The article is devoted to the key research directions presented in the third issue of the journal for 2026. The materials of this issue reflect the transition of contemporary science from traditional clinical observation and pathogenetic analysis to digital prediction, personalized risk assessment, and interdisciplinary interpretation of data. Particular attention is paid to publications addressing the use of artificial intelligence and machine learning for predicting pregnancy complications, as well as the need for critical assessment of source data quality, external validation, and clinical applicability of such models. In addition, the article discusses studies focused on hemostatic disorders, endothelial dysfunction, preeclampsia, reproductive health, gynecologic oncology, assisted reproductive technologies, and cancer-associated thrombosis. In the context of the growing role of digital technologies and generative artificial intelligence in medical science, the importance of methodological rigor, scientific continuity, and authorial responsibility is emphasized. The editorial board is concerned about the increasing number of manuscripts submitted by paper mills.

Aim: to assess the prevalence and pattern of latent thrombophilic conditions in pregnant and reproductive-age women with an adverse cerebrovascular history, as well as in patients at high risk of acute cerebrovascular events (ACVEs) identified using a previously developed prognostic model, based on a comprehensive clinical and hemostasiological analysis.

Materials and Methods. A two-stage observational study was conducted, consisting of sequential retrospective and prospective phases. In the retrospective phase, data from 50 patients with ACVEs that had occurred during pregnancy, in the early postpartum period, or outside gestation were analyzed; 30 clinically healthy pregnant women were included in control group. Based on the retrospective data, a prognostic model for cerebrovascular risk stratification had previously been developed; in the present study, this model was used solely as a tool to identify high-risk patients. In the prospective phase, 45 pregnant and reproductive-age women with ACVEs history or a high risk of their development, as identified by the above model, as well as 30 clinically healthy pregnant women, were examined. All patients underwent an extended clinical and hemostasiological evaluation, including assessing genetic thrombophilia, natural anticoagulant deficiencies, antiphospholipid antibodies (aPL), homocysteine levels, metalloproteinase ADAMTS-13 activity, anti-ADAMTS-13 antibodies, as well as parameters of the vWF/ADAMTS-13 axis.

Results. In the retrospective phase, inherited and acquired forms of thrombophilia were detected significantly more often in patients with ACVEs than in control group, 84.0 % versus 6.7 % cases, respectively. Pattern of cerebrovascular events was featured with ischemic stroke diagnosed in 58.0 % patients, whereas cerebral venous thrombosis – in 42.0 % cases. In prospective group, genetically determined thrombogenic abnormalities were detected in 35.6 % patients, criterial aPLs were detected in 28.9 %, hyperhomocysteinemia – in 15.6 %, reduced ADAMTS-13 activity – in 11.1 %, anti-ADAMTS-13 antibodies – in 26.7 %, and elevated von Willebrand factor levels – in 28.9 %. Combined thrombophilia was identified in 35.6 % patients in the prospective group, suggesting the multifactorial nature of prothrombotic predisposition.

Conclusion. Latent thrombophilic conditions are frequently detected in pregnant and reproductive-age women with ACVEs history, as well as in patients at ACVE high risk, and often have a combined pattern involving both genetically determined and acquired hemostatic disorders. These findings substantiate a need for extended clinical and hemostasiological assessment in this category of patients at the stage of pregnancy planning and during pregnancy to improve risk stratification and individualize prevention of thrombotic complications.

Aim: improving diagnosis of vascular disorders during pregnancy by using morphometric examination of desquamated endothelial cells (DECs).

Materials and Methods. An observational prospective study assessing endothelial status in pregnant women and fetuses was carried out using the "case-control" method. 180 women in first trimester who had terminated pregnancy were examined: 90 patients were diagnosed with undeveloped pregnancy and instrumental removal of the fetal egg was performed, 90 women had a medical abortion on request. Endothelial dysfunction was diagnosed in all pregnant women, and morphometry of circulating DECs was performed. The data obtained further underwent statistical analysis.

Results. A comparative analysis of endothelial lesion markers in pregnant women demonstrated the diagnostic significance of DECs morphometric examination.

Conclusion. Morphometric examination of peripheral blood DECs may be a diagnostic marker of vascular disorders in pregnant women and represents a promising area to prevent obstetric and perinatal pathology.

