Klinicka Onkologie最新文献

Background: The incidence of colorectal cancer (CRC) in the age group of young patients has been increasing. Furthermore, in these patients, CRC is more frequently an aggressive histological type of tumor, diagnosed in the late clinical stages of the disease. Another characteristic feature is a higher frequency of mismatch repair deficient (dMMR) tumors, in the treatment of which immunotherapy can be an effective treatment modality, used to prolong overall survival and improve quality of life. Conversely, the effect of chemotherapy may be lower.

Case: We present the case of a 35year-old patient treated with primary therapy for locally advanced dMMR rectal cancer. Neoadjuvant chemoradiotherapy was followed by rectal resection, which was accompanied by serious postoperative complications. In addition, there was an early local relapse of the disease, resistant to systemic chemotherapy treatment. After the progression of the disease, second line of the treatment with pembrolizumab was initiated.

Results: The treatment with pembrolizumab led to a partial regression of the disease and subsequently its stabilization, which has been lasting for 15 months. The improvement of the patient's quality of life, e. g. stabilization of the blood count and regression of diarrhea, is a significant benefit. In addition, the treatment has been given without the development of serious toxicity, so far.

Conclusion: Microsatellite instability testing in the management of locally advanced and metastatic colorectal cancer is of fundamental importance in setting the appropriate treatment procedures. In the future, we can expect results of several studies that will try to prove the effect of immunotherapy not only in metastatic disease, but also in the neoadjuvant regimen in resectable and potentially resectable dMMR rectal and colon cancers.

Background: Head-and-neck malignant neoplasms (diagnosis group C00-C14, according to ICD-10) form a heterogeneous group of diseases with close anatomical localization. The incidence is twice to three times higher in men than in women and is increasing worldwide.

Objective: The aim of our analysis was to estimate changes of incidence and mortality rates of head-and-neck malignancies associated with anatomical topographic regions over the time as well as to compare these indicators in different selected countries of the world. Secondary endpoints included the assessment of patients' age distribution, clinical stages of newly diagnosed cases, and point prevalence of the disease in the Slovak Republic (SR).

Material and methods: The data base for the calculations was obtained from national databases and outputs of the National Cancer Registry (NCR) of the SR (with summary data available from the National Epidemiological Portal of Malignant Tumors, which analyzed data from 1984-2003 and was available until 2009, the remaining data were obtained from annual analyses of the NCR of the SR and the National Centre for Health Information (NCZI)), from the Statistical Office of the SR, and from the IARC WHO global database outputs on incidence, mortality, prevalence and survival of the patients. Incidence and mortality data in the SR were available up to 2012 (including) and up to 2021 (including), respectively. A log-linear joinpoint regression model was used to analyze the development of incidence and mortality rates over time by using Joinpoint Regression Program software. To achieve maximum precision in the estimated total surviving population of patients with head and neck malignant neoplasms, a model was developed to calculate the point (overall) prevalence based on absolute numbers of long-term registered national counts of newly diagnosed patients, mortality from the disease, overall mortality, and survival probability. The representation of clinical stages of head and neck carcinoma in the SR was compiled from available national data (2000-2012) and from predictions and does not consider changes in TNM classifications over the time.

Results: The age-adjusted (to the world standard population, ASR-W) incidence rate and the age-adjusted (ASR-W) mortality rate of head-and-neck malignant tumors in the SR have shown a significantly decreasing tendency in men since 1990; however, in women both of these indicators have shown a significant increasing tendency, especially the significantly growing incidence since 2004. In 2012, the overall age-adjusted incidence and mortality rate of head-and-neck cancers in the SR were significantly higher in males (ASR-W incidence 22.6/100,000 and ASR-W mortality 15.26/100,000) compared to females (ASR-W incidence 4.21/100,000 and ASR-W mortality 1.52/100,000). More than 75% of newly diagnosed cases are already in advanced and metastat