted, including 167 patients with DTC treated between 2021 and 2023. The study was performed in the Republic of Kazakhstan among patients treated at the Radionuclide Therapy Department of the Center for Nuclear Medicine and Oncology, Health Department of the Abai Region. Depending on the response to radioiodine therapy, patients were divided into two groups: radioiodine-sensitive DTC (n = 130) and radioiodine-refractory DTC (n = 37). Multivariate analysis was performed to identify independent predictors of radioiodine refractoriness. The discriminatory ability of the prognostic model was assessed using ROC analysis. Results: The development of radioiodine refractoriness was associated with clinical-pathological signs of aggressive disease course, including elevated levels of thyroglobulin and/or antibodies to thyroglobulin, the presence of lymphogenous metastasis, and the need for more extensive surgical intervention. Individual BRAF and TERTp mutations did not demonstrate independent statistically significant prognostic value. At the same time, the simultaneous presence of BRAF and TERTp mutations was significantly associated with the development of radioiodine refractoriness. The integrated clinical-molecular model demonstrated good discriminatory ability (AUC = 0.796) and outperformed the model based solely on clinical-pathological characteristics, indicating the additional prognostic value of molecular profiling. Conclusions: The inclusion of molecular genetic profiling in comprehensive clinical-pathological assessment may improve the accuracy of risk stratification, contribute to early identification of patients with potentially aggressive disease course, and serve as a basis for personalization of treatment strategy.

Background/Objectives: Radioiodine-refractory differentiated thyroid carcinoma (RAIR-DTC) is associated with limited treatment options and a less favorable clinical course. Combining molecular alterations with clinicopathological characteristics may improve the early identification of patients at risk of radioiodine refractoriness. This study aimed to evaluate the association between molecular genetic alterations, particularly BRAF and TERT promoter mutations, and RAIR-DTC. Methods: This retrospective single-center study conducted in Kazakhstan included 167 patients with differentiated thyroid carcinoma treated between 2021 and 2023. Patients were classified into radioiodine-sensitive (n = 130) and radioiodine-refractory (n = 37) groups. Clinical, histopathological, and molecular genetic characteristics were analyzed. Results: Radioiodine refractoriness was observed in all 13 patients (100.0%) with concurrent BRAF and TERT promoter mutations, compared with 24 of 154 patients (15.6%) without this co-mutation (OR = 163.46, 95% CI 9.31–2870.79; p < 0.001). The BRAF + TERT co-mutation was also associated with less differentiated histological architecture and a higher T category. In contrast, the BRAF mutation alone showed a substantially weaker association with radioiodine refractoriness, highlighting the incremental value of the combined BRAF + TERT molecular status. Conclusions: The concurrent presence of BRAF and TERT promoter mutations, rather than the BRAF mutation alone, may improve the identification of patients at increased risk of radioiodine refractoriness. Integrating molecular profiling with clinicopathological characteristics may support individualized risk stratification and treatment planning.

