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Calcifying fibrous tumor of the rectum - a case report 直肠钙化性纤维瘤1例
Q4 Medicine Pub Date : 2020-12-21 DOI: 10.20471/LO.2020.48.02-03.20
Tomislav Pavlović, Rosana Troskot-Perić, Sanja Trtica
A calcifying fibrous tumor (CFT) is a benign tumor of unknown etiology. A calcifying fibrous tumor is rare in the intestinal tract. A calcifying fibrous tumor is characterized by hyalinized collagenous fibrous tissue, psammomatous or dystrophic calcification, and focal lymphoplasmacytic infiltrates on histology. Magnetic resonance imaging is the standard method for evaluating the lesions of the rectum, and CFTs should be considered in differentiating the rectal wall tumors. Herein, we report a case of a 68-year-old man with a rectal wall CFT.
钙化纤维瘤(CFT)是一种病因不明的良性肿瘤。钙化纤维瘤在肠道中很少见。钙化性纤维瘤的特征是透明化的胶原纤维组织,沙姆瘤或营养不良钙化,以及组织学上的局灶性淋巴浆细胞浸润。磁共振成像是评估直肠病变的标准方法,在鉴别直肠壁肿瘤时应考虑CFTs。在此,我们报告一例68岁男性直肠壁CFT。
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引用次数: 0
First-line treatment of advanced ovarian cancer: an expert update 晚期癌症的一线治疗:专家更新
Q4 Medicine Pub Date : 2020-12-21 DOI: 10.20471/LO.2020.48.02-03.14
B. Petrić-Miše
Ovarian cancer is the fifth most common cause of death among malignant diseases in women in Europe. The standard treatment is cytoreductive surgery, followed by platinum-taxane based chemotherapy. In patients with advanced disease, a valid option is a neoadjuvant chemotherapy followed by interval debulking surgery. Despite the progress in primary treatment, almost 70% of the patients relapse. There is a significant need for better first-line treatment to avoid or delay relapse and improve ovarian cancer outcomes. The most significant change involves the changes in the treatment schedule and new drugs in first-line chemotherapy. Bevacizumab is approved in first-line treatment combined with carboplatin and paclitaxel as it improves progression-free survival (PFS) in patients with a higher risk of recurrence. After achieving the response to first-line chemotherapy, maintenance therapy with poly-adenosine-diphosphate-ribose-polymerase (PARP) inhibitors prolongs PFS in patients with homologous recombination deficiency (HRD). Patients with BRCA mutations obtain the most significant benefit.
癌症是欧洲女性恶性疾病中第五常见的死亡原因。标准的治疗方法是细胞减灭术,然后是基于铂紫杉烷的化疗。对于晚期疾病患者,一个有效的选择是新辅助化疗,然后进行间隔性减瘤手术。尽管初级治疗取得了进展,但几乎70%的患者复发。需要更好的一线治疗来避免或延迟复发并改善癌症的预后。最显著的变化涉及一线化疗中治疗计划和新药的变化。贝伐单抗被批准与卡铂和紫杉醇联合用于一线治疗,因为它可以提高复发风险较高的患者的无进展生存期(PFS)。在获得对一线化疗的反应后,使用聚腺苷二磷酸核糖聚合酶(PARP)抑制剂的维持治疗延长了同源重组缺乏症(HRD)患者的PFS。BRCA突变的患者获得了最显著的益处。
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引用次数: 0
The importance of physical activity in colorectal cancer prevention 体育活动对预防结直肠癌的重要性
Q4 Medicine Pub Date : 2020-12-21 DOI: 10.20471/LO.2020.48.02-03.17
N. Antoljak
Colorectal cancer is the second most common malignant neoplasm and the second cause of death from malignancies in both sexes. In 2017, 3689 people were diagnosed in the Republic of Croatia. Two thousand ninety-five people died of colorectal cancer in 2019. Colorectal cancer is preventable, and it appears that smoking and obesity are factors that affect its onset. Physical inactivity is closely related to obesity, and the question is whether it can be an independent predictor of colon cancer. We searched the literature on Pubmed for the past five years, including systematic reviews and meta-analyses on the association between physical activity and colon cancer incidence. Studies are methodologically diverse and involve different approaches. In most observational studies, greater physical activity is associated with a lower incidence of colon cancer, while in the interventional studies, results were more diverse. In general, smoking tobacco products has a much greater effect on colon cancer development, but physical activity is linked to the onset of the disease and should be one of the prevention measures.
