S. Vokurka, A. Pokorná, J. Stryja, L. Krupová, V. Mezera, J. Cvek, P. Holečková, R. Ston, Libuše Hašková, Magda Audyová, Z. Pechacova, S. Šípová, K. Jirsova, L. Veverková
BACKGROUND Oncology wounds and wounds of other etiology are rare but serious complications, which significantly impair patients quality of life. Preventive and curative interventions and education of healthcare personnel and patients reduce the risk of either their occurrence or their impact and consequences. A working group of authors from professional groups (the Supportive Care Group of the Czech Society for Oncology, the Czech Society for Wound Healing, the Society for Radiation Oncology, Biology and Physics, and the Czech Nurses Association) prepared recommendations for care. A comprehensive approach to the treatment of oncological wounds, including symptomatic treatment of associated healing complications, prevention, early detection, interdisciplinary cooperation and education are essential to deal with wounds related to chemotherapy administration, radiotherapy and oncological treatment in general. The proper choice of local care products and the eventuality of active oncological treatment are important elements of care in ulcerating tumors. PURPOSE A basic summary of recommended interventions to prevent and treat oncology wounds in daily practice, defined based on expert societies guidelines, trials and literature data, proven practice and on the consensus opinions of the authors group members. The recommended procedures contribute to the reduction of the development, severity and consequences of oncological wounds and wounds of other etiology in oncological patients.
{"title":"Oncology wounds - recommendations for care based on multidisciplinary cooperation.","authors":"S. Vokurka, A. Pokorná, J. Stryja, L. Krupová, V. Mezera, J. Cvek, P. Holečková, R. Ston, Libuše Hašková, Magda Audyová, Z. Pechacova, S. Šípová, K. Jirsova, L. Veverková","doi":"10.48095/ccko2022408","DOIUrl":"https://doi.org/10.48095/ccko2022408","url":null,"abstract":"BACKGROUND\u0000Oncology wounds and wounds of other etiology are rare but serious complications, which significantly impair patients quality of life. Preventive and curative interventions and education of healthcare personnel and patients reduce the risk of either their occurrence or their impact and consequences. A working group of authors from professional groups (the Supportive Care Group of the Czech Society for Oncology, the Czech Society for Wound Healing, the Society for Radiation Oncology, Biology and Physics, and the Czech Nurses Association) prepared recommendations for care. A comprehensive approach to the treatment of oncological wounds, including symptomatic treatment of associated healing complications, prevention, early detection, interdisciplinary cooperation and education are essential to deal with wounds related to chemotherapy administration, radiotherapy and oncological treatment in general. The proper choice of local care products and the eventuality of active oncological treatment are important elements of care in ulcerating tumors.\u0000\u0000\u0000PURPOSE\u0000A basic summary of recommended interventions to prevent and treat oncology wounds in daily practice, defined based on expert societies guidelines, trials and literature data, proven practice and on the consensus opinions of the authors group members. The recommended procedures contribute to the reduction of the development, severity and consequences of oncological wounds and wounds of other etiology in oncological patients.","PeriodicalId":35565,"journal":{"name":"Klinicka Onkologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84084289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-29DOI: 10.1109/taee54169.2022.9840622
This paper defines the political boundaries of The Eastern Mediterranean region and analyzes the role and performance of major exchanges in this area. Furthermore, it explores the existence of bilateral agreements with a view to elaborating on the prospects for cooperation and/or integration opportunities in the area.
