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Śniadecki M, Guani B, Jaworek P, Klasa-Mazurkiewicz D, Mahiou K, Mosakowska K, Buda A, Poniewierza P, Piątek O, Crestani A, Stasiak M, Balaya V, Musielak O, Piłat L, Maliszewska K, Aristei C, Guzik P, Wojtylak S, Liro M, Gaillard T, Kocian R, Gołąbiewska A, Chmielewska Z, Wydra D. Tertiary prevention strategies for micrometastatic lymph node cervical cancer: A systematic review and a prototype of an adapted model of care. Crit Rev Oncol Hematol 2024; 197:104329. [PMID: 38527594 DOI: 10.1016/j.critrevonc.2024.104329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/29/2024] [Accepted: 03/12/2024] [Indexed: 03/27/2024] Open
Abstract
PURPOSE We found a need for balancing the application of clinical guidelines and tailored approaches to follow-up of cervical cancer (CC) patients in the lymph node micrometastatic (MICs) setting. This review aimed to determine the current knowledge of management of MIC-positive CC cases. METHODOLOGY We addressed prognostic and risk of recurrence monitoring impacts associated with MIC+ cases. The electronic databases for literature and relevant articles were analysed. RESULTS Fifteen studies, (4882 patients), were included in our systematic review. While the results show that MICs significantly worsen prognosis in early CC. A tertiary prevention algorithm for low volume lymph node disease may stratify follow-up according to the burden of nodal disease and provide data that helps improve follow-up performance. CONCLUSION MICs worsen prognosis and should be managed as suggested by the algorithm. However, this algorithm must be externally validated. The clinical impact of isolated tumor cells (ITC) remains unclear.
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Affiliation(s)
- Marcin Śniadecki
- Department of Gynaecology and Obstetrics, Medical University of Gdańsk, Gdańsk, Poland.
| | - Benedetta Guani
- Hospital of Fribourg HFR, Chemin des Pensionnats 2/6, Villars-sur-Glâne 1752, Switzerland
| | - Paulina Jaworek
- Department of Gynaecology and Obstetrics, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Katia Mahiou
- Breast, Gynaecology and Reconstructive Surgery Unit, Institute Curie, Paris, France
| | - Karolina Mosakowska
- Department of Gynaecology and Obstetrics, Medical University of Gdańsk, Gdańsk, Poland
| | - Alessandro Buda
- Department of Gynaecology Oncology, Michele e Pietro Ferrero Hospital, Verduno, Italy
| | | | - Olga Piątek
- Department of Gynaecology and Obstetrics, Medical University of Gdańsk, Gdańsk, Poland
| | - Adrien Crestani
- Department of Gynaecological Surgery, Hospital Tenon, Paris, France
| | - Maria Stasiak
- Department of Gynaecology and Obstetrics, Medical University of Gdańsk, Gdańsk, Poland
| | - Vincent Balaya
- Department of Obstetrics and Gynaecology, Félix Guyon Hospital, CHU La Réunion, La Reunion Island, France
| | - Oliwia Musielak
- Department of Surgical Oncology, Transplant and General Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Luiza Piłat
- Department of Gynaecology and Obstetrics, Medical University of Gdańsk, Gdańsk, Poland
| | - Karolina Maliszewska
- Department of Gynaecology and Obstetrics, Medical University of Gdańsk, Gdańsk, Poland
| | - Cynthia Aristei
- Radiation Oncology Section, Department of Medicine and Surgery, University of Perugia and Perugia General Hospital, Sant'Andrea delle Fratte, Perugia, Italy
| | - Paweł Guzik
- Clinical Department of Gynaecology and Obstetrics, City Hospital Rzeszów, Rzeszów, Poland
| | - Szymon Wojtylak
- Department of Pathology, Medical University of Gdańsk, Gdańsk, Poland
| | - Marcin Liro
- Department of Gynaecology and Obstetrics, Medical University of Gdańsk, Gdańsk, Poland
| | - Thomas Gaillard
- Department of Surgery, Institute Curie, University Paris Cite, Paris, France
| | - Roman Kocian
- Department of Gynaecology, Obstetrics and Neonatology, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Anna Gołąbiewska
- Department of Environmental Technology, Faculty of Chemistry, University of Gdańsk, Gdańsk, Poland
| | - Zuzanna Chmielewska
- Department of Gynaecology and Obstetrics, Medical University of Gdańsk, Gdańsk, Poland
| | - Dariusz Wydra
- Department of Gynaecology and Obstetrics, Medical University of Gdańsk, Gdańsk, Poland
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Westin SN, Moore K, Chon HS, Lee JY, Thomes Pepin J, Sundborg M, Shai A, de la Garza J, Nishio S, Gold MA, Wang K, McIntyre K, Tillmanns TD, Blank SV, Liu JH, McCollum M, Contreras Mejia F, Nishikawa T, Pennington K, Novak Z, De Melo AC, Sehouli J, Klasa-Mazurkiewicz D, Papadimitriou C, Gil-Martin M, Brasiuniene B, Donnelly C, del Rosario PM, Liu X, Van Nieuwenhuysen E. Durvalumab Plus Carboplatin/Paclitaxel Followed by Maintenance Durvalumab With or Without Olaparib as First-Line Treatment for Advanced Endometrial Cancer: The Phase III DUO-E Trial. J Clin Oncol 2024; 42:283-299. [PMID: 37864337 PMCID: PMC10824389 DOI: 10.1200/jco.23.02132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/13/2023] [Accepted: 10/14/2023] [Indexed: 10/22/2023] Open
Abstract
PURPOSE Immunotherapy and chemotherapy combinations have shown activity in endometrial cancer, with greater benefit in mismatch repair (MMR)-deficient (dMMR) than MMR-proficient (pMMR) disease. Adding a poly(ADP-ribose) polymerase inhibitor may improve outcomes, especially in pMMR disease. METHODS This phase III, global, double-blind, placebo-controlled trial randomly assigned eligible patients with newly diagnosed advanced or recurrent endometrial cancer 1:1:1 to: carboplatin/paclitaxel plus durvalumab placebo followed by placebo maintenance (control arm); carboplatin/paclitaxel plus durvalumab followed by maintenance durvalumab plus olaparib placebo (durvalumab arm); or carboplatin/paclitaxel plus durvalumab followed by maintenance durvalumab plus olaparib (durvalumab + olaparib arm). The primary end points were progression-free survival (PFS) in the durvalumab arm versus control and the durvalumab + olaparib arm versus control. RESULTS Seven hundred eighteen patients were randomly assigned. In the intention-to-treat population, statistically significant PFS benefit was observed in the durvalumab (hazard ratio [HR], 0.71 [95% CI, 0.57 to 0.89]; P = .003) and durvalumab + olaparib arms (HR, 0.55 [95% CI, 0.43 to 0.69]; P < .0001) versus control. Prespecified, exploratory subgroup analyses showed PFS benefit in dMMR (HR [durvalumab v control], 0.42 [95% CI, 0.22 to 0.80]; HR [durvalumab + olaparib v control], 0.41 [95% CI, 0.21 to 0.75]) and pMMR subgroups (HR [durvalumab v control], 0.77 [95% CI, 0.60 to 0.97]; HR [durvalumab + olaparib v control] 0.57; [95% CI, 0.44 to 0.73]); and in PD-L1-positive subgroups (HR [durvalumab v control], 0.63 [95% CI, 0.48 to 0.83]; HR [durvalumab + olaparib v control], 0.42 [95% CI, 0.31 to 0.57]). Interim overall survival results (maturity approximately 28%) were supportive of the primary outcomes (durvalumab v control: HR, 0.77 [95% CI, 0.56 to 1.07]; P = .120; durvalumab + olaparib v control: HR, 0.59 [95% CI, 0.42 to 0.83]; P = .003). The safety profiles of the experimental arms were generally consistent with individual agents. CONCLUSION Carboplatin/paclitaxel plus durvalumab followed by maintenance durvalumab with or without olaparib demonstrated a statistically significant and clinically meaningful PFS benefit in patients with advanced or recurrent endometrial cancer.
