Pub Date : 2021-05-25DOI: 10.20471/LO.2021.49.01.03
Ana Tečić-Vuger, R. Šeparović, L. Vazdar, M. Pavlovic, P. Linarić, S. Šitić, Martina Šepetavc, D. Vrbanec
Summary Tumor stimulates specific innate and acquired immune mechanisms. Main carriers of body’s immune response to tumor are T lymphocytes and main mechanism is killing of tumor cells by cytotoxic T lymphocytes CD8 +. In some cases, immune system can also have a protumor role, which is a paradox, given that it is known that the inflammatory state pro motes tumor growth. One of the major characteristics of tumors is the evading of immune response, in particular by mecha nisms of inhibition of active antitumor immune response via two major physiological inhibitory signals, CTLA-4 and PD1 / PDL1. Blockade of these checkpoints, that are T cell inhibitory mechanisms, has recently yielded best results in an immuno therapy approach to cancer treatment. Immune infiltrate in the tumor, as evidence of existence of an active intrinsic response of the organism, is heterogeneous, and composition often differs between different tumors and tumor cells, and mainly divides into two main cell lines: lymphoid and myeloid. On type of cell lines in the immune infiltrate and their activation and orientation depends the clinical response in different tumors. It is well known that immune infiltrate, especially tumor-infiltrating lymphocytes (TILs), can be predictive of response to therapy and have a prognostic role. In some solid tumors they are a good sign, while in some they signal worse prognosis. Numerous studies have evaluated role of lymphocytic in filtrate in breast cancer (BC) and, based on this knowledge, first consensus on standardization of TILs evaluation in solid tumors has been established on the BC model. Prognostic role of TILs in triple-negative breast cancer has received the most attention.
{"title":"Immunity and cancer: role of tumor-infiltrating lymphocytes in triple-negative breast cancer","authors":"Ana Tečić-Vuger, R. Šeparović, L. Vazdar, M. Pavlovic, P. Linarić, S. Šitić, Martina Šepetavc, D. Vrbanec","doi":"10.20471/LO.2021.49.01.03","DOIUrl":"https://doi.org/10.20471/LO.2021.49.01.03","url":null,"abstract":"Summary Tumor stimulates specific innate and acquired immune mechanisms. Main carriers of body’s immune response to tumor are T lymphocytes and main mechanism is killing of tumor cells by cytotoxic T lymphocytes CD8 +. In some cases, immune system can also have a protumor role, which is a paradox, given that it is known that the inflammatory state pro motes tumor growth. One of the major characteristics of tumors is the evading of immune response, in particular by mecha nisms of inhibition of active antitumor immune response via two major physiological inhibitory signals, CTLA-4 and PD1 / PDL1. Blockade of these checkpoints, that are T cell inhibitory mechanisms, has recently yielded best results in an immuno therapy approach to cancer treatment. Immune infiltrate in the tumor, as evidence of existence of an active intrinsic response of the organism, is heterogeneous, and composition often differs between different tumors and tumor cells, and mainly divides into two main cell lines: lymphoid and myeloid. On type of cell lines in the immune infiltrate and their activation and orientation depends the clinical response in different tumors. It is well known that immune infiltrate, especially tumor-infiltrating lymphocytes (TILs), can be predictive of response to therapy and have a prognostic role. In some solid tumors they are a good sign, while in some they signal worse prognosis. Numerous studies have evaluated role of lymphocytic in filtrate in breast cancer (BC) and, based on this knowledge, first consensus on standardization of TILs evaluation in solid tumors has been established on the BC model. Prognostic role of TILs in triple-negative breast cancer has received the most attention.","PeriodicalId":53700,"journal":{"name":"Libri Oncologici","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67598529","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 : 2021-05-25DOI: 10.20471/LO.2021.49.01.06
Vanda Paradžik-Pašalić, J. Lešin, V. Matković, Suzana Lide-Škalec
Choriocarcinoma is one of the histological types of entities called gestational trophoblastic neoplasia (GTN) that refers to a rare group of malignancies that are formed by abnormal proliferation of trophoblastic tissue. Choriocarcinoma is the most aggressive GTN histological type and is characterized by early vascular invasion and disseminated disease. The clinical presentation depends on the spread of the disease and the location of the seedlings. In this paper we present the case of a 32-year-old patient sent to our Department for a specific oncological treatment of uterine choriocarcinoma diagnosed in an external institution. The disease is according to FIGO and WHO scale classified as III stage, low risk and chemotherapy with methotrexate and folic acid is indicated. The chemotherapy achieved negativity of the initially elevated tumor marker human chorionic gonadotropin (hCG) and full regression of lesions described in computerized tomography (CT).
