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Gracia M, Yildirim Y, Macuks R, Mancari R, Achimas-Cadariu P, Cusine-Lopez L, Novak Z, Dallaku K, Zapardiel I. Impact of perioperative characteristics on the recurrence risk and survival of patients with uterine leiomyosarcoma. Int J Gynaecol Obstet 2023; 163:868-874. [PMID: 37485666 DOI: 10.1002/ijgo.14998] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/20/2023] [Accepted: 07/01/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVES To analyze the impact of perioperative characteristics on the risk of recurrence in patients with uterine leiomyosarcomas. METHODS A sub-analysis of the SARComa of the UTerus (SARCUT) study, which is a multicentric cross-sectional pan-European study that included 390 patients diagnosed with leiomyosarcoma, between 2001 and 2007. Perioperative factors related to risk of recurrence and survival were analyzed. RESULTS The 5-year and 10-year disease-free survivals (DFS) were 46% and 55%, respectively. Overall survival at 5 and 10 years was 34% and 47%, respectively. The most important factors related to global recurrence were the incomplete cytoreduction (hazard ratio [HR] 2.87; 95% confidence interval [CI] 1.91-4.31); performing bilateral adnexectomy (HR 2.71; 95% CI 1.23-5.93); tumor persistence after any treatment (HR 2.38; 95% CI 1.39-4.06); and adjuvant chemotherapy administration (HR 2.55; 95% CI 1.82-3.58) or adjuvant radiotherapy (HR 2.26; 95% CI 1.53-3.32). The major factors significantly associated with pelvic relapse were tumor persistence after any treatment (HR 3.63; 95% CI 1.83-7.20) and adjuvant radiotherapy (HR 2.74; 95% CI 1.44-5.20). Incomplete cytoreduction was the most important factor associated with distant relapse (HR 1.91; 95% CI 1.22-2.97). The most important factors related to overall survival were tumor persistence after any treatment (HR 4.59; 95% CI 2.51-8.40), incomplete cytoreduction (HR 3.68; 95% CI 2.44-5.56), tumor margin involvement (HR 2.41; 95% CI 1.64-3.55) and adjuvant chemotherapy (HR 1.91; 95% CI 1.31-2.78). CONCLUSIONS Complete cytoreduction is the main prognosis factor impacting the DFS and overall survival of patients with uterine leiomyosarcoma. Adjuvant chemotherapy administration was associated with decreased rates of DFS and overall survival. The adjuvant radiotherapy was associated with a higher risk of global recurrence.
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Affiliation(s)
- Myriam Gracia
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | | | - Ronalds Macuks
- Latvian Oncology Center of Riga Eastern Clinical University Hospital, Riga, Latvia
| | - Rosanna Mancari
- Division of Gynecologic Oncology, European Institute of Oncology, IRCCS, Milan, Italy
- Gynecologic Oncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | | | - Zoltan Novak
- Department of Gynecologic Oncology, National Institute of Oncology, Budapest, Hungary
| | - Kastriot Dallaku
- Obstetric Gynecology University Hospital Koco Gliozheni, Tirana, Albania
| | - Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
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Woopen H, Keller M, Zocholl D, Mittelstadt S, Barretina-Ginesta MP, Heinzelmann-Schwarz V, Lafleur J, Kocián R, Baum J, Krabisch P, Achimas-Cadariu P, Vardar MA, Vergote I, Nasser S, Link T, Gil-Martin M, Zwimpfer TA, Leitner K, Jedryka M, Boxler T, Braicu EI, Sehouli J. Side Effects from Cancer Therapies and Perspective of 1044 Long-Term Ovarian Cancer Survivors-Results of Expression VI-Carolin Meets HANNA-Holistic Analysis of Long-Term Survival with Ovarian Cancer: The International NOGGO, ENGOT, and GCIG Survey. Cancers (Basel) 2023; 15:5428. [PMID: 38001688 PMCID: PMC10670049 DOI: 10.3390/cancers15225428] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
The aim of this survey was to increase the knowledge on the characteristics and health concerns of long-term survivors (LTS; survival > 5 years) after ovarian cancer in order to tailor follow-up care. This international survey was initiated by the NOGGO and was made available to members of ENGOT and GCIG. The survey is anonymous and consists of 68 questions regarding sociodemographic, medical (cancer) history, health concerns including distress, long-term side effects, and lifestyle. For this analysis, 1044 LTS from 14 countries were recruited. In total, 58% were diagnosed with FIGO stage III/IV ovarian cancer and 43.4% developed recurrent disease, while 26.0% were receiving cancer treatment at the time of filling in the survey. LTS who survived 5-10 years self-estimated their health status as being significantly worse than LTS who survived more than 10 years (p = 0.034), whereas distress also remained high 10 years after cancer diagnosis. Almost half of the cohort (46.1%) reported still having symptoms, which were mainly lymphedema (37.7%), fatigue (23.9%), pain (21.6%), polyneuropathy (16.9%), gastrointestinal problems (16.6%), and memory problems (15.5%). Almost all patients (94.2%) regularly received follow-up care. Specialized survivorship care with a focus on long-term side effects, lifestyle, and prevention should be offered beyond the typical five years of follow-up care.
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Affiliation(s)
- Hannah Woopen
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
| | - Maren Keller
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
| | - Dario Zocholl
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
- Institute of Biometry and Clinical Epidemiology, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Suzana Mittelstadt
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
- Department of Women’s Health, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Maria-Pilar Barretina-Ginesta
- Institut Català d’Oncologia, Medical Oncology Department, 17007 Girona, Spain
- Precision Oncology Group, Institut d’Investigació Biomèdica de Girona, 17007 Girona, Spain
- Medical Sciences Department, Universitat de Girona, 17003 Girona, Spain
- Grupo Español de Investigación en Cáncer de Ovario (GEICO), 28003 Madrid, Spain
| | - Viola Heinzelmann-Schwarz
- Department of Gynecology and Gynecologic Oncology, University Hospital of Basel, 4056 Basel, Switzerland
- Swiss GO Trial Group (Swiss-GO), 4031 Basel, Switzerland
| | - Judith Lafleur
- Department of Gynecology and Obstetrics, Ordensklinikum Barmherzige Schwestern Linz, 4020 Linz, Austria
- Arbeitsgemeinschaft Gynaekologische Onkologie Austria (AGO Austria), 6020 Innsbruck, Austria
| | - Roman Kocián
- Department of Gynaecology, Obstetrics and Neonatology First Faculty of Medicine, Charles University and General University Hospital in Prague, 12 108 Prague, Czech Republic
- General University Hospital in Prague, 12 808 Prague, Czech Republic
- Central and Eastern European Gynecologic Oncology Group (CEEGOG), 128 51 Prague, Czech Republic
| | - Joanna Baum
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
| | - Petra Krabisch
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
- Department of Gynaecology and Obstetrics, Klinikum Chemnitz, 09116 Chemnitz, Germany
| | - Patriciu Achimas-Cadariu
- Institute of Oncology Prof. Dr. I. Chiricuta Cluj-Napoca, University of Medicine and Pharmacy Iuliu Hatieganu, 400015 Cluj-Napoca, Romania
| | - Mehmet Ali Vardar
- Department of Gynecologic Oncology, Cukurova University, 01250 Adana, Turkey
- Turkish Society of Gynecologic Oncology (TRSGO), Ovecler, 06450 Ankara, Turkey
| | - Ignace Vergote
- Division of Gynaecological Oncology, Leuven Cancer Institute, University Hospitals Leuven, 3000 Leuven, Belgium
- Belgium and Luxembourg Gynaecological Oncology Group (BGOG), 3000 Leuven, Belgium
| | - Sara Nasser
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
- Pan-Arabian Research Society of Gynecological Oncology (PARSGO), 13353 Berlin, Germany
| | - Theresa Link
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
- Department of Gynecology and Obstetrics, Technische Universität Dresden, 01307 Dresden, Germany
| | - Marta Gil-Martin
- Grupo Español de Investigación en Cáncer de Ovario (GEICO), 28003 Madrid, Spain
- Catalan Institute of Oncology—IDIBELL, L’Hospitalet-Barcelona, 08908 Barcelona, Spain
| | - Tibor A. Zwimpfer
- Department of Gynecology and Gynecologic Oncology, University Hospital of Basel, 4056 Basel, Switzerland
- Swiss GO Trial Group (Swiss-GO), 4031 Basel, Switzerland
| | - Katharina Leitner
- Arbeitsgemeinschaft Gynaekologische Onkologie Austria (AGO Austria), 6020 Innsbruck, Austria
- Department of Obstetrics and Gynecology, Innsbruck Medical University, 6020 Innsbruck, Austria
| | - Marcin Jedryka
- Central and Eastern European Gynecologic Oncology Group (CEEGOG), 128 51 Prague, Czech Republic
- Gynecological Oncology Department, Wroclaw Medical University, 50-367 Wroclaw, Poland
- Oncological Gynecology Department, Lower Silesian Oncology, Pulmonology and Hematology Center, 53-413 Wroclaw, Poland
| | | | - Elena Ioana Braicu
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
| | - Jalid Sehouli
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
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Gorostidi M, Yildirim Y, Macuks R, Mancari R, Achimas-Cadariu P, Ibañez E, Corrado G, Bartusevicius A, Sukhina O, Zapardiel I. Impact of Hospital Case Volume on Uterine Sarcoma Prognosis: SARCUT Study Subanalysis. Ann Surg Oncol 2023; 30:7645-7652. [PMID: 37460742 DOI: 10.1245/s10434-023-13826-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/12/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND High-complexity and low-prevalence procedures benefit from treatment by referral centers. The volume of cases necessary to maintain high training in the treatment of gynecologic sarcoma is currently unknown. This study aimed to determine differences in survival and recurrence as a function of the volume of patients treated per center. METHODS The multicentric cross-sectional SARComa of the Uterus (SARCUT) study retrospectively collected cases of uterine sarcomas from 44 centers in Europe from January 2001 to December 2007. The survival of patients treated in high case-volume (HighCV) centers was compared with the survival of patients treated in low case-volume (LowCV) centers. RESULTS The study enrolled 966 patients: 753 in the LowCV group and 213 in the HighCV. Overall survival (OS) was 117 months, and cancer-specific survival (CSS) was 126 months. The difference was significant (respectively p = 0.0003 and 0.0004, log rank). After adjustment for other confounding factors, the remaining significant factors were age (hazard ratio [HR], 1.04; 95% confidence interval [CI], 1.03-1.05), histology (HR, 1.19; 95% CI, 1.06-1.34), extrauterine involvement (HR, 1.61; 95% CI, 1.24-2.10) and persistent disease after treatment (HR, 3.22; 95% CI, 2.49-4.18). The cytoreduction performed was significantly associated with the CSS and OS in both groups. The log rank for surgical cytoreduction was a p value lower than 0.0001 for OS, lower than 0.0001 for the LowCV centers, and 0.0032 for the HighCV centers. CONCLUSIONS The prognosis for patients with uterine sarcoma is directly related to complete tumor cytoreduction, histologic type, and FIGO stage, with significant differences between low and high case-volume centers. Patients with uterine sarcomas should be centralized in HighCV centers to improve their oncologic outcomes.
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Affiliation(s)
- Mikel Gorostidi
- Obstetrics and Gynecology Department, Hospital Universitario Donostia, San Sebastián, Spain.
- Biodonostia Health Research Institute, San Sebastián, Spain.
- Basque Country University (UPV/EHU), San Sebastián, Spain.
| | | | - Ronalds Macuks
- Department of Gynecology and Obstetrics, Riga Stradin's University, Riga, Latvia
| | - Rosanna Mancari
- Division of Gynecologic Oncology, European Institute of Oncology, IRCCS, Milan, Italy
- Gynecologic Oncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | | | - Giacomo Corrado
- Dipartimento Scienze della Salute della Donna, del Bambino, e di Sanità Pubblica, Ginecologia Oncologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Woman, Child Health and Public Health, Gynecologic Oncology Unit, A. Gemelli University Hospital Foundation, IRCSC, Rome, Italy
| | | | - Olena Sukhina
- Clinical Oncology Department and Radiation Oncology Department, Grigoriev Institute for Medical Radiology and Oncology, Kharkov, Ukraine
| | - Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
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Gorostidi M, Yildirim Y, Macuks R, Mancari R, Achimas-Cadariu P, Ibañez E, Corrado G, Bartusevicius A, Sukhina O, Zapardiel I. ASO Visual Abstract: Impact of Hospital Case Volume on Uterine Sarcoma Prognosis: SARCUT Study Subanalysis. Ann Surg Oncol 2023; 30:7667-7668. [PMID: 37648890 DOI: 10.1245/s10434-023-14209-5] [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] [Indexed: 09/01/2023]
Affiliation(s)
- Mikel Gorostidi
- Gynecology Department, Hospital Universitario de Donostia, San Sebastián, Spain.
- Biodonostia Health Research Institute, San Sebastián, Spain.
- Basque Country University, San Sebastián, Spain.
| | | | - Ronalds Macuks
- Latvian Oncology Center of Riga Eastern Clinical University Hospital, Riga, Latvia
| | - Rosanna Mancari
- Division of Gynecologic Oncology, European Institute of Oncology, IRCCS, Milan, Italy
- Gynecologic Oncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | | | - Giacomo Corrado
- Department of Experimental Clinical Oncology, Gynecologic Oncology Unit, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy
- Department of Woman, Child Health, and Public Health, Gynecologic Oncology Unit, A. Gemelli University Hospital Foundation, IRCSC, Rome, Italy
| | | | - Olena Sukhina
- Clinical Oncology Department and Radiation Oncology Department, Grigoriev Institute for Medical Radiology and Oncology, Kharkov, Ukraine
| | - Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
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Macuks R, Yildirim Y, Mancari R, Achimas-Cadariu P, Madhuri TK, Ortega E, Mallmann M, Zivanovic O, Zapardiel I. Prognostic factors in undifferentiated uterine sarcoma: a subanalysis of the SARCUT study. Arch Gynecol Obstet 2023; 308:981-988. [PMID: 37193821 DOI: 10.1007/s00404-023-07057-x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/26/2023] [Indexed: 05/18/2023]
Abstract
PURPOSE The aim of this study was to analyze the prognostic factors related to the recurrence rate and overall survival of patients with undifferentiated uterine sarcoma. METHODS An international multicenter study involving 43 international centers, the SARCUT study, collected 966 uterine sarcoma cases; among them 39 cases corresponded to undifferentiated uterine sarcoma and where included in the present subanalysis. The risk factors related to the oncological outcomes where analyzed. RESULTS The median age of the patients was 63 (range 14-85) years. Seventeen (43.5%) patients presented FIGO stage I. The 5-year overall survival (OS) was 15.3% and 12-months disease-free survival (DFS) 41%. FIGO stage I was significantly associated with a better prognosis. In addition, patients who received adjuvant radiotherapy showed significant longer disease-free survival compared to those without adjuvant radiotherapy (20.5 vs. 4.0 months, respectively; p = 0.04) and longer overall survival (34.7 vs. 18.2 months, respectively; p = 0.05). Chemotherapy administration was associated with shorter DFS (HR 4.41, 95% CI 1.35-14.43, p = 0.014). Persistent disease after primary treatment (HR = 6.86, 95% CI 1.51-31.09, p = 0.012) and FIGO stage IV (HR 4.12, 95%CI 1.37-12.44, p = 0.011) showed significant worse prognosis for OS. CONCLUSION FIGO stage seems to be the most important prognostic factor in patients with undifferentiated uterine sarcoma. Adjuvant radiotherapy seems to be significantly associated also to a better disease-free and overall survival. On the contrary, the role of chemotherapy administration remains unclear since was associated to a shorted DFS.
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Affiliation(s)
- Ronalds Macuks
- Department of Gynecology and Obstetrics, Riga Stradins University, Dzirciema Street 16, RigaRiga, 1007, Latvia.
| | | | - Rosanna Mancari
- Division of Gynecologic Oncology, European Institute of Oncology, IRCCS, Milan, Italy
- Gynecologic Oncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | | | | | - Michael Mallmann
- Department of Obstetrics and Gynecology, University Hospital Bonn, Bonn, Germany
| | - Oliver Zivanovic
- Department of Obstetrics and Gynecology, University Hospital Bonn, Bonn, Germany
| | - Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
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Coronado PJ, Alonso-Espias M, Yildirim Y, Macuks R, Mancari R, Achimas-Cadariu P, Aniorte SM, Mitidieri M, Lambaudie E, Dubois N, Zapardiel I. Lymph node dissection in uterine leiomyosarcomas: A matched-pair study. Gynecol Oncol 2023; 174:28-33. [PMID: 37146437 DOI: 10.1016/j.ygyno.2023.04.007] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/01/2023] [Accepted: 04/12/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVE To assess the impact of the lymph node dissection (LND) in the disease-free (DFS) and overall survival (OS) of the women treated surgically of uterine leiomyosarcoma (ULMS). MATERIAL AND METHODS A multicentric retrospective study was conducted among European countries collecting patients diagnosed of uterine sarcoma (SARcoma of the UTerus - SARCUT study). A total of 390 ULMS were selected for the present study to compare patients who underwent LND and those who did not. A further matched-pair subanalysis identified 116 women, 58 pairs (58 with LND and 58 without it) comparable in age, tumor size, surgical procedures, extrauterine disease and adjuvant treatment. Demographic data, pathology results and follow-up were abstracted from medical records and analyzed. Disease-free (DFS) and overall survival (OS) were studied using Kaplan-Meier curves and Cox regression analysis. RESULTS Among the 390 patients, the 5-year DFS was significantly higher in no-LDN group comparing to the LDN group (57.7% vs. 33.0%; HR 1.75, 95% CI 1.19-2.56; p = 0.007), but not the 5-year OS (64.6% vs. 64.3%; HR 1,10 95% CI 0,77-1,79; p = 0.704). In the matched-pair subanalysis, there were no statistical differences between the study groups. The 5- year DFS was 50.5% in the no-LND and 33.0% in the LND group (HR 1.38; 95% CI 0,83-2.31; p = 0,218) and the 5-year OS was 59.7% and 64.3% respectively (HR 0.81; 95% CI 0,45-1,49; p = 0,509). CONCLUSIONS LND performed in women diagnosed of ULMS have no impact neither in the disease-free nor in the overall survival compared to patients without LDN in a complete homogeneous group.
