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Wójcik M, Juhas U, Mohammadi E, Mattisson J, Drężek-Chyła K, Rychlicka-Buniowska E, Bruhn-Olszewska B, Davies H, Chojnowska K, Olszewski P, Bieńkowski M, Jankowski M, Rostkowska O, Hellmann A, Pęksa R, Kowalski J, Zdrenka M, Kobiela J, Zegarski W, Biernat W, Szylberg Ł, Remiszewski P, Mieczkowski J, Filipowicz N, Dumanski JP. Loss of Y in regulatory T lymphocytes in the tumor micro-environment of primary colorectal cancers and liver metastases. Sci Rep 2024; 14:9458. [PMID: 38658633 PMCID: PMC11043399 DOI: 10.1038/s41598-024-60049-y] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 04/18/2024] [Indexed: 04/26/2024] Open
Abstract
Male sex is a risk factor for colorectal cancer (CRC) with higher illness burden and earlier onset. Thus, we hypothesized that loss of chromosome Y (LOY) in the tumor micro-environment (TME) might be involved in oncogenesis. Previous studies show that LOY in circulating leukocytes of aging men was associated with shorter survival and non-hematological cancer, as well as higher LOY in CD4 + T-lymphocytes in men with prostate cancer vs. controls. However, nothing is known about LOY in leukocytes infiltrating TME and we address this aspect here. We studied frequency and functional effects of LOY in blood, TME and non-tumorous tissue. Regulatory T-lymphocytes (Tregs) in TME had the highest frequency of LOY (22%) in comparison to CD4 + T-lymphocytes and cytotoxic CD8 + T-lymphocytes. LOY score using scRNA-seq was also linked to higher expression of PDCD1, TIGIT and IKZF2 in Tregs. PDCD1 and TIGIT encode immune checkpoint receptors involved in the regulation of Tregs function. Our study sets the direction for further functional research regarding a probable role of LOY in intensifying features related to the suppressive phenotype of Tregs in TME and consequently a possible influence on immunotherapy response in CRC patients.
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Affiliation(s)
- Magdalena Wójcik
- 3P-Medicine Laboratory, Medical University of Gdańsk, Dębinki 7, 80-211, Gdańsk, Poland
| | - Ulana Juhas
- 3P-Medicine Laboratory, Medical University of Gdańsk, Dębinki 7, 80-211, Gdańsk, Poland
- Department of Bioenergetics and Physiology of Exercise, Medical University of Gdańsk, Dębinki 1, 80-211, Gdańsk, Poland
| | - Elyas Mohammadi
- 3P-Medicine Laboratory, Medical University of Gdańsk, Dębinki 7, 80-211, Gdańsk, Poland
| | - Jonas Mattisson
- Department of Immunology, Genetics and Pathology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Kinga Drężek-Chyła
- 3P-Medicine Laboratory, Medical University of Gdańsk, Dębinki 7, 80-211, Gdańsk, Poland
| | | | - Bożena Bruhn-Olszewska
- Department of Immunology, Genetics and Pathology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Hanna Davies
- Department of Immunology, Genetics and Pathology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Katarzyna Chojnowska
- 3P-Medicine Laboratory, Medical University of Gdańsk, Dębinki 7, 80-211, Gdańsk, Poland
| | - Paweł Olszewski
- 3P-Medicine Laboratory, Medical University of Gdańsk, Dębinki 7, 80-211, Gdańsk, Poland
| | - Michał Bieńkowski
- Department of Pathomorphology, Medical University of Gdańsk, Gdańsk, Poland
| | - Michał Jankowski
- Surgical Oncology, Ludwik Rydygier's Collegium Medicum, Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
- Department of Surgical Oncology, Oncology Center - Prof. Franciszek Łukaszczyk Memorial Hospital, Bydgoszcz, Poland
| | - Olga Rostkowska
- Department of Oncological, Transplant and General Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Andrzej Hellmann
- Department of Oncological, Transplant and General Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Rafał Pęksa
- Department of Pathomorphology, Medical University of Gdańsk, Gdańsk, Poland
| | - Jacek Kowalski
- Department of Pathomorphology, Medical University of Gdańsk, Gdańsk, Poland
| | - Marek Zdrenka
- Department of Tumor Pathology and Pathomorphology, Oncology Center - Prof. Franciszek Łukaszczyk Memorial Hospital, Bydgoszcz, Poland
| | - Jarek Kobiela
- Department of Oncological, Transplant and General Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Wojciech Zegarski
- Surgical Oncology, Ludwik Rydygier's Collegium Medicum, Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
- Department of Surgical Oncology, Oncology Center - Prof. Franciszek Łukaszczyk Memorial Hospital, Bydgoszcz, Poland
| | - Wojciech Biernat
- Department of Pathomorphology, Medical University of Gdańsk, Gdańsk, Poland
| | - Łukasz Szylberg
- Department of Tumor Pathology and Pathomorphology, Oncology Center - Prof. Franciszek Łukaszczyk Memorial Hospital, Bydgoszcz, Poland
- Department of Clinical Pathomorphology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Piotr Remiszewski
- Department of Oncological, Transplant and General Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Jakub Mieczkowski
- 3P-Medicine Laboratory, Medical University of Gdańsk, Dębinki 7, 80-211, Gdańsk, Poland
| | - Natalia Filipowicz
- 3P-Medicine Laboratory, Medical University of Gdańsk, Dębinki 7, 80-211, Gdańsk, Poland.
| | - Jan P Dumanski
- 3P-Medicine Laboratory, Medical University of Gdańsk, Dębinki 7, 80-211, Gdańsk, Poland.
- Department of Immunology, Genetics and Pathology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
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Spychalski P, Kobiela J. The obesity phenomenon in colorectal cancer. Colorectal Dis 2023. [PMID: 37002546 DOI: 10.1111/codi.16563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 06/19/2023]
Affiliation(s)
- Piotr Spychalski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Gdansk, Poland
| | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Gdansk, Poland
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Rostkowska O, Olejniczak-Kęder A, Spychalski P, Szaryńska M, Kobiela J. Triiodothyronine lowers the potential of colorectal cancer stem cells in vitro. Oncol Rep 2022; 49:21. [PMID: 36484405 PMCID: PMC9773011 DOI: 10.3892/or.2022.8458] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/11/2022] [Indexed: 12/13/2022] Open
Abstract
Cancer stem cells (CSCs) play a key role in the development and progression of colorectal cancer (CRC), but the influence of triiodothyronine (T3) on the biological regulation of CSCs remains unclear. In the present study, it was reported that T3 exerts significant impact on CSCs of two CRC cell lines cultured in the form of colonospheres. It was observed that the incubation of colonospheres with T3 decreased the viability, proliferative and spherogenic potential of cancer cells (P<0.05). In addition, increased apoptotic rate of CRC cells treated with T3 was revealed. Furthermore, T3‑treated colonospheres were more likely to move into silenced pool in G0/G1 phase of the cell cycle. The smaller sizes of colonospheres observed after the treatment with T3 confirmed this conclusion. T3 could lower the proportion of primitive cells which supply the pool of proliferating cells within spheres. Thyroid receptors THRα1 and THRβ1 and two deiodinases (DIO2 and DIO3) were affected by T3 in manner depended on clinical stage of cancer and CRC cell line used for analysis. In summary, the present study uncovered a novel function of thyroid hormones signaling in the regulation of the CSCs of CRC, and these findings may be useful for developing novel therapies by targeting thyroid hormone functions in CRC cells.
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Affiliation(s)
- Olga Rostkowska
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | | | - Piotr Spychalski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Magdalena Szaryńska
- Histology Department, Medical University of Gdańsk, 80-210 Gdansk, Poland,Correspondence to: Dr Magdalena Szaryńska, Histology Department, Medical University of Gdansk, 1 Dębinki Street, 80-210 Gdansk, Poland, E-mail:
| | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, 80-214 Gdańsk, Poland
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Dobrzycka M, Bzoma B, Bieniaszewski K, Dębska-Ślizień A, Kobiela J. Pretransplant BMI Significantly Affects Perioperative Course and Graft Survival after Kidney Transplantation: A Retrospective Analysis. J Clin Med 2022; 11:jcm11154393. [PMID: 35956010 PMCID: PMC9369329 DOI: 10.3390/jcm11154393] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 06/14/2022] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 02/01/2023] Open
Abstract
Background. The number of kidney transplant recipients (KTRs) with overweight and obesity is increasing. It was shown that obesity is related to inferior patient and graft survival. We aimed to analyze intraoperative parameters and postoperative short and long-term course of kidney transplantation (KT) in body mass index (BMI)-stratified cohorts of KTRs. Methods. A retrospective analysis of a prospectively built database of 433 KTRs from 2014 to 2017 from a single transplant center was performed. The objective of the study was to analyze the association between BMI at the time of transplantation with intraoperative parameters, adverse events in early postoperative course, and the overall mortality and graft loss in BMI-stratified cohorts: normal (18.5 and 24.9 kg/m2), overweight (25−29.9 kg/m2) and obese (≥30 kg/m2). Results. Obesity was related to longer total procedure time (p = 0.0025) and longer warm ischemia time (p = 0.0003). The postoperative course in obese patients was complicated by higher incidence of DGF (delayed graft function), early surgical complications (defined as surgical complications <30 days from KT), reoperation rate, vascular complications, incidence of lymphocele and wound dehiscence. There was no difference between the normal weight and overweight KTRs. The one-month kidney function (p = 0.0001) and allograft survival (p = 0.029) were significantly inferior in obese patients with no difference between normal weight and overweight patients. One-year death-censored graft survival was better in patients with BMI < 30 (88.6 vs. 94.8% p = 0.05). BMI was a significant predictor of graft loss in univariate (p = 0.04) but not in multivariate analysis (p = 0.09). Conclusion. Pretransplant obesity significantly affects the intraoperative and postoperative course of kidney transplantation and graft function and survival. The course of transplantation of overweight is comparable to normal BMI KTRs, and presumably pretransplant weight reduction to the BMI < 30 kg/m2 may improve the short-term postoperative course of transplantation as well as may improve graft survival. Thus, pretransplant weight reduction in obese KTRs may significantly improve the results of kidney transplantation. Metabolic surgery may play a role in improving results of KT.
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Affiliation(s)
- Małgorzata Dobrzycka
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, 80-210 Gdansk, Poland; (K.B.); (J.K.)
- Correspondence:
| | - Beata Bzoma
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland; (B.B.); (A.D.-Ś.)
| | - Ksawery Bieniaszewski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, 80-210 Gdansk, Poland; (K.B.); (J.K.)
| | - Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland; (B.B.); (A.D.-Ś.)
| | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, 80-210 Gdansk, Poland; (K.B.); (J.K.)