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Affiliation(s)
| | - Kathleen Moore
- Stephenson Cancer Center at the University of Oklahoma Medical Center, Oklahoma, OK
| | | | - Jung-Yun Lee
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | | | | | - Ayelet Shai
- RAMBAM Health Care Campus, Haifa, and Israeli Society of Gynecologic Oncology (ISGO), Israel
| | | | - Shin Nishio
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Michael A. Gold
- Oklahoma Cancer Specialists and Research Institute, Tulsa, OK
| | - Ke Wang
- Tianjin Medical University Cancer Institute & Hospital, Tianjin, China
| | | | - Todd D. Tillmanns
- West Cancer Center Research Institute & University of Tennessee Health Science Center, Memphis, TN
| | - Stephanie V. Blank
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, and GOG Foundation (GOG-F), USA
| | - Ji-Hong Liu
- Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Michael McCollum
- Virginia Oncology Associates, Brock Cancer Center, Norfolk, VA, and GOG Foundation (GOG-F), USA
| | | | - Tadaaki Nishikawa
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kathryn Pennington
- Fred Hutchinson Cancer Center, University of Washington Medical Center, Seattle, WA
| | - Zoltan Novak
- National Institute of Oncology, Budapest, and Central and Eastern European Gynecologic Oncology Group (CEEGOG), Hungary
| | - Andreia Cristina De Melo
- Clinical Research and Technological Development Division, Brazilian National Cancer Institute, Rio de Janeiro, Brazil
| | - Jalid Sehouli
- Charité—Department of Gynecology with Center of Oncological Surgery, Universitätsmedizin Berlin, Berlin, and North Eastern German Society of Gynecological Oncology (NOGGO), Germany
| | - Dagmara Klasa-Mazurkiewicz
- Department of Obstetrics and Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdańsk, Gdańsk, and Polish Gynecologic Oncology Group (PGOG), Poland
| | - Christos Papadimitriou
- Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, and Hellenic Cooperative Oncology Group (HeCOG), Greece
| | - Marta Gil-Martin
- Medical Oncology Department, Catalan Institute of Oncology-Institut d'Investigació Biomédica de Bellvitge (IDIBELL), Hospital Duran i Reynals, L'Hospitalet-Barcelona, Barcelona, and Grupo Español de Investigación en Cáncer de Ovario (GEICO), Spain
| | - Birute Brasiuniene
- Department of Medical Oncology, National Cancer Institute of Lithuania, Faculty of Medicine of Vilnius University, Vilnius, and Nordic Society of Gynaecological Oncology (NSGO), Lithuania
| | - Conor Donnelly
- Oncology Biometrics, AstraZeneca, Cambridge, United Kingdom
| | | | - Xiaochun Liu
- Oncology R&D, Late-stage Development, AstraZeneca, Gaithersburg, MD
| | - Els Van Nieuwenhuysen
- University Hospital Leuven, Leuven, and Luxembourg Gynaecological Oncology Group (BGOG), Belgium
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Śniadecki M, Jaworek P, Chmielewska Z, Poniewierza P, Stasiak M, Danielkiewicz M, Stencelewski D, Brzeziński M, Boyke ZA, Wycinka E, Sunil M, Nguyen M, Klasa-Mazurkiewicz D, Koziełek K, Rak P, Wolny Y, Liro M, Guzik PW, Dobruch-Sobczak K, Wydra D. Protocol of Breast Cancer Prevention Model with Addition of Breast Ultrasound to Routine Gynecological Visits as a Chance for an Early Diagnosis and Treatment in 25 to 49-Year-Old Polish Females. Diagnostics (Basel) 2023; 13:diagnostics13020227. [PMID: 36673037 PMCID: PMC9857976 DOI: 10.3390/diagnostics13020227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/30/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
The low attendance rate for cancer screening tests in Poland is a major healthcare concern that requires specific analysis and the development of implementation recommendations for prevention, and both actions are likely to benefit culturally similar countries. Four female cancers account for approximately 20% of all cancer cases-breast cancer, cervical cancer, endometrial cancer, and ovarian cancer-suggesting that gynecologists have a significant preventative role. Of the four, breast cancer and cervical cancer are among the 10 most common malignant neoplasms globally, regardless of gender, occur only in women and are known to have effective screening measures. Our research aims to create a screening model that combines cervical cancer and breast cancer to maximize health outcomes for women at risk of both cancers. In the study protocol, we have created a model that maximizes benefits for patients with minimal additional costs to the health care system. To achieve the set goal, instead of regular clinical breast exams as recommended by the gynecological societies, we proposed an ultrasound examination, during which palpation may also be performed (in the absence of elastography). We present a scheme for such a protocol that takes into consideration all types of prevention in both cancers, and that emphasizes breast ultrasound as the most frequently missing element. Our study includes a discussion of the strengths and weaknesses of our strategy, and the crucial need for infrastructure and education for the successful implementation of the program. We conclude that our model merits consideration and discussion among health-care decision makers, as the screening changes we propose have significant potential benefits for the female population.
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Affiliation(s)
- Marcin Śniadecki
- Department of Gynecology and Obstetrics, Medical University of Gdańsk, 80-210 Gdańsk, Poland
- Correspondence: ; Tel.: +48-501-337-941
| | - Paulina Jaworek
- Department of Gynecology and Obstetrics, Medical University of Gdańsk, 80-210 Gdańsk, Poland
- The American Health Information Management Association (AHIMA), 60601-5809 Chicago, IL, USA
- Air Chair, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Zuzanna Chmielewska
- Department of Gynecology and Obstetrics, Medical University of Gdańsk, 80-210 Gdańsk, Poland
- Air Chair, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Patryk Poniewierza
- Medicover, Al. Jerozolimskie 96, 00-807 Warszawa, Poland
- Faculty of Medicine, Lazarski University, Swieradowska 43, 02-662 Warsaw, Poland
| | - Maria Stasiak
- Department of Gynecology and Obstetrics, Medical University of Gdańsk, 80-210 Gdańsk, Poland
- Air Chair, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Martyna Danielkiewicz
- Department of Gynecology and Obstetrics, Medical University of Gdańsk, 80-210 Gdańsk, Poland
- Air Chair, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Damian Stencelewski
- Department of Gynecology and Obstetrics, Medical University of Gdańsk, 80-210 Gdańsk, Poland
- Air Chair, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Michał Brzeziński
- Department of Gynecological Oncology, PCK Marine Hospital in Gdynia, 81-519 Gdynia, Poland
- Department of Oncological Propedeutics, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Zuzanna Anna Boyke
- Department of Art History, Faculty of History, University of Gdansk, 80-309 Gdańsk, Poland
| | - Ewa Wycinka
- Department of Statistics, Faculty of Management, University of Gdansk, 81-824 Sopot, Poland
| | - Medha Sunil
- Department of Gynecology and Obstetrics, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Marie Nguyen
- Department of Gynecology and Obstetrics, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | | | - Krzysztof Koziełek
- Mammography Laboratory, HCP Medical Center, Hospital St. John Paul II, 61-001 Poznan, Poland
| | - Piotr Rak
- Wyspa Medycyny Przyjaznej [The Island of Friendly Medicine], 80-747 Gdańsk, Poland
| | - Yvonne Wolny
- Amita Health St. Joseph Hospital Chicago, Chicago, IL 60657, USA
| | - Marcin Liro
- Department of Gynecology and Obstetrics, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Paweł Władysław Guzik
- Clinical Department of Gynecology and Obstetrics, City Hospital, 35-241 Rzeszów, Poland
| | - Katarzyna Dobruch-Sobczak
- Ultrasound Department, Institute of Fundamental Technological Research, Polish Academy of Sciences, 02-106 Warsaw, Poland
- Radiology Department II, Maria Sklodowska-Curie National Research Institute of Oncology, 00-001 Warsaw, Poland
| | - Dariusz Wydra
- Department of Gynecology and Obstetrics, Medical University of Gdańsk, 80-210 Gdańsk, Poland
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Śniadecki M, Poniewierza P, Jaworek P, Szymańczyk A, Andersson G, Stasiak M, Brzeziński M, Bońkowska M, Krajewska M, Konarzewska J, Klasa-Mazurkiewicz D, Guzik P, Wydra DG. Thousands of Women’s Lives Depend on the Improvement of Poland’s Cervical Cancer Screening and Prevention Education as Well as Better Networking Strategies Amongst Cervical Cancer Facilities. Diagnostics (Basel) 2022; 12:diagnostics12081807. [PMID: 35892517 PMCID: PMC9394414 DOI: 10.3390/diagnostics12081807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/20/2022] [Accepted: 07/23/2022] [Indexed: 11/21/2022] Open
Abstract
Proper targeted cancer prophylaxis reduces the incidence of cancer in all forms; this includes cancers with significant progression potential and poor prognosis. Based on the assumption that one of the risk factors of cervical cancer is the avoidance of screening tests, we analyzed the current scenario of cervical cancer (CC) screening and recommendations in Poland (country with a well-off socioeconomic status). Based on the comprehensive literature review concerning documents of guidelines and recommendations of various bodies, including national ones, data on the implementation of CC screening in Poland, and different models for medium-to-high-income countries, we proposed how the CC screening strategy could be improved. Finally, the new strategy was further developed for those who are prone to not being screened. The proposal on how to improve the Polish CC screening program is the following: refinement of the public education on CC risk factors, popularization of CC screening incentives amongst the public, and improvement of networking strategies between CC screening facilities (“cervical screening clinical”), allowing screenings to be more efficient and rapid. We believe that, to enhance the future quality of life of those with rapid CC progression by catching the disease preemptively and limiting the sequelae of the disease, we have to improve education and access to medical services.