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Affiliation(s)
- Pluvio J Coronado
- Women's Health Institute, Hospital Clínico San Carlos, IdISSC, School of Medicine, Complutense University, Madrid, Spain
| | | | | | - Ronalds Macuks
- Latvian Oncology Center of Riga Eastern Clinical University Hospital, Riga, Latvia
| | - Rosanna Mancari
- Division of Gynecologic Oncology, European Institute of Oncology, IRCCS, Milan; Gynecologic Oncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | | | | | | | | | - Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
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Turcas A, Leucuta D, Balan C, Clementel E, Gheara C, Kacso A, Kelly SM, Tanasa D, Cernea D, Achimas-Cadariu P. Deep-learning magnetic resonance imaging-based automatic segmentation for organs-at-risk in the brain: Accuracy and impact on dose distribution. Phys Imaging Radiat Oncol 2023; 27:100454. [PMID: 37333894 PMCID: PMC10276287 DOI: 10.1016/j.phro.2023.100454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/27/2023] [Accepted: 05/31/2023] [Indexed: 06/20/2023] Open
Abstract
Background and purpose Normal tissue sparing in radiotherapy relies on proper delineation. While manual contouring is time consuming and subject to inter-observer variability, auto-contouring could optimize workflows and harmonize practice. We assessed the accuracy of a commercial, deep-learning, MRI-based tool for brain organs-at-risk delineation. Materials and methods Thirty adult brain tumor patients were retrospectively manually recontoured. Two additional structure sets were obtained: AI (artificial intelligence) and AIedit (manually corrected auto-contours). For 15 selected cases, identical plans were optimized for each structure set. We used Dice Similarity Coefficient (DSC) and mean surface-distance (MSD) for geometric comparison and gamma analysis and dose-volume-histogram comparison for dose metrics evaluation. Wilcoxon signed-ranks test was used for paired data, Spearman coefficient(ρ) for correlations and Bland-Altman plots to assess level of agreement. Results Auto-contouring was significantly faster than manual (1.1/20 min, p < 0.01). Median DSC and MSD were 0.7/0.9 mm for AI and 0.8/0.5 mm for AIedit. DSC was significantly correlated with structure size (ρ = 0.76, p < 0.01), with higher DSC for large structures. Median gamma pass rate was 74% (71-81%) for Plan_AI and 82% (75-86%) for Plan_AIedit, with no correlation with DSC or MSD. Differences between Dmean_AI and Dmean_Ref were ≤ 0.2 Gy (p < 0.05). The dose difference was moderately correlated with DSC. Bland Altman plot showed minimal discrepancy (0.1/0) between AI and reference Dmean/Dmax. Conclusions The AI-model showed good accuracy for large structures, but developments are required for smaller ones. Auto-segmentation was significantly faster, with minor differences in dose distribution caused by geometric variations.
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Affiliation(s)
- Andrada Turcas
- The European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, RTQA, Brussels, Belgium
- SIOP Europe, The European Society for Paediatric Oncology (SIOPE), QUARTET Project, Brussels, Belgium
- University of Medicine and Pharmacy and Medicine “Iuliu Hatieganu”, Oncology Department, Cluj-Napoca, Romania
- Oncology Institute “Prof. Dr. Ion Chiricuta”, Radiotherapy Department, Cluj-Napoca, Romania
| | - Daniel Leucuta
- University of Medicine and Pharmacy “Iuliu Hatieganu”, Department of Medical Informatics and Biostatistics, Cluj-Napoca, Romania
| | - Cristina Balan
- Oncology Institute “Prof. Dr. Ion Chiricuta”, Radiotherapy Department, Cluj-Napoca, Romania
- “Babes-Bolyai” University, Faculty of Physics, Cluj-Napoca, Romania
| | - Enrico Clementel
- The European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, RTQA, Brussels, Belgium
| | - Cristina Gheara
- Oncology Institute “Prof. Dr. Ion Chiricuta”, Radiotherapy Department, Cluj-Napoca, Romania
- “Babes-Bolyai” University, Faculty of Physics, Cluj-Napoca, Romania
| | - Alex Kacso
- University of Medicine and Pharmacy and Medicine “Iuliu Hatieganu”, Oncology Department, Cluj-Napoca, Romania
- Oncology Institute “Prof. Dr. Ion Chiricuta”, Radiotherapy Department, Cluj-Napoca, Romania
| | - Sarah M. Kelly
- The European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, RTQA, Brussels, Belgium
- SIOP Europe, The European Society for Paediatric Oncology (SIOPE), QUARTET Project, Brussels, Belgium
| | - Delia Tanasa
- Oncology Institute “Prof. Dr. Ion Chiricuta”, Radiotherapy Department, Cluj-Napoca, Romania
| | - Dana Cernea
- Oncology Institute “Prof. Dr. Ion Chiricuta”, Radiotherapy Department, Cluj-Napoca, Romania
| | - Patriciu Achimas-Cadariu
- University of Medicine and Pharmacy and Medicine “Iuliu Hatieganu”, Oncology Department, Cluj-Napoca, Romania
- Oncology Institute “Prof. Dr. Ion Chiricuta”, Surgery Department, Cluj-Napoca, Romania
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8
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Zapardiel I, Gracia Segovia M, Macuks R, Mancari R, Achimas-Cadariu P, Corrado G, Bartusevicius A, Sukhin V, Muruzabal JC, Coronado Martín PJ, Gardella B, Piek JM, Concin N, Arab C, Papatheodorou D, Polterauer S, Iacoponi S, Nieto T, Lopez-Sanclemente MC, Trukhan H, Gil MM, Bakinovskaya I, Dalamanava A, Cucurull M, Rovski D, Baquedano L, Chiva L, Mardas M, Mavrichev SA, Klat J, Lopez de la Manzanara CA, Yildirim Y. Prognostic factors in patients with uterine sarcoma: the SARCUT study. Int J Gynecol Cancer 2023:ijgc-2022-004204. [PMID: 37192761 DOI: 10.1136/ijgc-2022-004204] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Abstract
OBJECTIVE Uterine sarcomas are a rare and heterogeneous group of malignancies that include different histological sub-types. The aim of this study was to identify and evaluate the impact of the different prognostic factors on overall survival and disease-free survival of patients with uterine sarcoma. METHODS This international multicenter retrospective study included 683 patients diagnosed with uterine sarcoma at 46 different institutions between January 2001 and December 2007. RESULTS The 5-year overall survival for leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma, and adenosarcoma was 65.3%, 78.3%, 52.4%, and 89.5%, respectively, and the 5-year disease-free survival was 54.3%, 68.1%, 40.3%, and 85.3%, respectively. The 10-year overall survival for leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma and adenosarcoma was 52.6%, 64.8%, 52.4%, and 79.5%, respectively, and the 10-year disease-free survival was 44.7%, 53.3%, 40.3%, and 77.5%, respectively. The most significant factor associated with overall survival in all types of sarcoma except for adenosarcoma was the presence of residual disease after primary treatment. In adenosarcoma, disease stage at diagnosis was the most important factor (hazard ratio 17.7; 95% CI 2.86 to 109.93). CONCLUSION Incomplete cytoreduction, tumor persistence, advanced stage, extra-uterine and tumor margin involvement, and the presence of necrosis were relevant prognostic factors significantly affecting overall survival in uterine sarcoma. The presence of lymph vascular space involvement and administration of adjuvant chemotherapy were significantly associated with a higher risk of relapse.
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Affiliation(s)
- Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | | | - Ronalds Macuks
- Riga East Clinical University Hospital Latvian Oncology Center, Riga, Latvia
| | - Rosanna Mancari
- Gynecologic Oncology Department, IRCCS, Milan, Italy
- Gynecologic Oncology Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Patriciu Achimas-Cadariu
- Gynecologic Oncology Department, The Oncology Institute 'Prof Dr Ion Chiricuta' Cluj-Napoca, Cluj-Napoca, Romania
| | - Giacomo Corrado
- Policlinico Universitario Agostino Gemelli Dipartimento Scienze della Salute della Donna e del Bambino, Roma, Italy
| | - Arnoldas Bartusevicius
- Department of Obstetrics and Gynaecology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vladyslav Sukhin
- Oncology, Radiology and Radiation Medicine, V N Karazin Kharkiv National University, Harkiv, Ukraine
- Oncogynecology, Grigoriev Institute for Medical Radiology NAMS of Ukraine, Harkiv, Ukraine
| | - Juan C Muruzabal
- Gynecologic Oncology Unit, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | | | - Barbara Gardella
- Gynecologic Oncology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Jurgen M Piek
- Gynecologic Oncology Department, Catharina Hospital and Catharina Cancer Institute, Eindhoven, Netherlands
| | - Nicole Concin
- Department of Gynecology and Obstetrics, Innsbruck Medical Univeristy, Innsbruck, Austria
- Division of General Gynecology and Gynecologic Oncology, Department of Obstetrics and Gynecology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Clemente Arab
- Gynecologic Oncology Department, Hospital Luis Tisné. Universidad de Chile, Santiago, Chile
| | | | - Stephan Polterauer
- Karl Landsteiner Institute for General Gynecology and Experimental Gynecologic Oncology, Vienna, Austria
| | - Sara Iacoponi
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | - Teresa Nieto
- Gynecologic Oncology Department, Hospital Universitario Santa Cristina, Madrid, Spain
| | - Martha C Lopez-Sanclemente
- Gynecologic Oncology Department, Torrecárdenas Hospital Complex, Almeria, Andalucía, Spain
- Gynecologic Oncology Department, Clinica Diatros, Barcelona, Spain
| | - Hanna Trukhan
- Gynecologic Oncology Department, N N Alexandrov National Cancer Center, Minsk, Belarus
| | - Maria M Gil
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | - Irina Bakinovskaya
- Gynecologic Oncology Department, N N Alexandrov National Cancer Center, Minsk, Belarus
| | - Alena Dalamanava
- Gynecologic Oncology Department, N N Alexandrov National Cancer Center, Minsk, Belarus
| | - Marc Cucurull
- Catalan Institute of Oncology, L'Hospitalet de Llobregat, Catalunya, Spain
| | - Dzmitry Rovski
- Gynecologic Oncology Department, N N Alexandrov National Cancer Center, Minsk, Belarus
| | - Laura Baquedano
- Gynecologic Oncology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Luis Chiva
- Obstetrics and Gynecology, Clinica Universidad de Navarra, Madrid, Spain
| | - Marcin Mardas
- Department of Gynecological Oncology, Poznan University of Medical Sciences, Poznan, Wielkopolskie, Poland
| | | | - Jaroslav Klat
- Obstetrics and Gynecology Department, University Hospital Ostrava, Ostrava, Moravskoslezský, Czech Republic
| | | | - Yusuf Yildirim
- Gynecologic Oncology Department, Tepecik Training and Research Hospital Clinics, Konak, Izmir, Turkey
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9
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Cheeseman S, Levick B, Sopwith W, Fenton H, Nam EJ, Kim D, Lim S, Martin E, Frenel JS, Bocquet F, Kubelac P, Achimas-Cadariu P, Vlad C, Chevrier M, Rouzier R, Carton M, Savva-Bordalo J, Magalhães M, Borges M, Wolf A, Becker S, Niklas N, Guergova-Kuras M, Hall G. Ovarian Real-World International Consortium (ORWIC): A multicentre, real-world analysis of epithelial ovarian cancer treatment and outcomes. Front Oncol 2023; 13:1114435. [PMID: 36776297 PMCID: PMC9911857 DOI: 10.3389/fonc.2023.1114435] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/09/2023] [Indexed: 01/28/2023] Open
Abstract
Introduction Much drug development and published analysis for epithelial ovarian cancer (EOC) focuses on early-line treatment. Full sequences of treatment from diagnosis to death and the impact of later lines of therapy are rarely studied. We describe the establishment of an international network of cancer centers configured to compare real-world treatment pathways in UK, Portugal, Germany, South Korea, France and Romania (the Ovarian Real-World International Consortium; ORWIC). Methods 3344 patients diagnosed with EOC (2012-2018) were analysed using a common data model and hub and spoke programming approach applied to existing electronic medical records. Consistent definition of line of therapy between sites and an efficient approach to analysis within the limitations of local information governance was achieved. Results Median age of participants was 53-67 years old and 5-29% were ECOG >1. Between 62% and 84% of patients were diagnosed with late-stage disease (FIGO III-IV). Sites treating younger and fitter patients had higher rates of debulking surgery for those diagnosed at late stage than sites with older, more frail patients. At least 21% of patients treated with systemic anti-cancer therapy (SACT) had recurrent disease following second-line therapy (2L); up to 11 lines of SACT treatment were recorded for some patients. Platinum-based SACT was consistently used across sites at 1L, but choices at 2L varied, with hormone therapies commonly used in the UK and Portugal. The use (and type) of maintenance therapy following 1L also varied. Beyond 2L, there was little consensus between sites on treatment choice: trial compounds and unspecified combinations of other agents were common. Discussion Specific treatment sequences are reported up to 4L and the establishment of this network facilitates future analysis of comparative outcomes per line of treatment with the aim of optimizing available options for patients with recurrent EOC. In particular, this real-world network can be used to assess the growing use of PARP inhibitors. The real-world optimization of advanced line treatment will be especially important for patients not usually eligible for involvement with clinical trials. The resources to enable this analysis to be implemented elsewhere are supplied and the network will seek to grow in coverage of further sites.
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Affiliation(s)
- Sue Cheeseman
- Leeds Cancer Center, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Bethany Levick
- Leeds Cancer Center, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom,Oncology Evidence Network, IQVIA, London, United Kingdom
| | - Will Sopwith
- Leeds Cancer Center, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom,Oncology Evidence Network, IQVIA, London, United Kingdom
| | - Hayley Fenton
- Leeds Cancer Center, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom,Oncology Evidence Network, IQVIA, London, United Kingdom
| | - Eun Ji Nam
- Department of Obstetrics and Gynecology, Institute of Women’s Medical Life Science, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - DongKyu Kim
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea,Real-World Evidence Team, ALYND, Yonsei University Health System, Seoul, Republic of Korea
| | - Subin Lim
- Real-World Evidence Team, ALYND, Yonsei University Health System, Seoul, Republic of Korea
| | - Elodie Martin
- Department of Biostatistics, Clinical Trial Sponsor Unit, Institut de Cancérologie de l’Ouest, Nantes-Angers, France
| | - Jean-Sébastien Frenel
- Oncology Department, Institut de Cancérologie de l’Ouest, Center for Research in Cancerology and Immunology, INSERM UMR 1232, Nantes University and Angers University, Nantes-Angers, France
| | - François Bocquet
- Data Factory and Analytics Department, Institut de Cancérologie de l’Ouest, Law and Social Change Laboratory, Faculty of Law and Political Sciences, CNRS UMR 6297, Nantes University, Nantes-Angers, France
| | - Paul Kubelac
- The Oncology Institute “Prof. Dr. Ion Chiricuta”, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Patriciu Achimas-Cadariu
- The Oncology Institute “Prof. Dr. Ion Chiricuta”, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Catalin Vlad
- The Oncology Institute “Prof. Dr. Ion Chiricuta”, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Marion Chevrier
- Department of Biostatistics, Institut Curie, Paris Sciences et Lettres (PSL) University, Paris, France
| | - Roman Rouzier
- Department of Breast and Gynecological Surgery, Institut Curie, Paris, France
| | - Matthieu Carton
- Department of Biostatistics, Institut Curie, Paris Sciences et Lettres (PSL) University, Paris, France
| | - Joana Savva-Bordalo
- Department of Medical Oncology, Portuguese Oncology Institute of Porto (IPO-Porto) Porto, Porto, Portugal
| | - Marta Magalhães
- Cancer Epidemiology Group-Research Center, IPO Porto, Comprehensive Cancer Center (Porto.CCC), RISE@CI-IPOP (Health Research Network), Porto, Portugal
| | - Marina Borges
- Management, Outcomes Research and Economics in Healthcare Group-Research Center, IPO Porto, Comprehensive Cancer Center (Porto.CCC), RISE@CI-IPOP (Health Research Network), Porto, Portugal
| | - Andrea Wolf
- Internal Medicine, Universitätsklinikum Frankfurt am Main, Frankfurt, Germany
| | - Sven Becker
- Internal Medicine, Universitätsklinikum Frankfurt am Main, Frankfurt, Germany
| | - Nicolas Niklas
- Internal Medicine, Universitätsklinikum Frankfurt am Main, Frankfurt, Germany,Oncology Evidence Network, IQVIA Commercial GmbH and Co. OHG, Frankfurt am Main, Frankfurt, Germany
| | | | - Geoff Hall
- Leeds Cancer Center, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom,*Correspondence: Geoff Hall,
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10
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Achimas-Cadariu P, Kubelac P, Irimie A, Berindan-Neagoe I, Rühli F. Evolutionary perspectives, heterogeneity and ovarian cancer: a complicated tale from past to present. J Ovarian Res 2022; 15:67. [PMID: 35659345 PMCID: PMC9164402 DOI: 10.1186/s13048-022-01004-1] [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: 10/10/2019] [Accepted: 05/24/2022] [Indexed: 11/21/2022] Open
Abstract
Ovarian cancer is composed of a complex system of cells best described by features such as clonal evolution, spatial and temporal genetic heterogeneity, and development of drug resistance, thus making it the most lethal gynecologic cancer. Seminal work on cancer as an evolutionary process has a long history; however, recent cost-effective large-scale molecular profiling has started to provide novel insights coupled with the development of mathematical algorithms. In the current review, we have systematically searched for articles that focused on the clonal evolution of ovarian cancer to offer the whole landscape of research that has been done and highlight future research avenues given its characteristic features and connections to evolutionary biology.