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Patel A, Spychalski P, Kobiela J. For and Against Routine Removal of Peripheral Intravenous Catheters. JAMA Intern Med 2022; 182:457. [PMID: 35156994 DOI: 10.1001/jamainternmed.2021.8307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Agastya Patel
- Department of General, Endocrine, and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Piotr Spychalski
- Department of General, Endocrine, and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Jarek Kobiela
- Department of General, Endocrine, and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
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Patel A, Spychalski P, Kobiela J. Short-course radiotherapy and consolidation chemotherapy: in search of a balanced protocol. Br J Surg 2021; 109:e50-e51. [PMID: 34964457 DOI: 10.1093/bjs/znab439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 11/28/2021] [Indexed: 11/12/2022]
Affiliation(s)
- Agastya Patel
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland.,First Doctoral School, Medical University of Gdansk, Gdansk, Poland
| | - Piotr Spychalski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
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Spychalski P, Kobiela J, Wieszczy P, Bugajski M, Reguła J, Kaminski MF. Adenoma to Colorectal Cancer Estimated Transition Rates Stratified by BMI Categories—A Cross-Sectional Analysis of Asymptomatic Individuals from Screening Colonoscopy Program. Cancers (Basel) 2021; 14:cancers14010062. [PMID: 35008224 PMCID: PMC8750540 DOI: 10.3390/cancers14010062] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 12/03/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 12/04/2022] Open
Abstract
Simple Summary Most colorectal cancers assumedly develop from precursor lesions, i.e., colorectal adenomas (adenoma-carcinoma sequence). Epidemiological and clinical data supporting this hypothesis are limited. Therefore, the aim of the present study was to estimate relative dynamics of colorectal adenoma-carcinoma sequence for groups of screenees stratified by body mass. We have analyzed 163,129 individuals that underwent screening colonoscopy and calculated adjusted prevalences of colorectal adenomas and colorectal. Based on that data we have found that obese individuals are more likely to develop adenomas, advanced adenomas and early CRC but less likely to progress to advanced CRC. Therefore, this study provides new evidence that obesity paradox exists for colorectal cancer. Abstract Most colorectal cancers (CRC) assumedly develop from precursor lesions, i.e., colorectal adenomas (adenoma-carcinoma sequence). Epidemiological and clinical data supporting this hypothesis are limited. Therefore, the aim of the present study is to estimate relative dynamics of colorectal adenoma-carcinoma sequence for groups of screenees stratified by BMI (body mass index) based on prevalence data from Polish Colonoscopy Screening Program (PCSP). We performed a cross-sectional analysis of database records of individuals who entered the national opportunistic colonoscopy screening program for CRC in Poland. We calculated prevalence of adenomas and CRCs adjusted for sex, 5-year age group, family history of CRC, smoking, diabetes and use of aspirin, hormonal therapy and proton-pump inhibitors use. Thereafter we calculated estimated transition rate (eTR) with confidence intervals (CIs) defined as adjusted prevalence of more advanced lesion divided by adjusted prevalence of less advanced lesion. All analyzes were stratified according to the BMI categories: normal (BMI 18.0 to <25.0), overweight (BMI 25.0 to <30.0) and obese (BMI ≥ 30.0). Results are reported in the same respective order. After exclusions we performed analyses on 147,385 individuals. We found that prevalence of non-advanced adenomas is increasing with BMI category (12.19%, 13.81%, 14.70%, respectively; p < 0.001). Prevalence of advanced adenomas was increasing with BMI category (5.20%, 5.77%, 6.61%, respectively; p < 0.001). Early CRCs prevalence was the highest for obese individuals (0.55%) and the lowest for overweight individuals (0.44%) with borderline significance (p = 0.055). For advanced CRC we found that prevalence seems to be inversely related to BMI category, however no statistically significant differences were observed (0.35%, 0.31%, 0.28%; p = 0.274). eTR for non-advanced adenoma to advanced adenoma is higher for obese individuals than for overweight individuals with bordering CIs (42.65% vs. 41.81% vs. 44.95%) eTR for advanced adenoma to early CRC is highest for normal individuals, however CIs are overlapping with remaining BMI categories (9.02% vs. 7.67% vs. 8.39%). eTR for early CRC to advanced CRC is lower for obese individuals in comparison to both normal and overweight individuals with marginally overlapping CIs (73.73% vs. 69.90% vs. 50.54%). Obese individuals are more likely to develop adenomas, advanced adenomas and early CRC but less likely to progress to advanced CRC. Therefore, this study provides new evidence that obesity paradox exists for colorectal cancer.
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Affiliation(s)
- Piotr Spychalski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, 80-210 Gdansk, Poland;
- Correspondence:
| | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, 80-210 Gdansk, Poland;
| | - Paulina Wieszczy
- Centre of Postgraduate Medical Education, Department of Gastroenterology, Hepatology and Clinical Oncology, 01-813 Warsaw, Poland; (P.W.); (M.B.); (J.R.); (M.F.K.)
- Clinical Effectiveness Research Group, Institute of Health and Society, Faculty of Medicine, University of Oslo, NO-0316 Oslo, Norway
| | - Marek Bugajski
- Centre of Postgraduate Medical Education, Department of Gastroenterology, Hepatology and Clinical Oncology, 01-813 Warsaw, Poland; (P.W.); (M.B.); (J.R.); (M.F.K.)
- Clinical Effectiveness Research Group, Institute of Health and Society, Faculty of Medicine, University of Oslo, NO-0316 Oslo, Norway
- Department of Oncological Gastroenterology, Maria Sklodowska-Curie National Research Institute of Oncology, 01-813 Warsaw, Poland
| | - Jaroslaw Reguła
- Centre of Postgraduate Medical Education, Department of Gastroenterology, Hepatology and Clinical Oncology, 01-813 Warsaw, Poland; (P.W.); (M.B.); (J.R.); (M.F.K.)
- Department of Oncological Gastroenterology, Maria Sklodowska-Curie National Research Institute of Oncology, 01-813 Warsaw, Poland
| | - Michał F. Kaminski
- Centre of Postgraduate Medical Education, Department of Gastroenterology, Hepatology and Clinical Oncology, 01-813 Warsaw, Poland; (P.W.); (M.B.); (J.R.); (M.F.K.)
- Clinical Effectiveness Research Group, Institute of Health and Society, Faculty of Medicine, University of Oslo, NO-0316 Oslo, Norway
- Department of Oncological Gastroenterology, Maria Sklodowska-Curie National Research Institute of Oncology, 01-813 Warsaw, Poland
- Department of Cancer Prevention, Maria Sklodowska-Curie National Research Institute of Oncology, 01-813 Warsaw, Poland
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Patel A, Spychalski P, Antoszewska M, Regula J, Kobiela J. Proton pump inhibitors and colorectal cancer: A systematic review. World J Gastroenterol 2021; 27:7716-7733. [PMID: 34908809 PMCID: PMC8641055 DOI: 10.3748/wjg.v27.i44.7716] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/14/2021] [Accepted: 09/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The use of proton pump inhibitors (PPI) is common worldwide, with reports suggesting that they may be overused. Several studies have found that PPI may affect colorectal cancer (CRC) risk.
AIM To summarize current knowledge on the relationship between PPI and CRC from basic research, epidemiological and clinical studies.
METHODS This systematic review was based on the patients, interventions, comparisons, outcome models and performed according to PRISMA guidelines. MEDLINE, EMBASE, Scopus, and Web of Science databases were searched from inception until May 17, 2021. The initial search returned 2591 articles, of which, 28 studies met the inclusion criteria for this review. The studies were categorized as basic research studies (n = 12), epidemiological studies (n = 11), and CRC treatment studies (n = 5). The quality of the included studies was assessed using the Newcastle-Ottawa Scale or Cochrane Risk of Bias 2.0 tool depending on the study design.
RESULTS Data from basic research indicates that PPI do not stimulate CRC development via the trophic effect of gastrin but instead may paradoxically inhibit it. These studies also suggest that PPI may have properties beneficial for CRC treatment. PPI appear to have anti-tumor properties (omeprazole, pantoprazole), and are potential T lymphokine-activated killer cell-originated protein kinase inhibitors (pantoprazole, ilaprazole), and chemosensitizing agents (pantoprazole). However, these mechanisms have not been confirmed in human trials. Current epidemiological studies suggest that there is no causal association between PPI use and increased CRC risk. Treatment studies show that concomitant PPI and capecitabine use may reduce the efficacy of chemotherapy resulting in poorer oncological outcomes, while also suggesting that pantoprazole may have a chemosensitizing effect with the fluorouracil, leucovorin, oxaliplatin (FOLFOX) regimen.
CONCLUSION An unexpected inhibitory effect of PPI on CRC carcinogenesis by way of several potential mechanisms is noted. This review identifies that different PPI agents may have differential effects on CRC treatment, with practical implications. Prospective studies are warranted to delineate this relationship and assess the role of individual PPI agents.
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Affiliation(s)
- Agastya Patel
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk 80-210, Poland
| | - Piotr Spychalski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk 80-210, Poland
| | - Magdalena Antoszewska
- Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, Gdansk 80-210, Poland
| | - Jaroslaw Regula
- Department of Gastroenterology, Hepatology and Oncology, Center of Postgraduate Medical Education, The Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw 01-813, Poland
| | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk 80-210, Poland
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Spychalski P, Błażyńska-Spychalska A, Kobiela J. Mortality Rates of Colorectal Cancer Screening Programs: Differing Methodologies, Complimentary Results. Clin Gastroenterol Hepatol 2021; 19:2454-2455. [PMID: 33220522 DOI: 10.1016/j.cgh.2020.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 11/14/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Piotr Spychalski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
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Patel A, Spychalski P, Corrao G, Jereczek-Fossa BA, Glynne-Jones R, Garcia-Aguilar J, Kobiela J. Neoadjuvant short-course radiotherapy with consolidation chemotherapy for locally advanced rectal cancer: a systematic review and meta-analysis. Acta Oncol 2021; 60:1308-1316. [PMID: 34308767 PMCID: PMC8448977 DOI: 10.1080/0284186x.2021.1953137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 07/03/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Short-course radiotherapy with consolidation chemotherapy (SCRT-CCT) has emerged as a promising alternative to the long course chemoradiotherapy (LCRT) regimen in locally advanced rectal cancer management. The systematic review and meta-analysis is aimed at summarizing current evidence on SCRT-CCT and comparing it to LCRT. MATERIAL AND METHODS Electronic databases of MEDLINE, Web of Science, and Cochrane library were searched using a predefined search strategy returning 3314 articles. This review included 11 studies (6 randomized trials and 5 non-randomized studies) on SCRT-CCT regimen based on seven different cohorts. Weighted arithmetic means and forest plots were generated to determine summary estimates. RESULTS The probability of achieving pathological complete response (pCR) was higher with SCRT-CCT compared to LCRT (risk ratio [RR] = 1.75, 95% confidence interval [CI]: 1.41-2.19). No statistically significant difference in 3-year overall survival (OS) was observed between the two groups (RR= 1.06, 95% CI: 0.98-1.14). The weighted arithmetic mean of 3-year OS and pCR was 83.6% versus 80.9%, and 24.5% versus 13.6% for SCRT-CCT and LCRT, respectively. R0 resection and T-downstaging rates ranged from 69.2-100% to 47-75% for SCRT-CCT, and 71-92.3% and 41-75% for LCRT, respectively. The regimens had similar compliance, postoperative, and late toxicity, however, acute toxicity rates varied primarily due to differences in treatment protocols. CONCLUSIONS This review highlights the ability of SCRT-CCT to produce improved tumor response with comparable OS, R0 resection, and T-downstaging at the cost of increased acute toxicity. However, heterogeneity in treatment protocols across studies makes it difficult to provide definitive conclusions regarding the regimen. Several ongoing trials are expected to provide further evidence confirming the findings of RAPIDO trial and detail appropriate SCRT-CCT protocols to improve oncological outcomes, minimize toxicity, and determine its effectiveness as the standard-of-care for locally advanced rectal cancer patients.