{"title":"[Proceedings book].","authors":"","doi":"10.1109/taee54169.2022.9840622","DOIUrl":"https://doi.org/10.1109/taee54169.2022.9840622","url":null,"abstract":"This paper defines the political boundaries of The Eastern Mediterranean region and analyzes the role and performance of major exchanges in this area. Furthermore, it explores the existence of bilateral agreements with a view to elaborating on the prospects for cooperation and/or integration opportunities in the area.","PeriodicalId":35565,"journal":{"name":"Klinicka Onkologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74969224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bone remineralization after palliative radiotherapy","authors":"Z. Pechacova, Antonín Vrána, T. Drbohlavová","doi":"10.48095/ccko2022240","DOIUrl":"https://doi.org/10.48095/ccko2022240","url":null,"abstract":"","PeriodicalId":35565,"journal":{"name":"Klinicka Onkologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48912559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
2. Broder J, Steele B, Kheang S. Elderly woman with pain and numbness in left hand. Ann Emerg Med 2016; 67(4): e13–e14. doi: 10.1016/j.annemergmed.2015.10. 005. 3. Siegel AU, Castro A, Sechrist J. Subclavian artery aneurysmal rupture and left internal mammary artery extravasation secondary to advanced Marfan syndrome. Am J Emerg Med 2021; 45: 684.e1–684.e3. doi: 10.1016/j. ajem.2020.12.045. 4. Miyamoto K, Nakamura M, Suzuki K et al. Diagnosis of neurofibromatosis type 1 after rupture of aneurysm and consequent fatal hemothorax. Am J Emerg Med 2020; 38(7): 1543.e3–1543.e5. doi: 10.1016/j.ajem.2020.04. 004. An impending rupture of the subclavian artery after chemoradiotherapy
{"title":"An impending rupture of the subclavian artery after chemoradiotherapy","authors":"So Hattori, Y. Kodama, Hiroaki Satoh","doi":"10.48095/ccko2022156","DOIUrl":"https://doi.org/10.48095/ccko2022156","url":null,"abstract":"2. Broder J, Steele B, Kheang S. Elderly woman with pain and numbness in left hand. Ann Emerg Med 2016; 67(4): e13–e14. doi: 10.1016/j.annemergmed.2015.10. 005. 3. Siegel AU, Castro A, Sechrist J. Subclavian artery aneurysmal rupture and left internal mammary artery extravasation secondary to advanced Marfan syndrome. Am J Emerg Med 2021; 45: 684.e1–684.e3. doi: 10.1016/j. ajem.2020.12.045. 4. Miyamoto K, Nakamura M, Suzuki K et al. Diagnosis of neurofibromatosis type 1 after rupture of aneurysm and consequent fatal hemothorax. Am J Emerg Med 2020; 38(7): 1543.e3–1543.e5. doi: 10.1016/j.ajem.2020.04. 004. An impending rupture of the subclavian artery after chemoradiotherapy","PeriodicalId":35565,"journal":{"name":"Klinicka Onkologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46724446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Z. Pechacova, R. Lohynská, Zdenka Weitoschová, M. Zikan, Oľga Dubová, V. Tomancová, E. Kmoníčková, M. Pala, T. Drbohlavová
BACKGROUND The aim of this study is a retrospective analysis of treatment outcomes and toxicity in a group of patients with cervical cancer who underwent (chemo) radiotherapy at the Institute of Radiation Oncology in Bulovka University Hospital in Prague in the period 2014-2017. PATIENTS AND METHODS During this period, 141 patients were treated, 105 (74.5%) of them underwent combined (chemo) radiotherapy with radical intent and palliative radiotherapy was performed in 36 (25.5%) cases. According to the International Federation of Gynecology and Obstetrics (FIGO) 2009 classification, the most numerous stages were IIB in 39 (27.7%) and IIIB in 64 (45.4%) cases; according to FIGO 2018, a significant number of newly established stages is evident: IIIC1 in 55 (39.0%) patients and IIIC2 in 22 (15.6%) cases. RESULTS The median progression-free survival (PFS) and overall survival (OS) reached 31.3, resp. 40.1 months in the whole group. In the subgroup of patients treated with radical intent, the median PFS was 44.0 months and OS 48.8 months; in the palliative subgroup, the median PFS was 9.4 months and OS 14.8 months. In a radically treated subgroup, 7 (6.7%) patients had gastrointestinal or genitourinary manifestations of G3-4 toxicity, and overall acute toxicity (including skin and haematological reactions) of G3-4 occurred in 18 (17.1%) patients. Late toxicity of G3-4 was reported in 13 (12.4%) cases. Patients who underwent complete brachytherapy (BRT) showed significantly better survival compared to patients with a lower number of BRT fractions. The prognostic potential of PS (performance status) and anemia was confirmed; significantly longer overall survival was observed in patients in good general condition or in those without anemia. CONCLUSION Our results confirmed the key role of BRT for the delivery of the curative dose to the target volume. The prognostic role of PS and anemia is evident. The side effects were in acceptable limits but we expect improvements because of the use of modern radiotherapy technologies.