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Affiliation(s)
- Patriciu Achimas-Cadariu
- Department of Surgery, The Oncology Institute 'Prof. Dr. Ion Chiricuta', 34-36 Republicii street, 400015 , Cluj-Napoca, Romania. .,Department of Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Paul Kubelac
- Department of Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Medical Oncology, The Oncology Institute 'Prof. Dr. Ion Chiricuta', Cluj-Napoca, Romania
| | - Alexandru Irimie
- Department of Surgery, The Oncology Institute 'Prof. Dr. Ion Chiricuta', 34-36 Republicii street, 400015 , Cluj-Napoca, Romania.,Department of Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioana Berindan-Neagoe
- Research Centre for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Research Center for Advanced Medicine Medfuture, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Functional Genomics and Experimental Pathology, The Oncology Institute 'Prof. Dr. Ion Chiricuta', Cluj-Napoca, Romania
| | - Frank Rühli
- Institute of Evolutionary Medicine, Zurich, Switzerland
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11
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Kubelac P, Preda A, Ciuleanu T, Todor N, Balacescu O, Achimas-Cadariu P, Iancu D, Mocan C, Bandi-Vasilica M, Lupse M, Briciu VT, Man MA, Vlad C. Outcomes of patients with cancer infected with SARS-CoV-2: results from the Ion Chiricuță Oncology Institute series. ESMO Open 2022; 7:100423. [PMID: 35279526 PMCID: PMC8828430 DOI: 10.1016/j.esmoop.2022.100423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/01/2022] [Indexed: 01/08/2023] Open
Abstract
Background The evolution of COVID-19 is a controversial topic in cancer patients. They have been designated by international organizations as a vulnerable population at greater risk for contracting SARS-CoV-2 and having a more severe clinical outcome. Patients and methods Active screening at our institution became routine early in the pandemic. We have examined the clinical data of 341 cancer patients, with a positive RT-PCR SARS-CoV-2 test between April 2020 and February 2021, in the prevaccination era. Results During the infection, 40.5% remained asymptomatic, 27.6% developed a mild form, 20.5% had a moderate form, and 11.4% a severe/critical form of COVID-19 that led to death in 7.6% of cases. Treatment was adapted to disease severity according to national guidelines. In our series, the incidence of COVID-19 infection was lower in cancer patients compared with the general population (P < 0.001), however, the mortality rate was higher in cancer patients in comparison with the general population (7.6% versus 2.9%, P < 0.001). The prognostic factors were assessed by three distinct univariate and multivariate analyses: (i) evolution to a moderate or severe/critical clinical manifestation, (ii) clinical worsening (severe/critical form or death), and (iii) overall survival. In the multivariate analysis, the prognostic factors associated with the evolution to a moderate or severe/critical clinical manifestation were: performance status (PS) (P < 0.0001) and no active treatment in the previous 3 months (P = 0.031). Factors associated with clinical worsening were: PS (P < 0.0001), peripheral arterial disease (P = 0.03), and chronic liver disease (P = 0.04). Factors associated with impaired overall survival were PS (P < 0.0001), ischemic cardiac disease (P = 0.0126), chronic liver disease (P = 0.001), and radiotherapy (P = 0.0027). Conclusion Our series confirms a more severe evolution for COVID-19 infection in cancer patients, with PS as the most prominent prognostic factor in all three multivariate analyses. By active screening, efforts should be in place to keep cancer units as coronavirus-free sanctuaries. This is the first comprehensive study addressing the impact of COVID-19 in a large cohort of cancer patients in Romania. Oncological patients had a higher death rate after COVID-19 infection in comparison with the general population. Decreased PS was the prominent prognostic factor correlated with worse outcomes and death in multiple multivariate analysis.
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12
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Yordanov A, Kostov S, Slavchev S, Strashilov S, Konsoulova A, Calleja-Agius J, Di Fiore R, Suleiman S, Kubelac P, Vlad C, Achimas-Cadariu P, Vasileva-Slaveva M. Adenosquamous Carcinoma of the Uterine Cervix - Impact of Histology on Clinical Management. Cancer Manag Res 2021; 13:4979-4986. [PMID: 34188551 PMCID: PMC8236277 DOI: 10.2147/cmar.s311326] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/12/2021] [Indexed: 12/27/2022] Open
Abstract
Introduction Historically, the incidence rate of cervical cancer (CC) in Eastern Europe and particularly in Bulgaria has constantly been higher than that in the other European countries. Adenosquamous carcinoma (ASC) is a rare histological subtype of CC with incidence rate of less than 6 per 100,000. We aimed to analyze the epidemiology and prognosis of all Bulgarian patients with ASC, registered at the Bulgarian National Cancer Registry (BNCR), and to compare patients’ characteristics and outcomes with those of patients, treated at a large specialized institution – the Department of Gynecologic Oncology, University Hospital in Pleven, Bulgaria. Materials and Methods This is a retrospective study of all cases of ASC, registered at the BNCR for a 10-year period of time. The Kaplan–Meier analysis with Log rank test was used to estimate the significant differences. Results The incidence rate of ASC was calculated as 3.2% of all CC registered in BNCR and 4.97% of all stage I patients, treated in our department. The 5-year overall survival (OS) rate of all patients with ASC tumors from the registry was 50.5%. A total of 171 (48.4%) of the patients had T1 tumors and a 5-year OS of 67.1%. Lymph node status was a significant prognostic factor for OS (p=0.001). Thirty-one patients with T1 tumors and ASC histology were treated in our department for the same period of time. Lymph node metastases were found in 10 of them (32.2%). The 5-year observed OS in ASC group was 74.19%. Conclusion The histological subtype of cancer of the uterine cervix has an impact on prognosis and should not be simply considered as a descriptive characteristic but a poor prognostic feature and should be an integral part of the decision-making in clinical management of patients.
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Affiliation(s)
- Angel Yordanov
- Department of Gynecologic Oncology, Medical University Pleven, Pleven, 5800, Bulgaria
| | - Stoyan Kostov
- Department of Gynecology, Medical University Varna "Prof. Dr. Paraskev Stoyanov", Varna, 9002, Bulgaria
| | - Stanislav Slavchev
- Department of Gynecology, Medical University Varna "Prof. Dr. Paraskev Stoyanov", Varna, 9002, Bulgaria
| | - Strahil Strashilov
- Department of plastic and reconstructive surgery, MU-Pleven, Pleven, 5800, Bulgaria
| | - Assia Konsoulova
- Department of Medical Oncology, Complex Oncological Center Burgas, Burgas, 8000, Bulgaria
| | - Jean Calleja-Agius
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, MSD 2080, Malta
| | - Riccardo Di Fiore
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, MSD 2080, Malta.,Center for Biotechnology, Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University, Philadelphia, PA, 19122, USA
| | - Sherif Suleiman
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, MSD 2080, Malta
| | - Paul Kubelac
- Department of Medical Oncology, The Oncology Institute "Prof. Dr. Ion Chiricuta", Cluj-Napoca, 400015, Romania.,Department of Oncology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, 400012, Romania
| | - Catalin Vlad
- Department of Oncology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, 400012, Romania.,Department of Surgery, The Oncology Institute "Prof. Dr. Ion Chiricuta", Cluj Napoca, 400015, Romania
| | - Patriciu Achimas-Cadariu
- Department of Oncology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, 400012, Romania.,Department of Surgery, The Oncology Institute "Prof. Dr. Ion Chiricuta", Cluj Napoca, 400015, Romania
| | - Mariela Vasileva-Slaveva
- Department of surgery, University Hospital Acibadem City Clinic, Sofia, Bulgaria.,Women for Oncology - Bulgaria Society, Bulgaria
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Cruceriu D, Baldasici O, Balacescu L, Gligor-Popa S, Flonta M, Man MA, Visan S, Vlad C, Trifa AP, Balacescu O, Achimas-Cadariu P. Critical Aspects Concerning the Development of a Pooling Approach for SARS-CoV-2 Diagnosis Using Large-Scale PCR Testing. Viruses 2021; 13:v13050902. [PMID: 34067983 PMCID: PMC8152296 DOI: 10.3390/v13050902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 01/01/2023] Open
Abstract
The primary approach to controlling the spread of the pandemic SARS-CoV-2 is to diagnose and isolate the infected people quickly. Our paper aimed to investigate the efficiency and the reliability of a hierarchical pooling approach for large-scale PCR testing for SARS-CoV-2 diagnosis. To identify the best conditions for the pooling approach for SARS-CoV-2 diagnosis by RT-qPCR, we investigated four manual methods for both RNA extraction and PCR assessment targeting one or more of the RdRp, N, S, and ORF1a genes, by using two PCR devices and an automated flux for SARS-CoV-2 detection. We determined the most efficient and accurate diagnostic assay, taking into account multiple parameters. The optimal pool size calculation included the prevalence of SARS-CoV-2, the assay sensitivity of 95%, an assay specificity of 100%, and a range of pool sizes of 5 to 15 samples. Our investigation revealed that the most efficient and accurate procedure for detecting the SARS-CoV-2 has a detection limit of 2.5 copies/PCR reaction. This pooling approach proved to be efficient and accurate in detecting SARS-CoV-2 for all samples with individual quantification cycle (Cq) values lower than 35, accounting for more than 94% of all positive specimens. Our data could serve as a comprehensive practical guide for SARS-CoV-2 diagnostic centers planning to address such a pooling strategy.
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Affiliation(s)
- Daniel Cruceriu
- Department of Genetics, Genomics and Experimental Pathology, The Oncology Institute “Prof. Dr. Ion Chiricuta”, 34-36, Republicii Street, 400015 Cluj-Napoca, Romania; (D.C.); (O.B.); (L.B.); (S.V.)
- Department of Molecular Biology and Biotechnology, “Babes-Bolyai” University, 1, M. Kogălniceanu Street, 400084 Cluj-Napoca, Romania
| | - Oana Baldasici
- Department of Genetics, Genomics and Experimental Pathology, The Oncology Institute “Prof. Dr. Ion Chiricuta”, 34-36, Republicii Street, 400015 Cluj-Napoca, Romania; (D.C.); (O.B.); (L.B.); (S.V.)
| | - Loredana Balacescu
- Department of Genetics, Genomics and Experimental Pathology, The Oncology Institute “Prof. Dr. Ion Chiricuta”, 34-36, Republicii Street, 400015 Cluj-Napoca, Romania; (D.C.); (O.B.); (L.B.); (S.V.)
| | - Stefana Gligor-Popa
- Department of Oncogenetics, The Oncology Institute “Prof. Dr. Ion Chiricuta”, 34-36, Republicii Street, 400015 Cluj-Napoca, Romania;
| | - Mirela Flonta
- Laboratory of Microbiology, Clinical Hospital of Infectious Diseases, 23, Iuliu Moldovan Street, 400348 Cluj-Napoca, Romania;
| | - Milena A. Man
- Department of Medical Sciences—Pulmonology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 8, Victor Babes Street, 400012 Cluj-Napoca, Romania;
- Covid Department, “Leon Daniello” Clinical Hospital of Pulmonology, 6, Hasdeu Street, 400371 Cluj-Napoca, Romania
| | - Simona Visan
- Department of Genetics, Genomics and Experimental Pathology, The Oncology Institute “Prof. Dr. Ion Chiricuta”, 34-36, Republicii Street, 400015 Cluj-Napoca, Romania; (D.C.); (O.B.); (L.B.); (S.V.)
| | - Catalin Vlad
- Department of Surgery, The Oncology Institute “Prof. Dr. Ion Chiricuta”, 34-36, Republicii Street, 400015 Cluj-Napoca, Romania; (C.V.); (P.A.-C.)
- Department of Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 8, Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Adrian P. Trifa
- Department of Oncogenetics, The Oncology Institute “Prof. Dr. Ion Chiricuta”, 34-36, Republicii Street, 400015 Cluj-Napoca, Romania;
- Department of Genetics, “Iuliu Hatieganu” University of Medicine and Pharmacy, 8, Victor Babes Street, 400012 Cluj-Napoca, Romania
- Correspondence: (A.P.T.); (O.B.); Tel.: +40-264-598-362 (O.B.)
| | - Ovidiu Balacescu
- Department of Genetics, Genomics and Experimental Pathology, The Oncology Institute “Prof. Dr. Ion Chiricuta”, 34-36, Republicii Street, 400015 Cluj-Napoca, Romania; (D.C.); (O.B.); (L.B.); (S.V.)
- Department of Medical Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 8, Victor Babes Street, 400012 Cluj-Napoca, Romania
- Correspondence: (A.P.T.); (O.B.); Tel.: +40-264-598-362 (O.B.)
| | - Patriciu Achimas-Cadariu
- Department of Surgery, The Oncology Institute “Prof. Dr. Ion Chiricuta”, 34-36, Republicii Street, 400015 Cluj-Napoca, Romania; (C.V.); (P.A.-C.)
- Department of Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 8, Victor Babes Street, 400012 Cluj-Napoca, Romania
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Baum J, Braicu EI, Hunsicker O, Vergote I, Concin N, Van Nieuwenhuysen E, Feldheiser A, Achimas-Cadariu P, Darb-Esfahani S, Berger A, Fetica B, Mahner S, Papadia A, Wölber L, Gasparri ML, Vanderstichele A, Benedetti Panici P, Mueller MD, Ruscito I, Woopen H, Sehouli J. Impact of clinical factors and surgical outcome on long-term survival in high-grade serous ovarian cancer: a multicenter analysis. Int J Gynecol Cancer 2021; 31:713-720. [PMID: 33563640 DOI: 10.1136/ijgc-2020-002023] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 01/06/2021] [Accepted: 01/11/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Long-term survivors of ovarian cancer are a unique group of patients in whom prognostic factors for long-term survival have been poorly described. Such factors may provide information for a more personalized therapeutic approach. The objective of this study is to determine further characteristics of long-term survivors with high-grade serous ovarian cancer. METHODS Long-term survivors were defined as patients living longer than 8 years after first diagnosis and were recruited within seven high volume centers across Europe from November 1988 to November 2008. The control group included patients with high-grade serous ovarian cancer with less than 5 years' survival identified from the systematic 'Tumorbank ovarian cancer' database. A subanalysis of Charité patients only was performed separately for in-depth analysis of tumor dissemination. Propensity score matching with nearest-neighbor caliper width was used to match long-term survivors and the control group regarding age, FIGO stage, and residual tumor. RESULTS A total of 276 patients with high-grade serous ovarian cancer were included, divided into 131 long-term survivors and 145 control group patients. After propensity score matching and multivariable adjustment, platinum sensitivity (p=0.002) was an independent favorable prognostic factor whereas recurrence (p<0.001) and ascites (p=0.021) were independent detrimental predictors for long-term survival. Significantly more long-term survivors tested positive for mutation in the BRCA1 gene than the BRCA2 gene (p=0.016). Intraoperatively, these patients had less tumor involvement of the upper abdomen at initial surgery (p=0.024). Complexity of surgery and surgical techniques were similar in both cohorts. CONCLUSION Platinum sensitivity constitutes a favorable factor for long-term survival whereas tumor involvement of the upper abdomen, ascites, and recurrence have a negative impact. Based on clinical estimation, long-term survival is associated with combinations of clinical, surgical, and molecular factors.