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Affiliation(s)
- Agastya Patel
- Department of General Surgery, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland
| | - Piotr Spychalski
- Department of General Surgery, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland
| | - Giulia Corrao
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Barbara A. Jereczek-Fossa
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Robert Glynne-Jones
- Department of Radiation Oncology, Mount Vernon Cancer Centre, Northwood, United Kingdom Department of Radiation Oncology, Mount Vernon Cancer Centre, Northwood, United Kingdom
| | - Julio Garcia-Aguilar
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Jarek Kobiela
- Department of General Surgery, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland
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Affiliation(s)
- Agastya Patel
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Piotr Spychalski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
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Pakiet A, Sikora K, Kobiela J, Rostkowska O, Mika A, Sledzinski T. Alterations in complex lipids in tumor tissue of patients with colorectal cancer. Lipids Health Dis 2021; 20:85. [PMID: 34348720 PMCID: PMC8340484 DOI: 10.1186/s12944-021-01512-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 07/26/2021] [Indexed: 12/29/2022] Open
Abstract
Background Accumulating evidence indicates alterations in lipid metabolism and lipid composition in neoplastic tissue. Earlier nuclear magnetic resonance studies showed that the contents of major lipid groups, such as triacylglycerols, phospholipids and cholesterol, are changed in colon cancer tissue. Methods In this study, a more detailed analysis of lipids in cancer and tumor adjacent tissues from colorectal cancer patients, using liquid chromatography–mass spectrometry, allowed for comparison of 199 different lipids between cancer tissue and tumor adjacent tissue using principal component analysis. Results Significant differences were found in 67 lipid compounds between the two types of tissue; many of these lipid compounds are bioactive lipids such as ceramides, lysophospholipids or sterols and can influence the development of cancer. Additionally, increased levels of phospholipids and sphingolipids were present, which are major components of the cell membrane, and increases in these lipids can lead to changes in cell membrane properties. Conclusions This study showed that many complex lipids are significantly increased or decreased in colon cancer tissue, reflecting significant alterations in lipid metabolism. This knowledge can be used for the selection of potential molecular targets of novel anticancer strategies based on the modulation of lipid metabolism and the composition of the cell membrane in colorectal cancer cells. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-021-01512-x.
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Affiliation(s)
- Alicja Pakiet
- Department of Environmental Analysis, Faculty of Chemistry, University of Gdansk, Wita Stwosza 63, 80-308, Gdansk, Poland
| | - Kinga Sikora
- Physics-Chemistry Workshops, Faculty of Chemistry, University of Gdansk, Wita Stwosza 63, 80-308, Gdansk, Poland
| | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Smoluchowskiego 17, 80-214, Gdansk, Poland
| | - Olga Rostkowska
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Smoluchowskiego 17, 80-214, Gdansk, Poland
| | - Adriana Mika
- Department of Pharmaceutical Biochemistry, Medical University of Gdansk, Debinki 1, 80-211, Gdansk, Poland
| | - Tomasz Sledzinski
- Department of Pharmaceutical Biochemistry, Medical University of Gdansk, Debinki 1, 80-211, Gdansk, Poland.
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Spychalski P, Błażyńska-Spychalska A, Kobiela J. Postcolonoscopy colorectal cancer - in search of quality. Colorectal Dis 2021; 23:750-751. [PMID: 33190409 DOI: 10.1111/codi.15441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 11/06/2020] [Indexed: 02/08/2023]
Affiliation(s)
- Piotr Spychalski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
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14
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Łącka M, Obłój P, Spychalski P, Łaski D, Rostkowska O, Wieszczy P, Kobiela J. Clinical presentation and outcomes of cholecystectomy for acute cholecystitis in patients with diabetes - A matched pair analysis. A pilot study. Adv Med Sci 2020; 65:409-414. [PMID: 32823170 DOI: 10.1016/j.advms.2020.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 06/06/2020] [Accepted: 08/06/2020] [Indexed: 01/12/2023]
Abstract
PURPOSE The primary aim of this study is to compare the clinical course and laboratory parameters of acute cholecystitis in patients with diabetes vs. patients without diabetes. MATERIALS AND METHODS The study involved patients who underwent emergency cholecystectomy in the Department of General, Endocrine and Transplant Surgery of University Clinical Center in Gdansk (Poland) between 2007 and 2017. There were 267 patients included in the study. The control group of 197 patients was age and sex matched at a 3:1 ratio. The following was compared between the groups: symptoms at admission, course of surgery, postoperative course, length of hospitalization, total costs of hospitalization and antibiotic therapy, other than routine perioperative prophylaxis. RESULTS There was no significant difference between the patients with and without diabetes regarding symptoms at admission. Operative and postoperative complication rates were significantly higher in the patients with diabetes. The operative time and length of hospitalization were significantly longer in the study group. The conversion rate was not higher in the study group, but classic surgery was performed significantly more often. The patients without diabetes had less pronounced symptoms with more locally advanced disease. CONCLUSIONS Our study demonstrates that patients with diabetes have a significantly more eventful course of acute cholecystitis than patients without diabetes. Patients with diabetes should therefore be qualified for cholecystectomy early in the course of acute cholecystitis.
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Affiliation(s)
- Monika Łącka
- Department of General, Endocrine and Transplant Surgery, University Clinical Center, Gdansk, Poland.
| | - Paweł Obłój
- Department of General, Endocrine and Transplant Surgery, University Clinical Center, Gdansk, Poland
| | - Piotr Spychalski
- Department of General, Endocrine and Transplant Surgery, University Clinical Center, Gdansk, Poland
| | - Dariusz Łaski
- Department of General, Endocrine and Transplant Surgery, University Clinical Center, Gdansk, Poland
| | - Olga Rostkowska
- Department of General, Endocrine and Transplant Surgery, University Clinical Center, Gdansk, Poland
| | - Paulina Wieszczy
- Central Coordination Center for Cervical Cancer Screening Program, Department of Cancer Prevention, Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland; Department of Gastroenterology, Hepatology and Oncology, Medical Center for Postgraduate Education, Warsaw, Poland
| | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, University Clinical Center, Gdansk, Poland
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15
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Kobiela J, Spychalski P, Wieszczy P, Pisera M, Pilonis N, Rupinski M, Bugajski M, Regula J, Kaminski MF. Mortality and Rate of Hospitalization in a Colonoscopy Screening Program From a Randomized Health Services Study. Clin Gastroenterol Hepatol 2020; 18:1501-1508.e3. [PMID: 31525515 DOI: 10.1016/j.cgh.2019.09.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/30/2019] [Accepted: 09/08/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS It is difficult to quantify adverse events related to screening colonoscopy due to lack of valid and adequately powered comparison groups. We compared mortality and rate of unplanned hospitalizations among subjects who underwent screening colonoscopies within the Polish Colonoscopy Screening Program (PCSP) vs unscreened matched controls in Poland. METHODS Persons 55-64 years old living in the area covered by the PCSP from 2012 through 2015 were assigned in a (1:1) to a group invited for screening colonoscopy (n = 338,477) or a matched group that would be invited 5 years later (controls, n = 338,557). All subjects in the screening group were assigned proposed screening colonoscopy dates (actual dates when invitees confirmed or rescheduled colonoscopy) and those in the control group were assigned virtual dates corresponding to the matched individuals from the screening group. In the screening group, 55,390 subjects (16.4%) underwent screening colonoscopy. Mortality and hospitalization data were obtained from National Registries. We compared mortality and rate of hospitalization between the groups for defined intervals before and after colonoscopy date. Hospitalizations were divided into related and unrelated to colonoscopy based on ICD codes by 3 specialists. Our primary aim was to compare mortality and hospitalization 6 weeks before and 30 days following the actual or virtual date of colonoscopy in the screening or control group. RESULTS In the intent to treat analysis, overall there were no significant differences in mortality between the colonoscopy group and control group (0.22% vs 0.22%; risk difference less than .01%; 95% CI, decrease of 0.02% to 0.02%; P = .913). The overall rate of unplanned hospitalization was significantly higher for the colonoscopy group (2.39% vs 2.31% for the control group; risk difference, 0.08%; 95% CI, 0.01%-0.15%; P=.026) for the entire observation period. This was due to the higher rate of hospitalizations after screening (1.10% vs 1.01% for the control group; risk difference, 0.09%; 95% CI, 0.04%-0.14%; P < .001) including higher proportion of hospitalizations that were assessed as related to colonoscopy (0.24% vs 0.22% for the control group; risk difference, 0.02%; 95% CI, 0.00%-0.05%; P = .046). In the per-protocol analysis, the overall rate of hospitalizations did not differ significantly between control and screening colonoscopy groups (1.87% vs 1.90%; P=.709). However, screening colonoscopy did increase rates of related hospitalizations after the date of screening (from 0.14% to 0.31%; P < .001). CONCLUSIONS In an analysis of data from the PCSP, we found high-quality evidence that colonoscopy as a screening intervention does not increase mortality before or after colonoscopy. However, it may be associated with a small but significant increase in unplanned hospitalizations, especially after the colonoscopy is completed.
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Affiliation(s)
- Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland; Department of Cancer Prevention, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Piotr Spychalski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland.
| | - Paulina Wieszczy
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland; Department of Oncological Gastroenterology, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Malgorzata Pisera
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Nastazja Pilonis
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland; Department of Oncological Gastroenterology, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Maciej Rupinski
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland; Department of Oncological Gastroenterology, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Marek Bugajski
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland; Department of Oncological Gastroenterology, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Jaroslaw Regula
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland; Department of Oncological Gastroenterology, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Michal F Kaminski
- Department of Cancer Prevention, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland; Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland; Department of Oncological Gastroenterology, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland; Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway
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Zurawa-Janicka D, Kobiela J, Slebioda T, Peksa R, Stanislawowski M, Wierzbicki PM, Wenta T, Lipinska B, Kmiec Z, Biernat W, Lachinski AJ, Sledzinski Z. Expression of HTRA Genes and Its Association with Microsatellite Instability and Survival of Patients with Colorectal Cancer. Int J Mol Sci 2020; 21:E3947. [PMID: 32486357 PMCID: PMC7312515 DOI: 10.3390/ijms21113947] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 05/28/2020] [Indexed: 02/07/2023] Open
Abstract
HtrA proteases regulate cellular homeostasis and cell death. Their dysfunctions have been correlated with oncogenesis and response to therapeutic treatment. We investigated the relation between HtrA1-3 expression and clinicopathological, and survival data, as well as the microsatellite status of tumors. Sixty-five colorectal cancer patients were included in the study. The expression of HTRA1-3 was estimated at the mRNA and protein levels by quantitative PCR and immunoblotting. Microsatellite status was determined by high-resolution-melting PCR. We found that the HTRA1 mRNA level was higher in colorectal cancer tissue as compared to the unchanged mucosa, specifically in primary lesions of metastasizing cancer. The levels of HtrA1 and HtrA2 proteins were reduced in tumor tissue when compared to unchanged mucosa, specifically in primary lesions of metastasizing disease. Moreover, a decrease in HTRA1 and HTRA2 transcripts' levels in cancers with a high level of microsatellite instability compared to microsatellite stable ones has been observed. A low level of HtrA1 or/and HtrA2 in cancer tissue correlated with poorer patient survival. The expression of HTRA1 and HTRA2 changes during colorectal carcinogenesis and microsatellite instability may be, at least partially, associated with these changes. The alterations in the HTRA1/2 genes' expression are connected with metastatic potential of colorectal cancer and may affect patient survival.