{"title":"Chemoradiotherapy in the treatment of cervical cancer - a single institution retrospective review.","authors":"Z. Pechacova, R. Lohynská, Zdenka Weitoschová, M. Zikan, Oľga Dubová, V. Tomancová, E. Kmoníčková, M. Pala, T. Drbohlavová","doi":"10.48095/ccko2022139","DOIUrl":"https://doi.org/10.48095/ccko2022139","url":null,"abstract":"BACKGROUND The aim of this study is a retrospective analysis of treatment outcomes and toxicity in a group of patients with cervical cancer who underwent (chemo) radiotherapy at the Institute of Radiation Oncology in Bulovka University Hospital in Prague in the period 2014-2017. PATIENTS AND METHODS During this period, 141 patients were treated, 105 (74.5%) of them underwent combined (chemo) radiotherapy with radical intent and palliative radiotherapy was performed in 36 (25.5%) cases. According to the International Federation of Gynecology and Obstetrics (FIGO) 2009 classification, the most numerous stages were IIB in 39 (27.7%) and IIIB in 64 (45.4%) cases; according to FIGO 2018, a significant number of newly established stages is evident: IIIC1 in 55 (39.0%) patients and IIIC2 in 22 (15.6%) cases. RESULTS The median progression-free survival (PFS) and overall survival (OS) reached 31.3, resp. 40.1 months in the whole group. In the subgroup of patients treated with radical intent, the median PFS was 44.0 months and OS 48.8 months; in the palliative subgroup, the median PFS was 9.4 months and OS 14.8 months. In a radically treated subgroup, 7 (6.7%) patients had gastrointestinal or genitourinary manifestations of G3-4 toxicity, and overall acute toxicity (including skin and haematological reactions) of G3-4 occurred in 18 (17.1%) patients. Late toxicity of G3-4 was reported in 13 (12.4%) cases. Patients who underwent complete brachytherapy (BRT) showed significantly better survival compared to patients with a lower number of BRT fractions. The prognostic potential of PS (performance status) and anemia was confirmed; significantly longer overall survival was observed in patients in good general condition or in those without anemia. CONCLUSION Our results confirmed the key role of BRT for the delivery of the curative dose to the target volume. The prognostic role of PS and anemia is evident. The side effects were in acceptable limits but we expect improvements because of the use of modern radiotherapy technologies.","PeriodicalId":35565,"journal":{"name":"Klinicka Onkologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89509638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miroslav Veselý, B. Gál, J. Rottenberg, M. Páleník, J. Hanak, D. Zicha
BACKGROUND Squamous cell carcinoma of the head and neck is characterized by local invasiveness and metastases to regional lymph nodes. In 60% of cases, these tumours are dia-gnosed at an advanced stage, and the prognosis is unfavorable. One of the important factors of local, hematogenous or lymphogenic spread of the tumour in the human body is tumour cells migration ability. Advanced microscopic methods provide a new perspective on cell migration. PURPOSE This paper presents a coherence controlled holographic microscopy method that provides a non-invasive quantitative evaluation of morphological and dynamic properties of living tumour cells. In connection with this method, new potential bio-markers are emerging, the significance of which, however, needs to be verified by correlation with clinical data.
{"title":"Coherence controlled holographic microscopy - a tool for detection of new biomarkers of head and neck squamous cell carcinoma.","authors":"Miroslav Veselý, B. Gál, J. Rottenberg, M. Páleník, J. Hanak, D. Zicha","doi":"10.48095/ccko2022128","DOIUrl":"https://doi.org/10.48095/ccko2022128","url":null,"abstract":"BACKGROUND\u0000Squamous cell carcinoma of the head and neck is characterized by local invasiveness and metastases to regional lymph nodes. In 60% of cases, these tumours are dia-gnosed at an advanced stage, and the prognosis is unfavorable. One of the important factors of local, hematogenous or lymphogenic spread of the tumour in the human body is tumour cells migration ability. Advanced microscopic methods provide a new perspective on cell migration.\u0000\u0000\u0000PURPOSE\u0000This paper presents a coherence controlled holographic microscopy method that provides a non-invasive quantitative evaluation of morphological and dynamic properties of living tumour cells. In connection with this method, new potential bio-markers are emerging, the significance of which, however, needs to be verified by correlation with clinical data.","PeriodicalId":35565,"journal":{"name":"Klinicka Onkologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76745845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND Acupuncture is one of the oldest therapeutic methods. The traditional view of acupuncture is represented by influencing energy pathways through stimulation of specific points. The original meridian theory, which works with the assumption of normalization of the flowing energy Qi in the organism is, with increasing evidence, supplemented with information about the bio-logical impact of the use of acupuncture from the perspective of Western medicine. Specific stimulation of particular points on the body leads to the activation of hypothalamus and pituitary gland through neurotransmitters, resulting in a wide range of systemic effects. Stimulation of nerves in the muscle, which then trans-mits a signal to the spinal cord, midbrain, and hypothalamic-pituitary system, releases neurotransmitters, endogenous opioid peptides, or hormones. Stimulation of acupuncture points changes the levels of proinflammatory cytokines, including IL-1-beta, IL-6, IL-17, and TNF-alpha. Currently, according to the National Comprehensive Cancer Network (NCCN) guidelines, the following symptoms are indicated for acupuncture treatment: pain including neuropathic pain, arthralgia, and myalgia, especially in the aromatase inhibitors therapy, nausea, and vomiting, fatigue, vasomotor symptoms in women and vasomotor symptoms in men caused by androgen deprivation therapy. Acupuncture seems to be an effective and safe treatment method for many of the cancer symptoms or the side effects of cancer treatment, but, like any other treatment method, it has its indications and contraindications. PURPOSE This work aims to provide a comprehensive overview of the use of acupuncture in defined indications, according to current international guidelines. Thus, the therapeutic possibilities of symptomatic treatment of cancer and therapy of adverse events of oncological treatment can be extended.