癌症是第二常见的恶性肿瘤,也是男女恶性肿瘤死亡的第二大原因。2017年,克罗地亚共和国有3689人确诊。2019年,2095人死于结直肠癌癌症。结直肠癌癌症是可以预防的,吸烟和肥胖似乎是影响其发病的因素。缺乏运动与肥胖密切相关,问题是它是否可以成为结肠癌的独立预测因子。我们检索了过去五年Pubmed的文献,包括关于身体活动与结肠癌癌症发病率之间关系的系统综述和荟萃分析。研究方法多样,涉及不同的方法。在大多数观察性研究中,更多的体力活动与较低的结肠癌癌症发病率相关,而在介入性研究中结果更为多样化。一般来说,吸烟烟草制品对癌症的发展有更大的影响,但体育活动与疾病的发病有关,应该是预防措施之一。
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引用次数: 0
The impact of COVID-19 epidemiological restriction guidelines measures in a Croatian tertiary colorectal cancer center 新冠肺炎流行病限制指南措施对克罗地亚癌症三级结直肠癌中心的影响
Q4 Medicine Pub Date : 2020-12-21 DOI: 10.20471/LO.2020.48.02-03.08
I. Kirac, Z. Misir, Vesna Vorih, Loris Ćurt, M. Šekerija, N. Antoljak
Background: In the past six months, Croatia faced a short lockdown and a slow return to most hospitals’ everyday activities. During the lockdown, our center, as a part of the University Hospital Centre specialized for solid cancer, was enabled to maintain most of the routine practices with the one-month colonoscopy exception. Aim: To determine the oscillation in the number of endoscopies and colorectal surgery for 13 months (six months pre and post COVID-19 lockdown). Materials and methods: From August 1st, 2019, until August 31st 2020, the hospital analytics determine the number of colonoscopies, screening colonoscopies, and surgeries. Results: During the given period number of detected and operated colorectal cancers was stable, except for April, when we mostly did not perform colonoscopies. Conclusion: We maintained a pre-COVID-19 pace in colorectal cancer treatment, colonoscopies, and colorectal surgery after epidemiological guidelines for colonoscopies and colorectal surgery were applied, owing to the relatively stable overall epidemiological situation.
背景:在过去六个月中,克罗地亚经历了短暂的封锁,大多数医院的日常活动缓慢恢复。在封锁期间,我们的中心作为大学医院中心专门治疗实体癌的一部分,除了一个月的结肠镜检查外,能够维持大多数常规手术。目的:了解13个月(COVID-19封锁前后6个月)内窥镜检查和结直肠手术次数的波动情况。材料和方法:从2019年8月1日至2020年8月31日,医院分析确定结肠镜检查,筛查结肠镜检查和手术的数量。结果:在给定的时间段内,发现和手术的结直肠癌数量稳定,除4月份外,我们大多没有进行结肠镜检查。结论:在应用结肠镜和结直肠手术流行病学指南后,由于总体流行病学形势相对稳定,我们在结直肠癌治疗、结肠镜检查和结直肠手术方面保持了covid -19前的步伐。
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引用次数: 1
Multidisciplinary surgical treatment of clear-cell renal carcinoma with inferior vena cava tumor thrombus level III and IV: our experience during the past decade 透明细胞肾癌合并下腔静脉肿瘤血栓III级和IV级的多学科外科治疗:我们近十年的经验
Q4 Medicine Pub Date : 2020-12-21 DOI: 10.20471/LO.2020.48.02-03.12
T. Hudolin, V. Ferenčak, L. Penezić, T. Zekulić, T. Kuliš, M. Marić, O. Pavlović, A. El-Saleh, N. Knezevic, E. Goluža, B. Biočina, Z. Kastelan
Patients with non-metastatic, stage T3 clear-cell renal cell cancer present a clinical challenge for urologists. The extent of tumor thrombus in inferior vena cava is the primary determinant of surgical procedure complexity. Level III and IV thrombi require the use of cardiopulmonary bypass and hypothermic arrest. Careful preoperative planning and a multidisciplinary approach are mandatory. In this paper, we report outcomes of 12 patients who were surgically treated in our center. The 29 months overall survival for all patients was 69%, while three patients died during follow-up. Of nine surviving patients, six are currently disease-free, whereas three had disease progression. Our study showed that carefully selected patients with clear-cell renal cell carcinoma with inferior vena cava tumor thrombus level III and IV could be successfully treated with an aggressive surgical approach.