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Affiliation(s)
- Dorota Zurawa-Janicka
- Department of General and Medical Biochemistry, Faculty of Biology, University of Gdansk, Wita Stwosza 59, 80-308 Gdansk, Poland; (T.W.); (B.L.)
| | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Faculty of Medicine, Medical University of Gdansk, Mariana Smoluchowskiego 17, 80-214 Gdansk, Poland; (J.K.); (A.J.L.); (Z.S.)
| | - Tomasz Slebioda
- Department of Histology, Faculty of Medicine, Medical University of Gdansk, Debinki 1, 80-211 Gdansk, Poland; (T.S.); (M.S.); (P.M.W.); (Z.K.)
| | - Rafal Peksa
- Department of Pathomorphology, Faculty of Medicine, Medical University of Gdansk, Mariana Smoluchowskiego 17, 80-214 Gdansk, Poland; (R.P.); (W.B.)
| | - Marcin Stanislawowski
- Department of Histology, Faculty of Medicine, Medical University of Gdansk, Debinki 1, 80-211 Gdansk, Poland; (T.S.); (M.S.); (P.M.W.); (Z.K.)
| | - Piotr Mieczyslaw Wierzbicki
- Department of Histology, Faculty of Medicine, Medical University of Gdansk, Debinki 1, 80-211 Gdansk, Poland; (T.S.); (M.S.); (P.M.W.); (Z.K.)
| | - Tomasz Wenta
- Department of General and Medical Biochemistry, Faculty of Biology, University of Gdansk, Wita Stwosza 59, 80-308 Gdansk, Poland; (T.W.); (B.L.)
| | - Barbara Lipinska
- Department of General and Medical Biochemistry, Faculty of Biology, University of Gdansk, Wita Stwosza 59, 80-308 Gdansk, Poland; (T.W.); (B.L.)
| | - Zbigniew Kmiec
- Department of Histology, Faculty of Medicine, Medical University of Gdansk, Debinki 1, 80-211 Gdansk, Poland; (T.S.); (M.S.); (P.M.W.); (Z.K.)
| | - Wojciech Biernat
- Department of Pathomorphology, Faculty of Medicine, Medical University of Gdansk, Mariana Smoluchowskiego 17, 80-214 Gdansk, Poland; (R.P.); (W.B.)
| | - Andrzej Jacek Lachinski
- Department of General, Endocrine and Transplant Surgery, Faculty of Medicine, Medical University of Gdansk, Mariana Smoluchowskiego 17, 80-214 Gdansk, Poland; (J.K.); (A.J.L.); (Z.S.)
| | - Zbigniew Sledzinski
- Department of General, Endocrine and Transplant Surgery, Faculty of Medicine, Medical University of Gdansk, Mariana Smoluchowskiego 17, 80-214 Gdansk, Poland; (J.K.); (A.J.L.); (Z.S.)
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17
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Dell'Acqua V, Surgo A, Arculeo S, Zerella MA, Bagnardi V, Frassoni S, Zampino MG, Ravenda PS, Rotundo MS, Kraja F, Kobiela J, Spychalski P, Fodor C, Gerardi MA, Cattani F, Bazani A, Petz W, Glynne-Jones R, Orecchia R, Leonardi MC, Jereczek-Fossa BA. Intensity-modulated radiotherapy (IMRT) in the treatment of squamous cell anal canal cancer: acute and early-late toxicity, outcome, and efficacy. Int J Colorectal Dis 2020; 35:685-694. [PMID: 32036405 DOI: 10.1007/s00384-020-03517-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2020] [Indexed: 02/04/2023]
Abstract
PURPOSE To retrospectively review our experience on 84 patients with squamous cell anal canal cancer (SCAC) within 12 months after combined treatment with intensity-modulated RT (IMRT), in terms of acute and early-late toxicity, overall treatment time and interruptions, colostomy-free survival (CFS), and tumor response. METHODS Acute gastrointestinal (GI), genitourinary (GU), and cutaneous (CU) toxicities were assessed according to Common Toxicity Criteria for Adverse Events (CTCAE) version 4.03. Early-late toxicity was scored using the Radiation Therapy Oncology Group (RTOG) late radiation morbidity scoring system. Tumor response was evaluated with response evaluation criteria in solid tumors (RECIST) v1.1. RESULTS Acute toxicity for 84 subjects (100%): severe (≥ G3) GI and skin toxicity was observed in 4 (5%) and 19 patients (23%), respectively. Early-late toxicity for 73 subjects (87%): severe (≥ G3) GI and vulvo-vaginal toxicity was observed in 2 (3%) and 2 (3%) patients, respectively. No acute or early-late severe GU toxicity was reported. A treatment interruption occurred in 65 patients (77%). CFS was 96% (95% CI 89-99) at 6 months and 92% (95% CI 83-96) at 12 months. At 6 months complete response (CR), partial response (PR) and progressive disease (PD) was observed in 70 (83%), 3 (4%), and 7 patients (8%), respectively. At 12 months, CR was observed in 60 patients (81%); eleven patients (15%) experienced PD. CONCLUSION Our study showed an excellent clinical result and very low acute toxicity rates, confirming the IMRT as standard of care for curative treatment of anal cancer patients. The current trial was registered with the number IEO N87/11.
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Affiliation(s)
- Veronica Dell'Acqua
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy
| | - Alessia Surgo
- Radiation Oncology Department, General Regional Hospital "F. Miulli", Acquaviva delle Fonti, Italy
| | - Simona Arculeo
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy
| | - Maria Alessia Zerella
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy.
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy.
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - Samuele Frassoni
- Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - Maria Giulia Zampino
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IRCCS, Milan, Italy
| | - Paola Simona Ravenda
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IRCCS, Milan, Italy
| | - Maria Saveria Rotundo
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IRCCS, Milan, Italy
| | - Fatjona Kraja
- Division of Oncology, University Hospital Centre "Mother Theresa", Rruga e Dibrës 372, 1000, Tirana, AL, Albania
| | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Marii Skłodowskiej-Curie 3a, 80-210, Gdańsk, Poland
| | - Piotr Spychalski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Marii Skłodowskiej-Curie 3a, 80-210, Gdańsk, Poland
| | - Cristiana Fodor
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy
| | | | - Federica Cattani
- Unit of Medical Physics, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy
| | - Alessia Bazani
- Unit of Medical Physics, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy
| | - Wanda Petz
- Division of Gastrointestinal Surgery, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy
| | | | - Roberto Orecchia
- Scientific Directorate, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141, Milan, Italy
| | - Maria Cristina Leonardi
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy
| | - Barbara Alicja Jereczek-Fossa
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy
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Spychalski P, Błażyńska-Spychalska A, Kobiela J. Estimating case fatality rates of COVID-19. Lancet Infect Dis 2020; 20:774-775. [PMID: 32243815 PMCID: PMC7270730 DOI: 10.1016/s1473-3099(20)30246-2] [Citation(s) in RCA: 117] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 01/06/2023]
Affiliation(s)
- Piotr Spychalski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Gdańsk PL-80-210, Poland
| | | | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Gdańsk PL-80-210, Poland
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19
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Wieszczy P, Kaminski MF, Franczyk R, Loberg M, Kobiela J, Rupinska M, Kocot B, Rupinski M, Holme O, Wojciechowska U, Didkowska J, Ransohoff D, Bretthauer M, Kalager M, Regula J. Colorectal Cancer Incidence and Mortality After Removal of Adenomas During Screening Colonoscopies. Gastroenterology 2020; 158:875-883.e5. [PMID: 31563625 DOI: 10.1053/j.gastro.2019.09.011] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 09/16/2019] [Accepted: 09/19/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Recommendation of surveillance colonoscopy should be based on risk of colorectal cancer and death after adenoma removal. We aimed to develop a risk classification system based on colorectal cancer incidence and mortality following adenoma removal. METHODS We performed a multicenter population-based cohort study of 236,089 individuals (median patient age, 56 years; 37.8% male) undergoing screening colonoscopies with adequate bowel cleansing and cecum intubation at 132 centers in the Polish National Colorectal Cancer Screening Program, from 2000 through 2011. Subjects were followed for a median 7.1 years and information was collected on colorectal cancer development and death. We used recursive partitioning and multivariable Cox models to identify associations between colorectal cancer risk and patient and adenoma characteristics (diameter, growth pattern, grade of dysplasia, and number of adenomas). We developed a risk classification system based on standardized incidence ratios, using data from the Polish population for comparison. The primary endpoints were colorectal cancer incidence and colorectal cancer death. RESULTS We identified 130 colorectal cancers in individuals who had adenomas removed at screening (46.5 per 100,000 person-years) vs 309 in individuals without adenomas (22.2 per 100,000 person-years). Compared with individuals without adenomas, adenomas ≥20 mm in diameter and high-grade dysplasia were associated with increased risk of colorectal cancer (adjusted hazard ratios 9.25; 95% confidence interval [CI] 6.39-13.39, and 3.58; 95% CI 1.96-6.54, respectively). Compared with the general population, colorectal cancer risk was higher or comparable only for individuals with adenomas ≥20 mm in diameter (standardized incidence ratio [SIR] 2.07; 95% CI 1.40-2.93) or with high-grade dysplasia (SIR 0.79; 95% CI 0.39-1.41), whereas for individuals with other adenoma characteristics the risk was lower (SIR 0.35; 95% CI 0.28-0.44). We developed a high-risk classification based on adenoma size ≥20 mm or high-grade dysplasia (instead of the current high-risk classification cutoff of ≥3 adenomas or any adenoma with villous growth pattern, high-grade dysplasia, or ≥10 mm in diameter). Our classification system would reduce the number of individuals classified as high-risk and requiring intensive surveillance from 15,242 (36.5%) to 3980 (9.5%), without increasing risk of colorectal cancer in patients with adenomas (risk difference per 100,000 person-years, 5.6; 95% CI -10.7 to 22.0). CONCLUSIONS Using data from the Polish National Colorectal Cancer Screening Program, we developed a risk classification system that would reduce the number of individuals classified as high risk and require intensive surveillance more than 3-fold, without increasing risk of colorectal cancer in patients with adenomas. This system could optimize the use of surveillance colonoscopy.
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Affiliation(s)
- Paulina Wieszczy
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland; Department of Oncological Gastroenterology and Department of Cancer Prevention, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland; Frontier Science Foundation, Boston, Massachusetts.
| | - Michal F Kaminski
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland; Department of Oncological Gastroenterology and Department of Cancer Prevention, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland; Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo and Department of Transplantation Medicine Oslo University Hospital, Oslo, Norway
| | - Robert Franczyk
- Department of Oncological Gastroenterology and Department of Cancer Prevention, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland; Department of Descriptive and Clinical Anatomy, Center of Biostructure Research, Medical University of Warsaw, Poland
| | - Magnus Loberg
- Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo and Department of Transplantation Medicine Oslo University Hospital, Oslo, Norway; Department of Transplantation Medicine and K. G. Jebsen Center for Colorectal Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Maria Rupinska
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland; Department of Oncological Gastroenterology and Department of Cancer Prevention, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Bartlomiej Kocot
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Maciej Rupinski
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland; Department of Oncological Gastroenterology and Department of Cancer Prevention, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Oyvind Holme
- Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo and Department of Transplantation Medicine Oslo University Hospital, Oslo, Norway; Department of Medicine, Sorlandet Hospital Kristiansand, Kristiansand, Norway
| | - Urszula Wojciechowska
- National Cancer Registry of Poland, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Joanna Didkowska
- National Cancer Registry of Poland, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - David Ransohoff
- Departments of Medicine and Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Michael Bretthauer
- Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo and Department of Transplantation Medicine Oslo University Hospital, Oslo, Norway; Department of Transplantation Medicine and K. G. Jebsen Center for Colorectal Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Mette Kalager
- Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo and Department of Transplantation Medicine Oslo University Hospital, Oslo, Norway; Department of Transplantation Medicine and K. G. Jebsen Center for Colorectal Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Jaroslaw Regula
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland; Department of Oncological Gastroenterology and Department of Cancer Prevention, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
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20
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Spychalski P, Kobiela J, Wieszczy P, Kamiński MF, Reguła J. Clinical stages of colorectal cancer diagnosed in obese and overweight individuals in the Polish Colonoscopy Screening Program. United European Gastroenterol J 2019; 7:790-797. [PMID: 31316783 DOI: 10.1177/2050640619840451] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 03/07/2019] [Indexed: 12/14/2022] Open
Abstract
Background Obesity is a known risk factor of colorectal cancer (CRC). However, precise interconnections between excessive body fat and CRC are still vague. Therefore, the aim of this study was to assess whether stage of CRC detected in overweight and obese individuals differs from individuals with normal body mass index (BMI). A secondary aim of this study was to elucidate whether overweight and obesity influence the overall survival in CRC. Methods This study was a cross-sectional analysis of 163,129 individuals who underwent screening colonoscopy performed on data from a prospectively maintained database of the Polish Colonoscopy Screening Program. Results Overweight and obese individuals present with a less advanced CRC in screening setting (p = 0.014). This trend is the most pronounced in males (p = 0.001). Univariable and multivariable analyses revealed that obesity was a negative predictor of detection of advanced CRC with odds ratio 0.72 (95% confidence interval 0.52-1.00; p = 0.047). Furthermore, overweight and obesity were not statistically significant predictors of risk of death (p = 0.614 and p = 0.446, respectively). Conclusions Obese screenees present with a less advanced disease in comparison to non-obese. Moreover, survival stratified by clinical stage seems to not be influenced by BMI category. Therefore, a higher proportion of early diagnosed cancers can potentially create a survival benefit in this group.