{"title":"Acupuncture from the perspective of evidence-based medicine - options of clinical use based on National Comprehensive Cancer Network (NCCN) guidelines.","authors":"J. Halámková, R. Dymáčková, D. Adámková Krákorová","doi":"10.48095/ccko202294","DOIUrl":"https://doi.org/10.48095/ccko202294","url":null,"abstract":"BACKGROUND\u0000Acupuncture is one of the oldest therapeutic methods. The traditional view of acupuncture is represented by influencing energy pathways through stimulation of specific points. The original meridian theory, which works with the assumption of normalization of the flowing energy Qi in the organism is, with increasing evidence, supplemented with information about the bio-logical impact of the use of acupuncture from the perspective of Western medicine. Specific stimulation of particular points on the body leads to the activation of hypothalamus and pituitary gland through neurotransmitters, resulting in a wide range of systemic effects. Stimulation of nerves in the muscle, which then trans-mits a signal to the spinal cord, midbrain, and hypothalamic-pituitary system, releases neurotransmitters, endogenous opioid peptides, or hormones. Stimulation of acupuncture points changes the levels of proinflammatory cytokines, including IL-1-beta, IL-6, IL-17, and TNF-alpha. Currently, according to the National Comprehensive Cancer Network (NCCN) guidelines, the following symptoms are indicated for acupuncture treatment: pain including neuropathic pain, arthralgia, and myalgia, especially in the aromatase inhibitors therapy, nausea, and vomiting, fatigue, vasomotor symptoms in women and vasomotor symptoms in men caused by androgen deprivation therapy. Acupuncture seems to be an effective and safe treatment method for many of the cancer symptoms or the side effects of cancer treatment, but, like any other treatment method, it has its indications and contraindications.\u0000\u0000\u0000PURPOSE\u0000This work aims to provide a comprehensive overview of the use of acupuncture in defined indications, according to current international guidelines. Thus, the therapeutic possibilities of symptomatic treatment of cancer and therapy of adverse events of oncological treatment can be extended.","PeriodicalId":35565,"journal":{"name":"Klinicka Onkologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82269996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND The cause of gynecological tumors is multifactorial. Risk factors include higher BMI and lack of physical activity. Gynecological oncological diseases are associated with loss of function due to the pathophysiological effects of the disease, treatment, and also mental stress in patients. These problems lead to greater rehabilitation demand of patients. Rehabilitation aims to help the patient to achieve the best possible level of functional status, to foster independence, to improve acceptance of the disease, to improve patient fatigue and improve the quality of life of the patients It is essential to focus the rehabilitation examination on several factors associated with impaired function, such as impaired cardiovascular and pulmonary function, urinary incontinence or psychological or psychological distress. The pleiotropic effect of rehabilitation can also be used in pain relief, improvement of chemotherapy tolerance, in the treatment of lymphedema and in the improvement of pelvic floor muscle function. PURPOSE The main aim of this paper is to summarize available options for rehabilitation after gynecological oncological diseases.