患有非味觉、T3期肾透明细胞癌症的患者对泌尿科医生来说是一个临床挑战。下腔静脉肿瘤血栓的程度是决定手术复杂性的主要因素。III级和IV级血栓需要使用体外循环和低温停搏。仔细的术前计划和多学科的方法是强制性的。在这篇论文中,我们报告了在我们中心接受手术治疗的12名患者的结果。所有患者29个月的总生存率为69%,而3名患者在随访中死亡。在9名幸存患者中,6人目前无病,3人病情进展。我们的研究表明,精心选择的下腔静脉肿瘤血栓等级为III和IV的透明细胞肾细胞癌患者可以通过积极的手术方法成功治疗。
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引用次数: 0
Overall survival and disease control rates for operable invasive breast cancer in the era of conservative surgery; retrospective, institutional, and five-year follow-up data 保守手术时代可手术浸润性乳腺癌的总生存率及疾病控制率回顾性、机构性和5年随访数据
Q4 Medicine Pub Date : 2020-12-21 DOI: 10.20471/LO.2020.48.02-03.11
Ana Car-Peterko, M. Avirović, Iva Skočilić, P. Valković-Zujić, ingrid Belac-Lovasić, F. Lovasić
Background: Following breast cancer treatment recommendations, the conservative approach is accepted and highly respected in the Clinical Hospital Center (CHC) Rijeka. However, we have found that institutional follow-up data are lacking. This retrospective analysis aims to update institutional data on survival and disease control rates. Methods: From 2011 till 2014, 915 breast cancer patients underwent surgery at CHC Rijeka, and 615 were included in this analysis. The Institutional Ethics Committee approved the analysis. Results: All patients were female, and the average age was 59 years. In the 5-year postoperative period, local, regional, and distant recurrence-free survival rates and overall survival and disease-free survival were calculated. All rates negatively correlate with a higher T and N status and a higher stage of the disease. The analysis has also demonstrated that in the pT1-3 pN0-1 subgroup, sentinel lymph node biopsy (SLNB) was not inferior to axillary lymph node dissection (ALND) in terms of locoregional control of disease and overall survival. Conclusion: Besides updating institutional data, the analysis confirmed that overall survival and locoregional control of the disease in the upfront-surgery patients are similar between pN0 and pN1 subpopulations and between pN2 and pN3, but statistically significantly different between pN0-1 and pN2-3. Currently ongoing, prospective observational multicenter clinical trial aims to translate the significance of these results into the neoadjuvant era.