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Affiliation(s)
- Piotr Spychalski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland.,Department of Cancer Prevention, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Paulina Wieszczy
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Department of Cancer Prevention, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Michał F Kamiński
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Department of Oncological Gastroenterology, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland.,Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Cancer Prevention, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Jarosław Reguła
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Department of Cancer Prevention, the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
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21
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Rostkowska O, Spychalski P, Dobrzycka M, Wilczyński M, Łachiński AJ, Obołończyk Ł, Sworczak K, Kobiela J. Effects of thyroid hormone imbalance on colorectal cancer carcinogenesis and risk — a systematic review. Endokrynologia Polska 2019; 70:190-197. [DOI: 10.5603/ep.a2019.0007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 09/27/2018] [Indexed: 11/25/2022]
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22
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Spychalski P, Kobiela J, Antoszewska M, Błażyńska-Spychalska A, Jereczek-Fossa BA, Høyer M. Patient specific outcomes of charged particle therapy for hepatocellular carcinoma - A systematic review and quantitative analysis. Radiother Oncol 2019; 132:127-134. [PMID: 30825961 DOI: 10.1016/j.radonc.2018.12.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 10/19/2018] [Revised: 12/09/2018] [Accepted: 12/12/2018] [Indexed: 01/04/2023]
Abstract
Hepatocellular carcinoma (HCC) is a raising condition world-wide. Most of patients are ineligible for surgery at diagnosis due to the advanced stage of the disease or poor medical condition of the patient. Charged particle therapy (CPT) is a radiotherapy modality showing promising results. The aim of this systematic review was to summarize current knowledge on patient-specific outcomes of CPT for HCC, including overall survival, local control, the effect of radiation dose and the toxicity burden. The systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). After comprehensive database search 17 cohorts (16 studies, 1516 patients) were included into qualitative and quantitative analyses; 11 of 16 studies were retrospective. Eleven studies were on protons, 2 studies were on protons and carbon ions and 4 on carbon ions alone, were identified. Median BED10 (biologically equivalent dose) range was 68.75-122.5 GyE. Mean weighted overall survival across studies was 86%, 62%, 59% and 35% at 1, 2, 3 and 5 years, respectively. Mean weighted local control was 86%, 89%, 87% and 89% at 1, 2, 3 and 5 years, respectively. Adjusted morbidity rates were: 54% for acute G1-2 toxicities and 6% for acute ≥G3 toxicities; 9% for late G1-2 toxicities and less than 4% for late ≥G3 toxicities. There was no treatment-associated mortality. CONCLUSIONS: CPT offers high local control, acceptable overall survival and low post-treatment morbidity. Quality of findings, especially on toxicities, is decreased by incomplete reporting and retrospective designs of available studies. Therefore, there is a strong need for better reporting and prospective studies.
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Affiliation(s)
- Piotr Spychalski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Poland; Danish Center for Particle Therapy, Aarhus University Hospital, Denmark.
| | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Poland
| | - Magdalena Antoszewska
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Poland
| | | | - Barbara A Jereczek-Fossa
- Department of Oncology and Hemato-oncology, University of Milan, Italy; Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Morten Høyer
- Danish Center for Particle Therapy, Aarhus University Hospital, Denmark
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23
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Kobiela J, Bertani E, Petz W, Crosta C, De Roberto G, Borin S, Ribero D, Baldassari D, Spychalski P, Spinoglio G. Double indocyanine green technique of robotic right colectomy: Introduction of a new technique. J Minim Access Surg 2019; 15:357-359. [PMID: 29974874 PMCID: PMC6839355 DOI: 10.4103/jmas.jmas_127_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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] [Indexed: 12/30/2022] Open
Abstract
In robotic right hemicolectomy for colorectal cancer (CRC), appropriate lymphadenectomy and anastomotic leak prevention are critical. Visualisation of lymph nodes and blood flow with near-infrared (NIR) fluorescence DaVinci® imaging system is a recent development. Herein, we present an improved robotic modified complete mesocolic excision (mCME) technique using indocyanine green (ICG) fluorescence. Before surgery, ICG is injected into the submucosa around the tumour with endoscopy for intraoperative detection of lymph nodes. Robotic mCME with central vascular ligation is performed, supplemented in most of the cases with selective extended lymphadenectomy. Intestinal blood flow before anastomosis is evaluated by administering ICG intravenously and NIR visualisation. Visualisation of the lymph nodes with ICG facilitates standard mCME lymphadenectomy and enables extended lymphadenectomy. Blood flow of the intestinal walls of the anastomotic site can be assessed and determines the extent of intestinal resection. Robotic double ICG technique for robotic right hemicolectomy enables improved lymphadenectomy and warrants the extent of intestinal resection; thus, becoming a strong candidate for gold standard in robotic resections of the right colon for CRC.
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Affiliation(s)
- Jarek Kobiela
- Medical University of Gdansk, General, Endocrine and Transplant Surgery, Gdansk, Poland
| | - Emilio Bertani
- European Institute of Oncology (IEO), Hepatobiliary, Pancreatic and Digestive Program, Milan, Italy
| | - Wanda Petz
- European Institute of Oncology (IEO), Division of Endoscopy, Milan, Italy
| | - Cristiano Crosta
- European Institute of Oncology (IEO), Division of Endoscopy, Milan, Italy
| | | | - Simona Borin
- European Institute of Oncology (IEO), Division of Endoscopy, Milan, Italy
| | - Dario Ribero
- European Institute of Oncology (IEO), Hepatobiliary, Pancreatic and Digestive Program, Milan, Italy
| | - Diana Baldassari
- European Institute of Oncology (IEO), Hepatobiliary, Pancreatic and Digestive Program, Milan, Italy
| | - Piotr Spychalski
- Medical University of Gdansk, General, Endocrine and Transplant Surgery, Gdansk, Poland
| | - Giuseppe Spinoglio
- European Institute of Oncology (IEO), Hepatobiliary, Pancreatic and Digestive Program, Milan, Italy
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Kobiela J, Dobrzycka M, Danielewicz R, Jończyk J, Łachiński AJ, Śledziński Z, Dębska-Ślizień A. Colonoscopy as Part of Pre-Transplant Work-Up in Successful Kidney Transplant Candidates: Single-Center Experience and Review of Literature. Ann Transplant 2018; 23:782-788. [PMID: 30409961 PMCID: PMC6247820 DOI: 10.12659/aot.910658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Screening colonoscopy is not obligatory in kidney pre-transplant work-up guidelines. According to recommendations, only transplant recipients over age 50 years should be screened. The aim of this study was to characterize endoscopic findings revealed as part of pre-transplant work-up. Material/Methods We retrospectively reviewed pre-transplant work-up charts of 434 adult patients who received a cadaveric donor kidney transplantation (KT) from 2012 to 2015. Endoscopic findings analysis with age subgroup (<50 and ≥50) analysis were performed. Results Out of 434 of patients that underwent KT, 29% have had a colonoscopy. In 75.6% of those, pathologies were found. Hemorrhoids were found in 33% and polyps in 30.7% of patients. Adenoma detection rate (ADR) was 18.1% (67.5% distal predominance). Advanced ADR was 10.2% (distal predominance). Diverticulosis was found in 28.3% of patients and ulcerative colitis was found in 2.4%. In age subgroup analysis, ADR was higher in patients ≥50 years compared to those <50 years (21.6% vs. 4%; p=0.041). Conclusions Colonoscopy as part of pre-transplant work-up enables removal of precancerous lesions and management of benign findings. All candidates meeting criteria for the general population should be screened. Patients under age 50 years could also benefit from colonoscopy as part of the pre-transplant work-up. Therefore, we suggest that baseline colonoscopy should be included in pre-transplant work-up guidelines for all patients, regardless of age. However, further studies are needed to confirm this recommendation.
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Affiliation(s)
- Jarek Kobiela
- Department of General, Endocrine, and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Małgorzata Dobrzycka
- Department of General, Endocrine, and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Roman Danielewicz
- Department of Surgical and Transplant Nursing, Medical University of Warsaw, Warsaw, Poland
| | - Justyna Jończyk
- Department of General, Endocrine, and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Andrzej J Łachiński
- Department of General, Endocrine, and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Zbigniew Śledziński
- Department of General, Endocrine, and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
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25
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Kobiela J, Wieszczy P, Reguła J, Kamiński MF. Association of obesity with colonic findings in screening colonoscopy in a large population-based study. United European Gastroenterol J 2018; 6:1538-1546. [PMID: 30574324 DOI: 10.1177/2050640618803825] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 08/28/2018] [Indexed: 12/31/2022] Open
Abstract
Background and aims Obesity is associated with an increased incidence of and mortality from colorectal cancer (CRC). Screening colonoscopy seems particularly important for individuals with obesity. The aim of this study is to analyse the characteristics of screening colonoscopy in individuals with obesity. Methods We performed a cross-sectional analysis of records of 75,278 patients from a national colonoscopy screening programme in Poland. The database contained demographic data, colonoscopy results, self-reported data on weight and height, a standardized screenees' experience questionnaire and colorectal findings. Results Adenoma detection rate and advanced neoplasia detection rate increased significantly in groups of increasing body mass index (BMI). In subjects with morbid obesity, odds ratios for proximal adenoma and proximal advanced neoplasia were 1.69 (95% confidence interval (CI) 1.28-2.21) and 1.66 (95% CI 1.01-2.72), respectively, despite the fact that with BMI increasing over 30 the preparation for colonoscopy was worse. Moreover, caecal intubation increased with increasing BMI. Tolerance of colonoscopy was better and preparation for colonoscopy was less inconvenient in individuals with obesity. Conclusions Obesity and morbid obesity are associated with increased detection of colorectal precursor lesions and better performance of screening colonoscopy. Participation in screening colonoscopy should be emphasized among individuals with obesity, taking into account the burden of CRC in this population.