{"title":"Uterine choriocarcinoma - a case report","authors":"Vanda Paradžik-Pašalić, J. Lešin, V. Matković, Suzana Lide-Škalec","doi":"10.20471/LO.2021.49.01.06","DOIUrl":"https://doi.org/10.20471/LO.2021.49.01.06","url":null,"abstract":"Choriocarcinoma is one of the histological types of entities called gestational trophoblastic neoplasia (GTN) that refers to a rare group of malignancies that are formed by abnormal proliferation of trophoblastic tissue. Choriocarcinoma is the most aggressive GTN histological type and is characterized by early vascular invasion and disseminated disease. The clinical presentation depends on the spread of the disease and the location of the seedlings. In this paper we present the case of a 32-year-old patient sent to our Department for a specific oncological treatment of uterine choriocarcinoma diagnosed in an external institution. The disease is according to FIGO and WHO scale classified as III stage, low risk and chemotherapy with methotrexate and folic acid is indicated. The chemotherapy achieved negativity of the initially elevated tumor marker human chorionic gonadotropin (hCG) and full regression of lesions described in computerized tomography (CT).","PeriodicalId":53700,"journal":{"name":"Libri Oncologici","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48319184","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 : 2021-05-25DOI: 10.20471/LO.2021.49.01.05
Nikolina Šantek, I. Kirac
Introduction: Cancer is one of the leading causes of death worldwide. However, if diagnosed in an operable stage, it is treated as a chronic disease. As such, long-term results and quality of life requirements imposed a comprehensive approach. Prehabilitation programs encompassing nutritional, physical, and psychological components improved the recovery and minimized the complication rate after surgery. We will focus on physiotherapy as part of prehabilitation in this review. Methods: For systematic search, we used the MEDLINE/PubMed (National Library of medicine), Cochrane Central Register of Controlled Trials (Wiley), Embase (Elsevier, Web of Science, and Cochrane database of systematic reviews. The last search update was on 15th December 2020. The search included randomized clinical trials or quasi-randomized clinical trials evaluating exercise or other non-pharmacological preoperative interventions in gastrointestinal cancers. Results: The ten trials included 1058 patients, 535 (50,6%) patients were in the experimental group, and 523 (49,4%) patients were in the control group. Bicycle exercise training was the best-ranked intervention with the standard mean difference (SMD) of 1,4077 (95% C.I. is 0,7018 – 2,1135) to improve vital functional capacity (s, VO ̇ 2 at uˆ L). Short-term exercise affected inspiratory muscle strength, and SMD was 1,1819 (95% C.I.,2953 – 2,0684). Shortterm intensity training program SMD was 0,8356 (95% C.I. 0,2042 1,4669), and shortterm intensity program for muscle endurance 0,8156 (95% C.I. 0,2042 – 1,4669). improves respiratory muscle endurance. Small effect was shown on quality of life in high-intensity cycling interval training SMD 0,7439( 95%C.. 0,0856 – 1,4023), WHO performance status in bicycle exercise training SMD 0,7068( 95% C.I. 0,0547 – 1,3589), mean number of complication in high-intensity endurance training SMD 0,3606 (95% C.I. 0,0072 – 0,7141). Conclusion: Although exercise therapy has been shown to improve vital capacity and respiratory muscle strength, there was a lack of comparison between different exercises. Evidence from these indirect-comparisons studies indicated that physical activity should be encouraged during the preoperative period before oncologic surgery.
