Wspolczesna Onkologia-Contemporary Oncology最新文献

Introduction: Despite the rising application of radiotherapy for cancer in Indonesia, no known radiotherapy utilization rate (RUR) figure has been produced for colon and rectal cancer in Indonesia. This study aims to depict the actual and optimal RUR for colon and rectal cancer in Indonesia.

Material and methods: Secondary data was obtained from hospitals providing radiotherapy services in Indonesia, and descriptive analysis was conducted in April-September 2022.

Results: Actual RUR (aRUR) of colon cancer was 5.3%, yet the calculated optimal RUR (oRUR) was 3.3% (3-3.7%) with an unmet need percentage of -60.6% [-76.7-(-43.2)%]. Actual RUR of rectal cancer in Indonesia was 19.5%, while calculated oRUR was 41% (28-66%) with an unmet need percentage of 52.4% (30.4-70.5%). In combination, 26.21% and 14.9% were the final calculation of colorectal cancer oRUR and aRUR, resulting in 45.5% (21.4-65.6%) unmet need. A substantial difference was also observed when sensitivity analysis was incorporated, with the percentage of unmet needs for colon and rectal cancer ranging from -76.7 to 86.5% and 2.2-94.2%, respectively.

Conclusions: There is a gap between aRUR and oRUR of colorectal cancer. Although oRUR of colon cancer seems to have been met, a significant gap persisted between oRUR and aRUR in rectal cancer. However, when sensitivity analysis was incorporated, notable disparity persisted for both colon and rectal cancer. Patient, clinician, and bureaucratic factors should be considered in increasing the RUR of colon and rectal cancer.

During the last 20 years, significant progress has been made in understanding the biology of cancer cells. Assessment of the molecular profile of neoplastic cells collected by tissue biopsy using next-generation sequencing techniques makes it possible to diagnose the specific diffuse large B-cell lymphoma subtype and to personalize the therapy applied through the rational use of molecularly targeted drugs. Similar to the other methods of biopsy material evaluation, this method has some limitations. It may fail in cases when tissue biopsies do not fully capture intratumor genetic heterogeneity. For this reason, research has been undertaken to find new laboratory methods to study the genetic heterogeneity of cancer cells and to characterize all lymphoma cells at once, regardless of the origin of the tumor cells and the stage of its transformation. One promising diagnostic approach is the evaluation of total free circulating DNA, including circulating tumor DNA, using molecular biology techniques.

[This corrects the article DOI: 10.5114/mp.2025.148753.].

Introduction: The current evidence is ambiguous regarding the comparative efficacy and safety of radiofrequency ablation (RFA) versus surgery as thera-peutic options for papillary thyroid microcarcinoma (PTMC). The principal aim of this study was to clarify these uncertainties.

Material and methods: A thorough investigation was performed using the Cochrane Library, Europe PMC, Scopus, and Medline databases until January 20^th, 2025, employing a combination of pertinent keywords. This review included studies that compared RFA and surgery for PTMC. We employed random-effects models to assess the mean difference (MD) and odds ratio (OR) for the reported outcomes.

Results: A total of 7 studies with 1,638 patients were included. Our meta- analysis indicated that RFA was associated with a shorter procedure time (MD -62.69 min; 95% CI: -78.33, -47.05, p < 0.00001), less blood loss (MD -24.13 ml; 95% CI: -30.02, -18.23, p < 0.00001), shorter hospitalization duration (MD -6.70 days; 95% CI: -8.85, -4.55, p < 0.00001), and lower total expenses (SMD -2.77; 95% CI: -4.27, -1.27, p = 0.0003) compared to surgery in PTMC patients. No significant difference in the tumor progression rate (p = 0.80), lymph node metastasis (p = 0.24), or recurrence rate (p = 0.38) was observed between RFA and surgery. In terms of safety, RFA exhibited fewer total complications (OR 0.33; 95% CI: 0.13-0.80, p = 0.01) than surgery.