Introduction. Genitourinary menopause syndrome (GUSM) significantly worsens the quality of life of postmenopausal women. Traditional diagnostic approaches based primarily on clinical manifestations provide no precisely assessed severity of pathomorphological disorders.

Aim: to study a relationship between estradiol level, estrogen receptors (ERα) state, the functional activity of vaginal epithelial cells, as well as the characteristics of the vaginal microbiome.

Materials and Methods. An interventional cross-sectional comparative study with 148 women was conducted. Depending on the present or absent of pathognomonic complaints and clinical signs of vulvovaginal atrophy (VVA), 113 postmenopausal patients were divided into 3 clinical groups: group 1 – 42 patients with VVA and reported subjective clinical symptoms and complaints; group 2 – 36 patients with VVA, visual signs of the atrophic process and no subjective clinical symptoms and complaints; group 3 – 35 healthy postmenopausal women without VVA signs. Control group consisted of 35 healthy women of reproductive age. The study used electrochemiluminescence immunoassay (ECLIA) to determine the level of blood plasma estradiol, molecular biological analysis (real-time polymerase chain reaction) – to study the vaginal microflora using the Femoflor-16 method. An assessment of epitheliocyte nucleus electrokinetic activity (ENEA) was carried out according to V.G. Shakhbazov et al. (1986) microelectrophoresis method, as well as an immunohistochemical (IHC) study of vaginal wall biopsies – to determine ERα expression using monoclonal antibodies as well as visualization systems and assessment conducted by Allred system.

Results. Our data showed that the pH of vaginal secretions increases from control group to groups with VVA, indicating a decreased acidity. In group 4 (reproductive age women), the pH was 3.89, significantly lower than in other groups (p < 0.001). In group 3 (postmenopause without VVA), the pH was higher than in control, but lower than that of in group with VVA (p < 0.001). Groups 1 and 2 (with VVA) have the highest pH, with group 1 (symptomatic) being higher than in group 2 (p < 0.001). In addition, there were also data obtained on microbiota state in the studied patients. All women (100.0 %) from group 1 had severe dysbiosis; in group 2, 25 % had severe dysbiosis, and 75 % had moderate dysbiosis. In group 3, individuals were distributed roughly equal proportions: normocenosis and normocenosis with signs of dysbiosis in 42.8 %, and 14.2 % with moderate dysbiosis. The maximum estradiol concentration in control group was 161.7 pg/ml, significantly higher than the others (p < 0.001). No significant differences between the groups with VVA were found. The ERa level decreased in groups with VVA: in asymptomatic vs. symptomatic patients with VVA, it was higher (p < 0.001). Women without VVA had the highest ERa level. ENEA decreased from control (53.9 %) to groups with VVA, especially in symptomatic subjects (up to 3.88 %). In patients from group 3, it was higher than in study groups with VVA (p < 0.001). Statistical analysis has shown that absolute normocenosis is associated with higher ENEA level compared to dysbiosis. The high correlation between ERa and ENEA shows that such indicators are interconnected and closely related to mucosal condition. The regression model showed that estradiol level and epithelial parameters were important for control group, while ENEA level and acidity dominated in VVA groups.

Conclusion. ENEA is a sensitive and non-invasive marker closely related to vaginal microbiota state. Its magnitude decreases in microbiota disorders and reaches 41.2 % in absolute normocenosis, mirroring a good mucosal condition. In postmenopause, even a conditional normocenosis is accompanied by ENEA decreased down to 35.2 %, which may suggest preclinical changes. With moderate dysbiosis, the indicators decrease by 3–4 times, and with severe dysbiosis – by more than 15 times, indicating seriously altered homeostasis. Statistical inter-group significance confirms the ENEA ability to objectively assess the degree of microbiological disorders. A level below 35 % highlights deviation from normal range, even without clinical symptoms. Magnitude of 2–10 % indicate severe dysbiosis requiring correction. Altered relationship between the parameters may suggest severity of the process and portend a poor response to treatment. Intensive combination therapy is recommended for patients with symptomatic VVA. With "silent" atrophy, therapy aimed at improving epithelial condition is sufficient, without significant changes in the hormonal background. Evidence suggests that preventive maintenance of microflora and acidity is important in postmenopausal women. For the first time, it is proposed to use ENEA as a parameter that bridges molecular disorders and clinical as well as microbiological manifestations of VVA, which lay a foundation for novel stratification and diagnosis system as well as differentiated treatment depending on regulatory relationships at the tissue level.