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Affiliation(s)
- Jarek Kobiela
- Medical Center for Postgraduate Education, Warsaw, Poland
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
- Department of Gastroenterological Oncology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland
| | | | - Jarosław Reguła
- Medical Center for Postgraduate Education, Warsaw, Poland
- Department of Gastroenterological Oncology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland
- Department of Gastroenterology and Hepatology, Medical Centre for Postgraduate Education, Warsaw, Poland
| | - Michał F Kamiński
- Medical Center for Postgraduate Education, Warsaw, Poland
- Department of Gastroenterological Oncology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland
- Department of Gastroenterology and Hepatology, Medical Centre for Postgraduate Education, Warsaw, Poland
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Abstract
OBJECTIVES Statins act by inhibiting 3-hydroxy-3-methylglutaryl-coenzyme A reductase and are an important drug class in the treatment of lipid disorders. They lower cholesterol levels and modulate cardiovascular disease risk in both primary and secondary prevention. In addition, some studies have shown that statins may have an effect on colorectal cancer development and treatment. Our objective is to summarize published studies on the effect of statins on colorectal carcinogenesis. METHODS A systematic review of the PubMed and Cochrane databases was performed to identify studies published between April 2010 and April 2018 that investigated the association between statin use and colorectal cancer incidence, mortality, and treatment. RESULTS Overall, 126 articles were identified with our search strategy. Based on the eligibility criteria, 69 studies were excluded from the review process. In vitro and animal studies have shown a potential chemopreventive effect of statins and their efficacy in adjuvant therapy of colorectal cancer. The anticarcinogenic effect on cancer risk in human studies was heterogeneous. Some studies reported better overall and cancer specific survival rates in patients using statins before and during colorectal cancer treatment. Statins also show a potential role in chemoprevention of colorectal cancer in patients with inflammatory bowel disease. CONCLUSIONS Accumulating evidence suggests that statins may have a role in colorectal cancer prevention and treatment. Further studies are necessary to define the associations between individual statin characteristics, their doses and colorectal cancer.
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Affiliation(s)
- Małgorzata Dobrzycka
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Piotr Spychalski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Andrzej J Łachiński
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Paulina Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland.,Department of Neonatology, Medical University of Gdańsk, Gdańsk, Poland
| | - Piotr Jędrusik
- Department of Neonatology, Medical University of Gdańsk, Gdańsk, Poland.,Department of Internal Medicine, Hypertension, and Angiology, Medical University of Warsaw, Warsaw, Poland
| | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
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27
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Dobosz Ł, Kobiela J, Danielewicz R, Śledziński Z, Dębska-Ślizień A. Gallbladder Pathologies in Kidney Transplant Recipients: Single-Center Experience and a Review of the Literature. Ann Transplant 2018; 23:572-576. [PMID: 30104561 PMCID: PMC6248059 DOI: 10.12659/aot.909653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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] [Indexed: 01/11/2023] Open
Abstract
Background In patients with end-stage renal disease, cholelithiasis is observed with an increased frequency. In transplant recipients, symptoms might be obscured, which may delay the diagnosis and lead to complications. The aim of our study was to evaluate the frequency of gallbladder pathologies in kidney transplant recipients (KTRs) in the Caucasian population, and to discuss the potential benefits of prophylactic cholecystectomy before kidney transplantation (KT). Material/Methods Data from 434 patients who underwent KT was analyzed. Demographic data along with gallbladder status were collected from the pre-transplantation charts. We compared our results to data from the general Polish population. Results In our analyzed group of KTRs, there were 284 men and 150 women. Complete data, including abdominal ultrasound description, were available in 412 cases. In this group, 36 patients (8.74%) underwent cholecystectomy before KT. Other gallbladder pathologies (gallstones and polyps) were found in 41 patients (9.95%) at pre-transplantation evaluation. The incidence of gallbladder pathologies in KTRs, being mostly cholelithiasis, was higher than in the general Polish population. Conclusions In specific age subgroups of KTRs, the frequency of gallbladder pathologies was higher than in the general population. Prophylactic cholecystectomy may potentially offer benefits in these subgroups of patients.
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Affiliation(s)
- Łukasz Dobosz
- Department of General, Endocrine and Transplant Surgery, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Roman Danielewicz
- Department of Surgical and Transplant Nursing, Medical University of Warsaw, Warsaw, Poland.,Polish Transplant Coordinating Center Poltransplant, Warsaw, Poland
| | - Zbigniew Śledziński
- Department of General, Endocrine and Transplant Surgery, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
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Kobiela J, Dobrzycka M, Jędrusik P, Kobiela P, Spychalski P, Śledziński Z, Zdrojewski T. Metformin and Colorectal Cancer – A Systematic Review. Exp Clin Endocrinol Diabetes 2018; 127:445-454. [DOI: 10.1055/a-0621-8830] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Abstract
Objectives Colorectal cancer (CRC) is the second leading cause of cancer-related deaths. The development of preventive strategies in CRC has been the subject of much research. Multiple studies have shown an association between diabetes and CRC. In addition to its glucose-lowering properties, metformin might have an additional role in the prevention and treatment of CRC.
Our objective was to summarize findings on role of metformin in colorectal cancer.
Methods We conducted a systematic review of the PubMed and Cochrane databases from January 2005 to December 2017 in search for studies on the association between metformin and CRC.
Results Of the total of 189 studies identified by the search, we excluded 123 studies and reviewed the remaining 66 studies on cell lines, animals, patients with diabetes, and healthy subjects. In vitro and animal studies have shown a protective effect of metformin use on the incidence of CRC and amplification of the therapeutic effects of CRC chemotherapy. Studies on patients with type 2 diabetes treated with metformin analyzed data on total of 146 496 patients. The results of those studies on the role of metformin in CRC suggest risk reduction and potential applications within therapeutic regimens, although some of those are conflicting.
Conclusion Further studies are warranted to define the role of metformin in both prevention and treatment of CRC.
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Affiliation(s)
- Jarek Kobiela
- Department of General, Endocrine, and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Małgorzata Dobrzycka
- Department of General, Endocrine, and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Piotr Jędrusik
- Department of Internal Medicine, Hypertension, and Angiology, Medical University of Warsaw, Warsaw, Poland
| | - Paulina Kobiela
- Department of Neonalology, Medical University of Gdańsk, Gdańsk, Poland
| | - Piotr Spychalski
- Department of General, Endocrine, and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Zbigniew Śledziński
- Department of General, Endocrine, and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Tomasz Zdrojewski
- Department of Arterial Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland
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Kobiela J, Spychalski P, Marvaso G, Ciardo D, Dell'Acqua V, Kraja F, Błażyńska-Spychalska A, Łachiński AJ, Surgo A, Glynne-Jones R, Jereczek-Fossa BA. Ablative stereotactic radiotherapy for oligometastatic colorectal cancer: Systematic review. Crit Rev Oncol Hematol 2018; 129:91-101. [PMID: 30097241 DOI: 10.1016/j.critrevonc.2018.06.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [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: 02/04/2018] [Revised: 06/13/2018] [Accepted: 06/13/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND SBRT is a novel modality in treatment for oligometastatic colorectal cancer. We aimed to perform a systematic review of results of SBRT in maintaining LC (local control) for CRC liver and lung oligometastases. MATERIALS AND METHODS The review was performed according to PRISMA and PICO guidelines. Database search using keywords: stereotactic, colon, colorectal, cancer, sbrt, sabr returned 457 results. 15 were included in the study. Only cohorts with CRC histology and reported LC were included. RESULTS For liver LC rates ranged from 50% to 100% after 1 year and 32% to 91% after 2 years. BED range 40.5-262.5 Gy (Gray). For lung LC rates ranged from 62% to 92% after 1 one year and from 53% to 92% after 2 years. BED range 51.3-262.5 Gy. CONCLUSIONS SBRT of oligometastatic CRC offers high LC with low morbidity and toxicity. It requires more observational studies and randomized trials but available data on clinical efficacy is promising, however not yet matured.
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Affiliation(s)
- J Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
| | - P Spychalski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland.
| | - G Marvaso
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - D Ciardo
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - V Dell'Acqua
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - F Kraja
- Department of Oncology, University Hospital Centre "Mother Theresa", Tirana, Albania
| | - A Błażyńska-Spychalska
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
| | - A J Łachiński
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
| | - A Surgo
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - R Glynne-Jones
- Mount Vernon Centre for Cancer Treatment, Northwood, Middlesex, HA6 2RN, UK
| | - B A Jereczek-Fossa
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Dell'Acqua V, Kobiela J, Kraja F, Leonardi MC, Surgo A, Zerella MA, Arculeo S, Fodor C, Ricotti R, Zampino MG, Ravenda S, Spinoglio G, Biffi R, Bazani A, Luraschi R, Vigorito S, Spychalski P, Orecchia R, Glynne-Jones R, Jereczek-Fossa BA. Genital marginal failures after intensity-modulated radiation therapy (IMRT) in squamous cell anal cancer: no higher risk with IMRT when compared to 3DCRT. Med Oncol 2018; 35:59. [PMID: 29594584 DOI: 10.1007/s12032-018-1118-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 03/22/2018] [Indexed: 12/16/2022]
Abstract
Intensity-modulated radiotherapy (IMRT) is considered the preferred option in squamous cell canal cancer (SCAC), delivering high doses to tumor volumes while minimizing dose to surrounding normal tissues. IMRT has steep dose gradients, but the technique is more demanding as deep understanding of target structures is required. To evaluate genital marginal failure in a cohort of patients with non-metastatic SCAC treated either with IMRT or 3DCRT and concurrent chemotherapy, 117 patients with SCAC were evaluated: 64 and 53 patients were treated with IMRT and 3DCRT techniques, respectively. All patients underwent clinical and radiological examination during their follow-up. Tumor response was evaluated with response evaluation criteria in solid tumors v1.1 guideline on regular basis. All patients' data were analyzed, and patients with marginal failure were identified. Concomitant chemotherapy was administered in 97 and 77.4% of patients in the IMRT and 3DCRT groups, respectively. In the IMRT group, the median follow-up was 25 months (range 6-78). Progressive disease was registered in 15.6% of patients; infield recurrence, distant recurrence and both infield recurrence and distant recurrence were identified in 5, 4 and 1 patient, respectively. Two out of 64 patients (3.1%) had marginal failures, localized at vagina/recto-vaginal septum and left perineal region. In the 3DCRT group, the median follow-up was 71.3 months (range 6-194 months). Two out of 53 patients (3.8%) had marginal failures, localized at recto-vaginal septum and perigenital structures. The rate of marginal failures was comparable in IMRT and 3DCRT groups (χ2 test p = 0.85). In this series, the use of IMRT for the treatment of SCAC did not increase the rate of marginal failures offering improved dose conformity to the target. Dose constraints should be applied with caution-particularly in females with involvement of the vagina or the vaginal septum.
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Affiliation(s)
- V Dell'Acqua
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - J Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdańsk, Poland
| | - F Kraja
- Division of Oncology, University Hospital Centre "Mother Theresa", Tirana, Albania
| | - M C Leonardi
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy.
| | - A Surgo
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - M A Zerella
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - S Arculeo
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - C Fodor
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - R Ricotti
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
| | - M G Zampino
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, Milan, Italy
| | - S Ravenda
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, Milan, Italy
| | | | - R Biffi
- Unit of Peritoneal Cancer Surgery, European Institute of Oncology, Milan, Italy
| | - A Bazani
- Unit of Medical Physics, European Institute of Oncology, Milan, Italy
| | - R Luraschi
- Unit of Medical Physics, European Institute of Oncology, Milan, Italy
| | - S Vigorito
- Unit of Medical Physics, European Institute of Oncology, Milan, Italy
| | - P Spychalski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdańsk, Poland
| | - R Orecchia
- Scientific Directorate, European Institute of Oncology, Milan, Italy
| | - R Glynne-Jones
- Mount Vernon Centre for Cancer Treatment, Northwood, Middlesex, HA6 2RN, UK
| | - B A Jereczek-Fossa
- Department of Radiotherapy, European Institute of Oncology, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Kobiela J, Łaski D, Stróżyk A, Proczko-Markuszewska M, Stefaniak T, Sworczak K, Łachiński AJ, Śledziński Z. From four-parathyroid gland exploration to a minimally invasive technique. Minimally invasive parathyroidectomy as a current approach in surgery for primary hyperparathyroidism. Endokrynol Pol 2016; 65:240-9. [PMID: 24971926 DOI: 10.5603/ep.2014.0033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 02/08/2014] [Indexed: 11/25/2022]
Abstract
Complete surgical resection of hyperfunctioning parathyriod tissue is essential for the treatment of primary hyperparathyroidism. During recent years, minimally invasive surgery has been successfully applied in neck exploration, because of significant developments of guidance by intraoperative scans, the use of quick, intraoperative PTH assay, and also preoperative imaging procedures such as high resolution ultrasonography and sestamibi scintigraphy. The results of operations which are performed with minimally invasive techniques are comparable to those of conventional surgery, and provide advantages with regard to cosmetic result, length of hospitalisation, and reduced post-operative pain.