Conclusions: RFA may serve as a feasible alternative for the treatment of PTMC in individuals who have opted against active surveillance or are ineligible for surgical intervention.

Retrotransposable elements are harmful at several levels, and host surveillance systems fail to consider all these elements in severe effects. The key role of retrotransposon in aging and age-associated diseases remains unclear. We summarise whether LINE-1 retrotransposable elements transcriptio-nally derepress and activate type-I interferon response during cellular senescence. Type-I interferon response is the late senescence phenotype that maintains the senescence-associated secretory phenotype. Cytoplasmic LINE-1 cDNA activates type-I interferon response, while LINE-1 reverse transcriptase inhibitors suppress it. The nucleoside reverse transcriptase inhibitor lamivudine downregulates activation of type-I interferon and age- associated inflammation in tissues in the treatment of aging. Activation of retrotransposons is a key factor in sterile inflammation, which is a hallmark of aging, and LINE-1 reverse trans-criptase is an important target for the treatment of age-associated diseases. Nucleoside reverse transcriptase inhibitor lamivudine downregulates activation of type-I interferon and age-associated inflammation.

Introduction: This study aimed to validate the prognostic value of alpha- fetoprotein (AFP) in AFP-negative hepatocellular carcinoma (HCC) and develop an AFP-integrated nomogram for post-resection recurrence-free survival (RFS) and overall survival (OS).

Material and methods: This retrospective study analyzed 453 HCC patients with preoperative AFP ≤ 20 ng/ml who underwent curative resection, divided into training (n = 317) and validation (n = 136) cohorts. The optimal AFP cutoff was determined using maximized χ² values. Nomograms were developed with repeated least absolute shrinkage and selection operator variable selection and stepwise Cox regression. Model performance was assessed using concordance (C-) indices, time-dependent area under the receiver operating characteristic curves (AUCs), calibration plots, and Kaplan-Meier (KM) curves.

Results: An alpha-fetoprotein cutoff of 7 ng/ml stratified patients for both RFS and OS (p < 0.001). The recurrence-free survival nomogram included AFP, age, sex, multiple tumors, and cirrhosis, while the OS nomogram incorporated AFP, albumin-bilirubin score, the up-to-7 criterion, des-γ-carboxy prothrombin, vascular invasion, and histological grade. In the training cohort, the nomograms demonstrated C-indices of 0.64 (95% CI: 0.60-0.68) for RFS and 0.72 (0.67-0.76) for OS. Validation cohort C-indices were 0.64 (0.62-0.65) for RFS and 0.67 (0.65-0.68) for OS. Time-dependent AUCs and calibration plots confirmed the predictive accuracy of the nomograms, and KM curves showed clear separation between high- and low-risk groups, further highlighting their clinical utility.

Conclusions: Alpha-fetoprotein retains prognostic value even within the clinically normal range for HCC. The AFP-integrated post-resection nomograms demonstrated acceptable predictive performance for AFP-negative patients, potentially enhancing personalized management strategies.

Introduction: Existing treatments for cervical cancer have side effects on the human body. Some lactobacilli inhibit tumour progression in a strain-specific manner without toxic side effects.

Material and methods: We explored whether Lactobacillus brevis YNH isolated from the vagina has anti-cervical cancer effects by performing Cell Counting Kit-8 assays, flow cytometry, JC-1 staining, and western blotting. Transcriptome sequencing was performed to determine the possible mechanism. Xenograft tumour model mice that were orally administered Lactobacillus brevis YNH were used to validate the anticancer effects in vivo.

Results: Our study revealed that Lactobacillus brevis YNH downregulated the expression of cyclin E1 and CDK2, resulting in cell cycle arrest at S phase and inhibition of HeLa cell proliferation. In addition, HeLa cells treated with Lactobacillus brevis YNH significantly promoted the cleavage of caspase-3 and caspase-8, and increased the expression of Bax. Also, the mitochondrial membrane potential decreased, which induced apoptosis of HeLa cells. Most of the differentially expressed genes were enriched in the PI3K/AKT pathway, indicating that Lactobacillus brevis YNH might exert its anticancer effects through the PI3K/AKT pathway. Most importantly, we found that the tumour volume of mice was significantly smaller than control group after orally administered Lactobacillus brevis YNH, and biochemical results showed that Lactobacillus brevis YNH had no toxic side effects on the liver or kidney, suggesting that Lactobacillus brevis YNH has anti-cervical cancer effects in vivo.