背景:在Rijeka临床医院中心(CHC),保守治疗方法被接受并受到高度尊重。然而,我们发现缺乏机构随访数据。本回顾性分析旨在更新有关生存率和疾病控制率的机构数据。方法:2011年至2014年在Rijeka CHC接受手术治疗的915例乳腺癌患者,其中615例纳入本分析。机构伦理委员会批准了该分析。结果:所有患者均为女性,平均年龄59岁。术后5年计算局部、区域和远处无复发生存率、总生存率和无病生存率。所有的比率与较高的T和N状态和较高的疾病阶段负相关。分析还表明,在pT1-3 pN0-1亚组中,前哨淋巴结活检(SLNB)在局部区域控制疾病和总生存方面并不逊于腋窝淋巴结清扫(ALND)。结论:除了更新机构数据外,分析证实pN0和pN1亚群之间以及pN2和pN3亚群之间的前期手术患者的总生存期和局部疾病控制相似,但pN0-1和pN2-3之间存在统计学差异。目前正在进行的前瞻性观察性多中心临床试验旨在将这些结果的意义转化为新辅助时代。
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引用次数: 0
Comparison of two planning techniques (FiF/IMRT) for postoperative radiation therapy of prostate cancer 两种计划技术(FiF/IMRT)在前列腺癌术后放疗中的比较
Q4 Medicine Pub Date : 2020-12-21 DOI: 10.20471/LO.2020.48.02-03.09
N. Obajdin, Đeni Smoilović-Radojčić, Dag Zahirović, Manda Švabić-Kolacio, David Rajlić, ingrid Belac-Lovasić, S. Jurković
Introduction: Within the past two decades, we made significant progress in radiation therapy for prostate cancer. At UH Rijeka IMRT became the technique of choice for radiation therapy following radical prostatectomy since 2016. Previously, an advanced 3-DCRT technique using the field-in-field (FiF) method was used for dose distribution optimization around target volumes and organs-at-risk. This research has been performed to investigate the influence of planning technique choice (FiF or IMRT) on coverage of target volumes with prescribed dose and organs-at-risk sparing. Materials and methods: Comparison of dose distributions calculated using FiF and IMRT techniques was performed retrospectively for ten patients who underwent postoperative radiotherapy. The prescribed dose for all patients was delivered using IMRT, and for this research, we also calculated dose distributions using the FiF technique. For FiF and IMRT techniques, we used linear accelerator photon beams. To determine the influence of planning technique on dose distribution parameters related to target volumes (GTV, CTV, PTV1, PTV2) were analyzed. For organs-at-risk sparing evaluation (rectum, bladder, femoral heads), we used dose-volume constraints. Results and discussion: The analysis of parameters related to target volumes has shown that most of them had no statistically significant difference (V100%(GTV), V100%(CTV), V95%(PTV2), V95%(PTV1)). For both planning techniques, internationally set dose constraints were achieved. Statistically, we found a significant difference for V100%(PTV2), p=0,000534, and V100%(PTV1), p=0,042944 in favor of IMRT. A statistically significant difference (p=0,045966) was found for the volume of the rectum, which receives 40Gy, and for the volume of femoral heads, which receives 30Gy (p=0,000385), where the sparing is better for IMRT. For dose-volume constraints related to the bladder, no statistically significant differences were found. Conclusion: Results of this research show a statistically significant difference for V100% target volume coverage for PTV1 and PTV2, with better dose coverage accomplished by IMRT. Concerning organs-at-risk sparing, a statistically significant difference in favor of IMRT was found for rectum volume, which receives 40Gy. Expectedly, IMRT was superior to the FiF technique. However, differences between the two planning techniques were relatively small, which points to the fact that the FiF technique is viable as a technique of choice.