Aim: to evaluate the clinical efficacy of laparoscopic myomectomy using transient uterine artery occlusion in reproductive age patients with symptomatic uterine fibroids.

Materials and Мethods. The prospective comparative study included 20 women randomly assigned to two groups: standard laparoscopic myomectomy (n = 10) and laparoscopic myomectomy with transient uterine arteries occlusion (n = 10). The duration of the operation, the volume of intraoperative blood loss, the dynamics of hemoglobin levels, the duration of hospitalization, and the frequency of complications were evaluated.

Results. Both groups were comparable in baseline clinical and demographic characteristics. In main group, there was a significant decrease in intraoperative blood loss (210.5 ± 195.4 ml vs. 365.2 ± 214.1 ml; p = 0.03), while the duration of surgery and the level of postoperative hemoglobin did not differ significantly. Most of the interventions were completed by laparoscopic access without conversion, and frequency of early complications was comparable in both groups.

Conclusion. Transient occlusion of the uterine arteries during laparoscopic myomectomy improves the safety of the intervention by reducing blood loss and does not increase the risk of complications. The practical significance implies that the use of this technology can contribute to safer operations and preserve patients’ reproductive health. Thus, positively contributes to improving current gynecological surgery.

Introduction. Iron deficiency conditions and folate insufficiency are highly prevalent among women of reproductive age in the Russian Federation and may adversely affect menstrual and reproductive function. Regional prevalence patterns and the effectiveness of combined correction for such deficiencies in the Republic of Bashkortostan remained understudied.

Aim: to assess the prevalence of iron and folic acid deficiency, associated dietary and gynecological risk factors, as well as the effectiveness of 3-month combined therapy with ferrous fumarate and folic acid in women of early reproductive age.

Materials and Methods. A prospective cohort study was conducted involving 372 women aged 20–25 years residing in the Republic of Bashkortostan. Actual nutrition was assessed (My Healthy Diet software), and menstrual blood loss was evaluated using the Mansfield–Voda–Jorgensen scale. Serum levels of ferritin, serum iron, total iron-binding capacity (TIBC), transferrin, transferrin iron saturation coefficient (TIS), folic acid, as well as complete blood count were measured. Women with iron deficiency received combined therapy – 163.56 mg ferrous fumarate (equivalent to 50 mg iron) + 540 µg folic acid (equivalent to 500 µg dry matter) for 3 months.

Results. Latent iron deficiency (ferritin < 15 µg/L) was detected in 34.4 %; 28.5 % had early latent iron deficiency (ferritin = 15 µg/L and changes in other ferrokinetic markers: decreased serum iron, TIS or increased transferrin and TIBC); the overall prevalence of iron deficiency signs was in 62.9 %. Manifest iron deficiency anemia (hemoglobin < 120 g/L) was detected in 27.4 %, folic acid deficiency (< 3 ng/mL) – in 23.7 %, and probable deficiency (3.0–5.9 ng/mL) – in 31.5 % of women. Inadequate iron intake (< 18 mg/day) was observed in 83.9 % of participants. Iron deficiency was associated with menorrhagia, abnormal uterine bleeding, and premenstrual syndrome. After 3 months of therapy, hemoglobin normalization was achieved in 95.2 %, ferritin normalization in 84.7 %, and serum folate normalization in 100,0 % of re-examined patients.

Conclusion. High prevalence of iron and folic acid deficiency associated with menstrual disorders and poor nutrition was found in women of early reproductive age in the Republic of Bashkortostan. Three-month combined therapy with ferrous fumarate and folic acid demonstrated high clinical and laboratory effectiveness.

Introduction. Complicated pregnancy and delivery pose risks not only to maternal health but also to the offspring in later life. Preeclampsia (PE) has long-term effects on child development, increasing the risk of metabolic and endocrine disorders. However, studies investigating the impact of PE on the reproductive health in adolescent girls are limited, and existing data remain controversial, underscoring the relevance of the current study.

Aim: to assess the reproductive health and metabolic profile in adolescent girls depending on maternal PE during pregnancy and childbirth.