简介：癌症是全球主要的死亡原因之一。然而，如果在可手术阶段被诊断，它将被视为慢性病。因此，长期成果和生活质量要求要求采取综合办法。包括营养、身体和心理组成部分的预适应计划提高了手术后的恢复率，并将并发症率降至最低。在这篇综述中，我们将把重点放在物理治疗作为康复的一部分。方法：为了进行系统检索，我们使用了MEDLINE/PubMed（国家医学图书馆）、Cochrane对照试验中央登记册（Wiley）、Embase（Elsevier，Web of Science）和Cochrane系统综述数据库。最后一次检索更新是在2020年12月15日。搜索包括随机临床试验或准随机临床试验，评估胃肠道癌症的运动或其他非药物术前干预措施。结果：10项试验包括1058例患者，实验组535例（50.6%），对照组523例（49.4%）。自行车运动训练是排名最好的干预措施，标准平均差（SMD）为14077（95%C.I.为07018–21135），以提高生命功能能力（s，在uëL时为VȮ2）。短期运动影响吸气肌力，SMD为11819（95%CI，2953-20684）。短期强度训练项目SMD为08356（95%C.I.02042 14669），肌肉耐力短期强度项目为08156（95%C.I.02042–14669）。提高呼吸肌耐力。高强度自行车间歇训练SMD 07439（95%C..00856–14023）对生活质量、世界卫生组织自行车运动训练SMD 07068（95%C.I.00547–13589）的表现状态、高强度耐力训练SMD 03606（95%C.C.00072–07141）的平均并发症数的影响较小。结论：尽管运动疗法已被证明可以提高肺活量和呼吸肌力量，但不同运动之间缺乏比较。这些间接比较研究的证据表明，在肿瘤手术前的术前阶段，应该鼓励身体活动。
{"title":"Effect of physiotherapy on vital capacity before major abdominal surgery in cancer patients: a systematic review","authors":"Nikolina Šantek, I. Kirac","doi":"10.20471/LO.2021.49.01.05","DOIUrl":"https://doi.org/10.20471/LO.2021.49.01.05","url":null,"abstract":"Introduction: Cancer is one of the leading causes of death worldwide. However, if diagnosed in an operable stage, it is treated as a chronic disease. As such, long-term results and quality of life requirements imposed a comprehensive approach. Prehabilitation programs encompassing nutritional, physical, and psychological components improved the recovery and minimized the complication rate after surgery. We will focus on physiotherapy as part of prehabilitation in this review. Methods: For systematic search, we used the MEDLINE/PubMed (National Library of medicine), Cochrane Central Register of Controlled Trials (Wiley), Embase (Elsevier, Web of Science, and Cochrane database of systematic reviews. The last search update was on 15th December 2020. The search included randomized clinical trials or quasi-randomized clinical trials evaluating exercise or other non-pharmacological preoperative interventions in gastrointestinal cancers. Results: The ten trials included 1058 patients, 535 (50,6%) patients were in the experimental group, and 523 (49,4%) patients were in the control group. Bicycle exercise training was the best-ranked intervention with the standard mean difference (SMD) of 1,4077 (95% C.I. is 0,7018 – 2,1135) to improve vital functional capacity (s, VO ̇ 2 at uˆ L). Short-term exercise affected inspiratory muscle strength, and SMD was 1,1819 (95% C.I.,2953 – 2,0684). Shortterm intensity training program SMD was 0,8356 (95% C.I. 0,2042 1,4669), and shortterm intensity program for muscle endurance 0,8156 (95% C.I. 0,2042 – 1,4669). improves respiratory muscle endurance. Small effect was shown on quality of life in high-intensity cycling interval training SMD 0,7439( 95%C.. 0,0856 – 1,4023), WHO performance status in bicycle exercise training SMD 0,7068( 95% C.I. 0,0547 – 1,3589), mean number of complication in high-intensity endurance training SMD 0,3606 (95% C.I. 0,0072 – 0,7141). Conclusion: Although exercise therapy has been shown to improve vital capacity and respiratory muscle strength, there was a lack of comparison between different exercises. Evidence from these indirect-comparisons studies indicated that physical activity should be encouraged during the preoperative period before oncologic surgery.","PeriodicalId":53700,"journal":{"name":"Libri Oncologici","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49446560","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 : 2021-05-25DOI: 10.20471/LO.2021.49.01.02
K. Katić, V. Matković, J. Lešin, Goran Vujić, A. Ćorušić
Introduction: Bevacizumab is a recombinant humanized anti-VEGF monoclonal antibody. It is an effective treatment for epithelial ovarian cancer, both in primary and recurrent disease. The incidence of ovarian cancer increases with advancing age. Despite the high prevalence of the ovarian cancer in elderly, the management of these patients is often less aggressive than in younger patients. In Croatia, from February 2017, we have opportunity to treat patients with epithelial ovarian, fallopian tube, or primary peritoneal cancer with bevacizumab in the first-line and second-line settings. Our aim was to investigate the safety of bevacizumab administration in patients older than 65 years. Methods: We have retrospectively analyzed the archive data of 65 patients with epithelial ovarian, fallopian tube, or primary peritoneal cancer who started treatment with bevacizumab in primary advanced and in first relapse setting at the Department of Gynecologic Oncology in the University Hospital Centre Zagreb in the period from January 2017 to December 2018. Patients were divided in two categories according to age: group 1 (≤65 years) and group 2 (>65 years). Results: Our analysis included 65 patients:47 (72.3%) patients in group 1 compared with 18 (27.7%) in group 2. Bevacizumab was administered to 39 (60%) patients as first-line treatment and to 26 (40%) patients as second-line treatment. The median age was 70 years (range 66-76 years) in group 2 and 55 years (range 35-65 years) in group 1. ECOG status 0 had 44.7% of patients in group 1 compared with only 22% in group 2. At the time of diagnosis, elderly patients had presented with at least one comorbidity in 94.4% of the cases, compared