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Affiliation(s)
- Joanna Baum
- Department of Gynecology, European Competence Center for Ovarian Cancer, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Tumorbank Ovarian Cancer Network, Berlin, Germany
| | - Elena Ioana Braicu
- Department of Gynecology, European Competence Center for Ovarian Cancer, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Tumorbank Ovarian Cancer Network, Berlin, Germany
| | - Oliver Hunsicker
- Department of Anaesthesiology and Intensive Care Medicine, CCM / CVK Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ignace Vergote
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology and Obstetrics, Leuven Cancer Institute, University Hospital Leuven, Catholic University of Leuven, Leuven, Belgium
| | - Nicole Concin
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology and Obstetrics, Innsbruck Medical University, Innsbruck, Austria
| | - Els Van Nieuwenhuysen
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology and Obstetrics, Leuven Cancer Institute, University Hospital Leuven, Catholic University of Leuven, Leuven, Belgium
| | - Aarne Feldheiser
- Department of Anaesthesiology and Intensive Care Medicine, CCM / CVK Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Patriciu Achimas-Cadariu
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Surgical and Gynecological Oncology, The Oncology Institute Cluj-Napoca, University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, Cluj-Napoca, Romania
| | - Silvia Darb-Esfahani
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Institute of Pathology, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Astrid Berger
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology and Obstetrics, Innsbruck Medical University, Innsbruck, Austria
| | - Bogdan Fetica
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Pathology, Oncology Institute Prof Dr Ion Chiricuta, Cluj-Napoca, Romania
| | - Sven Mahner
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany.,Department of Gynecology, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Andrea Papadia
- Department of Obstetrics and Gynecology, University of the Italian Switzerland (USI), Ente Ospedaliero Cantonale of Lugano, Lugano, Switzerland.,Department of Obstetrics and Gynecology, University Hospital of Bern and University of Bern, Bern, Switzerland
| | - Linn Wölber
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Maria Luisa Gasparri
- Department of Obstetrics and Gynecology, University of the Italian Switzerland (USI), Ente Ospedaliero Cantonale of Lugano, Lugano, Switzerland.,Department of Obstetrics and Gynecology, University Hospital of Bern and University of Bern, Bern, Switzerland
| | - Adriaan Vanderstichele
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology and Obstetrics, Leuven Cancer Institute, University Hospital Leuven, Catholic University of Leuven, Leuven, Belgium
| | | | - Michael D Mueller
- Department of Obstetrics and Gynecology, University Hospital of Bern and University of Bern, Bern, Switzerland
| | - Ilary Ruscito
- Department of Gynecology, European Competence Center for Ovarian Cancer, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Gynecology Division, Department of Medical and Surgical Sciences and Translational Medicine, Sant'Andrea University Hospital, Sapienza University of Rome, Rome, Italy
| | - Hannah Woopen
- Department of Gynecology, European Competence Center for Ovarian Cancer, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Tumorbank Ovarian Cancer Network, Berlin, Germany
| | - Jalid Sehouli
- Department of Gynecology, European Competence Center for Ovarian Cancer, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany .,Tumorbank Ovarian Cancer Network, Berlin, Germany
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15
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Di Fiore R, Suleiman S, Ellul B, O’Toole SA, Savona-Ventura C, Felix A, Napolioni V, Conlon NT, Kahramanoglu I, Azzopardi MJ, Dalmas M, Calleja N, Brincat MR, Muscat-Baron Y, Sabol M, Dimitrievska V, Yordanov A, Vasileva-Slaveva M, von Brockdorff K, Micallef RA, Kubelac P, Achimas-Cadariu P, Vlad C, Tzortzatou O, Poka R, Giordano A, Felice A, Reed N, Herrington CS, Faraggi D, Calleja-Agius J. GYNOCARE Update: Modern Strategies to Improve Diagnosis and Treatment of Rare Gynecologic Tumors—Current Challenges and Future Directions. Cancers (Basel) 2021; 13:cancers13030493. [PMID: 33514073 PMCID: PMC7865420 DOI: 10.3390/cancers13030493] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 12/31/2020] [Revised: 01/19/2021] [Accepted: 01/22/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary More than 50% of all the tumors affecting the female genital tract can be classified as rare and usually have a poor prognosis owing to delayed diagnosis and treatment. Currently, gynecologic cancer research, due to distinct scientific and technological challenges, is lagging behind. Moreover, the overall efforts for addressing these challenges are fragmented across different countries. The European Network for Gynecological Rare Cancer Research: GYNOCARE aims to address these challenges by creating a unique network between key stakeholders covering distinct domains from basic research to cure. GYNOCARE is part of a European Collaboration in Science and Technology (COST) with the aim to focus on the development of new approaches to improve the diagnosis and treatment of rare gynecological tumors. Here, we provide a brief overview describing the goals of this COST Action and its future challenges with the aim to continue fighting against this rare cancer. Abstract More than 50% of all gynecologic tumors can be classified as rare (defined as an incidence of ≤6 per 100,000 women) and usually have a poor prognosis owing to delayed diagnosis and treatment. In contrast to almost all other common solid tumors, the treatment of rare gynecologic tumors (RGT) is often based on expert opinion, retrospective studies, or extrapolation from other tumor sites with similar histology, leading to difficulty in developing guidelines for clinical practice. Currently, gynecologic cancer research, due to distinct scientific and technological challenges, is lagging behind. Moreover, the overall efforts for addressing these challenges are fragmented across different European countries and indeed, worldwide. The GYNOCARE, COST Action CA18117 (European Network for Gynecological Rare Cancer Research) programme aims to address these challenges through the creation of a unique network between key stakeholders covering distinct domains from concept to cure: basic research on RGT, biobanking, bridging with industry, and setting up the legal and regulatory requirements for international innovative clinical trials. On this basis, members of this COST Action, (Working Group 1, “Basic and Translational Research on Rare Gynecological Cancer”) have decided to focus their future efforts on the development of new approaches to improve the diagnosis and treatment of RGT. Here, we provide a brief overview of the current state-of-the-art and describe the goals of this COST Action and its future challenges with the aim to stimulate discussion and promote synergy across scientists engaged in the fight against this rare cancer worldwide.
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Affiliation(s)
- Riccardo Di Fiore
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, MSD 2080 Msida, Malta; (R.D.F.); (S.S.)
- Center for Biotechnology, Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA;
| | - Sherif Suleiman
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, MSD 2080 Msida, Malta; (R.D.F.); (S.S.)
| | - Bridget Ellul
- Centre for Molecular Medicine & Biobanking, University of Malta, MSD 2080 Msida, Malta;
| | - Sharon A. O’Toole
- Departments of Obstetrics and Gynaecology and Histopathology, Trinity St James’s Cancer Institute, Trinity College Dublin, Dublin 8, Ireland;
| | - Charles Savona-Ventura
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Surgery, University of Malta, MSD 2080 Msida, Malta;
| | - Ana Felix
- Department of Pathology, Campo dos Mártires da Pátria, Instituto Portugues de Oncologia de Lisboa, NOVA Medical School, UNL, 130, 1169-056 Lisboa, Portugal;
| | - Valerio Napolioni
- Genomic And Molecular Epidemiology (GAME) Lab., School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Camerino, Italy;
| | - Neil T. Conlon
- National Institute for Cellular Biotechnology, Dublin City University, Glasnevin, 9 Dublin, Ireland;
| | - Ilker Kahramanoglu
- Department of Gynecologic Oncology, Emsey Hospital, Istanbul 3400, Turkey;
| | - Miriam J. Azzopardi
- Directorate for Health Information and Research, PTA 1313 G’Mangia, Malta; (M.J.A.); (N.C.)
| | - Miriam Dalmas
- Office of the Chief Medical Officer, Department of Policy in Health, Ministry for Health, 15 Merchants Street, VLT 1171 Valletta, Malta;
| | - Neville Calleja
- Directorate for Health Information and Research, PTA 1313 G’Mangia, Malta; (M.J.A.); (N.C.)
| | - Mark R. Brincat
- Department of Obstetrics and Gynaecology, Mater Dei Hospital, Triq Dun Karm, MSD 2090 Msida, Malta; (M.R.B.); (Y.M.-B.)
| | - Yves Muscat-Baron
- Department of Obstetrics and Gynaecology, Mater Dei Hospital, Triq Dun Karm, MSD 2090 Msida, Malta; (M.R.B.); (Y.M.-B.)
| | - Maja Sabol
- Laboratory for Hereditary Cancer, Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia;
| | | | - Angel Yordanov
- Department of Gynecologic Oncology, Medical University Pleven, 5800 Pleven, Bulgaria;
| | | | - Kristelle von Brockdorff
- Sir Anthony Mamo Oncology Centre, Department of Oncology and Radiotherapy, Mater Dei Hospital, MSD 2090 Msida, Malta; (K.v.B.); (R.A.M.)
| | - Rachel A. Micallef
- Sir Anthony Mamo Oncology Centre, Department of Oncology and Radiotherapy, Mater Dei Hospital, MSD 2090 Msida, Malta; (K.v.B.); (R.A.M.)
| | - Paul Kubelac
- Department of Medical Oncology, The Oncology Institute “Prof. Dr. Ion Chiricuţă”. 34–36 Republicii Street, 400015 Cluj-Napoca, Romania;
- Department of Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (P.A.-C.); (C.V.)
| | - Patriciu Achimas-Cadariu
- Department of Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (P.A.-C.); (C.V.)
- Department of Surgical Oncology, The Oncology Institute “Prof. Dr. Ion Chiricuta”, 400015 Cluj-Napoca, Romania
| | - Catalin Vlad
- Department of Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (P.A.-C.); (C.V.)
- Department of Surgery, The Oncology Institute “Prof. Dr. Ion Chiricuta”, 400015 Cluj Napoca, Romania
| | - Olga Tzortzatou
- Biomedical Research Foundation of the Academy of Athens, Soranou Efesiou 4 str., 11527 Athens, Greece;
| | - Robert Poka
- Institute of Obstetrics and Gynaecology, University of Debrecen, Nagyerdei krt. 98, 4032 Debrecen, Hungary;
| | - Antonio Giordano
- Center for Biotechnology, Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA;
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Alex Felice
- Centre of Molecular Medicine and BioBanking, Department of Physiology & Biochemistry, Faculty of Medicine & Surgery, University of Malta, MSD 2080 Msida, Malta;
| | - Nicholas Reed
- Beatson Oncology Centre, Gartnavel General Hospital, 1053 Great Western Road, Glasgow G12 0YN, UK;
| | - C. Simon Herrington
- Cancer Research UK Edinburgh Centre, Western General Hospital, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK;
| | - David Faraggi
- Department of Statistics, University of Haifa, Haifa 31905, Israel;
| | - Jean Calleja-Agius
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, MSD 2080 Msida, Malta; (R.D.F.); (S.S.)
- Correspondence: ; Tel.: +356-2340-1892
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16
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Díaz-García D, Montalbán-Hernández K, Mena-Palomo I, Achimas-Cadariu P, Rodríguez-Diéguez A, López-Collazo E, Prashar S, Ovejero Paredes K, Filice M, Fischer-Fodor E, Gómez-Ruiz S. Role of Folic Acid in the Therapeutic Action of Nanostructured Porous Silica Functionalized with Organotin(IV) Compounds Against Different Cancer Cell Lines. Pharmaceutics 2020; 12:pharmaceutics12060512. [PMID: 32503320 PMCID: PMC7355810 DOI: 10.3390/pharmaceutics12060512] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 04/29/2020] [Revised: 05/29/2020] [Accepted: 06/01/2020] [Indexed: 01/30/2023] Open
Abstract
The synthesis, characterization and cytotoxic activity against different cancer cell lines of various mesoporous silica-based materials containing folate targeting moieties and a cytotoxic fragment based on a triphenyltin(IV) derivative have been studied. Two different mesoporous nanostructured silica systems have been used: firstly, micronic silica particles of the MSU-2 type and, secondly, mesoporous silica nanoparticles (MSNs) of about 80 nm. Both series of materials have been characterized by different methods, such as powder X-ray diffraction, X-ray fluorescence, absorption spectroscopy and microscopy. In addition, these systems have been tested against four different cancer cell lines, namely, OVCAR-3, DLD-1, A2780 and A431, in order to observe if the size of the silica-based systems and the quantity of incorporated folic acid influence their cytotoxic action. The results show that the materials are more active when the quantity of folic acid is higher, especially in those cells that overexpress folate receptors such as OVCAR-3 and DLD-1. In addition, the study of the potential modulation of the soluble folate receptor alpha (FOLR1) by treatment with the synthesized materials has been carried out using OVCAR-3, DLD-1, A2780 and A431 tumour cell lines. The results show that a relatively high concentration of folic acid functionalization of the nanostructured silica together with the incorporation of the cytotoxic tin fragment leads to an increase in the quantity of the soluble FOLR1 secreted by the tumour cells. In addition, the studies reported here show that this increase of the soluble FOLR1 occurs presumably by cutting the glycosyl-phosphatidylinositol anchor of membrane FR-α and by the release of intracellular FR-α. This study validates the potential use of a combination of mesoporous silica materials co-functionalized with folate targeting molecules and an organotin(IV) drug as a strategy for the therapeutic treatment of several cancer cells overexpressing folate receptors.
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Affiliation(s)
- Diana Díaz-García
- COMET-NANO Group, Departamento de Biología y Geología, Física y Química Inorgánica, ESCET, Universidad Rey Juan Carlos, 28933 Móstoles, Spain; (D.D.-G.); (K.M.-H.); (I.M.-P.); (S.P.)
- Tumour Biology Department, the Institute of Oncology “Prof. Dr. I. Chiricuta”, RO-400015 Cluj-Napoca, Romania
| | - Karla Montalbán-Hernández
- COMET-NANO Group, Departamento de Biología y Geología, Física y Química Inorgánica, ESCET, Universidad Rey Juan Carlos, 28933 Móstoles, Spain; (D.D.-G.); (K.M.-H.); (I.M.-P.); (S.P.)
- Innate Immunity Group, Laboratory of Tumour Immunology, IdiPAZ Institute for Health Research, La Paz University Hospital, 28046 Madrid, Spain;
| | - Irene Mena-Palomo
- COMET-NANO Group, Departamento de Biología y Geología, Física y Química Inorgánica, ESCET, Universidad Rey Juan Carlos, 28933 Móstoles, Spain; (D.D.-G.); (K.M.-H.); (I.M.-P.); (S.P.)
- Innate Immunity Group, Laboratory of Tumour Immunology, IdiPAZ Institute for Health Research, La Paz University Hospital, 28046 Madrid, Spain;
| | - Patriciu Achimas-Cadariu
- Department of Surgery, the Institute of Oncology “Prof. Dr. I. Chiricuta”, RO-400015 Cluj-Napoca, Romania;
- Department of Surgery and Gynecological Oncology, the University of Medicine and Pharmacy “Iuliu Hatieganu”, RO-400337 Cluj-Napoca, Romania
| | - Antonio Rodríguez-Diéguez
- Departamento de Química Inorgánica, Universidad de Granada, Facultad de Ciencias, Campus de Fuentenueva, Avda. Fuentenueva s/n, E-18071 Granada, Spain;
| | - Eduardo López-Collazo
- Innate Immunity Group, Laboratory of Tumour Immunology, IdiPAZ Institute for Health Research, La Paz University Hospital, 28046 Madrid, Spain;
| | - Sanjiv Prashar
- COMET-NANO Group, Departamento de Biología y Geología, Física y Química Inorgánica, ESCET, Universidad Rey Juan Carlos, 28933 Móstoles, Spain; (D.D.-G.); (K.M.-H.); (I.M.-P.); (S.P.)
| | - Karina Ovejero Paredes
- Nanobiotechnology for Life Sciences Group, Department of Chemistry in Pharmaceutical Sciences, Faculty of Pharmacy, Universidad Complutense de Madrid (UCM), Plaza Ramón y Cajal s/n, E-28040 Madrid, Spain; (K.O.P.); (M.F.)
- Microscopy and Dynamic Imaging Unit, Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Calle Melchor Fernandez Almagro 3, E-28029 Madrid, Spain
| | - Marco Filice
- Nanobiotechnology for Life Sciences Group, Department of Chemistry in Pharmaceutical Sciences, Faculty of Pharmacy, Universidad Complutense de Madrid (UCM), Plaza Ramón y Cajal s/n, E-28040 Madrid, Spain; (K.O.P.); (M.F.)
- Microscopy and Dynamic Imaging Unit, Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Calle Melchor Fernandez Almagro 3, E-28029 Madrid, Spain
| | - Eva Fischer-Fodor
- Tumour Biology Department, the Institute of Oncology “Prof. Dr. I. Chiricuta”, RO-400015 Cluj-Napoca, Romania
- Medfuture-Research Center for Advanced Medicine, the University of Medicine and Pharmacy “Iuliu Hatieganu”, RO-400337 Cluj-Napoca, Romania
- Correspondence: (E.F.-F.); (S.G.-R.)
| | - Santiago Gómez-Ruiz
- COMET-NANO Group, Departamento de Biología y Geología, Física y Química Inorgánica, ESCET, Universidad Rey Juan Carlos, 28933 Móstoles, Spain; (D.D.-G.); (K.M.-H.); (I.M.-P.); (S.P.)
- Correspondence: (E.F.-F.); (S.G.-R.)