Materials and Methods. An ambispective cohort study was conducted. A total of 1,706 delivery records of women who gave birth to female infants in 2006, 2007 and 2008 were analyzed. From these, 184 adolescent girls who met the inclusion criteria were selected: singleton full-term spontaneous pregnancy, presence or absence of maternal PE, and live-born fullterm females delivered between 2006 and 2008. Participants were divided into two groups: main group – 128 girls born to mothers with moderate or severe PE, control group comprised 56 girls whose mothers had an uncomplicated pregnancy and delivery. A retrospective analysis of obstetric records and a prospective clinical assessment of adolescent girls were performed, including anthropometric evaluation with calculated standard deviation score (SDS) of body mass index (BMI), assessed menstrual and reproductive function, hormonal profiling, and ultrasound examination of the pelvic organs and mammary glands.

Results. In the main group, a higher prevalence of dysmenorrhea (p = 0.027) and earlier age at menarche (p = 0.001) was observed compared to control group. At the same time, no significant inter-group differences in menstrual cycle regularity, menstrual blood loss, or time to cycle establishment (p > 0.05) were found. Evaluation of physical development revealed significant differences in BMI category distribution (p = 0.031). In main group, both underweight (20.3 % vs. 7.1 % in controls) and obesity (10.9 % vs. 7.1 %), including severe forms (class III and morbid obesity), were more frequently observed; the latter were absent in control group. Among girls in main group, fetal growth restriction (FGR) was observed significantly more frequently – 26.6 % vs. 0.0 % in controls, (p < 0.001), and both birth weight and birth length were significantly lower (p = 0.002 and p < 0.001, respectively). Incomplete menstrual cycle maturation (14.1 % vs. 10.7 %) and prolonged cycle establishment (> 3 years: 4.7 % vs. 0,0 %) tended to be higher in the main group although the difference was not statistically significant (p = 0.176).

Conclusion. Maternal pregnancy complicated by preeclampsia is associated with altered reproductive health and metabolic profile in adolescent girls born to mothers with PE more frequently exhibiting primary dysmenorrhea, earlier menarche, and deviations in physical development such as bimodal distribution of BMI categories (increased prevalence of both underweight and obesity). These findings indicate a high-risk of menstrual dysfunction and metabolic disorders in girls born to mothers with PE, supporting a need for follow-up by a pediatric and adolescent gynecologist as well as development of personalized early prevention strategies.

Cancer-associated thrombosis is traditionally viewed mainly in the context of venous thromboembolism, however, the spectrum of thrombotic complications is markedly broader in patients with cancer. Apart from deep vein thrombosis and pulmonary embolism, it may include arterial thrombosis, cerebral venous thrombosis, splanchnic vein thrombosis, ovarian and renal vein thrombosis, as well as treatment- and immune-associated thrombotic disorders. The aim of this review is to discuss rare forms and atypical sites for cancer-associated thrombosis by covering their clinical significance, pathogenetic basis, association with anticancer therapy as well as concomitant prothrombotic conditions. The article discusses the main mechanisms underlying tumor-associated hypercoagulability, including the role for endothelial dysfunction, platelet activation, neutrophil extracellular traps, and thromboinflammation. Special attention is paid to arterial thrombosis, breast cancer therapy, cerebral venous thrombosis, abdominal vein thrombosis, COVID-19-associated coagulopathy as well as vaccine-induced immune thrombotic thrombocytopenia. Timely recognition of such conditions requires a multidisciplinary approach, proper imaging, and assessment of tumor-, patient-, and treatment-related risk factors.

Aim: to compare the predictive performance of artificial intelligence (AI) and machine learning (ML) models trained on multiparametric datasets for the prediction of preeclampsia (РЕ) and obstetric hemorrhage.

Materials and Methods. This systematic review was conducted in accordance with the PRISMA guidelines. PubMed and Cochrane Central databases were searched for studies published between 2015 and 2025. We included studies applying AI/ML with ≥ 2 predictors/data modalities and reporting outcomes related to РЕ/eclampsia or obstetric hemorrhage (including postpartum hemorrhage). Risk of bias was assessed using Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool and the Newcastle–Ottawa Scale (NOS).

Results. Twenty-eight studies were included (18 on РЕ and 10 on hemorrhage). Most common algorithms were gradient boosting methods, random forests, XGBoost, and neural networks were the most common algorithms. For preeclampsia, stronger performance was more consistently reported when maternal risk factors were combined with blood pressure features and first-trimester screening components (uterine artery Doppler and placental biomarkers). For hemorrhage prediction, models based on electronic health records and preoperative clinical and laboratory variables, including risk stratification in placenta previa/placenta accreta spectrum (PAS), appeared particularly relevant. The evidence base is limited by predominantly retrospective designs and insufficient external/prospective validation, which undermines model transportability across settings and over time.