with 42.6% in group 1. The median number of cycles of bevacizumab was 9 in elderly patients and 17 cycles in group 1. Among those patients receiving bevacizumab in the first-line setting, median progression free interval (PFI) was 12 months in younger patients versus 7 months in elderly patients. Similarly, among those receiving bevacizumab in the second-line setting PFI was 9 months in younger patients versus 1 months in elderly patients. The occurrence of non-hematological adverse events did not increase in elderly patients; 51.1% of patients in group 1 reported some of non-hematological adverse events versus only 27.8% in elderly patients. Conclusion: Our experience in treating patients with bevacizumab shows good results with acceptable toxicity and our findings suggest that its use in the elderly population should be considered as safe and manageable. KeYWorDs: ovary cancer, bevacizumab, therapy, elderly patients
{"title":"Tolerability of bevacizumab in elderly patients with ovarian cancer: an experience from the Department of Gynecologic Oncology in the University Hospital Centre Zagreb","authors":"K. Katić, V. Matković, J. Lešin, Goran Vujić, A. Ćorušić","doi":"10.20471/LO.2021.49.01.02","DOIUrl":"https://doi.org/10.20471/LO.2021.49.01.02","url":null,"abstract":"Introduction: Bevacizumab is a recombinant humanized anti-VEGF monoclonal antibody. It is an effective treatment for epithelial ovarian cancer, both in primary and recurrent disease. The incidence of ovarian cancer increases with advancing age. Despite the high prevalence of the ovarian cancer in elderly, the management of these patients is often less aggressive than in younger patients. In Croatia, from February 2017, we have opportunity to treat patients with epithelial ovarian, fallopian tube, or primary peritoneal cancer with bevacizumab in the first-line and second-line settings. Our aim was to investigate the safety of bevacizumab administration in patients older than 65 years. Methods: We have retrospectively analyzed the archive data of 65 patients with epithelial ovarian, fallopian tube, or primary peritoneal cancer who started treatment with bevacizumab in primary advanced and in first relapse setting at the Department of Gynecologic Oncology in the University Hospital Centre Zagreb in the period from January 2017 to December 2018. Patients were divided in two categories according to age: group 1 (≤65 years) and group 2 (>65 years). Results: Our analysis included 65 patients:47 (72.3%) patients in group 1 compared with 18 (27.7%) in group 2. Bevacizumab was administered to 39 (60%) patients as first-line treatment and to 26 (40%) patients as second-line treatment. The median age was 70 years (range 66-76 years) in group 2 and 55 years (range 35-65 years) in group 1. ECOG status 0 had 44.7% of patients in group 1 compared with only 22% in group 2. At the time of diagnosis, elderly patients had presented with at least one comorbidity in 94.4% of the cases, compared with 42.6% in group 1. The median number of cycles of bevacizumab was 9 in elderly patients and 17 cycles in group 1. Among those patients receiving bevacizumab in the first-line setting, median progression free interval (PFI) was 12 months in younger patients versus 7 months in elderly patients. Similarly, among those receiving bevacizumab in the second-line setting PFI was 9 months in younger patients versus 1 months in elderly patients. The occurrence of non-hematological adverse events did not increase in elderly patients; 51.1% of patients in group 1 reported some of non-hematological adverse events versus only 27.8% in elderly patients. Conclusion: Our experience in treating patients with bevacizumab shows good results with acceptable toxicity and our findings suggest that its use in the elderly population should be considered as safe and manageable. KeYWorDs: ovary cancer, bevacizumab, therapy, elderly patients","PeriodicalId":53700,"journal":{"name":"Libri Oncologici","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48880479","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 : 2021-05-25DOI: 10.20471/LO.2021.49.01.01
Petar Matosevic, Vedrana Biošić, Lucija Brkić, Andrija Matijević, Ozana Miličević, Ines Trkulja, H. Silovski, Emil Kinda
Colorectal cancer (CRC) is one of the most prevalent oncological diseases globally, taking 3rd place in incidence in the general population. High in mortality, it is also a form of cancer whose outcome is highly dependable on its stage at diagnosis. Therefore, many countries have adopted a more or less successful screening process to ensure early diagnosis and, in turn, higher survival rates and better results overall. The COVID-19 pandemic has altered the established medical routines worldwide, with massively postponing diagnostic procedures and elective surgeries. This study aims to measure the effect the pandemic has had on colorectal cancer treatment in our Institution. Variables such as deferral time from diagnosis to commencement of treatment, lapse of time between different phases of the treatment process, time of presentation (elective versus emergent surgery), the physical status of the patient at the time of surgery (ASA classification) and metastatic index (positive lymph node ratio), were