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Affiliation(s)
- Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk - Invasive Medicine Centre, Gdansk, Poland.
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Kobiela J, Mittlener S, Gorycki T, Lachinski AJ, Adrych K. Vast collection of foreign bodies in the stomach presenting as acute gastrointestinal bleeding in a patient with schizophrenia. Endoscopy 2016. [PMID: 26218047 DOI: 10.1055/s-0034-1392611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland
| | - Stanislaw Mittlener
- Department of Gastroenterology and Hepatology, Medical University of Gdansk, Poland
| | - Tomasz Gorycki
- Department of Radiology, Medical University of Gdansk, Poland
| | - Andrzej J Lachinski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland
| | - Krystian Adrych
- Department of Gastroenterology and Hepatology, Medical University of Gdansk, Poland
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Affiliation(s)
- Jarek Kobiela
- Department of General, Endocrine, and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Paulina Kobiela
- Department of Neonatology, Medical University of Gdansk, Gdansk, Poland
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34
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Kobiela J, Hac S. Hybrid biliary interventions for Roux-en-Y anatomy. Endoscopy 2015; 47:955. [PMID: 26417971 DOI: 10.1055/s-0034-1392410] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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35
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Kobiela J, Łaski D, Kaska Ł. Detailed anatomy of staple line crossings in sleeve gastrectomies for morbid obesity. Surg Obes Relat Dis 2015; 11:1404-5. [PMID: 26363713 DOI: 10.1016/j.soard.2015.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 07/04/2015] [Accepted: 07/06/2015] [Indexed: 11/17/2022]
Affiliation(s)
- Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland.
| | - Dariusz Łaski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Łukasz Kaska
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
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Smoczyński M, Marek I, Dubowik M, Rompa G, Kobiela J, Studniarek M, Pieńkowska J, Adrych K. Endoscopic drainage/debridement of walled-off pancreatic necrosis--single center experience of 112 cases. Pancreatology 2013; 14:137-42. [PMID: 24650969 DOI: 10.1016/j.pan.2013.11.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 10/08/2013] [Accepted: 11/15/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND Endoscopic drainage of the pancreatic pseudocysts has been accepted as a valid alternative to surgical and percutaneous drainage. Endoscopic treatment of the symptomatic walled-off necrosis was not, however, univocally accepted by all authors. THE AIM The aim of this study was to assessed the effectiveness and safety of the endoscopic drainage of walled-off necrosis. METHODS AND MATERIAL Between 2001 and 2011 one hundred and twelve patients with symptomatic walled-off necrosis were treated in the Department of Gastroenterology and Hepatology of the Medical University of Gdansk, using endoscopic drainage. The drainage system was set up by introducing endoprostheses and drains through gastric and duodenal fistulas, transpapillary, and additionally--in cases when the necrosis was spreading outside of the lesser sac--percutaneously. The results and complications of the endoscopic treatment were assessed retrospectively. RESULTS Initial success was achieved in 104/112 (92.9%) patients. Long term success was achieved in 94/112 (83.9%) patients in intention to treat analysis and 94/102 (90.4%) patients in per protocol analysis. Recurrence of pancreatic fluid collection was observed in 19/97(19.6%) patients. Procedure-related complications were observed in 29/112 patients (25.9%). Most of them were treated conservatively. Procedure-related mortality was 1.8%. CONCLUSIONS In a large group of selected patients with symptomatic walled-off necrosis, endoscopic drainage enables high success rate with acceptable complication rate and low procedure-related mortality.
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Affiliation(s)
- M Smoczyński
- Department of Gastroenterology and Hepatology of Medical University of Gdańsk, Gdańsk, Poland.
| | - I Marek
- Department of Gastroenterology and Hepatology of Medical University of Gdańsk, Gdańsk, Poland
| | - M Dubowik
- Department of Gastroenterology and Hepatology of Medical University of Gdańsk, Gdańsk, Poland
| | - G Rompa
- Department of Gastroenterology and Hepatology of Medical University of Gdańsk, Gdańsk, Poland
| | - J Kobiela
- Department of General, Endocrine and Transplant Surgery of Medical University of Gdańsk, Poland
| | - M Studniarek
- Department of Radiology of Medical University of Gdańsk, Poland
| | - J Pieńkowska
- Department of Radiology of Medical University of Gdańsk, Poland
| | - K Adrych
- Department of Gastroenterology and Hepatology of Medical University of Gdańsk, Gdańsk, Poland
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Kobiela J. Hand hygiene in the endoscopy unit: a surgical perspective. Endoscopy 2013; 45:932. [PMID: 24165819 DOI: 10.1055/s-0033-1344433] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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Proczko M, Kaska L, Kobiela J, Stefaniak T, Zadrożny D, Sledziński Z. Roux-en-Y gastric bypass in dialysed morbidly obese patients as a preparation for a kidney transplantation: case series. Wideochir Inne Tech Maloinwazyjne 2013; 8:174-7. [PMID: 23837104 PMCID: PMC3699771 DOI: 10.5114/wiitm.2011.32852] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 12/20/2012] [Accepted: 12/27/2012] [Indexed: 11/17/2022] Open
Abstract
Morbid obesity in group of patients with chronic kidney failure has an important impact on access to kidney transplantation. Bariatric procedures can be used as an preparation for potential recipients, which can help to improve their metabolic status and reduce weight. We present the first experience of our centre based on a series of 3 morbidly obese patients with chronic kidney disease underwent Roux-en-Y gastric bypass before being reported to the national registry of recipients.
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Affiliation(s)
- Monika Proczko
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland
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Kobiela J, Grymek S, Wojanowska M, Łubniewski M, Makarewicz W, Dobrowolski S, Łachiński AJ, Śledziński Z. Magnetic instrumentation and other applications of magnets in NOTES. Wideochir Inne Tech Maloinwazyjne 2012; 7:67-73. [PMID: 23256005 PMCID: PMC3516979 DOI: 10.5114/wiitm.2011.25665] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [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: 09/25/2011] [Revised: 10/18/2011] [Accepted: 11/11/2011] [Indexed: 12/13/2022] Open
Abstract
Modern surgery is developing towards a minimally invasive approach. To minimize the trauma the number of ports is either limited as in single incision laparoscopic procedures or ports are introduced through natural orifices as in natural orifice translumenal endoscopic surgery (NOTES). To provide surgeons with appropriate instrumentation novel technologies are employed involving magnets. This article summarizes the theoretical background, technology and currently developed magnetic instrumentation for NOTES, laparoscopic surgery and endoscopy. Moreover, current limitations and future goals are addressed to outline the prospects for use of magnetic instrumentation in the surgery of tomorrow.
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Affiliation(s)
- Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland
| | - Szymon Grymek
- Department of Machine Design and Exploitation, Faculty of Mechanical Engineering, Technical University of Gdansk, Poland
| | - Magdalena Wojanowska
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland
| | - Marek Łubniewski
- Department of Machine Design and Exploitation, Faculty of Mechanical Engineering, Technical University of Gdansk, Poland
| | - Wojciech Makarewicz
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland
| | - Sebastian Dobrowolski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland
| | - Andrzej J. Łachiński
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland
| | - Zbigniew Śledziński
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland
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Kobiela J, Stefaniak T, Dobrowolski S, Makarewicz W, Lachiński AJ, Sledziński Z. Transvaginal NOTES cholecystectomy in my partner? No way! Wideochir Inne Tech Maloinwazyjne 2011; 6:236-41. [PMID: 23255986 PMCID: PMC3516946 DOI: 10.5114/wiitm.2011.26258] [Citation(s) in RCA: 10] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2011] [Revised: 07/21/2011] [Accepted: 09/02/2011] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Natural orifice transluminal endoscopic surgery (NOTES) transvaginal cholecystectomy is being intensively studied. A few studies have been recently published evaluating patients' attitude towards NOTES with its individual accesses. However, the choice of a transvaginal access with its potential influence on sex life and fertility is not restricted entirely to women. The sexual partner would at least give his opinion or decide together with the woman. AIM The aim of the study was to assess the attitude of male sexual partners of potential NOTES transvaginal patients towards the surgical access. MATERIAL AND METHODS Hundred males were asked for their opinion in a specially designed instrument. RESULTS The general attitude of male sexual partners of potential NOTES transvaginal cholecystectomy patients is negative. With several possible problems and complications feared by the partners, they would mostly oppose or dissuade against NOTES transvaginal cholecystectomy. The cosmetic benefit seems not to justify undergoing a novelty procedure with potential complications threatening sexual life and procreation. This attitude was especially observed in young, sexually active males with high appreciation of sexual life. CONCLUSIONS Both scientific and educational efforts are required to prove safety and efficiency of NOTES transvaginal cholecystectomy beyond question.
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Affiliation(s)
- Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland
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Kobiela J, Hac S, Sledzinski Z. Single-port transgastric access for repeated debridement of infected pancreatic necrotic tissue. Endoscopy 2011; 42 Suppl 2:E354-5. [PMID: 21181628 DOI: 10.1055/s-0030-1255903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- J Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland
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Proczko-Markuszewska M, Kobiela J, Stefaniak T, Lachinski A, Sledzinski Z. Postoperative PTH measurement as a predictor of hypocalcaemia after thyroidectomy. Acta Chir Belg 2010; 110:40-4. [PMID: 20306908 DOI: 10.1080/00015458.2010.11680563] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [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
BACKGROUND Hypocalcaemia after thyroidectomy is the most common postoperative complication, with a reported incidence from 0.5% to even 50% of the operated patients. Hypoparathyroidism could be a result of careless or inadequate preparation during the surgical procedure. There is a variety of proposed options for the prediction of the incidence of hypocalcaemia. The most effective of them are the peri-operative and intra-operative measurements of the parathyroid hormone (PTH) level. METHODS A prospective study was performed on 100 patients who underwent total thyroidectomy from January 2007 to June 2008. The total calcium level and intact human PTH (iPTH) levels were measured 24 hours before as well as 1 hour and 24 hours after the surgery. THE AIM The goal of the study was to assess the potential correlation between the iPTH levels after the operation and the development of hypocalcaemia. The possible prediction value of postoperative iPTH levels was to be assessed. RESULTS We have presented a significant correlation between early iPTH measurement and the risk of hypocalcaemia. Moreover, a significant correlation between the iPTH level one hour after operation with the calcium level 24 hours after the operation was demonstrated. CONCLUSION Early postoperative assessment of iPTH levels can be used to identify the group of patients at risk of hypocalcaemia after thyroidectomy. Pre-emptive calcium supplementation can lead to the avoidance of complications causing prolonged hospital stay and most importantly to prevent severe hypocalcaemia.