Conclusion. AI supported by multiparametric monitoring shows promise for predicting РЕ and obstetric hemorrhage; however, real-world implementation requires standardized reporting, external validation, and ongoing calibration monitoring.

Aim: to evaluate the effectiveness of low-molecular-weight heparins (LMWHs) in preventing placenta-associated complications (РАС), such as preeclampsia (PE), fetal growth restriction (FGR), intrauterine fetal death (IUFD) and placental abruption (PА), in women at high risk for these complications but without thrombophilia or thromboembolic complications, based on a review and meta-analysis of publications released within the last twenty years.

Materials and Methods. A search for relevant randomized controlled trials was conducted in electronic databases (PubMed/ MEDLINE, Embase, Web of Science, etc.) spanning from 2005 to 2025. The meta-analysis included 11 trials involving a total of 1965 women. PE, FGR, IUFD, and PA were considered as the primary outcomes. Fixed-effects models were used for analysis, and the results were presented as risk ratios with 95 % confidence intervals.

Results. LMWHs use was associated with a reduced IUFD risk (0.69 [0.55; 0.86]; p = 0.001), PA (0.67 [0.52; 0.86]; p =0.002), and PE occurrence (0.66 [0.52; 0.85]; p = 0.001). No significant effect of LMWHs use on FGR risk was found (0.93 [0.69; 1.25]; p = 0.62). Considerable heterogeneity (I² > 60 %) was observed while analyzing IUFD, PE and PA. Funnel plot assessment did not rule out a potential risk of publication bias and requires further investigation.

Conclusion. Prophylactic LMWHs use in women at high risk for РАС without thrombophilia may reduce the incidence of complications such as PE, IUFD, and PA. These findings indicate the need for multicenter studies with detailed analyses to identify patient cohorts where prophylactic LMWHs use for complication prevention provides a clear clinical and pathogenetic rationale.

Deep infiltrating endometriosis is a socially significant condition that markedly reduces patients’ quality of life due to chronic pain syndrome and a high risk of infertility. In recent years, increasing evidence has emerged regarding the malignant transformation of the disease, with the malignant foci developing predominantly in the ovaries, as well as in extra-ovarian locations. The similarity of clinical manifestations, morphological characteristics, and molecular alterations between benign and malignant disease forms markedly complicates differential diagnosis. This article summarizes current concepts regarding the criteria for distinguishing deep infiltrating endometriosis from endometriosis-associated cancer. It highlights the limited evidence base and the need to develop standardized integrative approaches to improve diagnostic accuracy and stratification of oncological risk in this group of patients.

Aim: to systematically summarize published findings on reference (normative) heart rate (HR) magnitude in healthy term newborns during the first 7 days of life and to examine HR variability with respect to measurement method and age at assessment; additionally, to provide a historical bibliographic perspective on how neonatal HR norms evolved.

Materials and Methods. We conducted a PRISMA-reported systematic review for the contemporary evidence base and a separate historical bibliographic component. Searches were performed in PubMed/MEDLINE, Cochrane Central, eLibrary, and CyberLeninka. After deduplication, 705 unique records were screened; 23 studies were included in the systematic component. Thirteen historical sources were additionally included (overall period covered 1710–2025). Data extraction followed a standardized form; methodological quality for the systematic component was appraised using the JBI checklist. All quantitative comparisons were performed at the study level and interpreted as exploratory.

Results. Historical sources report a wide HR range predominantly obtained by clinical assessment (e.g., 72–172 bpm). Contemporary instrumental studies confirm substantial physiological variability in healthy term newborns, with reported HR values spanning from 55 bpm up to 240 bpm. Mean HR values appear broadly comparable across source groups (approximately 136–140 bpm). However, maximal HR values are lower in historical sources compared with contemporary instrumental data, and marked differences exist across groups in HR measurement methods.

Conclusion. Reference HR values in healthy term newborns exhibit wide physiological variability, limiting the use of rigid thresholds without considering postnatal age, functional state, and measurement modality. While mean HR values remain broadly comparable across historical periods, extreme values (particularly maximal HR) and measurement approaches differ substantially.