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Affiliation(s)
- Marcin Śniadecki
- Department of Obstetrics and Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.J.); (A.S.); (G.A.); (M.S.); (M.K.); (D.K.-M.); (D.G.W.)
- Correspondence: ; Tel.: +48-501-337-941
| | | | - Paulina Jaworek
- Department of Obstetrics and Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.J.); (A.S.); (G.A.); (M.S.); (M.K.); (D.K.-M.); (D.G.W.)
| | - Ada Szymańczyk
- Department of Obstetrics and Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.J.); (A.S.); (G.A.); (M.S.); (M.K.); (D.K.-M.); (D.G.W.)
| | - Gorm Andersson
- Department of Obstetrics and Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.J.); (A.S.); (G.A.); (M.S.); (M.K.); (D.K.-M.); (D.G.W.)
| | - Maria Stasiak
- Department of Obstetrics and Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.J.); (A.S.); (G.A.); (M.S.); (M.K.); (D.K.-M.); (D.G.W.)
| | - Michał Brzeziński
- Department of Gynecologic Oncology, PCK Marine Hospital in Gdynia, 81-519 Gdynia, Poland;
| | - Małgorzata Bońkowska
- Emergency Department, University Clinical Center in Gdańsk, 80-952 Gdańsk, Poland;
| | - Magdalena Krajewska
- Department of Obstetrics and Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.J.); (A.S.); (G.A.); (M.S.); (M.K.); (D.K.-M.); (D.G.W.)
| | - Joanna Konarzewska
- Department of Radiology, Medical University of Gdańsk, 80-210 Gdańsk, Poland;
| | - Dagmara Klasa-Mazurkiewicz
- Department of Obstetrics and Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.J.); (A.S.); (G.A.); (M.S.); (M.K.); (D.K.-M.); (D.G.W.)
| | - Paweł Guzik
- Clinical Department of Gynecology and Obstetrics, City Hospital Rzeszów, 35-241 Rzeszów, Poland;
| | - Dariusz Grzegorz Wydra
- Department of Obstetrics and Gynecology, Gynecological Oncology and Gynecological Endocrinology, Medical University of Gdańsk, 80-210 Gdańsk, Poland; (P.J.); (A.S.); (G.A.); (M.S.); (M.K.); (D.K.-M.); (D.G.W.)
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5
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Jassem-Bobowicz JM, Klasa-Mazurkiewicz D, Żawrocki A, Stefańska K, Domżalska-Popadiuk I, Kwiatkowski S, Preis K. Prediction Model for Bronchopulmonary Dysplasia in Preterm Newborns. Children (Basel) 2021; 8:children8100886. [PMID: 34682151 PMCID: PMC8534367 DOI: 10.3390/children8100886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE: To develop a multifactorial model that allows the prediction of bronchopulmonary dysplasia (BPD) in preterm newborns. MATERIALS AND METHODS: A single-center retrospective study of infants born below 32 + 0 weeks gestational age. We created a receiver operating characteristic curve to assess the multifactorial BPD risk and calculate the BPD risk accuracy using the area under the curve (AUC). BPD risk was categorized using a multifactorial predictive model based on the weight of the evidence. RESULTS: Of the 278 analyzed preterm newborns, 127 (46%) developed BPD. The significant risk factors for BPD in the multivariate analysis were gestational age, number of red blood cell concentrate transfusions, number of surfactant administrations, and hemodynamically significant patent ductus arteriosus. The combination of these factors determined the risk of developing BPD, with an AUC value of 0.932. A multifactorial predictive model based on these factors, weighted by their odds ratios, identified four categories of newborns with mean BPD risks of 9%, 59%, 82%, and 100%. CONCLUSION: A multifactorial model based on easily available clinical factors can predict BPD risk in preterm newborns and inform potential preventive measures.
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Affiliation(s)
- Joanna Maria Jassem-Bobowicz
- Department of Neonatology, Medical University of Gdańsk, 80-214 Gdańsk, Poland;
- Correspondence: ; Tel.: +48-58-584-41-48
| | - Dagmara Klasa-Mazurkiewicz
- Department of Gynaecology and Oncological Gynaecology, Medical University of Gdańsk, 80-214 Gdańsk, Poland;
| | - Anton Żawrocki
- Department of Pathology, Specialist Hospital in Wejherowo, 84-200 Wejherowo, Poland;
| | - Katarzyna Stefańska
- Department of Obstetrics, Medical University of Gdańsk, 80-214 Gdańsk, Poland; (K.S.); (K.P.)
| | | | - Sebastian Kwiatkowski
- Department of Obstetrics and Gynecology, Pomeranian Medical University of Szczecin, 70-111 Szczecin, Poland;
| | - Krzysztof Preis
- Department of Obstetrics, Medical University of Gdańsk, 80-214 Gdańsk, Poland; (K.S.); (K.P.)
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Michalik A, Wójcicka L, Zdun-Ryżewska A, Czerwińska-Osipiak A, Krzemiński M, Olszewska J, Klasa-Mazurkiewicz D, Huizink AC. Polish Adaptation of the Pregnancy-Related Anxiety Questionnaire-Revised 2 for All Pregnant Women. Healthcare (Basel) 2021; 9:917. [PMID: 34356295 PMCID: PMC8307515 DOI: 10.3390/healthcare9070917] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 11/16/2022] Open
Abstract
Pregnancy-related anxiety (PrA) is a specific type of anxiety characteristic of the perinatal period. PrA can affect pregnancy and birth. However, no validated tool exists to measure PrA in Polish obstetric practice. The aim of this study was to translate the Pregnancy-Related Anxiety Questionnaire-Revised 2 (PRAQ-R2) into Polish and to evaluate its reliability and factorial and construct validity. This study was conducted in Poland as an online questionnaire in April 2020 and included 175 healthy women. To validate the PRAQ-R2, we used standardized tools for the measurement of general anxiety: the modified Visual Analog Scale (VAS), the Ten-Item Personality Inventory (TIPI), and the Hospital Anxiety and Depression Scale (HADS). Scale reliability was assessed using Cronbach's alpha. Concurrent validity was evaluated by calculating Spearman's rho correlation coefficients. Statistical analyses were performed using R ver. 4.0.2. Values for comparative fit index >0.90, Tucker-Lewis index >0.90, and root mean square error of approximation <0.08 indicated acceptable model fit, confirming the reliability of the three-factor structure of the translation. The subscales and total scores had good consistency (α > 0.7), and convergent validity was demonstrated. The PRAQ-R2 as translated into Polish represents the first validated tool in Poland to measure PrA for all pregnant women.
