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

Background: Medical psychology research shows that how a patient communicates appears to be the strongest predictor of physician behavior during a consultation and that patient's activity also influences how much information a physician communicates to a patient about his or her illness and treatment. Thus, being a patient is a skill that needs to be developed to balance the responsibilities of doctors and patients in each of their encounters. There is a lack of clear recommendations and education in this area, and patients' behaviour is instead governed by the etiquette of courtesy.

Purpose: The main aim of this article is to create a list of recommendations for patients and physicians to develop the skill of a competent patient in mutual communication and to include these recommendations into an educational leaflet with the aim to support the diagnostic and therapeutic process and personalized care.

Material and methods: Literature sources were selected unsystematically for the purpose of a narrative review, guided by the question: "What patient skills and competencies promote effective communication with the physician?" We adopted the snowball method, sometimes referred to as chain or reference selection, to generate the list.

Results: The results of the current narrative review demonstrate that the topic of patient communication competencies interests researchers and clinicians across medical disciplines. A summary of patient competencies was developed into an educational handout entitled "Before I go to the doctor". The leaflet can be freely distributed in a printed form, as presented in the article, or patients can be referred to its electronic version (via QR code on the leaflet or on the website of the Department of Medical Psychology and Psychosomatics of the Faculty of Medicine, Masaryk University, in the educational materials section at https: //upp.med.muni.cz/zdroje/edu). The educational leaflet can be used as educational material in any healthcare facility.

Conclusion: Being a competent patient is an ideal state that we strive for from the position of patients and physicians in order to develop medicine more symmetrically, in partnership and with an optimal distribution of responsibility for health, illness and treatment. The information leaflet is one of the possible and fundamental interventions to develop the skill of competent communication on the part of the patient. It is the most commonly used communication channel in patient education. The current list of recommendations is not definitive and binding. However, it opens up the topic itself. It names the dimensions of doctor-patient communication and gives both parties the opportunity to consider what their relationship should be like, what is missing in this relationship, and what is important to both parties.

Background: The fifth edition of World Health Organization classification of urinary and male genital tumours also brought news regarding testicular tumours. In contrast to the previous editions' radical alterations, the adjustments in the fifth edition are subtle and mostly impact the terminology, categorization of some of the rare tumours and diagnostic criteria.

Purpose: Acquainting with current terms and tumor classification, which is necessary for good clinical practice.