Preeclampsia (PE) is not only an acute obstetric complication but also a significant factor in long-term cardiovascular risk. This article analyzes the pathogenetic mechanisms linking recurrent severe PE with the development of chronic arterial hypertension, coronary heart disease, stroke, and heart failure in the long-term. Particular attention is paid to the two-stage PE model, as well as the key role for immune-inflammatory responses, oxidative stress, and hemostatic disorders. Recurrent PE is shown to cause cumulative damage to the vascular bed, transforming acute inflammation into chronic cardiovascular pathology. Neutrophil extracellular traps collectively resulting in innate immune activation, hypercoagulability, and endothelial damage, play a central role in the pathogenesis. Current approaches to preventing recurrent PE such as acetylsalicylic acid, calcium supplements, and low-molecular-weight heparins are discussed.

Despite substantial advances in assisted reproductive technologies (ART), the proportion of unsuccessful in vitro fertilization cycles remains considerable, highlighting the need for additional prognostic tools. In recent years, increasing attention has been directed toward molecular and immunological markers that reflect oocyte competence, embryo developmental potential, endometrial receptivity, and the patient’s systemic inflammatory status. This review summarizes current evidence regarding the diagnostic and predictive value of biomarkers identified in follicular fluid, peripheral blood, and endometrial tissue. Particular emphasis is placed on oxidative stress markers (malondialdehyde, advanced oxidation protein products), antioxidant enzymes (including glutathione peroxidase), microRNAs and other non-coding RNAs, as well as immunological parameters such as cytokines, complement components, and immune cell subsets. Data on circulating cell-free DNA as an indicator of follicular microenvironment status are also discussed. Available evidence suggests that disturbances in redox balance and alterations in local immune regulation may be associated with impaired embryo quality and reduced implantation rates. However, substantial methodological heterogeneity, small sample sizes, and the lack of standardized assessment protocols limit the clinical applicability for many proposed biomarkers. Integration of molecular markers with clinical parameters, supported by multi-omics approaches, offers promising opportunities for the personalization of ART strategies. Nevertheless, large prospective studies with robust validation and evaluation of cost-effectiveness are required before these biomarkers can be incorporated into routine clinical practice.

Vulvar premalignant lesions and vulvar cancer represent a significant issue in modern gynecologic oncology. The importance of this problem is driven by the increasing incidence, the impact on patients’ quality of life, and the difficulty of early-stage diagnosis. In recent decades, understanding of the pathogenesis, classification, and treatment approaches for such pathologies has been dramatically changed. This review presents current data on the epidemiology, classification, molecular mechanisms of development, diagnostic methods as well as treatment of vulvar premalignant lesions and vulvar cancer. Special attention is paid to the role played by immunohistochemical markers, novel non-invasive diagnostic methods, and organ-preserving therapeutic approaches. Issues of secondary prevention, including HPV vaccination, as well as modern rehabilitation strategies aimed to improve patients’ quality of life are also outlined.

The article presents a historical and scientific review regarding the development of concepts about interplay between malignant neoplasms and thrombotic complications. The evolution of views on cancer-associated thrombosis is outlined: from the first clinical observations by J.-B. Bouillaud and the classic description by Armand Trousseau to the modern concept of tumor-associated coagulopathy and thrombotic risk stratification. The significance of the works carried out by R. Virchow and T. Billroth for the transition from clinical observations to a pathogenetic understanding of thrombosis as well as H. Dvorak’s contribution to form insights into tumor as a “wound that never heals,” pathological angiogenesis, vascular permeability, and the role for vascular endothelial growth factor are demonstrated. Special attention is paid to emergence of clinical hemostasiology, including the studies by M.-M. Samama, the International Conference on Thrombosis and Hemostasis Issues in Cancer (ICTHIC), and the contribution of the Russian Z.S. Barkagan and A.D. Makatsariya scientific schools to investigating hemostatic disorders, thrombophilia, and thrombosis in cancer patients. The final stage of this historical timeline is associated with the works by A. Khorana and the transition to formalized risk assessment of venous thromboembolic complications in patients with malignant neoplasms. Such analysis allows cancer-associated thrombosis to be envisioned not only as a vascular complication related to tumor process, but also as a genuine manifestation of the complex crosstalk between the tumor, the hemostatic system, the endothelium, inflammation, anticancer treatment, and individual patient risk factors.