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Affiliation(s)
- Anna Michalik
- Department of Obstetrical and Gynaecological Nursing, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.M.); (L.W.); (A.C.-O.); (J.O.)
| | - Lucyna Wójcicka
- Department of Obstetrical and Gynaecological Nursing, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.M.); (L.W.); (A.C.-O.); (J.O.)
| | - Agata Zdun-Ryżewska
- Department of Quality of Life Research, Medical University of Gdansk, 80-210 Gdansk, Poland;
| | - Agnieszka Czerwińska-Osipiak
- Department of Obstetrical and Gynaecological Nursing, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.M.); (L.W.); (A.C.-O.); (J.O.)
| | - Michał Krzemiński
- Institute of Applied Mathematics, Faculty of Applied Physics and Mathematics, Gdansk University of Technology, 80-233 Gdansk, Poland;
| | - Jolanta Olszewska
- Department of Obstetrical and Gynaecological Nursing, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.M.); (L.W.); (A.C.-O.); (J.O.)
| | - Dagmara Klasa-Mazurkiewicz
- Department of Gynaecology, Oncologic Gynaecology and Gynaecological Endocrinology, Medical University of Gdansk, 80-214 Gdansk, Poland;
| | - Anja C. Huizink
- Department of Clinical Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
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Śniadecki M, Brzeziński M, Darecka K, Klasa-Mazurkiewicz D, Poniewierza P, Krzeszowiec M, Kmieć N, Wydra D. BARD1 and Breast Cancer: The Possibility of Creating Screening Tests and New Preventive and Therapeutic Pathways for Predisposed Women. Genes (Basel) 2020; 11:genes11111251. [PMID: 33114377 PMCID: PMC7693009 DOI: 10.3390/genes11111251] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 10/10/2020] [Indexed: 02/07/2023] Open
Abstract
Current oncological developments are based on improved understanding of genetics, and especially the discovery of genes whose alterations affect cell functions with consequences for the whole body. Our work is focused on the one of these genes, BRCA1-associated RING domain protein 1 (BARD1), and its oncogenic role in breast cancer. Most importantly, the study points to new avenues in the treatment and prevention of the most frequent female cancer based on BARD1 research. The BARD1 and BRCA1 (BReast CAncer type 1) proteins have similar structures and functions, and they combine to form the new molecule BARD1-BRCA1 heterodimer. The BARD1-BRCA1 complex is involved in genetic stabilization at the cellular level. It allows to mark abnormal DNA fragments by attaching ubiquitin to them. In addition, it blocks (by ubiquitination of RNA polymerase II) the transcription of damaged DNA. Ubiquitination, as well as stabilizing chromatin, or regulating the number of centrosomes, confirms the protective cooperation of BARD1 and BRCA1 in the stabilization of the genome. The overexpression of the oncogenic isoforms BARD1β and BARD1δ permit cancer development. The introduction of routine tests, for instance, to identify the presence of the BARD1β isoform, would make it possible to detect patients at high risk of developing cancer. On the other hand, introducing BARD1δ isoform blocking therapy, which would reduce estrogen sensitivity, may be a new line of cancer therapy with potential to modulate responses to existing treatments. It is possible that the BARD 1 gene offers new hope for improving breast cancer therapy.
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Affiliation(s)
- Marcin Śniadecki
- Department of Gynecology, Gynecologic Endocrinology and Gynecologic Oncology, Medical University of Gdańsk, Prof. Marian Smoluchowski Str. No. 17, 80-214 Gdańsk, Poland; (M.B.); (D.K.-M.); (M.K.); (D.W.)
- Correspondence: ; Tel.: +48-501-337-941
| | - Michał Brzeziński
- Department of Gynecology, Gynecologic Endocrinology and Gynecologic Oncology, Medical University of Gdańsk, Prof. Marian Smoluchowski Str. No. 17, 80-214 Gdańsk, Poland; (M.B.); (D.K.-M.); (M.K.); (D.W.)
| | - Katarzyna Darecka
- St. Adalbert’s Hospital, Department of Gynecology and Obstetrics, St. Jean Paul 2nd No. 50 Avenue, 80-462 Gdańsk, Poland;
| | - Dagmara Klasa-Mazurkiewicz
- Department of Gynecology, Gynecologic Endocrinology and Gynecologic Oncology, Medical University of Gdańsk, Prof. Marian Smoluchowski Str. No. 17, 80-214 Gdańsk, Poland; (M.B.); (D.K.-M.); (M.K.); (D.W.)
| | - Patryk Poniewierza
- Warsaw College of Engineering and Health, The Battle of Warsaw 1920. Str. No. 18, 02-366 Warsaw, Poland;
| | - Marta Krzeszowiec
- Department of Gynecology, Gynecologic Endocrinology and Gynecologic Oncology, Medical University of Gdańsk, Prof. Marian Smoluchowski Str. No. 17, 80-214 Gdańsk, Poland; (M.B.); (D.K.-M.); (M.K.); (D.W.)
| | - Natalia Kmieć
- Department of Oncology and Radiotherapy, University Clinical Center in Gdańsk, Prof. Marian Smoluchowski Str. No. 17, 80-214 Gdańsk, Poland;
| | - Dariusz Wydra
- Department of Gynecology, Gynecologic Endocrinology and Gynecologic Oncology, Medical University of Gdańsk, Prof. Marian Smoluchowski Str. No. 17, 80-214 Gdańsk, Poland; (M.B.); (D.K.-M.); (M.K.); (D.W.)
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Sniadecki M, Swierzko A, Dabkowski M, Orlowska-Volk M, Wycinka E, Klasa-Mazurkiewicz D, Milewska A, Poniewierza P, Liro M, Wydra D. New therapeutic approaches in the treatment of node-positive cervical cancer patients based on molecular targets: a systematic review. Ginekol Pol 2020; 90:336-345. [PMID: 31276186 DOI: 10.5603/gp.2019.0062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 06/04/2019] [Accepted: 06/05/2019] [Indexed: 11/25/2022] Open
Abstract
Cervical uterine cancer is the second most frequent female cancer worldwide and a substantial burden for low-income societies and the patients themselves. Understanding the molecular mechanisms of metastasis permits the development of therapies that limit tumor progression, as well as providing health and social benefits. Pathomorphology is still the basis of research and a reference standard for molecular analysis. The aim of our study was to research and critically evaluate clinical trials that use new oncological approaches for node-positive cervical cancer to gain an insight into the molecular mechanisms of tumor metastasis. INCLUSION CRITERIA node-positive disease at baseline; at least a first phase clinical study comprising adult female patients; novel clinical approach (e.g., radiotherapy, immunotherapy, targeted therapy, vaccines, radiosurgery); histologic measurement of treatment efficacy (preferably lymph node ultrastaging); and publications in English language only. INFORMATION SOURCES US Clinical trials registry, EU Clinical trials register, ISRCTN registry, and Ovid, EBSCO and Cochrane Collaboration databases. Access dates: from January 2010 to April 2018. EXCLUSIONS Abstracts that did not meet the inclusion criteria or with unreliable data. We collected complete data (e.g., the entire publication associated with included abstracts, heterogeneity examination of individual studies, and validity measurement of the statistical methods used). Results were analyzed in relation to the most recent understanding of the pathogenesis of cervical cancer metastasis. We proposed a possible direction for drug treatment of epithelial tumors based on the mechanisms of metastasis.
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Affiliation(s)
- Marcin Sniadecki
- Department of Gynecology, Gynecologic Oncology and Gynecologic Endocrinology, Medical University of Gdansk, Gdansk, Poland.
| | - Anna Swierzko
- Polish Academy of Sciences, Institute for Medical Biology, Lodz, Poland
| | - Mateusz Dabkowski
- M. Sklodowska-Curie Institute - Oncology Center, Brachytherapy Facility, Warsaw, Poland
| | | | - Ewa Wycinka
- Department of Statistics, Faculty of Management, Gdansk University, Sopot, Poland
| | | | | | | | - Marcin Liro
- Department of Gynecology, Gynecologic Oncology and Gynecologic Endocrinology, Medical University of Gdansk, Gdansk, Poland
| | - Dariusz Wydra
- Department of Gynecology, Gynecologic Oncology and Gynecologic Endocrinology, Medical University of Gdansk, Gdansk, Poland
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Milczek T, Klasa-Mazurkiewicz D, Wydra D. Complications associated with 9-10Fr venous access port use in adjuvant intraperitoneal chemotherapy after a cytoreductive surgery in ovarian cancer patients. Adv Med Sci 2015; 60:216-9. [PMID: 25863871 DOI: 10.1016/j.advms.2015.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Revised: 02/23/2015] [Accepted: 03/19/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE To determine the complication rate associated with using a single-lumen intravenous access port with a silicone catheter of 9-10Fr size in the intraperitoneal treatment, including hyperthermic intraperitoneal chemotherapy, in ovarian cancer. PATIENTS/METHODS We reviewed 27 patients who had subcutaneous venous access ports placed for the administration of IP chemotherapy. With four patients, the catheter was implanted during a hyperthermic intraperitoneal chemotherapy-related laparotomy using the closed technique. Each case was categorized as to the number of cycles of IP therapy received. RESULTS Seven catheter-related complications were noted. These were divided into two categories: six malfunctions (24%) and one infection (4%). Overall, of the patients who had IP catheters placed and received IP chemotherapy, 13 (54.2%) were able to complete the six regimens. Among the four (14.8%) patients who had the catheters planted directly following the HIPEC, one experienced a catheter leak, one an infection and one concluded the treatment successfully; one is still being treated. CONCLUSIONS A subcutaneous single-lumen intravenous access port with a silicone catheter of a large size (9-10Fr) is related to a lower rate of catheter-related complications than previously reported open-ended Tenckhoff catheter treatment. An additional advantage is the possibility of removing the catheter as an office procedure under local anesthesia. Intraperitoneal chemotherapy following a HIPEC procedure may cause increased occurrence of catheter-related complications. As of 2010 we have been using silicone subcutaneous catheters in our center.