{"title":"Rehabilitation and physical activity in gynecological oncological diseases.","authors":"D. Líška, J. Kováč, Sebastian Rutkowski","doi":"10.48095/ccko2022114","DOIUrl":"https://doi.org/10.48095/ccko2022114","url":null,"abstract":"BACKGROUND\u0000The cause of gynecological tumors is multifactorial. Risk factors include higher BMI and lack of physical activity. Gynecological oncological diseases are associated with loss of function due to the pathophysiological effects of the disease, treatment, and also mental stress in patients. These problems lead to greater rehabilitation demand of patients. Rehabilitation aims to help the patient to achieve the best possible level of functional status, to foster independence, to improve acceptance of the disease, to improve patient fatigue and improve the quality of life of the patients It is essential to focus the rehabilitation examination on several factors associated with impaired function, such as impaired cardiovascular and pulmonary function, urinary incontinence or psychological or psychological distress. The pleiotropic effect of rehabilitation can also be used in pain relief, improvement of chemotherapy tolerance, in the treatment of lymphedema and in the improvement of pelvic floor muscle function.\u0000\u0000\u0000PURPOSE\u0000The main aim of this paper is to summarize available options for rehabilitation after gynecological oncological diseases.","PeriodicalId":35565,"journal":{"name":"Klinicka Onkologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86685213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Kysela, Z. Kala, M. Zatloukal, M. Raudenská, D. Brančíková
BACKGROUND Though the sixth most frequent malignancy, hepatocellular carcinoma (HCC) is the third most common cause of death amongst solid tumours. Only surgery in the early stages may provide the cure; however, HCC still has a high recurrence rate. Non-surgical treatment lacks comparable efficacy. It was not sooner than in 2017 that the therapy galore started to extend. Thus prognostic factors driving the therapy have been gaining importance. MATERIAL AND METHODS All relevant literature was checked for aetiology, epidemiology, dia-gnostic means, and individualised treatment of HCC. Cytochrome P-450 expression data from 22 patients operated in the University Hospital Brno in the period 2017-2020 were included. RESULTS Screening the population at risk (presence of cirrhosis) with the transabdominal ultrasound lies at the centre of the dia-gnostic algorithm. Making the dia-gnosis does not require a bio-psy in most cases. Only a few parameters are thus known before the treatment - a size and number of lesions, and AFP level. These drive the indication to surgery. Relapses after surgery and response to palliative treatment depend on the expression of MET and AXL that directly affect anti-VEGF therapy. High AFP predicts a good response to regorafenib but early relapse after surgery. The pattern of P450 expression was found linked with tumour differentiation. The differentiation correlates with the size and number of lesions. We also found a link between the P450 expression and some mi-RNAs possibly detectable using liquid bio-psy techniques. CONCLUSION The share of deaths from HCC overweighs its incidence. The risk population to screen is well-defined (cirrhosis). The BCLC staging system probably gives the best complication/efficacy results. This system does not require any bio-psy and does not comprise all predictive factors important in the expanding targeted molecular therapy. According to our results, small molecules to treat HCC should work better in poorly differentiated tumours. Surgery is more effective in those well-differentiated. It isnt easy to get all relevant information before therapy. Some factors need macrobio-psy (surgical). The pretreatment workup will probably require a mandatory bio-psy in BCLC B and C stages to get the information. This opens up a way for the liquid bio-psy that could use some specific mi RNAs.
{"title":"Hepatocellular carcinoma - prognostic criteria of individualized treatment.","authors":"P. Kysela, Z. Kala, M. Zatloukal, M. Raudenská, D. Brančíková","doi":"10.48095/ccko2022100","DOIUrl":"https://doi.org/10.48095/ccko2022100","url":null,"abstract":"BACKGROUND\u0000Though the sixth most frequent malignancy, hepatocellular carcinoma (HCC) is the third most common cause of death amongst solid tumours. Only surgery in the early stages may provide the cure; however, HCC still has a high recurrence rate. Non-surgical treatment lacks comparable efficacy. It was not sooner than in 2017 that the therapy galore started to extend. Thus prognostic factors driving the therapy have been gaining importance.