Conclusions: This study revealed the anti-cervical cancer effects of Lactobacillus brevis YNH, providing a new candidate bioactive substance for the treatment of cervical cancer.

Immune checkpoint inhibitors (ICIs) have become a cornerstone in the treatment of various solid tumors due to their proven efficacy. However, their use is associated with immune-related adverse events (irAEs), which arise from the immune response activated by ICIs. Gastrointestinal irAEs are among the most common and often present as diarrhea or colitis, conditions that can sometimes require discontinuation of ICI therapy. Although irAE gastritis is less frequently reported, it can lead to severe complications, such as gastrorrhagia. Diagnosing immune-related gastritis early can be challenging due to its diverse clinical presentations. While glucocorticoids and other immunosuppressive therapies are standard treatments for irAEs, the optimal management strategy and dosing for immune-related gastritis remain unclear. This case series on ga-stritis caused by ICI therapy aims to provide clinicians with valuable insights into this complex condition and its management.

Introduction: The aim of the study is to present the results of the first Polish cohort of patients treated with fractionated stereotactic radiotherapy (fSRT) for large and/or juxtapapillary uveal melanoma (UM).

Material and methods: The medical records of the patients who underwent the fSRT for UM in Poznań (cooperation between the Department of Ophthalmology, Poznań University of Medical Sciences and Greater Poland Cancer Centre) in 2014-2020 were retrospectively reviewed. The diagnosis was made in each case after detailed clinical examination, ultrasound and/or choroidal biopsy in selected patients. The irradiation protocol was to deliver 50 Gy in 5 fractions.

Results: We identified 27 patients, 12 men, 15 women, with a median age of 61.5 years. The median longitudinal basal diameter of treated tumours was 11.7 mm (range 5.2-17.8 mm), median thickness - 7.5 mm (range 1.7-9.7 mm). The median follow-up was 38 months (range 5-101 months). We observed neovascular glaucoma in 9 (34%) patients, which was the reason for globe removal in 3 (11%) of them. There was one local tumour recurrence (3.8%) with extraorbital extension 6 years post-treatment. Local tumour control in our cohort was 96.2%. By the study end, 5 (18.5%) patients died, including 3 (11%) of metastatic disease. The final visual acuity was logMAR 0.3 or better for 3 patients (11%).

Conclusions: As reported also by other authors, fSRT could be a useful treatment modality for selected large and/or juxtapapillary melanomas.

Introduction: This study evaluated the surgical learning curve associated with the simultaneous use of arterial and venous couplers, alongside flap survival outcomes, in head and neck cancer reconstruction.

Material and methods: A total of 127 pa-- tients (51 women, 76 men; aged 30-84 years) underwent microvascular free tissue transfer using the Synovis coupler device. Three flap types were used: radial forearm free flap, anterolateral thigh flap, and free fibula flap. Flap viability was assessed clinically during the first 7 postoperative days and at monthly follow-ups for up to one year. Operative time was recorded to monitor procedural efficiency.

Results: Four flap failures were observed. The cumulative sum analysis of surgical time revealed three distinct learning phases: Initial Learning (cases 1-30), Performance Improvement (31-58), and Plateau (59 onward). Piecewise linear regression confirmed minimal trend predictability in the first two phases (R² = 0.08), while Phase 3 demonstrated a strong linear decline in operative time (R² = 0.82), indicating attainment of surgical proficiency.

Conclusions: While hand-sewn anastomosis remains the standard in microsurgical reconstruction, this study supports arterial couplers as a safe, efficient alternative with a manageable learning curve -encouraging broader adoption in clinical practice.