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Laudański P, Kowalczuk O, Klasa-Mazurkiewicz D, Milczek T, Rysak-Luberowicz D, Garbowicz M, Baranowski W, Charkiewicz R, Szamatowicz J, Chyczewski L. Selective gene expression profiling of mTOR-associated tumor suppressor and oncogenes in ovarian cancer. Folia Histochem Cytobiol 2011; 49:317-24. [DOI: 10.5603/fhc.2011.0044] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Klasa-Mazurkiewicz D, Jarząb M, Milczek T, Lipińska B, Emerich J. Clinical significance of VEGFR-2 and VEGFR-3 expression in ovarian cancer patients. POL J PATHOL 2011; 62:31-40. [PMID: 21574104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
The vascular endothelial growth factor (VEGF) family and VEGF receptors (VEGFR) play an essential role in angiogenesis and lymphangiogenesis. The aim of this study was to clarify the prognostic significance of VEGFR expression in ovarian carcinoma. Levels of VEGFR-2 and VEGFR-3 tissue expression in human ovarian tumours were assayed by immunoblotting and the correlations between analysed factors and clinicopathological features were examined. Tissue samples consisted of 42 benign and 10 borderline (low malignant potential - LMP) tumours, 76 ovarian carcinomas, 8 Krukenberg tumours and 32 normal ovarian tissues. The highest relative level of VEGFR-2 was detected in cases with at the early stages of cancer development. The highest level of VEGFR-3 was detected advanced cancer stages and those with Krukenberg tumours. Overexpression of VEGFR-3 was found to correlate with the debulking status (p = 0.02) and positive response to chemotherapy (p = 0.04). A statistically significant longer progression free survival (PFS) was observed in women with a low than with a high expression of VEGFR-3 (p = 0.01). Increased levels of VEGFR-2 expression at the early stages of ovarian cancer may indicate the significance of neoangiogenesis at these stages. Overexpression of VEGFR-3 reflects the aggressiveness of ovarian carcinoma spread and has a predictive value for identifying high-risk patients with poor prognosis.
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Klasa-Mazurkiewicz D, Milczek T, Jarzab M, Narkiewicz J, Lipiñska B, Wydra D. Clinical significance of selected angiogenesis and lymphangiogenesis modulators and markers in ovarian cancer patients. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.5119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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13
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Milczek T, Klasa-Mazurkiewicz D, Emerich J, Kobierski J. Second line platinum-based intraperitoneal chemotherapy for advanced ovarian cancer. Acta Obstet Gynecol Scand 2009; 88:463-7. [PMID: 19235559 DOI: 10.1080/00016340902777525] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To report the results of ovarian cancer treatment, where a regimen of intravenous cyclophosphamide followed by intraperitoneal cisplatin or carboplatin was administered as second line treatment. DESIGN Retrospective observational study on 198 women with stage I-IV histologically documented epithelial ovarian cancer after one or more prior regimens of chemotherapy. SETTING University tertiary referral clinic, Gdansk, Poland. METHODS The study group was recruited from among 593 ovarian cancer patients treated between January 1996 and December 2006. Conditions of inclusion for intraperitoneal treatment were: relapse or recurrence of disease after surgery followed by first line treatment. Recurrences were confirmed through re-staging laparotomy or second-look laparotomy. Patients received 90 mg/m(2) cisplatin, or carboplatin AUC 6 intraperitoneally and cyclophosphamide 750 mg/m(2) intravenously. Four or six courses were planned for each patient. MAIN OUTCOME MEASURES Response to treatment defined as complete or partial response, or progressive disease, and survival rates. RESULTS There were 67 (34%) with complete and 61 (31%) with partial response, while 69 (35%) developed progressive disease. Median survival from the initiation of intraperitoneal chemotherapy (IP) was 51 months and significantly longer for patients who received four cycles of IP: 78 months vs. 20 months for patients who received six intraperitoneal cycles. CONCLUSIONS IP can be used in second line treatment of ovarian cancer, but six treatment cycles appear associated with worse results compared to four.
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Affiliation(s)
- Tomasz Milczek
- Department of Gynecology and Gynecologic Oncology, Medical University of Gdansk, Poland.
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Klasa-Mazurkiewicz D, Narkiewicz J, Milczek T, Lipińska B, Emerich J. Maspin overexpression correlates with positive response to primary chemotherapy in ovarian cancer patients. Gynecol Oncol 2009; 113:91-8. [DOI: 10.1016/j.ygyno.2008.12.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2008] [Revised: 12/23/2008] [Accepted: 12/29/2008] [Indexed: 10/21/2022]
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Narkiewicz J, Klasa-Mazurkiewicz D, Zurawa-Janicka D, Skorko-Glonek J, Emerich J, Lipinska B. Changes in mRNA and protein levels of human HtrA1, HtrA2 and HtrA3 in ovarian cancer. Clin Biochem 2008; 41:561-9. [PMID: 18241672 DOI: 10.1016/j.clinbiochem.2008.01.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2007] [Revised: 12/17/2007] [Accepted: 01/07/2008] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Expression of human HtrA1, HtrA2, HtrA3 and TGF-beta1 genes was examined in ovarian tissue specimens including 19 normal ovaries, 20 benign tumors, 7 borderline tumors, 44 cancers and 8 Krukenberg tumors. DESIGN AND METHODS mRNA and protein levels were evaluated by semi-quantitative RT-PCR and Western-blotting methods, respectively. RESULTS A statistically significant decrease of HtrA1 and HtrA3 expression in ovarian tumors comparing to normal tissues was observed. A dramatic decrease of HtrA3 mRNA and protein levels in all tumor tissue groups, and a loss of HtrA3 protein in 30% malignant tumors were found. A significant decrease of HtrA1 mRNA, and of HtrA3 mRNA and protein in malignant tumors compared to benign tumors was revealed. HtrA2 expression in tumor tissues was slightly decreased. Expression of TGF-beta1 in tumor tissues was not significantly different compared to control tissues. CONCLUSIONS Our results show downregulation of HtrA1 and HtrA3 genes' expression in different types of ovarian tumors and give additional evidence that these genes may function as tumor suppressors.
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Affiliation(s)
- Joanna Narkiewicz
- Department of Biochemistry, University of Gdansk, Kladki 24, 80-822 Gdansk, Poland
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Gołka KA, Klasa-Mazurkiewicz D, Milczek T, Emerich J. [A rare case of post-partum urethrovaginal fistula. Management of obstetric complications]. Ginekol Pol 2008; 79:56-59. [PMID: 18510052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
A rare case of a 22-year old patient with obstetric urethrovaginal fistula, resulting in urinary incontinence, has been reported in the following report The emphasis is put on a number of medical and social consequences related to the formation of the fistula. Authors have presented the diagnostic difficulties. The aim of the report is to draw attention to the probable complications following prolonged labour and the necessity of appropriate treatment.
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Milczek T, Gołka K, Klasa-Mazurkiewicz D, Emerich J. [The course of actinomycosis of female reproductive organs mimicking ovarian cancer--the diagnostic limits and difficulties]. Ginekol Pol 2006; 77:957-61. [PMID: 17373123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
Abstract
A case of actinomycosis presenting as tubo-ovarian abscess, misdiagnosed as ovarian malignancy in 54-year old woman with IUD is reported. Author presents the diagnostic problems due to uncommon location, no reliable clinical manifestation and nonspecific CT imaging findings, based on current literature. Knowledge of the characteristic features may help one consider the possibility of actinomycetic infection in the differential diagnosis, in patients with a previous history of predisposing factors and treat them appropriately.