taken into account. We juxtaposed data from patients treated at the Surgical Department of Clinical Hospital Center in Zagreb in 2019 and 2020, the latter being heavily affected by the pandemic. In 2019 and 2020, 347 and 314 patients, respectively, with C18-C20 diagnoses (International Statistical Classification of Diseases and Related Health Problems ICD-10), have been treated at our Hospital. With exclusion criteria applied, the patient count falls to 173 for 2019 and 157 for 2020. These numbers include operated cases with or without an anastomosis formation and with or without neoadjuvant chemotherapy applied. From the analysis we excluded patients with recurrent colorectal tumors, synchronous and metachronous tumors, and patients treated palliatively. Furthermore, colorectal adenomas were also excluded from the study. Our data shows significant difference between observed variables in the two patient groups, attributed to the COVID- 19 pandemic. Since there is still no reliable way to predict the duration of this global health crisis, it is imperative to implement strategies to lessen the damaging effect the pandemic has had on favourable oncosurgical treatment outcomes in colorectal cancer patients.
{"title":"COVID-19 and colorectal cancer – signs of a toxic relationship and how to break the cycle: a single institution, tertiary centre experience","authors":"Petar Matosevic, Vedrana Biošić, Lucija Brkić, Andrija Matijević, Ozana Miličević, Ines Trkulja, H. Silovski, Emil Kinda","doi":"10.20471/LO.2021.49.01.01","DOIUrl":"https://doi.org/10.20471/LO.2021.49.01.01","url":null,"abstract":"Colorectal cancer (CRC) is one of the most prevalent oncological diseases globally, taking 3rd place in incidence in the general population. High in mortality, it is also a form of cancer whose outcome is highly dependable on its stage at diagnosis. Therefore, many countries have adopted a more or less successful screening process to ensure early diagnosis and, in turn, higher survival rates and better results overall. The COVID-19 pandemic has altered the established medical routines worldwide, with massively postponing diagnostic procedures and elective surgeries. This study aims to measure the effect the pandemic has had on colorectal cancer treatment in our Institution. Variables such as deferral time from diagnosis to commencement of treatment, lapse of time between different phases of the treatment process, time of presentation (elective versus emergent surgery), the physical status of the patient at the time of surgery (ASA classification) and metastatic index (positive lymph node ratio), were taken into account. We juxtaposed data from patients treated at the Surgical Department of Clinical Hospital Center in Zagreb in 2019 and 2020, the latter being heavily affected by the pandemic. In 2019 and 2020, 347 and 314 patients, respectively, with C18-C20 diagnoses (International Statistical Classification of Diseases and Related Health Problems ICD-10), have been treated at our Hospital. With exclusion criteria applied, the patient count falls to 173 for 2019 and 157 for 2020. These numbers include operated cases with or without an anastomosis formation and with or without neoadjuvant chemotherapy applied. From the analysis we excluded patients with recurrent colorectal tumors, synchronous and metachronous tumors, and patients treated palliatively. Furthermore, colorectal adenomas were also excluded from the study. Our data shows significant difference between observed variables in the two patient groups, attributed to the COVID- 19 pandemic. Since there is still no reliable way to predict the duration of this global health crisis, it is imperative to implement strategies to lessen the damaging effect the pandemic has had on favourable oncosurgical treatment outcomes in colorectal cancer patients.","PeriodicalId":53700,"journal":{"name":"Libri Oncologici","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46005955","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 : 2020-12-21DOI: 10.20471/LO.2020.48.02-03.13
E. Kresic, A. Alduk, M. Prutki, Ivan Karlak, Karolina Bolanča-Čulo, M. Čavka
To present our results from 2018 and 2019 and to present the clinical data of the accuracy and clinical usefulness of computed tomography (CT)-guided biopsy for diagnosing suspicious bone lesion. The retrospective study included 98 consecutive patients who underwent CT-guided bone lesion biopsy from January 2018 to December 2019. The localization of the bone lesions, the adequacy of the sample for histopathological analysis, histopathological results, and the procedure’s complications were analyzed. The specimens collected from 76 patients/lesions (77.6%) were considered appropriate for diagnosis. Histological analysis of bone samples showed 52 (68.4%) metastatic lesions. The most common primary tumor origins were breast carcinoma 28 (53.8%) and lung carcinoma six (11.5%). In three patients (4%), the infection was confirmed. No tumor cells were found in 17 (22.4%) patients. There were no post-procedural complications. CT-guided bone lesion biopsy is a safe and effective method for diagnosing suspicious bone lesions that has a great effect in clinical practice without any significant complications.