在过去的二十年里,我们在前列腺癌的放射治疗方面取得了重大进展。在里耶卡大学,自2016年以来,IMRT成为根治性前列腺切除术后放射治疗的首选技术。在此之前,一种先进的3-DCRT技术使用场中场(field-in-field, FiF)方法来优化靶体积和危险器官周围的剂量分布。本研究旨在探讨计划技术选择(FiF或IMRT)对规定剂量靶体积覆盖和高危器官保留的影响。材料与方法:回顾性比较10例术后放疗患者使用FiF和IMRT技术计算的剂量分布。所有患者的处方剂量均使用IMRT,在本研究中,我们还使用FiF技术计算剂量分布。对于FiF和IMRT技术,我们使用了线性加速器光子束。分析规划技术对靶体积(GTV、CTV、PTV1、PTV2)相关剂量分布参数的影响。对于保留危险器官(直肠、膀胱、股骨头)的评估,我们使用了剂量-容量限制。结果与讨论:靶容积相关参数分析显示,多数指标(V100%(GTV)、V100%(CTV)、V95%(PTV2)、V95%(PTV1))无统计学差异。对于这两种规划技术,都达到了国际设定的剂量限制。统计学上,我们发现V100%(PTV2), p= 0.000534, V100%(PTV1), p= 0.042944有利于IMRT。直肠体积(40Gy)和股骨头体积(30Gy)的差异有统计学意义(p=0,045966),其中IMRT的保留效果更好。对于与膀胱相关的剂量-容量限制,没有发现统计学上的显著差异。结论:本研究结果显示PTV1和PTV2的V100%靶体积覆盖率差异有统计学意义,IMRT的剂量覆盖率更好。对于有危险的器官,直肠体积的IMRT有统计学上的显著差异,直肠体积接受40Gy。预期IMRT优于FiF技术。然而,两种规划技术之间的差异相对较小,这表明FiF技术作为一种选择技术是可行的。
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引用次数: 0
Management of cancer of unknown primary 原发不明癌症的处理
Q4 Medicine Pub Date : 2020-12-21 DOI: 10.20471/LO.2020.48.02-03.15
Iva Andrašek, M. Ravlić, Martina Mikulandra, F. Cmrečak, Sara Bilić-Knežević, L. Beketić-Orešković
Cancer of an unknown primary site is most commonly an aggressive metastatic tumor with a median patient survival of 6 to 9 months. Histologically, it is predominantly adenocarcinoma, and if the primary site is subsequently diagnosed, it is usually the pancreas or lung. Biopsy should be performed whenever possible to classify a tumor of unknown primary origin into one of the following entities: adenocarcinoma, poorly differentiated carcinoma with characteristics similar to adenocarcinoma, squamous cell carcinoma, neuroendocrine carcinoma, poorly differentiated neoplasm. After determining the primary tumor type, the subtype is determined by immunohistochemical staining. In oligometastatic disease, there is a possibility of surgical treatment. Radiotherapy is used as a part of combined modality treatment. Most patients with cancer of unknown primary have an unfavorable prognosis despite multiple chemotherapy agents, and no protocol can be recommended as standard therapy.
原发部位未知的癌症通常是侵袭性转移性肿瘤,患者的中位生存期为6至9个月。组织学上,它主要是腺癌,如果原发部位随后被诊断,通常是胰腺或肺。只要可能,就应进行活检,将原发不明的肿瘤分为以下几种:腺癌、特征与腺癌相似的低分化癌、鳞状细胞癌、神经内分泌癌、低分化肿瘤。确定原发肿瘤类型后,免疫组化染色确定亚型。对于少转移性疾病,有手术治疗的可能性。放射治疗是综合治疗的一部分。大多数原发不明的癌症患者,尽管使用了多种化疗药物,但预后不良,没有一种方案可以推荐作为标准治疗。
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引用次数: 0
Histopathological features of breast cancer from 2005 to 2019 in a single center in Croatia: an overview of changes following the introduction of mammography screening 2005年至2019年克罗地亚单个中心癌症的组织病理学特征:引入乳房X光检查后的变化概述
Q4 Medicine Pub Date : 2020-07-07 DOI: 10.20471/lo.2020.48.01.03
S. Ramić, M. Perić-Balja, V. Ramljak, Sara Zadro, I. Kirac, T. Orešić, I. Milas
formed difference in logic MATERIALS METHODS: Data was collected retrospectively in a single high volume center for women diag nosed with invasive BC in the period before the introduction of mammography screening (2005-2007; N=1833), and from newly diagnosed (2017-2019; N=2676). Statistical significance of the findings was evaluated using Chi square test. RESULTS: We recorded a 31.5% increase in the number of patients referred to our hospital in the post-screening period. However, no statistically significant reduction in tumor size, histological grade or the number of positive axillary lymph nodes was detected in newly diagnosed BC compared to those diagnosed over ten years ago. The mean age of BC incidence was 61 years, with the mean tumor size of 22 mm (median 18 mm), in both periods. The significant difference occurred in the distribu tion of the intrinsic subtypes of BC (P<.001). About 45% of patients were diagnosed with pT1N0 stage, in both periods. CONCLUSION: In the post-screening period, we treated 32% more newly diagnosed breast cancers. However, patho histological features of BC, along with the average tumor size, did not change.