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Milczek T, Klasa-Mazurkiewicz D, Emerich J, Debniak J. [Prognostic significance of Sphase fraction in ovarian cancer patients]. Ginekol Pol 2006; 77:840-7. [PMID: 17378122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
Abstract
INTRODUCTION The established of prognostics factors in ovarian cancer patients can be used to predict the outcome of the disease, and gives possibilities to identified the group of patients who must be treated more aggressive. Some authors believe that (SPF) is prognostic factor in ovarian cancer. AIM OF THE STUDY Evaluation of prognostic significance of S phase fraction in ovarian cancer patients determined by flow cytometric (FC) analysis. MATERIAL AND METHODS Percent of S phase fraction by FC was investigated in group of 102 ovarian cancer patients from freshfrozen samples. FIGO: I--18 (17.65%), II--10 (9.8%), III--66 (64.7%), IV--8 (7.85%). Histopathologic grades (G): G1--u 30 (29.5%), (G2)--43 (42.16%), G3--26 (25.5%), Gx--2.94%). Serous tumours--66 (64.7%), endometrioid--5 (14.7%), undifferentiated--10 (9.8%), mucinous--7 (6.9%), clear cell tumours--4 (3.9%). The oldest patient was 82 and the youngest 24 mean 54 years. After primary citoreductive surgery patients was treated with intravenous chemotherapy 6 cycles. Tissue was fixed in liquid nitrogen (-195 degrees C), and after different period of time prepared according Vidlov method. SPF was measured with FACScan flow cytometr (FACS-Calibur Becton-Dickinson). In statistical analysis established confidential level was 95% (p < 0.05). RESULTS We excluded 7 patients from the study. Average SPF in whole group--13.0637% (0.58-57.62), average SPF in aneuploidy group--13.536% standard deviation (SD)--10.71, in diploidy group--12.365%, SD 10.63. No differentiation between groups was found p = 0.66. We did not find, in whole group a ny influence of SPF on survival p = 0.992. CONCLUSION S-phase fraction has no prognostic significance in ovarian cancer.
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Milczek T, Klasa-Mazurkiewicz D, Emerich J, Debniak J. [DNA ploidy and results of first line chemotherapy in ovarian cancer patients]. Ginekol Pol 2006; 77:589-96. [PMID: 17076189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
AIM OF THE STUDY The prognostic significance of DNA ploidy in ovarian cancer patients determined by flow cytometric analysis, in correlation with effectiveness of first line chemotherapy. MATERIAL AND METHODS DNA ploidy by FC was investigated in group of 102 ovarian cancer patients from fresh frozen samples (4 patients was excluded from the study). RESULTS Positive answer for first line treatment we notified in 64(62,75%) cases, lack of answer 34 (37,25%) patients. Aneuploidy was more frequent in negative group 31(91,18%), diploid tumours occurred in 3(8.82%) cases. In positive group aneuploid tumours occurred in 29(45,31%) and diploid in 35(54,69%) patients (p<0,001). Median survival in positive group--45 months, in negative group 12 months (p<0,0001). In positive group median survival in patients with aneuploid tumours--31 months, in patients with diploid tumours median survival was not reached (p=0,0102). In negative group DNA ploidy has no impact on survival (p=0,1027) CONCLUSIONS 1. DNA ploidy determined by flow cytometry is prognostic factor in ovarian cancer patients who answered positively for first line treatment. 2. Aneuploid tumours appear much often then diploid in group of patient who did not answer for first line chemotherapy 3. Patients with diploid tumours have better prognosis. 4. Lack of positive answer for first line treatment is bad prognostic factor.
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Wydra D, Klasa-Mazurkiewicz D, Emerich J, Milczek T. The problem of accurate initial diagnosis of Bartholin's gland carcinoma resulting in delayed treatment and aggressive course of the disease. Int J Gynecol Cancer 2006; 16:1469-72. [PMID: 16803552 DOI: 10.1111/j.1525-1438.2006.00571.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Carcinoma of the Bartholin's gland is a rare lesion accounting for only 5% of all vulvar cancers. Initial diagnosis of Bartholin's gland cancer (BGC) and recurrence after primary radical surgery and adjuvant radiotherapy poses a challenge in the treatment of BGC. This case report presents a particularly aggressive course of BGC. Spontaneous rupture of the femoral artery in the postoperative period was observed. The length of the survival period from the moment of diagnosis amounted to less than 16 months. Aspects of initial diagnosis problem and treatment options in groin recurrence of vulvar carcinoma and vascular complications are discussed.
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Affiliation(s)
- D Wydra
- Department of Gynecology, Medical University of Gdansk, ul. Kliniczna 1A, Gdansk 80-402, Poland.
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Wydra D, Klasa-Mazurkiewicz D, Emerich J, Milczek T. The problem of accurate initial diagnosis of Bartholin's gland carcinoma resulting in delayed treatment and aggressive course of the disease. Int J Gynecol Cancer 2006. [DOI: 10.1136/ijgc-00009577-200605000-00084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Carcinoma of the Bartholin's gland is a rare lesion accounting for only 5% of all vulvar cancers. Initial diagnosis of Bartholin's gland cancer (BGC) and recurrence after primary radical surgery and adjuvant radiotherapy poses a challenge in the treatment of BGC. This case report presents a particularly aggressive course of BGC. Spontaneous rupture of the femoral artery in the postoperative period was observed. The length of the survival period from the moment of diagnosis amounted to less than 16 months. Aspects of initial diagnosis problem and treatment options in groin recurrence of vulvar carcinoma and vascular complications are discussed.
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Preis K, Ciach K, Kowalewska-Włas A, Wójcik D, Swiatkowska-Freundi M, Klasa-Mazurkiewicz D. [Twin pregnancy with single fetal death due to triploidy--a case report]. Ginekol Pol 2005; 76:648-51. [PMID: 16363372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
The incidence of multiple pregnancies is associated with the increased risk in maternal and fetal complications. Intrauterine death of one twin in the second trimester is a rare obstetric complication. Authors report a case of a twin pregnancy with triploidy of one fetus and no chromosomal anomaly of the other twin in a dichorionic diamniotic twin pregnancy. Amniocentesis at 16th weeks disclosed triploidy of this fetus who died afterwards at 20th week of gestation. The pregnancy was continued with special care of the mother and the alive fetus. The second twin was successfully delivered by cesarean section in the 41st week of pregnancy due to the intrauterine fetal distress.
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Dudziak M, Klasa-Mazurkiewicz D, Milczek T, Zmudzińska E, Emerich J. [The correlation between prognostic factors and outcome of second look laparotomy in ovarian cancer]. Ginekol Pol 2005; 76:555-63. [PMID: 16363382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
OBJECTIVES The objective of this study was to verify the correlation between prognostic factors, positive or negative second look laparotomy (SLL) and 5-year survival in patients with ovarian cancer. MATERIAL Between 1984 and 1993, 178 patients after primary surgery and first-line chemotherapy with complete clinical response underwent second look laparotomy. The correlation between clinical stage and grade of cancers, residual disease, age of patients in two group of patients: with positive and negative second look laparotomy were evaluated. RESULTS 95 patients (53%) had positive SLL. The 5-years survival in this group was only 20%. Adverse prognostic factors were: advanced primary stage (IV-0% of 5-years survival), low grade of differentiation (9.1% of 5-years survival) and residual disease > 2cm (9.4% of 5-years survival). The 5-year survival in group with negative SLL was 78.3%. The analysed prognostic factors in this group were insignificant in predicting 5-year survival. CONCLUSIONS This study confirms that the SLL can provide an important prognostic evaluation in patients without evidence of disease and allows surgical cytoreduction in group with positive SLL (more than 50% of patients). The analyzed prognostic factors in group with negative SLL were insignificant in predicting 5-year survival. The multicenter research for new prognostic factors in this group are required.
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Klasa-Mazurkiewicz D, Debniak J, Milczek T, Emerich J. [Comparative analysis of patients with multiple pregnancy hospitalized at the Gynecology and Obstetrics Department of the Medical University of Gdansk in 1981-1990 and 1991-2000]. Ginekol Pol 2005; 76:115-21. [PMID: 15847078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
OBJECTIVE The purpose of this study was to present twinning rates and to compare patients with multiple pregnancy delivered at Gynaecology and Obstetrics Department of Medical University of Gdansk in 1981-1990 and 1991-2000. MATERIAL AND METHODS A retrospective study of 523 twin births was performed. The analysis concerned: maternal age, place of living, education, parity, using of assisted reproductive techniques. RESULTS The incidence of twin pregnancy was 1.0%. The percentage of twin deliveries in 1981-1990 was 0.84% and in 1991-2000: 1.28%. The number of twin pregnancies depending on maternal age in two periods was analysed. The statistically significant differences were observed in maternal age interval 21-25 years (32.4% in 1981-1990 versus 20.8% in 1991-2000, p=0.01) and in age interval < 20 years (3.5% in 1981-1990 versus 8.8% in 1991-2000, p=0.009). There were 3.2% patients with multiple pregnancy treated due to infertility in 1981-1990 and 7.4% in 1991-2000 (p=0.04). CONCLUSIONS We observed the increase in twinning rates in our department. The mean age of patients with multiple pregnancy increased. We noticed the increase in number of iatrogenic multiple pregnancies.