{"title":"Computed tomography-guided bone lesion biopsy, our experience in 2018 and 2019","authors":"E. Kresic, A. Alduk, M. Prutki, Ivan Karlak, Karolina Bolanča-Čulo, M. Čavka","doi":"10.20471/LO.2020.48.02-03.13","DOIUrl":"https://doi.org/10.20471/LO.2020.48.02-03.13","url":null,"abstract":"To present our results from 2018 and 2019 and to present the clinical data of the accuracy and clinical usefulness of computed tomography (CT)-guided biopsy for diagnosing suspicious bone lesion. The retrospective study included 98 consecutive patients who underwent CT-guided bone lesion biopsy from January 2018 to December 2019. The localization of the bone lesions, the adequacy of the sample for histopathological analysis, histopathological results, and the procedure’s complications were analyzed. The specimens collected from 76 patients/lesions (77.6%) were considered appropriate for diagnosis. Histological analysis of bone samples showed 52 (68.4%) metastatic lesions. The most common primary tumor origins were breast carcinoma 28 (53.8%) and lung carcinoma six (11.5%). In three patients (4%), the infection was confirmed. No tumor cells were found in 17 (22.4%) patients. There were no post-procedural complications. CT-guided bone lesion biopsy is a safe and effective method for diagnosing suspicious bone lesions that has a great effect in clinical practice without any significant complications.","PeriodicalId":53700,"journal":{"name":"Libri Oncologici","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48647809","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 : 2020-12-21DOI: 10.20471/LO.2020.48.02-03.16
F. Cmrečak, Iva Andrašek, Višnja Gregov, L. Beketić-Orešković
For the past several decades, we have witnessed the emergence of the obesity pandemic worldwide and, simultaneously, the increase of incidence of malignant diseases. The effects of obesity and overweight on cancer incidence, morbidity, and mortality started to be meticulously researched only recently. According to the epidemiological data analysis, the connection between obesity and increased risk of numerous cancers has been established. Estimations are that a change in lifestyle and diet can prevent 30-50% of malignant diseases. After smoking, obesity is the second largest preventable cause of cancer. Obesity affects the quality of life and increases the risk of cancer recurrence and cancer-related mortality. By reducing body mass and avoiding gaining weight during adulthood, the risk of getting cancer is lowered. Numerous studies have shown the beneficial effects of physical activity during and after cancer treatment. Obesity influences cancer development; however, the mechanisms responsible for it are still unclear. It is considered that chronic inflammation, caused by the overabundance of nutrients, increases the levels of inflammatory cytokines and immune cells. It has been discovered that adipocytes have an important endocrine role; they synthesize numerous hormones and adipocytokines, such as leptin and adiponectin. High levels of leptons and low levels of adiponectin can activate intracellular signaling pathways involving malignant cells’ development. An important part of cancer development can be attributed to insulin metabolism, insulin-like growth factors, and sex hormones.