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17
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Molnar E, Gal E, Gaina L, Cristea C, Fischer-Fodor E, Perde-Schrepler M, Achimas-Cadariu P, Focsan M, Silaghi-Dumitrescu L. Novel Phenothiazine-Bridged Porphyrin-(Hetero)aryl dyads: Synthesis, Optical Properties, In Vitro Cytotoxicity and Staining of Human Ovarian Tumor Cell Lines. Int J Mol Sci 2020; 21:ijms21093178. [PMID: 32365924 PMCID: PMC7246510 DOI: 10.3390/ijms21093178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 03/26/2020] [Revised: 04/24/2020] [Accepted: 04/26/2020] [Indexed: 01/28/2023] Open
Abstract
We report here the synthetic procedure applied for the preparation of new AB3-type and trans-A2B2 type meso-halogenophenothiazinyl-phenyl-porphyrin derivatives, their metal core complexation and their peripheral modification using Suzuki-Miyaura cross coupling reactions with various (hetero)aryl (phenothiazinyl, 7-formyl-phenothiazinyl, (9-carbazolyl)-phenyl and 4-formyl-phenyl, phenyl) boronic acid derivatives. The meso-phenothiazinyl-phenyl-porphyrin (MPP) dyes family was thus extended by a series of novel phenothiazine-bridged porphyrin-(hetero)aryl dyads characterized by UV-Vis absorption/emission properties typical to the porphyrin chromophore, slightly modulated by increasing the size of peripheral substituents. Three phenothiazine-bridged porphyrin-heteroaryl dyads with fluorescence emission above 655 nm were selected as fluorophores in red spectral region for applications in cellular staining of human ovarian tumors. In vitro experiments of cell metabolic activity displayed a moderate toxicity on human ovarian tumor cell lines (OVCAR-3, cisplatin-sensitive A2780 and cisplatin-resistant A2780cis respectively). Visualization of the stained living cells was performed both by fluorescence microscopy imaging and by fluorescence lifetime imaging under two photon excitation (TPE-FLIM), confirming their cellular uptake and the capability of staining the cell nucleus.
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Affiliation(s)
- Eva Molnar
- The Research Center on Fundamental and Applied Heterochemistry, Department of Chemistry, Faculty of Chemistry and Chemical Engineering, Babeş-Bolyai University, 11 Arany Janos street, RO-400028 Cluj-Napoca, Romania; (E.M.); (E.G.); (L.G.); (L.S.-D.)
| | - Emese Gal
- The Research Center on Fundamental and Applied Heterochemistry, Department of Chemistry, Faculty of Chemistry and Chemical Engineering, Babeş-Bolyai University, 11 Arany Janos street, RO-400028 Cluj-Napoca, Romania; (E.M.); (E.G.); (L.G.); (L.S.-D.)
| | - Luiza Gaina
- The Research Center on Fundamental and Applied Heterochemistry, Department of Chemistry, Faculty of Chemistry and Chemical Engineering, Babeş-Bolyai University, 11 Arany Janos street, RO-400028 Cluj-Napoca, Romania; (E.M.); (E.G.); (L.G.); (L.S.-D.)
| | - Castelia Cristea
- The Research Center on Fundamental and Applied Heterochemistry, Department of Chemistry, Faculty of Chemistry and Chemical Engineering, Babeş-Bolyai University, 11 Arany Janos street, RO-400028 Cluj-Napoca, Romania; (E.M.); (E.G.); (L.G.); (L.S.-D.)
- Correspondence: ; Tel.: +40-264-593833
| | - Eva Fischer-Fodor
- Department of Radiobiology and Tumor Biology, Institute of Oncology “Prof.Dr. Ion Chiricuta”, 34-36 Republicii street, RO-400015 Cluj-Napoca, Romania; (E.F.-F.); (M.P.-S.)
- Medfuture Research Center for Advanced Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, 8 Babes street, RO-400012 Cluj-Napoca, Romania
| | - Maria Perde-Schrepler
- Department of Radiobiology and Tumor Biology, Institute of Oncology “Prof.Dr. Ion Chiricuta”, 34-36 Republicii street, RO-400015 Cluj-Napoca, Romania; (E.F.-F.); (M.P.-S.)
| | - Patriciu Achimas-Cadariu
- Department of Surgery, Institute of Oncology “Prof.Dr. Ion Chiricuta”, 34-36 Republicii street, 400015 Cluj-Napoca, Romania;
- Department of Surgery and Gynecological Oncology, University of Medicine and Pharmacy Iuliu Hatieganu, 23 Marinescu street, 400337 Cluj-Napoca, Romania
| | - Monica Focsan
- Institute for Interdisciplinary Experimental Research in Bionanoscience, Nanobiophotonics Laboratory, Babeş-Bolyai University, 42 Laurian street, 400271 Cluj-Napoca, Romania;
| | - Luminita Silaghi-Dumitrescu
- The Research Center on Fundamental and Applied Heterochemistry, Department of Chemistry, Faculty of Chemistry and Chemical Engineering, Babeş-Bolyai University, 11 Arany Janos street, RO-400028 Cluj-Napoca, Romania; (E.M.); (E.G.); (L.G.); (L.S.-D.)
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18
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Kubelac P, Genestie C, Auguste A, Mesnage S, Le Formal A, Pautier P, Gouy S, Morice P, Bentivegna E, Maulard A, Adam J, Achimas-Cadariu P, Leary A. Changes in DNA Damage Response Markers with Treatment in Advanced Ovarian Cancer. Cancers (Basel) 2020; 12:E707. [PMID: 32192091 PMCID: PMC7140046 DOI: 10.3390/cancers12030707] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 03/08/2020] [Accepted: 03/11/2020] [Indexed: 12/19/2022] Open
Abstract
Ovarian cancer (OC) is sensitive to upfront chemotherapy, which is likely attributable to defects in DNA damage repair (DDR). Unfortunately, patients relapse and the evolution of DDR competency are poorly described. We examined the expression of proposed effectors in homologous recombination (HR: RAD51, ATM, FANCD2), error-prone non-homologous end-joining (NHEJ: 53BP1), and base excision repair pathways (BER: PAR and PARP1) in a cohort of sequential OC samples obtained at diagnosis, after neoadjuvant chemotherapy (NACT), and/or at relapse from a total of 147 patients. Immunohistochemical (IHC) expression was quantified using the H-score (0-300), where H ≤ 10 defined negativity. Before NACT, a significant number of cases lacked the expression of some effectors: 60%, 60%, and 24% were PAR-, FANCD2-, or RAD51-negative, with a reassuringly similar proportion of negative biomarkers after NACT. In multivariate analysis, there was a poorer progression-free survival (PFS) and overall survival (OS) for cases with competent HR at diagnosis (PRE-NACT 53BP1-/RAD51+, hazard ratio (HR) 3.13, p = 0.009 and HR 2.78, p = 0.024) and after NACT (POST-NACT FANCD2+/RAD51+ HR 1.89, p = 0.05 and HR 2.38, p = 0.02; POST-NACT PARP-1+/RAD51+ HR 1.79, p = 0.038 and HR 2.04, p = 0.034), reflecting proficient DNA repair. Overall, HR-competent tumors appeared to have a dismal prognosis in comparison with tumors utilizing NHEJ, as assessed either at baseline or post-NACT. Accurate knowledge of the HR status during treatment is clinically important for the efficient timing of platinum-based and targeted therapies with poly(ADP-ribose) polymerase inhibitors (PARPi).
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Affiliation(s)
- Paul Kubelac
- Department of Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj Napoca, Romania; (P.K.); (P.A.-C.)
- The Oncology Institute “Prof. Dr. Ion Chiricuta”, 400015 Cluj Napoca, Romania
| | - Catherine Genestie
- INSERM U981, Gustave Roussy Cancer Center, 94805 Villejuif, France; (C.G.); (A.A.); (S.M.); (A.L.F.)
- Gustave Roussy Cancer Center, Department of Pathology, Université Paris-Saclay, 94805 Villejuif, France;
| | - Aurelie Auguste
- INSERM U981, Gustave Roussy Cancer Center, 94805 Villejuif, France; (C.G.); (A.A.); (S.M.); (A.L.F.)
| | - Soizick Mesnage
- INSERM U981, Gustave Roussy Cancer Center, 94805 Villejuif, France; (C.G.); (A.A.); (S.M.); (A.L.F.)
| | - Audrey Le Formal
- INSERM U981, Gustave Roussy Cancer Center, 94805 Villejuif, France; (C.G.); (A.A.); (S.M.); (A.L.F.)
| | - Patricia Pautier
- Gustave Roussy Cancer Center, Department of Medical Oncology, Université Paris-Saclay, 94805 Villejuif, France;
| | - Sebastien Gouy
- Gustave Roussy Cancer Center, Department of Surgery, Université Paris-Saclay, 94805 Villejuif, France; (S.G.); (P.M.); (E.B.); (A.M.)
| | - Philippe Morice
- Gustave Roussy Cancer Center, Department of Surgery, Université Paris-Saclay, 94805 Villejuif, France; (S.G.); (P.M.); (E.B.); (A.M.)
| | - Enrica Bentivegna
- Gustave Roussy Cancer Center, Department of Surgery, Université Paris-Saclay, 94805 Villejuif, France; (S.G.); (P.M.); (E.B.); (A.M.)
| | - Amandine Maulard
- Gustave Roussy Cancer Center, Department of Surgery, Université Paris-Saclay, 94805 Villejuif, France; (S.G.); (P.M.); (E.B.); (A.M.)
| | - Julien Adam
- Gustave Roussy Cancer Center, Department of Pathology, Université Paris-Saclay, 94805 Villejuif, France;
| | - Patriciu Achimas-Cadariu
- Department of Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj Napoca, Romania; (P.K.); (P.A.-C.)
- The Oncology Institute “Prof. Dr. Ion Chiricuta”, 400015 Cluj Napoca, Romania
| | - Alexandra Leary
- INSERM U981, Gustave Roussy Cancer Center, 94805 Villejuif, France; (C.G.); (A.A.); (S.M.); (A.L.F.)
- Gustave Roussy Cancer Center, Department of Medical Oncology, Université Paris-Saclay, 94805 Villejuif, France;
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Rohr I, Alavi S, Richter R, Keller M, Chekerov R, Oskay-Özcelik G, Heinrich M, Taskiran C, Joly F, Berger R, du Bois A, Gornjec A, Vergote I, Achimas-Cadariu P, Lorusso D, Maenpaa J, Sehouli J. Expectations and preferences of patients with primary and relapsed ovarian cancer to maintenance therapy: A NOGGO/ENGOT-ov22 and GCIG survey (Expression IV). Int J Gynecol Cancer 2020; 30:509-514. [PMID: 32139438 DOI: 10.1136/ijgc-2019-000892] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/20/2019] [Accepted: 01/22/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Maintenance therapy induces remission and prolongs disease free interval in primary and recurrent ovarian disease. For the treatment decision making process, aspects of quality of life and patients' preferences are crucial, despite the fact that scientific data are lacking. Therefore, we conducted this European-wide study in patients with ovarian cancer. METHODS A 25 item questionnaire was provided to ovarian cancer patients via the internet or as a paper version in 10 European countries (Austria, Belgium, France, Germany, Italy, Romania, Slovenia, Finland, Turkey, and Spain). Data recorded were demographics, tumor stage, therapy after firstline and recurrent disease, preferences for administration, and expectations concerning maintenance therapy. RESULTS Overall, 1954 patients participated from September 2013 to March 2016; 42% had recurrent disease. Most patients (98%) with primary epithelial ovarian cancer underwent surgery followed by chemotherapy (91%). Almost one-third of participants (29%) were receiving maintenance therapy whereas 45% had only heard of it. For 70% of patients with primary epithelial ovarian cancer, they heard about maintenance therapy from their doctor, 10% heard about maintenance therapy from other patients, and 8% from the internet. The main source of information about maintenance therapy in patients with epithelial ovarian cancer relapse was from the treating physician (72%), from other patients (8%), and from the internet (7%). For patients undergoing maintenance therapy, the four most disturbing adverse effects were polyneuropathy (37%), nausea (36%), hair loss (34%), and vomiting (34%). The main objective of maintenance treatment, as perceived by patients, was to increase the chances of cure (73%), improvement in quality of life (47%), and delay in tumor growth (37%). Many patients were willing to undergo maintenance therapy until tumor progression (38%) and 39% would prefer oral administration. No significant differences were detected in the cross country subanalysis regarding expectations of maintenance therapy and patients with primary or relapsed ovarian cancer. CONCLUSION Patients with ovarian cancer were willing to accept maintenance therapy of prolonged duration and preferred oral administration. There is still a gap between the efficacy of maintenance therapy and patient expectations. Patients need more information on the adverse effects and treatment goals of maintenance therapy to avoid misunderstandings.
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Affiliation(s)
- Irena Rohr
- Department of Gynecology, European Competence Center for Ovarian Cancer, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Charite, Germany
| | - Sara Alavi
- Department of Gynecology, European Competence Center for Ovarian Cancer, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Charite, Germany
| | - Rolf Richter
- Department of Gynecology, European Competence Center for Ovarian Cancer, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Charite, Germany
| | - Maren Keller
- Department of Gynecology, European Competence Center for Ovarian Cancer, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Charite, Germany
| | - Radoslav Chekerov
- Department of Gynecology, European Competence Center for Ovarian Cancer, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Charite, Germany
| | | | - Michaela Heinrich
- Department of Gynecology, European Competence Center for Ovarian Cancer, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Charite, Germany.,Alice Salomon University of Applied Science Berlin, Berlin, Germany
| | - Cagatay Taskiran
- Department of Obsteterics and Gynecology, Division of Gynecologic Oncology On behalf of TRSGO: Turkish Society of Gynecologic Oncology, Koc University School of Medicine, Istanbul, Turkey
| | - Florence Joly
- GINECO and Regional Centre Control Against Cancer Francois, Baclesse Caen, France
| | - Regina Berger
- AGO-Austria and University Hospital for Gynaecology and Obstetrics, Medical University of Innsbruck, Innsbruck, Austria
| | - Andreas du Bois
- Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) Study Group and Kliniken Essen Mitte, Kliniken Essen Mitte, Essen, Germany
| | - Andreja Gornjec
- Gynecologic Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Ignace Vergote
- Department of Oncology, Laboratory of Tumor Immunology and Immunotherapy, ImmunOvar Research Group, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Patriciu Achimas-Cadariu
- University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, Institute of Oncology Prof Dr. Ion Chiricuta Cluj-Napoca, Cluj-Napoca, Romania
| | - Domenica Lorusso
- MITO and Fondazione Policlinico Universitario A Gemelli IRCCS, Rome and Fondazione IRCCS Istituto Nazionale Die Tumori, Milan, Italy
| | - Johanna Maenpaa
- Department of Obstetrics and Gynecology, NSGO and University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Jalid Sehouli
- Department of Gynecology, European Competence Center for Ovarian Cancer, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Charite, Germany
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20
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Roman A, Palego F, Achimas-Cadariu P, Vlad C, Andries A, Tomuleasa CI, Gata VA, Pintican R, Rada MP, Feier D. Prospective investigation of pain associated with ultrasound- and computed tomography-guided percutaneous biopsies in oncological patients. Med Ultrason 2020; 22:65-70. [PMID: 32096790 DOI: 10.11152/mu-2256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
AimsThe present study aims to investigate the pain, anxiety and other factors that are associated with percutaneous computed tomography (CT)- and ultrasound (US)-guided biopsies of tumors.Material and MethodsThe study prospectively included 60 consecutive patients, of which 24 underwent CT-guided biopsies and 36 US-guided biopsies. The location of targeted tumors was within the thorax, abdomen, pelvis, and limbs. A questionnaire containing numerical rate scales (0-10) regarding procedural and post-procedural pain, anxiety, and other associated parameters was filled out by each patient 2-6 hours after the procedure. CT and ultrasound parameters were compared. The two groups were then pooled together in order to compare pain scores per targeted organ and to analyze the parameters that were associated with pain.ResultsThere was no significant difference between the CT and US group with the exception of the positional discomfort, which was higher in the CT group (p=0.003). The average procedural pain score (2.0) was significantly higher than the post-procedural pain (1.3, p=0.006) and the phlebotomy pain (0.8, p<0.0001). There was no significant difference between the targeted organs with regards to the pain score. The factors that showed a positive correlation with the procedural pain were procedure-related anxiety (p=0.005), positional discomfort (p=0.01), and phlebotomy pain (p=0.0008). The pre interventional use of an analgesic was negatively correlated with the procedural pain (p=0.02).ConclusionsCT- and US- guided percutaneous biopsies are associated with low levels of pain that are generally well tolerated by patients irrespective of the targeted organ.
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Affiliation(s)
- Andrei Roman
- Radiology Department, "Prof. Dr. Ion Chiricuţă" Oncology Institute, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Federica Palego
- "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Patriciu Achimas-Cadariu
- Surgery Department, "Prof. Dr. Ion Chiricuţă" Oncology Institute, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Catalin Vlad
- Surgery Department, "Prof. Dr. Ion Chiricuţă" Oncology Institute, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Alexandra Andries
- Radiology Department, "Prof. Dr. Ion Chiricuţă" Oncology Institute, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Ciprian Ionut Tomuleasa
- Hematology Department, "Prof. Dr. Ion Chiricuţă" Oncology Institute, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Vlad Alexandru Gata
- Surgery Department, "Prof. Dr. Ion Chiricuţă" Oncology Institute, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Roxana Pintican
- Radiology Department, County Emergency Hospital Cluj-Napoca, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Maria Patricia Rada
- Second Gynecology Department, County Emergency Hospital Cluj-Napoca, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Diana Feier
- Radiology Department, County Emergency Hospital Cluj-Napoca, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
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21
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Bogdan Rusu C, Bujoreanu CE, Irimie A, Achimas-Cadariu P, Vlad C, Kubelac P, Hardo VV, Maghiar TT, Maris CV, Idris Y, Petrut B. Totally intracorporeal 3D laparoscopic orthotopic neobladder reconstruction following radical cystectomy for infiltrative bladder tumors: the experience of modified Studer and modified Y-shaped ileal reconstruction techniques. J BUON 2020; 25:286-294. [PMID: 32277644] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE We report our experience with 23 cases in utilizing ileum to perform totally intracorporeal 3D laparoscopic neobladder reconstruction using two different surgical techniques. METHODS Patients candidates for reconstructive surgery were in a good biological status with a body mass index (BMI) in the range of 18.5-25 and presented a muscle-infiltrative bladder tumor with negative nodal frozen sections performed during the operation. Twenty-one modified Studer neobladder and 2 modified Y-shaped neobladder techniques for totally intracorporeal 3D laparoscopic ileal neobladder cases were performed using drawings and intra-operative images. An emphasis was made on different tips and tricks that can be applied when using ileum for the neobladder reconstruction, to avoid surgical complications and obtain optimal functional results. RESULTS The operations were performed in a mean time of 5 h, with a mean blood loss of 350 ml and grade II postoperative Clavien Dindo complications. The 23 patients were discharged after a mean hospital stay of 21 days and had a functional ileal neobladder after a mean of 30 days. The results were monitored also on the long-term, taking into account functional results and possible complications from utilizing ileum as a urinary reservoir. CONCLUSION Resecting a digestive segment and using it as a urinary reservoir may lead to multiple complications. Therefore, laparoscopic technical adaptations and highly skilled surgical teams are required for performing a totally intracorporeal 3D laparoscopic orthotopic ileal neobladder reconstruction.