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Klasa-Mazurkiewicz D, Milczek T, Emerich J. [Vesicouterine fistula as a complication after previous cesarean section 18 years earlier]. Ginekol Pol 2004; 75:548-52. [PMID: 15517776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
A case of vesicouterine fistula diagnosed in 40-year old woman who underwent cesarean section 18 years earlier was presented. The clinical features, etiologic factors, diagnostic procedures and treatment modalities were discussed in relation to the case and others reported in the literature. The gift of contrast by catheter to bladder allowed to visualize the fistula.
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Klasa-Mazurkiewicz D, Emerich J, Milczek T. [Clinical course of clarocellular ovarian cancer in 27-year old woman. Laparoscopy in management of malignant ovarian tumors]. Ginekol Pol 2003; 74:1567-71. [PMID: 15029751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
A case of clarocellular ovarian cancer in 27-year old woman is reported. Authors present the diagnostic and management problems, their experience and the review of current literature. The place of laparoscopy in management of malignant ovarian tumors is discussed.
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Debniak J, Stukan M, Pietrzak-Stukan M, Klasa-Mazurkiewicz D. [Cancer antigen CA 125 in ovarian cancer]. Ginekol Pol 2003; 74:701-9. [PMID: 14674111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
AIM To estimate the diagnostic and prognostic value, pathological and clinical correlation of cancer antigen 125 (CA125) in ovarian cancer (OC). Retrospective analysis was done of 350 patients who were operated for OC in years 1990-2001 in Gynecology Clinic MU of Gdansk. We analyzed those before primary operation (PO) and second look laparotomy (SLL). Chi 2 and t-Student tests were used. RESULTS Before PO 18% OC patients had CA125 less than 35 and 43.8% more than 600 U/ml, for benign tumors it was 59.9 and 1.1 respectively (p < 0.001). 56.2% with complete remission and 43.8% with progress disease in SLL had normal values of antigen before the operation. There were 32 patients who had CA125 > 600 before SLL and all of those had progress disease. The positive and negative predictive value of CA125 before SLL were 0.94 and 0.56 respectively. Cytoreduction with no macroscopic disease was achieved in 45% of patients with CA125 < 600 U/ml before PO, and it was 19.2% for those with antigen > 600 (p = 0.001). We looked for differences of CA125 levels depending on clinical and pathological data. According to our results only histology (p = 0.02) and clinical stage (p = 0.02) influenced CA 125 levels. CONCLUSIONS There is a good correlation between elevated levels of CA125 and state of the disease in SLL, and we consider SLL as obligatory to perform as there is a low negative predictive value of CA125. The CA125 before primary operation has prognostic significance to possibility of optimal cytoreduction.
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Milczek T, Emerich J, Klasa-Mazurkiewicz D. [Surgical complications connected with intraperitoneal chemotherapy in ovarian cancer]. Ginekol Pol 2003; 74:817-23. [PMID: 14674130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
OBJECTIVES From a theoretical viewpoint, intraperitoneal therapy (i.p.) in-patients with ovarian cancer, a malignancy, which remains mainly, confined to the peritoneal cavity is logical. Intraperitoneal catheters have moved to the forefront as a delivery system in cancer treatment. Authors have described complications during the placement, usage, and evacuation of Tenckhoff catheters. MATERIAL AND METHODS From January 1996 to January 2003, 118 patients with recurrent or persistent ovarian cancer, after surgery and first line chemotherapy, have had catheter insertion, but only 91 have had catheter evacuation: because of: not complete therapy (21 patients). Three patients died during i.p. therapy, Four times intraperitoneal catheter has spontaneously fold out. RESULTS During insertion total number of complications reached (7.63%)--6 bowel incision, 1 bladder incision, 1 hernia of the linea alba, 1 incision of bowel and bladder. During catheter evacuation total number of complications was 9 (7.63%), 8 bowel incisions, 1 hernia of the linea alba. Complications connected with catheter function: only 10 patients required cessation of chemotherapy prior to its expected completion because of following reasons: 2 fistula of the catheter to vagina, 2 fistulas to bowel, in four cases intraperitoneal catheter has spontaneously fold out due to abscess (two after citostatics flow under the skin, and two without clear reason probably because of not proper fixation) one because of abscess in peritoneal cavity, and problems with citostatics inflow, one because of subileus. CONCLUSION 1 Surgical complications occurring during IPC are not dangerous for patients. 2 IPC is valid and safety way of treatment ovarian cancer patients. 3 The frequency of complications occurring during insertion of Tenckhoff catheter depends on the way of placement. 4 We do not noticed connections between frequency of complications and sum of insertion made by the surgeon.
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Sliwiński W, Milczek T, Klasa-Mazurkiewicz D. [Acute myocardial infarction during the second trimester of pregnancy]. Ginekol Pol 2003; 74:312-6. [PMID: 12916275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
UNLABELLED Acute myocardial infarction during pregnancy is a very rare event. It occurs from 1 per 10,000 to 1 per 30,000 deliveries. Diagnosis of myocardial ischaemia is difficult because of typical complaints in pregnancy such as breathlessness and pain in chest. Its first recognisable symptom is very often loss of consciousness and cardiac death. We present the case of a 36-year-old woman with cardiac arrest in the second trimester of pregnancy. The defibrillation was applied four times with power ranging from 150 J to 200 J. Acute myocardial infarction was diagnosed on the basis of biochemical and electrocardiological examinations. Pharmacological treatment consisted of adrenalin, lidocaine, dopamine, heparin, insulin and cordarone. Uncomplicated pregnancy and delivery by caesarean section is described. A review of literature follows. CONCLUSION Although myocardial infarction is a rare complication of pregnancy, it always should be taken in consideration, especially in case of multipara older than 32, suffered from hypercholesterolemia or diabetes, treated with beta-mimetics or ergot alkaloid.
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Debniak J, Klasa-Mazurkiewicz D, Stukan M, Emerich J. GASTROINTESTINAL PROCEDURES IN PATIENTS WITH OVARIAN CANCER. Int J Gynecol Cancer 2003. [DOI: 10.1136/ijgc-00009577-200303001-00131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Klasa-Mazurkiewicz D, Emerich J, Milczek T, Ciach K. [Primary Bartholin gland carcinoma]. Ginekol Pol 2003; 74:220-3. [PMID: 12916260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Carcinoma of the Bartholin gland is rate, comprising less then 1% of female genital tract neoplasms. We present the case of 52-year-old female with Bartholin gland carcinoma, discuss the therapeutic problems and review the data from the world literature.
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Milczek T, Emerich J, Klasa-Mazurkiewicz D. EFFECTS OF INTRAPERITONEAL CHEMOTHERAPY AS A SECOND LINE THERAPY, FOR PATIENTS WITH OVARIAN CANCER. Int J Gynecol Cancer 2003. [DOI: 10.1136/ijgc-00009577-200303001-00046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Milczek T, Emerich J, Klasa-Mazurkiewicz D. SURGICAL COMPLICATIONS CONNECTED WITH INTRAPERITONEAL HEMOTHERAPY IN OVARIAN CANCER. Int J Gynecol Cancer 2003. [DOI: 10.1136/ijgc-00009577-200303001-00130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Milczek T, Emerich J, Debniak J, Klasa-Mazurkiewicz D. [Evaluation of the effectiveness of second-line intraperitoneal chemotherapy for patients with ovarian cancer]. Ginekol Pol 2002; 73:1027-33. [PMID: 12722394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
OBJECTIVES From a theoretical viewpoint, intraperitoneal therapy in patients with ovarian cancer, a malignancy, which remains mainly confined to the peritoneal cavity is logical. Intraperitoneal catheters have moved to the forefront as a delivery system in cancer treatment. DESIGN The authors sought to evaluate effects of intraperitoneal chemotherapy (IPC) as a second line therapy for ovarian cancer patients. MATERIAL AND METHODS From January 1996 to January 2002, 92 patients with recurrent or persistent cancer, after surgery, and first line chemotherapy, were treated with intraperitoneal chemotherapy as a second-line treatment. Only 74 were included in the study, due to incomplete of therapy (6 patients), spontaneous fold-out of catheter (3 patients), five patients were treated because of some other kind of carcinomas, three patients passed away during therapy because of independent reasons, and weren't be verified and a patient who had wrong pathological diagnosis in SLL. RESULTS The three year survival in the whole group reached 58.62% for patients who responded to the first line chemotherapy, or when the debulking surgery was completed, which was a significant improvement in survival. There was a significant improvement in survival for patients with residual tumor < 5 mm compared with the whole group, and especially with these, whose residual tumors were greater then 5 mm. CONCLUSIONS 1. Survival was increased for patients who had a positive response to the first line intravenous chemotherapy, or had complete a debulking surgery 2. The response for IPC depends on the size of residual disease. 3. Intraperitoneal chemotherapy improves survival in ovarian cancer.