Introduction. In Kazakhstan, as well as globally, the incidence of thyroid cancer is increasing. In 2023 the incidence rate rose by 13.1% compared to the previous year. Radioactive iodine therapy (I-131) is the primary treatment method for highly differentiated thyroid cancer (HDTC) following surgical tumor removal. However, in some patients distant metastases may develop, worsening the prognosis and necessitating an assessment of the effectiveness of radioiodine therapy in such cases. Objective: To study the incidence of distant metastases and evaluate the effectiveness of radioiodine therapy (I-131) in patients with thyroid cancer. Materials and Methods. A retrospective analysis of medical records was conducted for 443 patients diagnosed with HDTC who underwent treatment in the radionuclide therapy department from January to December 2023. Among them, 33 patients (7.4%) were diagnosed with distant metastases. The localization of metastases, therapeutic doses of I-131, and clinical outcomes were assessed based on medical documentation. Results. Among the 443 patients studied, 7.4% had distant metastases of thyroid cancer. As a result, metastatic lesions were localized in the lungs in 54.5% of cases, in the bones in 12.1%, and in distant lymph nodes in 15.2%. Complete remission was achieved in 44% of patients, while disease stabilization was observed in 50%. In 6% of cases, radioiodine therapy did not produce a significant effect. Additionally, 3% of patients had rare metastatic sites, including the brain and ovaries. These findings highlight the need for further research into factors influencing the effectiveness of radioiodine therapy. Further studies in this area are necessary to optimize treatment strategies for patients with metastatic disease. Conclusion. The incidence of distant metastases in HDTC was 7.4%, with the lungs being the most frequently affected site. Radioiodine therapy demonstrated high effectiveness in treating patients with metastatic disease, particularly in cases of pulmonary metastases. The obtained data underscore the importance of early diagnosis and timely therapy to improve the prognosis in patients with metastatic lesions. Введение. В Казахстане, как и в мире, наблюдается рост заболеваемости раком щитовидной железы. В 2023 году уровень заболеваемости увеличился на 13,1% по сравнению с предыдущим годом. (I131) является основным методом лечения высокодифференцированного рака щитовидной железы (ВДРЩЖ) после хирургического удаления опухоли. Однако у части пациентов возможно развитие отдалённых метастазов, что ухудшает прогноз и требует оценки эффективности радиойодтерапии в таких случаях. Цель. Изучить частоту встречаемости отдаленных метастазов и оценить эффективность метода лечения радиоактивном йодом (I131) у пациентов с раком щитовидной железы Материалы и методы. Проведён ретроспективный анализ историй болезней 443 пациентов с диагнозом ВДРЩЖ, прошедших лечение в отделении радионуклидной терапии с января по декабрь 2023 года. Среди них у 33 (7,4%) были диагностированы отдалённые метастазы. Локализация метастазов, терапевтические дозы I131 и клинические исходы оценивались на основе медицинской документации. Результаты. В рамках исследования среди 443 пациентов у 7,4% были выявлены отдалённые метастазы рака щитовидной железы. В результате, у 54,5% пациентов с метастазами поражение локализовалось в лёгких, у 12,1% – в костях, у 15,2% – в отдалённых лимфатических узлах. Полная ремиссия была достигнута у 44% пациентов, тогда как у 50% зафиксирована стабилизация заболевания. В 6% случаев наблюдалось отсутствие значимого эффекта от радиойодтерапии. Кроме того, у 3% пациентов были выявлены редкие локализации метастазов (головной мозг, яичник). Полученные результаты подчеркивают необходимость дальнейшего изучения факторов, влияющих на эффективность радиойодтерапии. Дальнейшие исследования в этом направлении необходимы для оптимизации стратегий лечения пациентов с метастатическим поражением. Заключение. Частота отдаленного метастазирования ВДРЩЖ составила 7,4%, при этом наиболее часто поражаются лёгкие. Радиойодтерапия продемонстрировала высокую эффективность в лечении пациентов с метастатическим поражением, особенно в случаях лёгочного метастазирования. Полученные данные...

Background/Objectives: Although papillary thyroid carcinoma generally has an excellent prognosis, recurrence remains an important clinical problem in adolescents and young adults (AYA), while the prognostic value of molecular markers in this population is still unclear. This study aimed to identify clinicopathological and molecular predictors of recurrence in young patients with papillary thyroid carcinoma from Kazakhstan. Methods: This retrospective multicenter study included 246 consecutive patients with histologically confirmed papillary thyroid carcinoma. Tumor specimens collected between 2016 and 2020 were obtained from three tertiary oncology centers in Kazakhstan. Results: In the AYA subgroup, none of the evaluated clinicopathological or molecular variables was significantly associated with recurrence after multivariable adjustment. TERT promoter-related alterations showed the largest estimated association with recurrence, with an odds ratio (OR) of 9.05 (95% confidence interval [CI], 1.00–59.86; p = 0.333), while lymph node metastasis demonstrated the strongest trend toward poorer progression-free survival in the overall cohort, with a hazard ratio (HR) of 9.61 (95% CI, 0.92–100.49; p = 0.059); no significant predictors of overall survival were identified. Conclusions: Recurrence risk among adolescents and young adults with papillary thyroid carcinoma is heterogeneous and may be more accurately assessed by combining conventional clinicopathological factors with molecular markers, particularly TERT promoter mutation status. These findings support a more personalized approach to postoperative surveillance and precision management of young patients in Central Asia.