\u0000\u0000\u0000MATERIAL AND METHODS\u0000All relevant literature was checked for aetiology, epidemiology, dia-gnostic means, and individualised treatment of HCC. Cytochrome P-450 expression data from 22 patients operated in the University Hospital Brno in the period 2017-2020 were included.\u0000\u0000\u0000RESULTS\u0000Screening the population at risk (presence of cirrhosis) with the transabdominal ultrasound lies at the centre of the dia-gnostic algorithm. Making the dia-gnosis does not require a bio-psy in most cases. Only a few parameters are thus known before the treatment - a size and number of lesions, and AFP level. These drive the indication to surgery. Relapses after surgery and response to palliative treatment depend on the expression of MET and AXL that directly affect anti-VEGF therapy. High AFP predicts a good response to regorafenib but early relapse after surgery. The pattern of P450 expression was found linked with tumour differentiation. The differentiation correlates with the size and number of lesions. We also found a link between the P450 expression and some mi-RNAs possibly detectable using liquid bio-psy techniques.\u0000\u0000\u0000CONCLUSION\u0000The share of deaths from HCC overweighs its incidence. The risk population to screen is well-defined (cirrhosis). The BCLC staging system probably gives the best complication/efficacy results. This system does not require any bio-psy and does not comprise all predictive factors important in the expanding targeted molecular therapy. According to our results, small molecules to treat HCC should work better in poorly differentiated tumours. Surgery is more effective in those well-differentiated. It isnt easy to get all relevant information before therapy. Some factors need macrobio-psy (surgical). The pretreatment workup will probably require a mandatory bio-psy in BCLC B and C stages to get the information. This opens up a way for the liquid bio-psy that could use some specific mi RNAs.","PeriodicalId":35565,"journal":{"name":"Klinicka Onkologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87494919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ľ. Harvanová, L. Petrikova, E. Bojtárová, B. Žiaková, M. Martišová, Vladimíra Lábska, M. Hrubiško, A. Bátorová, B. Mladosievičová
BACKGROUND Allogeneic hematopoietic stem cell transplantation (HSCT) offers potentially curative therapy for numerous malignant and non-malignant diseases. The number of survivors and length of follow-up after successful HSCT is continually increasing. Hematopoietic stem cell transplantation can induce damage of various organs and tissues - from minimal potentially progressive subclinical changes to life-threatening conditions. The aim of this thesis was the evaluation of the prevalence of metabolic syndrome (MS) among survivors of allogeneic HSCT. PATIENTS AND METHODS We analyzed 74 patients with a median age at transplant of 35 years, who had been followed for a median of 5 years (2-23 years) after allogeneic HSCT. MS was defined according to the National Cholesterol Education Programs Adult Treatment Panel III (NCEP ATP III) criteria and by the International Diabetes Federation (IDF) definition. RESULTS The prevalence of MS among HSCT recipients was 40.5% applying the NCEP ATP III definition and 39.2% the IDF, a 2.02-fold increase compared to the general Slovak population. MS was more common in men. The most common MS features were abdominal obesity, hypertriglyceridemia and hypertension. The lowest prevalence of MS was in the age group of 20-29 years; and the highest prevalence in the age group of 60-69 years. The 10-year cumulative incidence of MS was 32.5%. The most significant risk factor for MS was total body irradiation, positive family history and age > 40 years at HSCT. Seven patients (9.45%) developed cardiovascular complications. The median 10-year general cardiovascular risk scores for males and females were found to be 13.3% and 6.68%, respectively. CONCLUSIONS Detected increased prevalence of metabolic syndrome after allogeneic HSCT in patients surviving more than 2 years after this procedure may provide next stimulus to promote longer follow-up studies and to design of interventions to prevent late effects among survivors of serious hematologic diseases.
同种异体造血干细胞移植(HSCT)为许多恶性和非恶性疾病提供了潜在的治疗方法。HSCT成功后的存活人数和随访时间不断增加。造血干细胞移植可以引起各种器官和组织的损伤——从潜在的微小的进行性亚临床变化到危及生命的疾病。本论文的目的是评估代谢综合征(MS)在同种异体造血干细胞移植幸存者中的患病率。患者和方法我们分析了74例移植时中位年龄为35岁的患者，这些患者在同种异体造血干细胞移植后中位随访时间为5年(2-23年)。MS是根据国家胆固醇教育计划成人治疗小组III (NCEP ATP III)标准和国际糖尿病联合会(IDF)定义的。结果采用NCEP ATP III定义的HSCT受者MS患病率为40.5%，IDF为39.2%，与斯洛伐克普通人群相比增加了2.02倍。多发性硬化症在男性中更为常见。MS最常见的特征是腹部肥胖、高甘油三酯血症和高血压。20 ~ 29岁年龄组MS患病率最低;在60-69岁年龄组患病率最高。10年MS累计发病率为32.5%。MS最重要的危险因素是全身照射、阳性家族史和接受HSCT时年龄> 40岁。7例(9.45%)出现心血管并发症。男性和女性的10年一般心血管风险评分中位数分别为13.3%和6.68%。结论:同种异体造血干细胞移植术后存活超过2年的患者代谢综合征患病率增加，可能为促进更长时间的随访研究和设计干预措施提供下一个刺激，以防止严重血液病幸存者的晚期效应。
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