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22
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Oskay-Özcelik G, Alavi S, Richter R, Keller M, Chekerov R, Cecere SC, Cormio G, Joly F, Kurtz JE, du Bois A, Maciejewski M, Jedryka M, Vergote I, Van Nieuwenhuysen E, Casado A, Mendiola C, Achimas-Cadariu P, Vlad C, Reimer D, Zeimet AG, Friedlander M, Sehouli J. Expression III: patients' expectations and preferences regarding physician-patient relationship and clinical management-results of the international NOGGO/ENGOT-ov4-GCIG study in 1830 ovarian cancer patients from European countries. Ann Oncol 2019; 29:910-916. [PMID: 29415128 DOI: 10.1093/annonc/mdy037] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Backround The primary aim of this study was to investigate information needs and treatment preferences of patients with ovarian cancer, focusing especially on physician-patient relationship and treatment. Patients and methods A questionnaire was developed based on the experiences of the national German survey 'Expression II', and was provided to patients with ovarian cancer either at initial diagnosis or with recurrent disease via Internet (online-version) or as print-out-version. Results From December 2009 to October 2012, a total of 1830 patients with ovarian cancer from eight European countries (Austria, Belgium, France, Germany, Italy, Poland, Romania, Spain) participated, 902 (49.3%) after initial diagnosis and 731 (39.9%) with recurrent ovarian cancer. The median age was 58 years (range 17-89). Nearly all patients (96.2%) had experienced upfront surgery followed by first-line chemotherapy (91.8%). The majority of patients were satisfied with the completeness and comprehensibility of the explanation about the diagnosis and treatment options. The three most important aspects, identified by patients to improve the treatment for ovarian cancer included: 'the therapy should not induce alopecia' (42%), 'there must be more done to counter fatigue' (34.5%) and 'the therapy should be more effective' (29.7%). Out of 659 (36%) patients, who were offered participation in a clinical trial, 476 (26%) were included. Conclusion This study underlines the high need of patients with ovarian cancer for all details concerning treatment options irrespective of their cultural background, the stage of disease and the patient's age. Increased information requirements regarding potential side effects and treatment alternatives were recorded. Besides the need for more effective therapy, alopecia and fatigue are the most important side effects of concern to patients.
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Affiliation(s)
- G Oskay-Özcelik
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Gynecology, Charité European Competence Center for Ovarian Cancer, Berlin; North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany
| | - S Alavi
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Gynecology, Charité European Competence Center for Ovarian Cancer, Berlin; North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany
| | - R Richter
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Gynecology, Charité European Competence Center for Ovarian Cancer, Berlin
| | - M Keller
- North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany
| | - R Chekerov
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Gynecology, Charité European Competence Center for Ovarian Cancer, Berlin; North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany
| | - S C Cecere
- Division of Medical Oncolog, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Naples, Italy
| | - G Cormio
- Department of Biomedical Science and Human Oncolog, Obstetrics and Gynecology Unit, University of Bari, Bari, Italy
| | - F Joly
- Department of Medical Oncolog, Centre Francois Baclesse, Universite Basse Normandie, Caen, France
| | - J E Kurtz
- Oncology and Hematology, Hôpitaux Universitaires de Strasbourg, Strasbourg
| | - A du Bois
- Deptartment of Gynecology and Gynecologic Oncology, Kliniken Essen Mitte (KEM), Essen, Germany
| | - M Maciejewski
- Dolnoslaskie Centrum onkologii/Oddzial Ginekologii Onkologicznej, Wroclaw, Poland
| | - M Jedryka
- Department of Oncology and Gynaecological Oncology Clinic, Wroclaw Medical University, Wroclaw, Poland
| | - I Vergote
- Division of Gynaecological Oncol, Leuven Cancer Institute, Department of Gynaecology and Obstetrics, Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, Leuven, Belgium
| | - E Van Nieuwenhuysen
- Division of Gynaecological Oncol, Leuven Cancer Institute, Department of Gynaecology and Obstetrics, Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, Leuven, Belgium
| | - A Casado
- Department of Medical Oncology, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - C Mendiola
- University Hospital 12 de Octubre, Madrid, Spain
| | - P Achimas-Cadariu
- Department of Surgery, The Oncology Institute Ion Chiricuţă, Cluj-Napoca, Romania; Department of Surgery and Gynecologic Oncology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - C Vlad
- Department of Surgery, The Oncology Institute Ion Chiricuţă, Cluj-Napoca, Romania; Department of Surgery and Gynecologic Oncology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - D Reimer
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - A G Zeimet
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - M Friedlander
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - J Sehouli
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Gynecology, Charité European Competence Center for Ovarian Cancer, Berlin; North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany.
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23
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Moisoiu V, Stefancu A, Gulei D, Boitor R, Magdo L, Raduly L, Pasca S, Kubelac P, Mehterov N, Chiș V, Simon M, Muresan M, Irimie AI, Baciut M, Stiufiuc R, Pavel IE, Achimas-Cadariu P, Ionescu C, Lazar V, Sarafian V, Notingher I, Leopold N, Berindan-Neagoe I. SERS-based differential diagnosis between multiple solid malignancies: breast, colorectal, lung, ovarian and oral cancer. Int J Nanomedicine 2019; 14:6165-6178. [PMID: 31447558 PMCID: PMC6684856 DOI: 10.2147/ijn.s198684] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [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: 12/18/2018] [Accepted: 04/16/2019] [Indexed: 12/20/2022] Open
Abstract
Purpose Surface-enhanced Raman scattering (SERS) spectroscopy on serum and other biofluids for cancer diagnosis represents an emerging field, which has shown promising preliminary results in several types of malignancies. The purpose of this study was to demonstrate that SERS spectroscopy on serum can be employed for the differential diagnosis between five of the leading malignancies, ie, breast, colorectal, lung, ovarian and oral cancer. Patients and methods Serum samples were acquired from healthy volunteers (n=39) and from patients diagnosed with breast (n=42), colorectal (n=109), lung (n=33), oral (n=17), and ovarian cancer (n=13), comprising n=253 samples in total. SERS spectra were acquired using a 532 nm laser line as excitation source, while the SERS substrates were represented by Ag nanoparticles synthesized by reduction with hydroxylamine. The classification accuracy yielded by SERS was assessed by principal component analysis–linear discriminant analysis (PCA-LDA). Results The sensitivity and specificity in discriminating between cancer patients and controls was 98% and 91%, respectively. Cancer samples were correctly assigned to their corresponding cancer types with an accuracy of 88% for oral cancer, 86% for colorectal cancer, 80% for ovarian cancer, 76% for breast cancer and 59% for lung cancer. Conclusion SERS on serum represents a promising strategy of diagnosing cancer which can discriminate between cancer patients and controls, as well as between cancer types such as breast, colorectal, lung ovarian and oral cancer.
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Affiliation(s)
- Vlad Moisoiu
- Faculty of Physics, Babeș-Bolyai University, Cluj-Napoca, Romania.,Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andrei Stefancu
- Faculty of Physics, Babeș-Bolyai University, Cluj-Napoca, Romania.,MedFuture - Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Diana Gulei
- MedFuture - Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Radu Boitor
- School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Lorand Magdo
- Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Lajos Raduly
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Pathophysiology, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Sergiu Pasca
- Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Paul Kubelac
- Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Medical Oncology, Prof. Dr. Ion Chiricuta Clinical Cancer Center, Cluj-Napoca, Romania
| | - Nikolay Mehterov
- Department of Medical Biology, Faculty of Medicine, Medical University-Plovdiv, Plovdiv, Bulgaria.,Technological Center for Emergency Medicine, Plovdiv, Bulgaria
| | - Vasile Chiș
- Faculty of Physics, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Marioara Simon
- Department of Bronchology, Leon Daniello Pneumophysiology Clinical Hospital, Cluj-Napoca, Romania
| | - Mihai Muresan
- Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,5th Surgical Department, Cluj-Napoca Municipal Hospital, Cluj-Napoca, Romania.,Department of Surgical and Gynecological Oncology, Prof. Dr. Ion Chiricuta Clinical Cancer Center, Cluj-Napoca, Romania
| | - Alexandra Iulia Irimie
- Department of Prosthetic Dentistry and Dental Materials, Division Dental Propaedeutics, Aesthetics, Faculty of Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Baciut
- Department of Cranio-Maxillofacial Surgery and Dental Emergencies, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Rares Stiufiuc
- MedFuture - Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Pharmaceutical Physics-Biophysics, Faculty of Pharmacy, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioana E Pavel
- MedFuture - Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Chemistry, Wright State University, Dayton, OH, USA
| | - Patriciu Achimas-Cadariu
- Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Surgical Oncology, Prof. Dr. Ion Chiricuta Clinical Cancer Center, Cluj-Napoca, Romania
| | - Calin Ionescu
- Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,5th Surgical Department, Cluj-Napoca Municipal Hospital, Cluj-Napoca, Romania
| | - Vladimir Lazar
- Worldwide Innovative Network for Personalized Cancer Therapy, Villejuif, France
| | - Victoria Sarafian
- Department of Medical Biology, Faculty of Medicine, Medical University-Plovdiv, Plovdiv, Bulgaria.,Technological Center for Emergency Medicine, Plovdiv, Bulgaria
| | - Ioan Notingher
- School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Nicolae Leopold
- Faculty of Physics, Babeș-Bolyai University, Cluj-Napoca, Romania.,MedFuture - Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioana Berindan-Neagoe
- MedFuture - Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Functional Genomics and Experimental Pathology, Prof. Dr. Ion Chiricuta Clinical Cancer Center, Cluj-Napoca, Romania
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24
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Groza M, Zimta AA, Irimie A, Achimas-Cadariu P, Cenariu D, Stanta G, Berindan-Neagoe I. Recent advancements in the study of breast cancer exosomes as mediators of intratumoral communication. J Cell Physiol 2019; 235:691-705. [PMID: 31328284 DOI: 10.1002/jcp.29096] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 04/02/2019] [Accepted: 06/25/2019] [Indexed: 12/24/2022]
Abstract
Breast cancer is a heterogeneous disease, with a morbidity rate of 27.8% and a mortality rate of 15% among women population worldwide. Understanding how this cancer develops and the mechanisms behind tumor progression and chemoresistance is of utmost importance. Exosomes mediate communication in a population of heterogeneous tumoral cells. They have a cargo composed of oncogenes and oncomiRs which change the transcriptomic scenario of their targeted cells and activate numerous tumor-promoting signaling pathways. Exosomes secreted by breast cancer cells lead to enhanced cell proliferation, replicative immortality, angiogenesis, invasion, migration, and chemoresistance. Studying exosomes from this perspective offers more in depth understanding of breast malignancy and may aid in the future development of early diagnostic, prognostic and therapeutic options. We present the latest findings in this area and offer practical solutions which may further stimulate the much-needed research of exosome in breast cancer.
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Affiliation(s)
- Monica Groza
- Department of Medical Oncology, The Oncology Institute "Prof. Dr. Ion Chiricuta", Cluj-Napoca, Romania
| | - Alina-Andreea Zimta
- MEDFUTURE-Research Center for Advanced Medicine, University of Medicine and Pharmacy Iuliu-Hatieganu, Cluj-Napoca, Romania
| | - Alexandru Irimie
- 11th Department of Oncological Surgery and Gynecological Oncology, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.,Department of Surgery, The Oncology Institute "Prof. Dr. Ion Chiricuta", Cluj-Napoca, Romania
| | - Patriciu Achimas-Cadariu
- 11th Department of Oncological Surgery and Gynecological Oncology, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.,Department of Surgery, The Oncology Institute "Prof. Dr. Ion Chiricuta", Cluj-Napoca, Romania
| | - Diana Cenariu
- MEDFUTURE-Research Center for Advanced Medicine, University of Medicine and Pharmacy Iuliu-Hatieganu, Cluj-Napoca, Romania
| | - Giorgio Stanta
- DSM, Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Ioana Berindan-Neagoe
- MEDFUTURE-Research Center for Advanced Medicine, University of Medicine and Pharmacy Iuliu-Hatieganu, Cluj-Napoca, Romania.,Research Center for Functional Genomics, Biomedicine and Translational Medicine, uliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Functional Genomics and Experimental Pathology, The Oncology Institute "Prof. Dr. Ion Chiricuta", Cluj-Napoca, Romania
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25
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Constantinescu C, Bodolea C, Pasca S, Teodorescu P, Dima D, Rus I, Tat T, Achimas-Cadariu P, Tanase A, Tomuleasa C, Einsele H. Clinical Approach to the Patient in Critical State Following Immunotherapy and/or Stem Cell Transplantation: Guideline for the On-Call Physician. J Clin Med 2019; 8:jcm8060884. [PMID: 31226876 PMCID: PMC6616972 DOI: 10.3390/jcm8060884] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 05/02/2019] [Revised: 06/17/2019] [Accepted: 06/18/2019] [Indexed: 12/11/2022] Open
Abstract
The initial management of the hematology patient in a critical state is crucial and poses a great challenge both for the hematologist and the intensive care unit (ICU) physician. After years of clinical practice, there is still a delay in the proper recognition and treatment of critical situations, which leads to late admission to the ICU. There is a much-needed systematic ABC (Airway, Breathing, Circulation) approach for the patients being treated on the wards as well as in the high dependency units because the underlying hematological disorder, as well as disease-related complications, have an increasing frequency. Focusing on score-based decision-making on the wards (Modified Early Warning Score (MEWS), together with Quick Sofa score), active sepsis screening with inflammation markers (C-reactive protein, procalcitonin, and presepsin), and assessment of microcirculation, organ perfusion, and oxygen supply by using paraclinical parameters from the ICU setting (lactate, central venous oxygen saturation (ScVO2), and venous-to-arterial carbon dioxide difference), hematologists can manage the immediate critical patient and improve the overall outcome.
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Affiliation(s)
- Catalin Constantinescu
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania.
- Intensive Care Unit, Ion Chiricuta Clinical Cancer Center, 400005 Cluj Napoca, Romania.
| | - Constantin Bodolea
- Department of Anesthesia, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania.
| | - Sergiu Pasca
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania.
| | - Patric Teodorescu
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania.
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400005 Cluj Napoca, Romania.
| | - Delia Dima
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400005 Cluj Napoca, Romania.
| | - Ioana Rus
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400005 Cluj Napoca, Romania.
| | - Tiberiu Tat
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400005 Cluj Napoca, Romania.
| | - Patriciu Achimas-Cadariu
- Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania.
| | - Alina Tanase
- Department of Stem Cell Transplantation, Fundeni Clinical Institute, 022328 Bucharest, Romania.
| | - Ciprian Tomuleasa
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania.
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400005 Cluj Napoca, Romania.
- Research Center for Functional Genomics and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Victor Babes Street, 400124 Cluj Napoca, Romania.
| | - Hermann Einsele
- Department of Internal Medicine II, University Hospital Wuerzburg, 97070 Wuerzburg, Germany.