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Affiliation(s)
| | - J. Kobiela
- Dept. of General, Endocrine and Transplant Surgery, Medical Univ. of Gdansk, Poland
| | - T. Stefaniak
- Dept. of General, Endocrine and Transplant Surgery, Medical Univ. of Gdansk, Poland
| | - A.J. Lachinski
- Dept. of General, Endocrine and Transplant Surgery, Medical Univ. of Gdansk, Poland
| | - Z. Sledzinski
- Dept. of General, Endocrine and Transplant Surgery, Medical Univ. of Gdansk, Poland
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Abstract
Ligation of the inferior mesenteric artery (IMA) during sigmoid colectomy may cause sympathetic denervation of the rectal stump. The purpose of our study was to investigate the functional results after sigmoid resection following ligation or preservation of the IMA. We prospectively analysed 44 patients (21 female and 23 male, mean age 60.6 +/- 11.79 years) with sigmoid tumour. Sigmoid colectomy with preservation of the IMA was performed in 21 patients, and ligation of the IMA with sigmoidectomy was carried out in 23 patients. Bowel function follow-up was performed by use of questionnaires: standardized functional questionnaire, constipation-specific, and incontinence scales before, 6 and 12 months after surgery. The quality of life was measured by means of the Fecal Incontinence Quality of Life (FIQL) scale. After sigmoid colectomy with division of the IMA, patients presented with a higher rate of fecal incontinence and increased stool frequency compared with patients after sigmoid resection with preservation of the IMA. Deterioration of FIQL was also observed in patients with ligated IMA. Preservation of the IMA during sigmoid colectomy in selected patients lowers the frequency of postoperative impaired anorectal function.
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Affiliation(s)
- S Dobrowolski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland.
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Kobiela J, Stefaniak T, Krajewski J, Kalinska-Blach B, Zuawa-Janicka D, Lachinski A, Gackowski D, Olinski R, Nowak J, Knap N, Lipinska B, Sledzinski Z, Wozniak M. Dynamics of oxidative damage at early stages of estrogen-dependant carcinogenesis. Adv Exp Med Biol 2008; 617:609-15. [PMID: 18497088 DOI: 10.1007/978-0-387-69080-3_63] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
The objective of this study was to assess the dynamics of oxidative damage to cellular macromolecules such as proteins, lipids, and DNA under conditions of oxidative stress triggering early stages of estrogen-dependent carcinogenesis. A rodent model of carcinogenesis was used. Syrian hamsters were sacrificed after 1, 3, 5 h and 1 month from the initial implantation of 17beta-estradiol (E2). Matching control groups were used. Kidneys as target organs for E2-mediated oxidative stress were excised and homogenized for biochemical assays. Subcellular fractions were isolated. Carbonyl groups (as a marker of protein oxidation) and lipid hydroxyperoxides were assessed. DNA was isolated and 8-oxodGuo was assessed. Electron paramagnetic resonance spectroscopy was used to confirm the results for lipid peroxidation. Exposition to E2 in rodent model leads to a damage of macromolecules of the cell, including proteins and DNA, but not lipids. Proteins appear to be primary target of the damage but are shortly followed by DNA. It has previously been speculated that protein peroxides can increase DNA modifications. This time sequence was observed in our study. Nevertheless, direct relation between protein and DNA damage still remains unsolved.
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Affiliation(s)
- Jarek Kobiela
- Department of Medical Chemistry, Medical University of Gdansk, Gdansk, Poland
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45
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Kobiela J, Stefaniak T, Mackowiak M, Lachinski AJ, Sledzinski Z. NOTES--third generation surgery. Vain hopes or the reality of tomorrow? Langenbecks Arch Surg 2008; 393:405-11. [PMID: 18340458 DOI: 10.1007/s00423-008-0319-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2007] [Accepted: 01/28/2008] [Indexed: 12/21/2022]
Abstract
BACKGROUND Laparoscopic approach has made many procedures less invasive; however, it seems like this is not enough. The newest challenge for the medical environment is applying the scarless surgery in humans. In this article, we review the origin, current state of art, and future of natural orifice transluminal endoscopic surgery (NOTES). The registered base of research in humans is yet scarce; however, the porcine model experimental studies hold a great promise. In NOTES, peritoneal cavity can be easily achieved, and some procedures are feasible through the natural orifices like digestive tract, vagina, or urinary bladder. If safety and advantages of these approaches will be proven beyond question, NOTES procedures are likely to be adapted in humans after overcoming the critical obstacles, like reliable closure methods, indispensable equipment invention, the multidisciplinary specialists training, etc. The aim of this article was to review available literature to provide current state of art in NOTES surgery. MATERIALS AND METHODS Medical databases were searched for animal and human experience with NOTES to give an overview of history, current state of art, and future of this technique. RESULTS NOTES is currently the subject of the intensive research. It seems like this is only the matter of time when a transluminal access to the abdominal or even thoracic cavity will become the reality. Moreover, this will enable the management of some diseases in a possibly minimally invasive pattern, nearly painless and leaving no scar at all.
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Affiliation(s)
- Jarek Kobiela
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland.
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46
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Kobiela J, Stefaniak T, Krajewski J, Kalinska-Blach B, Zurawa-Janicka D, Lachinski A, Gackowski D, Olinski R, Nowak J, Knap N, Lipinska B, Sledzinski Z, Wozniak M. Dynamics of estrogen-induced oxidative stress. Acta Biochim Pol 2007. [DOI: 10.18388/abp.2007_3249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The objective of this study was to assess the dynamics of oxidative damage to cellular macromolecules such as proteins, lipids and DNA under conditions of oxidative stress triggering early stages of estrogen-dependent carcinogenesis. A rodent model of carcinogenesis was used. Syrian hamsters were sacrificed after 1, 3, 5 h and one month from the initial implantation of estradiol. Matching control groups were used. Kidneys as target organs for estradiol-mediated oxidative stress were excised and homogenized for biochemical assays. Subcellular fractions were isolated. Carbonyl groups (as a marker of protein oxidation) and lipid hydroxyperoxides were assessed. DNA was isolated and 8-oxodGuo was assessed. Electron paramagnetic resonance spectroscopy was used to confirm the results for lipid peroxidation. Exposition to estradiol in the rodent model leads to damage of macromolecules of the cell, including proteins and DNA, but not lipids. Proteins appear to be the primary target of the damage but are closely followed by DNA. It has previously been speculated that protein peroxides can increase DNA modifications. This time sequence was observed in our study. Nevertheless, the direct relation between protein and DNA damage still remains unsolved.
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47
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Makarewicz W, Kaska L, Kobiela J, Stefaniak T, Krajewski J, Stankiewicz M, Wujtewicz MA, Lachinski AJ, Sledzinski Z. Wernicke’s Syndrome after Sleeve Gastrectomy. Obes Surg 2007; 17:704-6. [PMID: 17658035 DOI: 10.1007/s11695-007-9114-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [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: 10/23/2022]
Abstract
We report a case of Wernicke's encephalopathy after sleeve gastrectomy, which had been complicated by stomach wall edema and aggravated by dietary non-compliance. Despite intense parenteral nutrition, thiamine deficiency became clinically evident. It suggests that nutritional preparations used were unable to cover the increased thiamine requirement. After intense thiamine supplementation, gradual improvement occurred during the 6 months after the diagnosis, without permanent cognitive impairment. Clinicians involved in postoperative management of bariatric surgery patients must consider Wernicke's syndrome in hyper-emetic patients, who show unclear neurological deterioration. Early diagnosis and treatment can instantly improve the patient's condition without permanent sequelae.
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Affiliation(s)
- Wojciech Makarewicz
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland.
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Stefaniak T, Vingerhoets A, Makarewicz W, Kaska L, Kobiela J, Kwiecińska B, Stanek A, Lachinski AJ, Sledziński Z. Opioid use determines success of videothoracoscopic splanchnicectomy in chronic pancreatic pain patients. Langenbecks Arch Surg 2007; 393:213-8. [PMID: 17436011 DOI: 10.1007/s00423-007-0177-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [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: 10/21/2006] [Accepted: 02/14/2007] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Videoscopic splanchnicectomy (VSPL) is a method of pain relief in chronic pancreatitis patients. Because this method is not equally effective in all patients, this study was designed to identify the factors determining the unfavorable results of VSPL. MATERIALS AND METHODS This is a non-randomized prospective case-controlled study designed to compare a group of patients suffering from chronic pancreatitis treated with VSPL (N = 48) versus a group of patients treated symptomatically (N = 42). The outcome was measured as the intensity of pain ailments [visual analog scale (VAS)-pain scale] and subjective satisfaction of the patients from the surgical treatment [Functional Assessment of Chronic Illness Therapy-Treatment Satisfaction (FACIT-TS)]. The predictive variables considered in this study were: age, sex, emotional status, social support (the two last variables were measured by subscales of quality-of-life questionnaire from the group of FACIT), history of previous surgical treatment, and opioid use for at least 3 months before VSPL. The follow-up was 18 months. Logistic regression was performed using dichotomized pain as outcome variable: high score more than 66.7 on VAS scale and low under 50 points on VAS scale 18 months after VSPL. RESULTS VSPL significantly reduced the pain ailments at all points of the study when compared to the control. However, the pain intensity at the end of the study was higher than directly after the surgery. In the patients treated with opioids before the surgery, the pain intensity was significantly higher than in the patients not using this group of drugs. Logistic regression revealed that opioid administration before VSPL was the most important predictor of high pain scores 18 months after the surgery. CONCLUSION When planning the VSPL in the treatment of pain in patients suffering from chronic pancreatitis, it is necessary to take into consideration the previous chronic use of opioids, as this variable can significantly influence poorer results of this surgical pain management.
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Affiliation(s)
- Tomasz Stefaniak
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland.
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Affiliation(s)
- S Hac
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland.
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Kobiela J, Stefaniak T, Krajewski J, Kalinska-Blach B, Zurawa-Janicka D, Lachinski A, Gackowski D, Olinski R, Nowak J, Knap N, Lipinska B, Sledzinski Z, Wozniak M. Dynamics of estrogen-induced oxidative stress. Acta Biochim Pol 2007; 54:289-95. [PMID: 17502926] [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] [Received: 10/03/2006] [Revised: 04/12/2007] [Accepted: 04/12/2007] [Indexed: 05/15/2023]
Abstract
The objective of this study was to assess the dynamics of oxidative damage to cellular macromolecules such as proteins, lipids and DNA under conditions of oxidative stress triggering early stages of estrogen-dependent carcinogenesis. A rodent model of carcinogenesis was used. Syrian hamsters were sacrificed after 1, 3, 5 h and one month from the initial implantation of estradiol. Matching control groups were used. Kidneys as target organs for estradiol-mediated oxidative stress were excised and homogenized for biochemical assays. Subcellular fractions were isolated. Carbonyl groups (as a marker of protein oxidation) and lipid hydroxyperoxides were assessed. DNA was isolated and 8-oxodGuo was assessed. Electron paramagnetic resonance spectroscopy was used to confirm the results for lipid peroxidation. Exposition to estradiol in the rodent model leads to damage of macromolecules of the cell, including proteins and DNA, but not lipids. Proteins appear to be the primary target of the damage but are closely followed by DNA. It has previously been speculated that protein peroxides can increase DNA modifications. This time sequence was observed in our study. Nevertheless, the direct relation between protein and DNA damage still remains unsolved.
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Affiliation(s)
- Jarek Kobiela
- Department of Medical Chemistry, Medical University of Gdansk, Gdańsk, Poland
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