{"title":"Obesity and cancer","authors":"F. Cmrečak, Iva Andrašek, Višnja Gregov, L. Beketić-Orešković","doi":"10.20471/LO.2020.48.02-03.16","DOIUrl":"https://doi.org/10.20471/LO.2020.48.02-03.16","url":null,"abstract":"For the past several decades, we have witnessed the emergence of the obesity pandemic worldwide and, simultaneously, the increase of incidence of malignant diseases. The effects of obesity and overweight on cancer incidence, morbidity, and mortality started to be meticulously researched only recently. According to the epidemiological data analysis, the connection between obesity and increased risk of numerous cancers has been established. Estimations are that a change in lifestyle and diet can prevent 30-50% of malignant diseases. After smoking, obesity is the second largest preventable cause of cancer. Obesity affects the quality of life and increases the risk of cancer recurrence and cancer-related mortality. By reducing body mass and avoiding gaining weight during adulthood, the risk of getting cancer is lowered. Numerous studies have shown the beneficial effects of physical activity during and after cancer treatment. Obesity influences cancer development; however, the mechanisms responsible for it are still unclear. It is considered that chronic inflammation, caused by the overabundance of nutrients, increases the levels of inflammatory cytokines and immune cells. It has been discovered that adipocytes have an important endocrine role; they synthesize numerous hormones and adipocytokines, such as leptin and adiponectin. High levels of leptons and low levels of adiponectin can activate intracellular signaling pathways involving malignant cells’ development. An important part of cancer development can be attributed to insulin metabolism, insulin-like growth factors, and sex hormones.","PeriodicalId":53700,"journal":{"name":"Libri Oncologici","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44337549","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 : 2020-12-21DOI: 10.20471/LO.2020.48.02-03.19
D. Danolić, L. Marcelić, I. Alvir, I. Mamić, L. Šušnjar, Z. Rendić-Miočević, M. Puljiz
Metastases to the female genital tract from extra-genital primary cancers are uncommon and usually occur during widespread metastatic disease. Breast cancers are the most frequent primaries, predominantly the lobular type. Here, we report a case of a 55-year-old woman with breast cancer endometrial metastasis who presented with postmenopausal vaginal bleeding. We highlight the importance of endometrial sampling to confirm the diagnosis and distinguish primary from metastatic cancer of the endometrium since the treatment and prognosis of these conditions are entirely different.
{"title":"Rare case of invasive lobular breast cancer metastasis to the endometrium","authors":"D. Danolić, L. Marcelić, I. Alvir, I. Mamić, L. Šušnjar, Z. Rendić-Miočević, M. Puljiz","doi":"10.20471/LO.2020.48.02-03.19","DOIUrl":"https://doi.org/10.20471/LO.2020.48.02-03.19","url":null,"abstract":"Metastases to the female genital tract from extra-genital primary cancers are uncommon and usually occur during widespread metastatic disease. Breast cancers are the most frequent primaries, predominantly the lobular type. Here, we report a case of a 55-year-old woman with breast cancer endometrial metastasis who presented with postmenopausal vaginal bleeding. We highlight the importance of endometrial sampling to confirm the diagnosis and distinguish primary from metastatic cancer of the endometrium since the treatment and prognosis of these conditions are entirely different.","PeriodicalId":53700,"journal":{"name":"Libri Oncologici","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44484254","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 : 2020-12-21DOI: 10.20471/LO.2020.48.02-03.10
S. Ramić, Gabriela Alfier, I. Kirac, I. Milas, T. Orešić
Breast cancer (BC) represents 25% of all malignancies in Croatian women, and in 18.8% of cases, it is diagnosed before the age of 50. Croatia launched BRCA testing of people at increased family risk. Hereditary BC is mainly caused by a pathogenic mutation in the BRCA1 or BRCA2 gene and is a significant risk factor for developing breast and ovarian cancer. The present study included 127 women diagnosed with BC, with a strong family history of BC and the known status of the germline mutations in the BRCA1/BRCA2 genes. The majority of women were BRCA1/2 mutation non-carriers, while 15.7% were BRCA1/2 mutation carriers, and 4% had a variant of unknown significance (VUS). BRCA1/2 mutation carriers were younger than non-carriers (median 38.5 years vs. 44 years) (P=.01) and had tumors of higher histological grade (P<.001). The intrinsic subtype of BC differs significantly depending on the type of mutation (P<.001). Triple-negative BC prevailed (87.5%) in BRCA1 mutation carriers, and 12.5% had a luminal B/HER2-negative BC. Four patients were BRCA2 mutation carriers, and two of them had luminal B/HER2-positive BC. Most BRCA1/2 non-carriers (69.2%) and all VUS-carriers have luminal B/HER2-negative BC. Our results show that BRCA1/2 mutation testing is essential for women with a family history burden. It is a piece of valuable information in breast cancer risk assessment and contributes to early diagnosis.