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Bonci E, Petrusan A, Bobes V, Titu S, Puscas E, Lisencu C, Irimie A, Achimas-Cadariu P, Piciu D, Fetica B. Corrigendum to “A retrospective study on parasitic thyroid nodules: A Romanian single-center 20-years experience” [45 (2) (February 2019) e124]. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2019.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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27
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Guan J, Darb-Esfahani S, Richter R, Taube ET, Ruscito I, Mahner S, Woelber L, Prieske K, Concin N, Vergote I, Van Nieuwenhuysen E, Achimas-Cadariu P, Glajzer J, Woopen H, Stanske M, Kulbe H, Denkert C, Sehouli J, Braicu EI. Vascular endothelial growth factor receptor 2 (VEGFR2) correlates with long-term survival in patients with advanced high-grade serous ovarian cancer (HGSOC): a study from the Tumor Bank Ovarian Cancer (TOC) Consortium. J Cancer Res Clin Oncol 2019; 145:1063-1073. [PMID: 30810838 DOI: 10.1007/s00432-019-02877-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 02/16/2019] [Accepted: 02/22/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The impact of angiogenesis on long-term survival of high-grade serous ovarian cancer (HGSOC) patients remains unclear. This study investigated whether angiogenic markers correlated with 5-year progression-free survival (PFS) in a large cohort of matched advanced HGSOC tissue samples. METHODS Tumor samples from 124 primary HGSOC patients were retrospectively collected within the Tumor Bank Ovarian Cancer ( http://www.toc-network.de ). All patients were in advanced stages (FIGO stage III-IV). No patient had received anti-angiogenesis therapy. The cohort contains 62 long-term survivors and 62 controls matched by age and post-surgical tumor residuals. Long-term survivors were defined as patients with no relapse within 5 years after the end of first-line chemotherapy. Controls were patients who suffered from first relapse within 6-36 months after primary treatment. Samples were assessed for immunohistochemical expression of vascular endothelial growth factor (VEGF) A and VEGF receptor 2 (VEGFR2). Expression profiles of VEGFA and VEGFR2 were compared between the two groups. RESULTS Significant correlation between VEGFA and VEGFR2 expression was observed (p < 0.0001, Spearman coefficient 0.347). A high expression of VEGFR2 (VEGFR2high) was found more frequently in long-term survivors (77.4%, 48/62) than in controls (51.6%, 30/62, p = 0.001), independent of FIGO stage and VEGFA expression in multivariate analysis (p = 0.005). Also, VEGFR2high was found the most frequently in women with PFS ≥ 10 years (p = 0.001) among all 124 patients. However, no significant association was detected between VEGFA expression and 5-year PFS (p = 0.075). CONCLUSIONS VEGFR2 overexpression significantly correlated with long-term PFS in HGSOC patients, independent of age, FIGO stage, tumor residual and VEGFA expression.
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Affiliation(s)
- Jun Guan
- Department of Gynecology, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.,Tumorbank Ovarian Cancer Network, Berlin, Germany
| | - Silvia Darb-Esfahani
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Berlin Institute of Health, Institute of Pathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Rolf Richter
- Department of Gynecology, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.,Tumorbank Ovarian Cancer Network, Berlin, Germany
| | - Eliane T Taube
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Berlin Institute of Health, Institute of Pathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ilary Ruscito
- Department of Gynecology, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.,Tumorbank Ovarian Cancer Network, Berlin, Germany.,Laboratory of Cell Therapy and Tumor Immunology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Sven Mahner
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, University-Medical-Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Obstetrics and Gynecology, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Linn Woelber
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, University-Medical-Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katharina Prieske
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, University-Medical-Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nicole Concin
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ignace Vergote
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology and Obstetrics, University Hospital Leuven, Leuven, Belgium
| | - Els Van Nieuwenhuysen
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology and Obstetrics, University Hospital Leuven, Leuven, Belgium
| | - Patriciu Achimas-Cadariu
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Surgical and Gynecological Oncology, The Oncology Institute Cluj-Napoca, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Joanna Glajzer
- Department of Gynecology, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.,Tumorbank Ovarian Cancer Network, Berlin, Germany
| | - Hannah Woopen
- Department of Gynecology, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.,Tumorbank Ovarian Cancer Network, Berlin, Germany
| | - Mandy Stanske
- Department of Gynecology, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Hagen Kulbe
- Department of Gynecology, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.,Tumorbank Ovarian Cancer Network, Berlin, Germany
| | - Carsten Denkert
- Department of Gynecology, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.,Tumorbank Ovarian Cancer Network, Berlin, Germany
| | - Jalid Sehouli
- Department of Gynecology, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.,Tumorbank Ovarian Cancer Network, Berlin, Germany
| | - Elena Ioana Braicu
- Department of Gynecology, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany. .,Tumorbank Ovarian Cancer Network, Berlin, Germany.
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Bonci E, Petrusan A, Bobes V, Titu S, Puscas E, Lisencu C, Irimie A, Achimas-Cadariu P, Piciu D, Fetica B. A retrospective study on parasitic thyroid nodules: a Romanian single-center 20-years experience. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Pop B, Fetica B, Blaga ML, Trifa AP, Achimas-Cadariu P, Vlad CI, Achimas-Cadariu A. The role of medical registries, potential applications and limitations. Med Pharm Rep 2019; 92:7-14. [PMID: 30957080 PMCID: PMC6448488 DOI: 10.15386/cjmed-1015] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 03/13/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 12/14/2022] Open
Abstract
Medical registries provide highly reliable data, challenged hierarchically only by randomized controlled trials. Although registries have been used in several fields of medicine for more than a century and a half, their key role is frequently overlooked and poorly recognized. Medical registries have evolved from calculating basic epidemiological data (incidence, prevalence, mortality) to diverse applications in disease prevention, early diagnosis and screening programs, treatment response, health care planning, decision making and disease control programs. Implementing, maintaining and running a medical registry requires substantial effort. Developing the registry represents a complex task and is one of the major barriers in widespread use of registries. Medical registries have potential to evolve to a next generation by taking benefit from recent semantic web technology developments. This paper is aimed at providing a summary of the basic information available on medical registries and to highlight the progress and potential applications in this field.
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Affiliation(s)
- Bogdan Pop
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Pathology, "Prof. Dr. Ion Chiricuta" Oncology Institute, Cluj-Napoca, Romania
| | - Bogdan Fetica
- Department of Pathology, "Prof. Dr. Ion Chiricuta" Oncology Institute, Cluj-Napoca, Romania
| | - Mihaiela Luminita Blaga
- Department of Information Technology, "Prof. Dr. Ion Chiricuta" Oncology Institute, Cluj-Napoca Cluj-Napoca, Romania
| | - Adrian Pavel Trifa
- Department of Medical Genetics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Genetic Explorations, "Prof. Dr. Ion Chiricuta" Oncology Institute, Cluj-Napoca Cluj-Napoca, Romania
| | - Patriciu Achimas-Cadariu
- Department of Surgical and Gynecological Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Surgery, "Prof. Dr. Ion Chiricuta" Oncology Institute, Cluj-Napoca, Romania
| | - Catalin Ioan Vlad
- Department of Surgical and Gynecological Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Surgery, "Prof. Dr. Ion Chiricuta" Oncology Institute, Cluj-Napoca, Romania
| | - Andrei Achimas-Cadariu
- Department of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Roman A, Achimas-Cadariu P, Fetica B, Gata V, Seicean A. CT-guided procedures: an initial experience. ACTA ACUST UNITED AC 2018; 91:427-434. [PMID: 30564019 PMCID: PMC6296730 DOI: 10.15386/cjmed-1145] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 09/11/2018] [Accepted: 09/17/2018] [Indexed: 01/05/2023]
Abstract
Background and aims Despite their usefulness, CT-guided procedures have a low profile in Romania. The current study has the purpose of describing a first experience in performing these procedures. Methods Tumors and fluid collections that were inaccessible for biopsy or drainage by ultrasound or endoscopic guidance were included. The procedures were performed using a 64-slice GE Optima CT660 CT scanner. The biopsies were carried out using the coaxial technique with an 18 G semiautomatic needle. The drainages were performed using 10 F pig-tail drains that were inserted using the Seldinger technique. Data regarding the size and location of the target lesion, puncture technique, success and complication rates were recorded. Results Between May 2017 and April 2018, 30 procedures were performed, of which 26 biopsies and 4 drainage insertions. Of the biopsies 3 were mediastinal, 8 pulmonary, 6 retroperitoneal, 4 pelvic, and 5 of the bone. The drainages were performed for pelvic lymphoceles. The average lesion size was 3.2 cm (0.7–9 cm), with a depth from the skin of 9.1 cm (0.6–15.2 cm). The average procedure duration was 58 minutes (31–93 minutes). A conclusive histopathological diagnosis was set after 92.3% of biopsies. Three procedures resulted in complications, two being minor (hemothorax, soft tissue hematoma) and one severe (tension pneumothorax requiring drainage). Conclusions CT guidance offers safe access to lesions that cannot be biopsied or drained under ultrasound or endoscopic guidance.
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Affiliation(s)
- Andrei Roman
- Radiology Department, "Prof. Dr. Ion Chiricuţă" Oncology Institute, Cluj-Napoca, Romania
| | | | - Bogdan Fetica
- Pathology Department, "Prof. Dr. Ion Chiricuţă" Oncology Institute, Cluj-Napoca, Romania
| | - Vlad Gata
- Radiology Department, "Prof. Dr. Ion Chiricuţă" Oncology Institute, Cluj-Napoca, Romania
| | - Andrada Seicean
- Gastrolenterology Department, "Prof Dr Octavian Fodor" Regional Institute of Gastroenterology & Hepatology, Cluj-Napoca, Romania
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31
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Darb-Esfahani S, Kolaschinski I, Trillsch F, Mahner S, Concin N, Vergote I, Van Nieuwenhuysen E, Achimas-Cadariu P, Glajzer J, Woopen H, Wienert S, Taube ET, Stanske M, Kulbe H, Denkert C, Sehouli J, Braicu EI. Morphology and tumour-infiltrating lymphocytes in high-stage, high-grade serous ovarian carcinoma correlated with long-term survival. Histopathology 2018; 73:1002-1012. [PMID: 30007074 DOI: 10.1111/his.13711] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 04/11/2018] [Revised: 07/11/2018] [Accepted: 07/11/2018] [Indexed: 12/01/2022]
Abstract
AIMS Advanced-stage ovarian high-grade serous carcinoma (HGSC) is a poor-prognosis cancer; however, a small and poorly characterised subset of patients shows long-term survival. We aimed to establish a cohort of HGSC long-term survivors for histopathological and molecular analysis. METHODS AND RESULTS Paraffin blocks from 151 patients with primary FIGO III/IV HGSC and progression-free survival (PFS) >5 years were collected within the Tumorbank Ovarian Cancer (TOC) Network; 77 HGSC with a PFS <3 years were used as a control group. A standardised analysis of histological type and morphological features was performed. Ki67 index, tumour-infiltrating lymphocytes (TILs) and major histocompatibility complex expression (MHC1/2) were determined by immunohistochemistry. A total of 117 of 151 tumours (77.5%) in the long-term survivor group fulfilled the World Health Organisation (WHO) criteria of HGSC after review, and of these, 83 patients (70.9%) fulfilled all clinical criteria for inclusion into our cohort. Tumours of long-term survivors had significantly higher CD3+ and CD8+ TILs and were more frequently positive for MHC2 than controls (P = 0.004, P = 0.025, P = 0.048). However, there were also long-term survivors (up to 20%) with low TILs or low MHC expression. TILs and MHC had no impact on survival in long-term survivors. Morphological and Ki67 analysis revealed no differences between long-term survivors and controls. CONCLUSIONS HGSC from long-term survivors have higher-level T cell infiltration and antigen-presentation capacity; however, this is not a prerequisite for an excellent prognosis. Histopathological criteria are not capable to identify these patients. Further extensive clinical and molecular characterisation of this enigmatic subgroup is ongoing to understand the reasons of long-term survival in HGSC.
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Affiliation(s)
- Silvia Darb-Esfahani
- Institute of Pathology, Charité University Hospital Berlin, Berlin, Germany.,Tumorbank Ovarian Cancer Network, Berlin, Germany
| | | | - Fabian Trillsch
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, University-Medical-Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sven Mahner
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, University-Medical-Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nicole Concin
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ignace Vergote
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology and Obstetrics, University Hospital Leuven, Leuven, Germany
| | - Els Van Nieuwenhuysen
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Gynaecological Oncology, KU Leuven, Leuven, Belgium
| | - Patriciu Achimas-Cadariu
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Surgical and Gynecological Oncology, The Oncology Institute Cluj-Napoca, University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, Cluj-Napoca, Romania
| | - Joanna Glajzer
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, Charité University Hospital Berlin, Berlin, Germany
| | - Hannah Woopen
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, Charité University Hospital Berlin, Berlin, Germany
| | - Stefan Wienert
- Institute of Pathology, Charité University Hospital Berlin, Berlin, Germany
| | - Eliane T Taube
- Institute of Pathology, Charité University Hospital Berlin, Berlin, Germany.,Tumorbank Ovarian Cancer Network, Berlin, Germany
| | - Mandy Stanske
- Institute of Pathology, Charité University Hospital Berlin, Berlin, Germany
| | - Hagen Kulbe
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, Charité University Hospital Berlin, Berlin, Germany
| | - Carsten Denkert
- Institute of Pathology, Charité University Hospital Berlin, Berlin, Germany.,Tumorbank Ovarian Cancer Network, Berlin, Germany
| | - Jalid Sehouli
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, Charité University Hospital Berlin, Berlin, Germany
| | - Elena I Braicu
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, Charité University Hospital Berlin, Berlin, Germany
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Giffard D, Fischer-Fodor E, Vlad C, Achimas-Cadariu P, Smith GS. Synthesis and antitumour evaluation of mono- and multinuclear [2+1] tricarbonylrhenium(I) complexes. Eur J Med Chem 2018; 157:773-781. [DOI: 10.1016/j.ejmech.2018.08.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/03/2018] [Accepted: 08/04/2018] [Indexed: 12/15/2022]
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Darb-Esfahani S, Kolaschinski I, Trillsch F, Mahner S, Concin N, Vergote I, Van Nieuwenhuysen E, Achimas-Cadariu P, Glajzer J, Woopen H, Wienert S, Taube ET, Stanske M, Kulbe H, Denkert C, Sehouli J, Braicu EI. Morphology and tumour-infiltrating lymphocytes in high-stage, high-grade serous ovarian carcinoma correlated with long-term survival. Histopathology 2018. [PMID: 30007074 DOI: 10.1111/his.13711] [] [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] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS Advanced-stage ovarian high-grade serous carcinoma (HGSC) is a poor-prognosis cancer; however, a small and poorly characterised subset of patients shows long-term survival. We aimed to establish a cohort of HGSC long-term survivors for histopathological and molecular analysis. METHODS AND RESULTS Paraffin blocks from 151 patients with primary FIGO III/IV HGSC and progression-free survival (PFS) >5 years were collected within the Tumorbank Ovarian Cancer (TOC) Network; 77 HGSC with a PFS <3 years were used as a control group. A standardised analysis of histological type and morphological features was performed. Ki67 index, tumour-infiltrating lymphocytes (TILs) and major histocompatibility complex expression (MHC1/2) were determined by immunohistochemistry. A total of 117 of 151 tumours (77.5%) in the long-term survivor group fulfilled the World Health Organisation (WHO) criteria of HGSC after review, and of these, 83 patients (70.9%) fulfilled all clinical criteria for inclusion into our cohort. Tumours of long-term survivors had significantly higher CD3+ and CD8+ TILs and were more frequently positive for MHC2 than controls (P = 0.004, P = 0.025, P = 0.048). However, there were also long-term survivors (up to 20%) with low TILs or low MHC expression. TILs and MHC had no impact on survival in long-term survivors. Morphological and Ki67 analysis revealed no differences between long-term survivors and controls. CONCLUSIONS HGSC from long-term survivors have higher-level T cell infiltration and antigen-presentation capacity; however, this is not a prerequisite for an excellent prognosis. Histopathological criteria are not capable to identify these patients. Further extensive clinical and molecular characterisation of this enigmatic subgroup is ongoing to understand the reasons of long-term survival in HGSC.
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Affiliation(s)
- Silvia Darb-Esfahani
- Institute of Pathology, Charité University Hospital Berlin, Berlin, Germany.,Tumorbank Ovarian Cancer Network, Berlin, Germany
| | | | - Fabian Trillsch
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, University-Medical-Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sven Mahner
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, University-Medical-Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nicole Concin
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ignace Vergote
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology and Obstetrics, University Hospital Leuven, Leuven, Germany
| | - Els Van Nieuwenhuysen
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Gynaecological Oncology, KU Leuven, Leuven, Belgium
| | - Patriciu Achimas-Cadariu
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Surgical and Gynecological Oncology, The Oncology Institute Cluj-Napoca, University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, Cluj-Napoca, Romania
| | - Joanna Glajzer
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, Charité University Hospital Berlin, Berlin, Germany
| | - Hannah Woopen
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, Charité University Hospital Berlin, Berlin, Germany
| | - Stefan Wienert
- Institute of Pathology, Charité University Hospital Berlin, Berlin, Germany
| | - Eliane T Taube
- Institute of Pathology, Charité University Hospital Berlin, Berlin, Germany.,Tumorbank Ovarian Cancer Network, Berlin, Germany
| | - Mandy Stanske
- Institute of Pathology, Charité University Hospital Berlin, Berlin, Germany
| | - Hagen Kulbe
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, Charité University Hospital Berlin, Berlin, Germany
| | - Carsten Denkert
- Institute of Pathology, Charité University Hospital Berlin, Berlin, Germany.,Tumorbank Ovarian Cancer Network, Berlin, Germany
| | - Jalid Sehouli
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, Charité University Hospital Berlin, Berlin, Germany
| | - Elena I Braicu
- Tumorbank Ovarian Cancer Network, Berlin, Germany.,Department of Gynecology, Charité University Hospital Berlin, Berlin, Germany
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Traila A, Dima D, Achimas-Cadariu P, Micu R. Fertility preservation in Hodgkin's lymphoma patients that undergo targeted molecular therapies: an important step forward from the chemotherapy era. Cancer Manag Res 2018; 10:1517-1526. [PMID: 29942153 PMCID: PMC6005299 DOI: 10.2147/cmar.s154819] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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] [Indexed: 12/14/2022] Open
Abstract
In total, 80%-90% of Hodgkin's lymphoma (HL) patients are curable with combination chemoradiotherapy. Due to improvements in therapeutic strategies, 50% of all relapsed/refractory patients may undergo complete clinical responses and have long-term survival. Treatment options for HL are effective, but may have a negative impact on post-chemotherapy fertility. Thus, cryopreservation of semen prior to treatment is recommended for male patients. For female patients, assisted reproductive techniques (ART) consult and fertility preservation should be offered as a therapeutical option. In the last years, new targeted molecules have been available for HL treatment. These new drugs showed a high rate of overall responses in the setting of heavily pretreated patients, most of them in relapse after autologous stem cell transplantation, a group previously considered very poor risk. Up to 50% of patients have a complete response and an improved overall survival. Future studies will address the usefulness of novel molecules as a frontline therapy. Considering the high response and survival rates with monoclonal antibody-based therapeutics, fertility has become a concerning issue for long-term HL survivors. As progress has been made regarding ART, with the rigorous steps planned for HL patients, more survivors will become parents.