材料方法:回顾性收集单个高容量中心在引入乳房x线摄影筛查之前诊断为浸润性BC的妇女的数据(2005-2007;N=1833),以及新诊断(2017-2019;N = 2676)。采用卡方检验评价结果的统计学显著性。结果:我们记录了31.5%的患者转诊到我们医院在筛选后的时期。然而,与十年前诊断的BC相比,新诊断的BC在肿瘤大小、组织学分级或阳性腋窝淋巴结数量方面没有统计学上的显著减少。在这两个时期,BC发病的平均年龄为61岁,平均肿瘤大小为22毫米(中位为18毫米)。BC固有亚型的分布差异有统计学意义(P< 0.001)。在这两个时期,约45%的患者被诊断为pT1N0期。结论:在筛查后,我们治疗的新诊断乳腺癌增加了32%。然而,BC的病理组织学特征以及肿瘤的平均大小并没有改变。
{"title":"Histopathological features of breast cancer from 2005 to 2019 in a single center in Croatia: an overview of changes following the introduction of mammography screening","authors":"S. Ramić, M. Perić-Balja, V. Ramljak, Sara Zadro, I. Kirac, T. Orešić, I. Milas","doi":"10.20471/lo.2020.48.01.03","DOIUrl":"https://doi.org/10.20471/lo.2020.48.01.03","url":null,"abstract":"formed difference in logic MATERIALS METHODS: Data was collected retrospectively in a single high volume center for women diag nosed with invasive BC in the period before the introduction of mammography screening (2005-2007; N=1833), and from newly diagnosed (2017-2019; N=2676). Statistical significance of the findings was evaluated using Chi square test. RESULTS: We recorded a 31.5% increase in the number of patients referred to our hospital in the post-screening period. However, no statistically significant reduction in tumor size, histological grade or the number of positive axillary lymph nodes was detected in newly diagnosed BC compared to those diagnosed over ten years ago. The mean age of BC incidence was 61 years, with the mean tumor size of 22 mm (median 18 mm), in both periods. The significant difference occurred in the distribu tion of the intrinsic subtypes of BC (P<.001). About 45% of patients were diagnosed with pT1N0 stage, in both periods. CONCLUSION: In the post-screening period, we treated 32% more newly diagnosed breast cancers. However, patho histological features of BC, along with the average tumor size, did not change.","PeriodicalId":53700,"journal":{"name":"Libri Oncologici","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.20471/lo.2020.48.01.03","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41826287","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}
引用次数: 1
Large fibroepithelial polyp in prostatic urethra of 29-year-old male patient 29岁男性前列腺尿道大纤维上皮息肉
Q4 Medicine Pub Date : 2020-07-07 DOI: 10.20471/lo.2020.48.01.06
T. Kuliš, T. Zekulić, M. Ćorić, M. Marić, N. Knezevic, Ivana Pušenjak, T. Hudolin, Z. Kastelan
1Department of Urology, University Hospital Centre Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia; 2Department of Pathology and Cytology, University Hospital Centre Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia; 3Department of Anesthesiology, Reanimatology and Intensive Care, University Hospital Centre Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
1克罗地亚萨格勒布萨格勒布大学医学院萨格勒布医院中心泌尿外科;2克罗地亚萨格勒布萨格勒布大学医学院萨格勒布医院中心病理学和细胞学系;3克罗地亚萨格勒布萨格勒布大学医学院萨格勒布医院中心麻醉学、再生医学和重症监护科
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引用次数: 0
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Libri Oncologici
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