{"title":"Characteristics of breast cancer in BRCA1/BRCA2 mutation carriers and non-carriersfrom a genetic counseling unit in Croatia","authors":"S. Ramić, Gabriela Alfier, I. Kirac, I. Milas, T. Orešić","doi":"10.20471/LO.2020.48.02-03.10","DOIUrl":"https://doi.org/10.20471/LO.2020.48.02-03.10","url":null,"abstract":"Breast cancer (BC) represents 25% of all malignancies in Croatian women, and in 18.8% of cases, it is diagnosed before the age of 50. Croatia launched BRCA testing of people at increased family risk. Hereditary BC is mainly caused by a pathogenic mutation in the BRCA1 or BRCA2 gene and is a significant risk factor for developing breast and ovarian cancer. The present study included 127 women diagnosed with BC, with a strong family history of BC and the known status of the germline mutations in the BRCA1/BRCA2 genes. The majority of women were BRCA1/2 mutation non-carriers, while 15.7% were BRCA1/2 mutation carriers, and 4% had a variant of unknown significance (VUS). BRCA1/2 mutation carriers were younger than non-carriers (median 38.5 years vs. 44 years) (P=.01) and had tumors of higher histological grade (P<.001). The intrinsic subtype of BC differs significantly depending on the type of mutation (P<.001). Triple-negative BC prevailed (87.5%) in BRCA1 mutation carriers, and 12.5% had a luminal B/HER2-negative BC. Four patients were BRCA2 mutation carriers, and two of them had luminal B/HER2-positive BC. Most BRCA1/2 non-carriers (69.2%) and all VUS-carriers have luminal B/HER2-negative BC. Our results show that BRCA1/2 mutation testing is essential for women with a family history burden. It is a piece of valuable information in breast cancer risk assessment and contributes to early diagnosis.","PeriodicalId":53700,"journal":{"name":"Libri Oncologici","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48782150","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 : 2020-12-21DOI: 10.20471/LO.2020.48.02-03.18
B. Petrić-Miše, Dinka Šundov
Low-grade serous ovarian cancer (LGSOC) has less aggressive behavior and a better clinical outcome than high-grade serous ovarian cancer (HGSOC). Considering that this malignancy is relatively chemoresistant, surgery is the keystone of treatment, with a strong recommendation for maximal cytoreduction. Women with stage IA-IB disease should undergo observation alone after primary cytoreductive surgery. In contrast, observation, chemotherapy, or endocrine therapy are possible options for those with stage IC-IIA disease. Patients with stage IIB-IV disease receive either chemotherapy with carboplatin and paclitaxel for six cycles followed by endocrine therapy, most commonly with aromatase inhibitors, or endocrine therapy alone until disease progression or unacceptable toxicity. Surgery, chemotherapy, and endocrine therapy are also used in patients with recurrent disease. Targeted agents, especially mitogen-activated protein kinase (MEK) inhibitors and cyclin-dependent kinase (CDK) inhibitors, are currently under evaluation in this clinical setting. Additional research on the genomics of LGSOC to better define the activating gene mutations involved in the carcinogenesis is strongly warranted to improve the prognosis with this malignancy.
{"title":"A therapeutic approach to low-grade serous ovarian carcinoma","authors":"B. Petrić-Miše, Dinka Šundov","doi":"10.20471/LO.2020.48.02-03.18","DOIUrl":"https://doi.org/10.20471/LO.2020.48.02-03.18","url":null,"abstract":"Low-grade serous ovarian cancer (LGSOC) has less aggressive behavior and a better clinical outcome than high-grade serous ovarian cancer (HGSOC). Considering that this malignancy is relatively chemoresistant, surgery is the keystone of treatment, with a strong recommendation for maximal cytoreduction. Women with stage IA-IB disease should undergo observation alone after primary cytoreductive surgery. In contrast, observation, chemotherapy, or endocrine therapy are possible options for those with stage IC-IIA disease. Patients with stage IIB-IV disease receive either chemotherapy with carboplatin and paclitaxel for six cycles followed by endocrine therapy, most commonly with aromatase inhibitors, or endocrine therapy alone until disease progression or unacceptable toxicity. Surgery, chemotherapy, and endocrine therapy are also used in patients with recurrent disease. Targeted agents, especially mitogen-activated protein kinase (MEK) inhibitors and cyclin-dependent kinase (CDK) inhibitors, are currently under evaluation in this clinical setting. Additional research on the genomics of LGSOC to better define the activating gene mutations involved in the carcinogenesis is strongly warranted to improve the prognosis with this malignancy.","PeriodicalId":53700,"journal":{"name":"Libri Oncologici","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41293035","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}
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