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Debniak J, Klasa-Mazurkiewicz D, Stukan M, Wydra D, Emerich J. [Gastrointestinal surgery in patients with ovarian cancer]. Ginekol Pol 2002; 73:1071-7. [PMID: 12722401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
OBJECTIVES The objectives were to assess indications as well as outcome and morbidity of gastrointestinal surgery in patients with ovarian cancer. METHODS The study included 74 patients with primary ovarian cancer who had debulking surgery (bowel surgery) from 1987 to 2001. RESULTS In our group postoperative residual tumor was--R0 in 15 cases (20.3%) and < or = 2 cm (R2) in 33 patients (44.6%). CONCLUSION Gastrointestinal surgery is frequently indicated during operation in ovarian cancer. Gynecologic cancer surgeons should be trained accordingly.
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Klasa-Mazurkiewicz D, Emerich J, Milczek T. [The evaluation how FIGO stage in cervical cancer depends on frequency of gynaecological control]. Ginekol Pol 2002; 73:823-8. [PMID: 12619315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
OBJECTIVES The authors sought to evaluate how FIGO stage in cervical cancer depends on frequency of gynaecological control. MATERIAL AND METHODS From March 2000 to January 2001, 74 patients with cervical cancer were treated in 2-nd Dept. of Obstetrics and Gynaecology Medical University of Gdańsk. The authors analysed frequency of gynaecological control, although patients age, number of delivery, socio-economic status, living place. RESULTS The median interval, from last gynaecological examination to cervical cancer diagnosis was 8.6 year (1-26), number of delivery: 0-0.5%, 1-10%, 2-21%, 3-21%, 10-1%, 67% patients lived in town and 32.4% in villages. CONCLUSION Women from Gdańsk area who developed cervical cancer were not gynaecological controlled from 1 to 26 year (median--8.6). Authors noticed that FIGO stage of ovarian cancer depends seriously on interval between last gynaecological control and cervical cancer diagnosis. The old, not working, and those who live in villages in Gdańsk area have an especially low level of health education.
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Makarewicz H, Emerich J, Olszewski J, Klasa-Mazurkiewicz D. [Pregnancy and delivery after conservative treatment of borderline ovarian tumor with FIGO stage III C--a case report]. Ginekol Pol 2002; 73:225-9. [PMID: 12092257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
This study presents a case of pregnancy after conservative surgical treatment of borderline ovarian tumor with III C stage according to FIGO classification. The caesarean section in 37 week of pregnancy was performed and connected with very precise staging. In normal-appearing both ovaries the foci of borderline ovarian tumor were found. There were no foci of borderline ovarian tumor or foci of invasive carcinoma in tissues routinely sampled during the second look operation. All benefits and costs of conservative surgical approaches to very young, childless women with advanced borderline ovarian tumor were exactly estimated.
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Affiliation(s)
- Hanna Makarewicz
- II Kliniki Połoznictwa i Ginekologii Akademii Medycznej w Gdańsku
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Makarewicz H, Emerich J, Olszewski J, Klasa-Mazurkiewicz D. [Conservative treatment of patients with borderline ovarian tumors]. Ginekol Pol 2001; 72:134-8. [PMID: 11398581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
OBJECTIVES The aim of this study was to characterise group of patients with borderline tumours undergoing surgical treatment. DESIGN The analysis included 83 patients with ovarian tumours of borderline malignancy at stage Ia, operated in the Gynaecological Department of Medical University of Gdańsk between 1978-1997. The study takes into account comparison of: age of patients, type of surgery, tumour pathology, post surgical treatment. Furthermore, long term follow up was assessed. RESULTS In the group of 83 patients with stage Ia 37 ware treated with conservative surgery, 46 underwent radical treatment. Postsurgical chemical treatment was not applied. Three patients had to be reoperated because of neoplasm disease recurrence. 8 patients were died from reasons not connected with main disease. CONCLUSIONS Conservative surgery is proper treatment for young women with borderline ovary tumours in stage Ia. For older, perimenopausal women TAH with BSO without additional chemotherapy is suggested.
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Affiliation(s)
- H Makarewicz
- II Kliniki Połoznictwa i Ginekologii Akademi Medycznej w Gdańsku
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Klasa-Mazurkiewicz D, Debniak J, Olszewski J, Makarewicz H. [Analysis of premature twin pregnancies and deliveries]. Ginekol Pol 2000; 71:1360-4. [PMID: 11216143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
Preterm labor is the most frequent complication of twin gestation. Between 1988-1998, 123 twin pregnancies complicated by preterm labor were observed. Complications during pregnancy, mode of delivery, neonatal outcomes, mortality and morbidity were presented. We compared our outcomes to data from current literature.
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Klasa-Mazurkiewicz D, Emerich J, Konefka T, Makarewicz H. [Dramatic course of massive pulmonary embolism in a woman at 31st gestational week. Case report]. Ginekol Pol 2000; 71:628-31. [PMID: 11002572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Pulmonary embolism during pregnancy is infrequent but serious complication. We report a case of 32-year old women at 31-st gestational week with massive pulmonary embolism. The management of the case and the review of current literature are presented. Our experience demonstrates the importance of interdisciplinary care.
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Milczek T, Michalska J, Olszewski J, Starnawski M, Klasa-Mazurkiewicz D. [Hypothyroidism coexisting with pregnancy]. Ginekol Pol 1998; 69:1093-6. [PMID: 10224783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
DESIGN The aim of the study was to describe pregnancies, deliveries, and puerperal times, and to compare them with the reached scientific communications. MATERIAL AND METHODS Four pregnancies in women with the hypothyroidism were described. All cases were taken from the group of twenty pregnancies (18 women) who were treated because of thyroid gland diseases in our clinic. RESULTS We found that every infant was born in good condition, deliveries and childbeds were uncomplicated. CONCLUSIONS Our notices are similar to new scientific communications, that hypothyroidism coexists with pregnancy much often then everybody, till now, suspected and infants have not so often congenital defects.
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Affiliation(s)
- T Milczek
- II Kliniki Ginekologii i Połoznictwa Akademii Medycznej w Gdańsku
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Sliwiński W, Mielcarek P, Klasa-Mazurkiewicz D, Królikowska B, Olszewski J. [Contraception and pregnancy in severe systemic lupus erythematosus: a case report]. Ginekol Pol 1998; 69:1054-8. [PMID: 10224775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
Systemic Lupus Erythematosus (SLE) during pregnancy may cause serious complications in the mother and fetus. We report a case of pregnancy in 23 years old woman with SLE. Pregnancy was complicated with spontaneous abortion and septic shock. Furthermore in our paper we discussed contraceptive methods proper for women with SLE. The choice of an optimal contraceptive method (OC) therapy is a significant problem in female SLE patients. In view of the influence of sex hormones on the evolution of SLE, oral contraceptive (OC) therapy has to be efficient, reversible and safe, without aggravating disease activity and causing metabolic and vascular side effects. As regards oral contraceptives, all authors agree that oestrogen-progestin combination pills are harmful, but the best alternative hormonal contraception remains to be determined. The management of the case and the review of current literature are presented. Our experience demonstrates the importance of interdisciplinary care.
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Affiliation(s)
- W Sliwiński
- II Kliniki Ginekologii i Połoznictwa Akademii Medycznej w Gdańsku
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Starnawski M, Olszewski J, Milczek T, Klasa-Mazurkiewicz D. [Pregnancy in women with multiple sclerosis (MS): a report of 2 cases]. Ginekol Pol 1998; 69:1032-4. [PMID: 10224770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
We report two cases of pregnancy in patients with multiple sclerosis. Both of women were primigravidas. In both cases pregnancy were ended by cesarean section: in first case due to obstetric indications, in second due to neurological indications. Our experience and a review of current literature are presented.
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Affiliation(s)
- M Starnawski
- II Kliniki Połoznictwa i Ginekologii Akademii Medycznej w Gdańsku
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