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Affiliation(s)
- Alexandra Traila
- School of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
- Department of Surgical Oncology, Ion Chiricuta Oncology Institute, Cluj Napoca, Romania
| | - Delia Dima
- Department of Hematology, Ion Chiricuta Oncology Institute, Cluj Napoca, Romania
| | - Patriciu Achimas-Cadariu
- School of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
- Department of Surgical Oncology, Ion Chiricuta Oncology Institute, Cluj Napoca, Romania
| | - Romeo Micu
- School of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
- Department of Human Assisted Reproduction of 1st Gynecology Clinic, Cluj Napoca, Romania
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Kubelac P, Auguste A, Genestie C, Mesnage S, Le Formal A, Achimas-Cadariu P, Leary A. Changes in DNA damage response markers with treatment in advanced ovarian cancer. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Vasile Bochis O, Achimas-Cadariu P, Vlad C, Fetica B, Corneliu Leucuta D, Ioan Busuioc C, Irimie A. The prognostic role of Skp2 and the tumor suppressor protein p27 in colorectal cancer. J BUON 2017; 22:1122-1130. [PMID: 29135092] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE This study aimed at exploring the role of Skp2, p27 and Cks1 expression as prognostic factors for colorectal cancer (CRC) patients, and to identify a correlation between their expression and the cell proliferation marker Ki67. METHODS We conducted a retrospective study on 130 patients with CRC treated with surgery and adjuvant treatment at the Oncology Institute Cluj-Napoca between 2006- 2010. The Skp2, p27, Cks1 and Ki67 immunoexpression was grouped from 1 to 4, according to percents of tumor cells with nuclear reactivity. Their correlation with overall survival (OS), recurrence free survival (RFS) and with the classical histopathological prognostic factors were analyzed. All patients had 5-year follow-up. RESULTS The majority of patients had locally advanced TNM stages II and III. More than a half of the tumors had low immunoexpression of Skp2 and Cks1, and high and moderate p27 and Ki67 expression. Skp2 overexpression negatively influenced the p27 (p=0.002). Both OS and RFS were significantly higher in patients with moderate and high expression of p27 (p=0.005). Skp2 and Cks1 overexpression negatively influenced OS and RFS. Skp2 overexpression positively correlated with TNM stage (p<0.001), node capsular invasion (p=0.002) and lymphovascular invasion (p=0.042). Ki67 expression did not correlate with Skp2 (p=0.88), Cks1 (p=0.67) and p27 (p=0.40), neither with OS (p=0.841) and RFS (p=0.84). CONCLUSIONS The most important prognostic factor was the Skp2 overexpression. It was the only protein we studied that correlated with the other well-known prognostic factors in CRC. The expression of Ki67 did not bring any novel prognostic information regarding CRC.
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Affiliation(s)
- Ovidiu Vasile Bochis
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca; Department of Medical Oncology, "Prof. Dr. Ion Chiricuta" Institute of Oncology, Cluj-Napoca, Romania
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Iancu M, Pop F, Farcaș RI, Gherman A, Zgaia A, Vlad C, Irimie A, Achimas-Cadariu P. The effect of psychological group intervention on emotional problems, event impact and quality of life in breast cancer patients under radiotherapy: a pilot study. J Evid-Based Psychot 2017. [DOI: 10.24193/jebp.2017.2.8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Braicu OL, Budisan L, Buiga R, Jurj A, Achimas-Cadariu P, Pop LA, Braicu C, Irimie A, Berindan-Neagoe I. miRNA expression profiling in formalin-fixed paraffin-embedded endometriosis and ovarian cancer samples. Onco Targets Ther 2017; 10:4225-4238. [PMID: 28894379 PMCID: PMC5584916 DOI: 10.2147/ott.s137107] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Endometriosis is an inflammatory pathology associated with a negative effect on life quality. Recently, this pathology was connected to ovarian cancer, in particular with endometrioid ovarian cancer. microRNAs (miRNAs) are a class of RNA transcripts ~19–22 nucleotides in length, the altered miRNA pattern being connected to pathological status. miRNAs are highly stable transcripts, and these can be assessed from formalin-fixed paraffin-embedded (FFPE) samples leading to the identification of miRNAs that could be developed as diagnostic and prognostic biomarkers, in particular those involved in malignant transformation. The aim of our study was to evaluate miRNA expression pattern in FFPE samples from endometriosis and ovarian cancer patients using PCR-array technology and also to compare the differential expression pattern in ovarian cancer versus endometriosis. For the PCR-array study, we have used nine macrodissected FFPE samples from endometriosis tissue, eight samples of ovarian cancers and five normal ovarian tissues. Quantitative real-time PCR (qRT-PCR) was used for data validation in a new patient cohort of 17 normal samples, 33 endometriosis samples and 28 ovarian cancer macrodissected FFPE samples. Considering 1.5-fold expression difference as a cut-off level and a P-value <0.05, we have identified four miRNAs being overexpressed in endometrial tissue, while in ovarian cancer 15 were differentially expressed (nine overexpressed and six downregulated). The expression level was confirmed by qRT-PCR for miR-93, miR-141, miR-155, miR-429, miR-200c, miR-205 and miR-492. Using the interpretative program Ingenuity Pathway Analysis revealed several deregulated pathways due to abnormal miRNA expression in endometriosis and ovarian cancer, which in turn is responsible for pathogenesis; this differential expression of miRNAs can be exploited as a therapeutic target. A higher number of altered miRNAs were detected in endometriosis versus ovarian cancer tissue, most of them being linked with epithelial-to-mesenchymal transition.
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Affiliation(s)
- Ovidiu-Leonard Braicu
- Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca
| | - Liviuta Budisan
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy
| | - Rares Buiga
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy.,Pathology Department, The Oncology Institute Prof. Dr. Ion Chiricuta, Cluj-Napoca
| | - Ancuta Jurj
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy
| | - Patriciu Achimas-Cadariu
- Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca.,Department of Surgical Oncology, The Oncology Institute Prof. Dr. Ion Chiricuta, Cluj-Napoca
| | - Laura Ancuta Pop
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy
| | - Cornelia Braicu
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy
| | - Alexandru Irimie
- Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca.,Department of Surgical Oncology, The Oncology Institute Prof. Dr. Ion Chiricuta, Cluj-Napoca
| | - Ioana Berindan-Neagoe
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy.,MEDFUTURE-Research Center for Advanced Medicine, University of Medicine and Pharmacy Iuliu-Hatieganu, Cluj-Napoca.,Department of Functional Genomics, Proteomics and Experimental Pathology, The Oncology Institute Prof. Dr. Ion Chiricuta, Cluj-Napoca, Romania
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Micu R, Petrut B, Zlatescu-Marton C, Traila A, Harsa R, Achimas-Cadariu P. Current strategies and future perspectives in fertility preservation for cancer patients. J BUON 2017; 22:844-852. [PMID: 29155509] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Nowadays, cancer is being detected at younger ages. Health care providers should consider cancer patients' desire towards fertility preservation before the initiation of possibly sterilizing treatments. The aim of the current review was to register the current state of fertility preservation procedures available for male and female cancer patients.
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Affiliation(s)
- Romeo Micu
- University of Medicine and Pharmacy "Iuliu Hatieganu", Department of Human Assisted Reproduction of 1st Gynecology Clinic, Cluj-Napoca, Romania
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Sucala M, Cuijpers P, Muench F, Cardoș R, Soflau R, Dobrean A, Achimas-Cadariu P, David D. Anxiety: There is an app for that. A systematic review of anxiety apps. Depress Anxiety 2017; 34:518-525. [PMID: 28504859 DOI: 10.1002/da.22654] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [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: 12/03/2016] [Revised: 03/25/2017] [Accepted: 03/31/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Smartphones and mobile devices have become ubiquitous, and with the rapid advance of technology, the number of health applications (apps) that are available for consumers on these devices is constantly growing. In particular, there has been a recent proliferation of anxiety apps. However, there has been no review of the quality or content of these anxiety apps and little is known about their purpose, the features they contain, and their empirical support. The goal of this systematic review was to assess the commercially available anxiety apps. METHODS A list of anxiety apps was collected in January 2017, using the Power Search function of iTunes and Google Play. Of 5,078 identified apps, 52 met our inclusion criteria (i.e., being defined as an anxiety/worry relief app, and offering psychological techniques aimed primarily at reducing anxiety) and were further reviewed. RESULTS The majority (67.3%) of the currently available anxiety apps were found to lack the involvement of health care professionals in their development, and very few (3.8%) of them have been rigorously tested. CONCLUSIONS At the moment, although anxiety apps have the potential to enhance access to mental health care, there is a marked discrepancy between the wealth of commercially available apps, and the paucity of data regarding their efficacy and effectiveness. Although the great promise of apps is their ability to increasing access to evidence-based mental health, the field is not quite there yet and the full potential of apps for treating anxiety has yet to be exploited.
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Affiliation(s)
- Madalina Sucala
- Babeș-Bolyai University, Department of Clinical Psychology and Psychotherapy, Cluj-Napoca, Romania.,Icahn School of Medicine at Mount Sinai, Department of Oncological Sciences, New York, NY, USA
| | - Pim Cuijpers
- Vrije Universiteit Amsterdam, Department of Clinical Psychology, Amsterdam, Netherlands
| | - Frederick Muench
- Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Northwell Health, Manhasset, NY, USA
| | - Roxana Cardoș
- Babeș-Bolyai University, Department of Clinical Psychology and Psychotherapy, Cluj-Napoca, Romania
| | - Radu Soflau
- Babeș-Bolyai University, Department of Clinical Psychology and Psychotherapy, Cluj-Napoca, Romania
| | - Anca Dobrean
- Babeș-Bolyai University, Department of Clinical Psychology and Psychotherapy, Cluj-Napoca, Romania
| | - Patriciu Achimas-Cadariu
- Iuliu Hațieganu University of Medicine and Pharmacy, Department of Surgery, Cluj-Napoca, Romania
| | - Daniel David
- Babeș-Bolyai University, Department of Clinical Psychology and Psychotherapy, Cluj-Napoca, Romania.,Icahn School of Medicine at Mount Sinai, Department of Oncological Sciences, New York, NY, USA
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Gata VA, Lisencu CI, Vlad CI, Piciu D, Irimie A, Achimas-Cadariu P. Tumor infiltrating lymphocytes as a prognostic factor in malignant melanoma. Review of the literature. J BUON 2017; 22:592-598. [PMID: 28730761] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Malignant melanoma represents the major cause of mortality among skin cancers, with increasing incidence and mortality rates worldwide. Despite the numerous public health campaigns and the efforts undertaken in the last decade regarding the establishment of a rapid diagnostic and an efficient treatment for these patients, the long-term prognosis has not been significantly improved. Thus, numerous studies were conducted in order to establish a more accurate prognosis, tumor infiltrating lymphocytes (TILs) being considered in many studies as independent prognostic factors of lymph node metastasis and overall survival in patients with melanoma. Moreover, immunotherapy has been intensively studied and evolved in recent times, and represents a promising treatment option for patients with advanced stage (metastatic) malignant melanoma. In this review article, we provided a literature overview on the histological classification, the history and the essential role of TILs, as well as the implications of regulatory T (Treg) cells and FOX P3 transcription factor in malignant melanoma.
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Affiliation(s)
- Vlad A Gata
- Surgical and Gynecologic Oncology, Department 11 - Oncology, Faculty of Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca
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Vlad C, Kubelac P, Alexandru I, Achimas-Cadariu P. Preliminary study on the role of secondary surgery in ovarian cancer patients. Experience of a tertiary institution. J BUON 2017; 22:802-803. [PMID: 28730795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Catalin Vlad
- "Ion Chiricuta" Oncology Institute, Cluj-Napoca, Romania
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Fetica B, Pop B, Blaga ML, Fulop A, Dima D, Zdrenghea MT, Vlad CI, Bojan AS, Achimas-Cadariu P, Lisencu CI, Irimie A, Weisenburger DD. High prevalence of viral hepatitis in a series of splenic marginal zone lymphomas from Romania. Blood Cancer J 2016; 6:e498. [PMID: 27834940 PMCID: PMC5148050 DOI: 10.1038/bcj.2016.102] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Affiliation(s)
- B Fetica
- Department of Pathology, The Oncology Institute 'Prof. dr. I. Chiricuta', Cluj-Napoca, Romania
| | - B Pop
- Department of Pathology, The Oncology Institute 'Prof. dr. I. Chiricuta', Cluj-Napoca, Romania.,Department of Pathology, University of Medicine and Pharmacy 'Iuliu Hatieganu', Cluj-Napoca, Romania
| | - M L Blaga
- Department of Epidemiology and Biostatistics, The Oncology Institute 'Prof. dr. I. Chiricuta', Cluj-Napoca, Romania
| | - A Fulop
- Department of Pathology, The Oncology Institute 'Prof. dr. I. Chiricuta', Cluj-Napoca, Romania
| | - D Dima
- Department of Hematology, The Oncology Institute 'Prof. dr. I. Chiricuta', Cluj-Napoca, Romania
| | - M T Zdrenghea
- Department of Hematology, The Oncology Institute 'Prof. dr. I. Chiricuta', Cluj-Napoca, Romania.,Department of Hematology, University of Medicine and Pharmacy 'Iuliu Hatieganu', Cluj-Napoca, Romania
| | - C I Vlad
- Department of Surgery, The Oncology Institute 'Prof. dr. I. Chiricuta', Cluj-Napoca, Romania.,Department of Surgery and Gynecologic Oncology, University of Medicine and Pharmacy 'Iuliu Hatieganu', Cluj-Napoca, Romania
| | - A S Bojan
- Department of Hematology, The Oncology Institute 'Prof. dr. I. Chiricuta', Cluj-Napoca, Romania.,Department of Hematology, University of Medicine and Pharmacy 'Iuliu Hatieganu', Cluj-Napoca, Romania
| | - P Achimas-Cadariu
- Department of Surgery, The Oncology Institute 'Prof. dr. I. Chiricuta', Cluj-Napoca, Romania.,Department of Surgery and Gynecologic Oncology, University of Medicine and Pharmacy 'Iuliu Hatieganu', Cluj-Napoca, Romania
| | - C I Lisencu
- Department of Surgery, The Oncology Institute 'Prof. dr. I. Chiricuta', Cluj-Napoca, Romania.,Department of Surgery and Gynecologic Oncology, University of Medicine and Pharmacy 'Iuliu Hatieganu', Cluj-Napoca, Romania
| | - A Irimie
- Department of Surgery, The Oncology Institute 'Prof. dr. I. Chiricuta', Cluj-Napoca, Romania.,Department of Surgery and Gynecologic Oncology, University of Medicine and Pharmacy 'Iuliu Hatieganu', Cluj-Napoca, Romania
| | - D D Weisenburger
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
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Zgaia A, Pop F, Irimie A, Rogobete A, Achimas-Cadariu P. Abstract PR348. Anesth Analg 2016. [DOI: 10.1213/01.ane.0000492743.10184.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Braicu C, Selicean S, Cojocneanu-Petric R, Lajos R, Balacescu O, Taranu I, Marin DE, Motiu M, Jurj A, Achimas-Cadariu P, Berindan-Neagoe I. Evaluation of cellular and molecular impact of zearalenone and Escherichia coli co-exposure on IPEC-1 cells using microarray technology. BMC Genomics 2016; 17:576. [PMID: 27506675 PMCID: PMC4977621 DOI: 10.1186/s12864-016-2830-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 07/31/2015] [Accepted: 06/10/2016] [Indexed: 02/07/2023] Open
Abstract
Background The gastrointestinal tract is the primary site of toxin interaction, an interface between the organism and its surroundings. In this study, we assessed the alteration of intestinal mRNA profile in the case of co-occurrence of zearalenone (ZEA), a secondary Fusarium metabolite, and Escherichia coli (E. coli), on the intestinal porcine epithelial cells IPEC-1. We chose this model since the pig is a species which is susceptible to pathogen and mycotoxin co-exposure. Results After treating the cells with the two contaminants, either separately or in combination, the differential gene expression between groups was assessed, using the microarray technology. Data analysis identified 1691 upregulated and 797 downregulated genes as a response to E. coli exposure, while for ZEA treated cells, 303 genes were upregulated and 49 downregulated. The co-contamination led to 991 upregulated and 800 downregulated genes. The altered gene expression pattern was further classified into 8 functional groups. In the case of co-exposure to ZEA and E.coli, a clear increase of proinflammatory mechanisms. Conclusions These results demonstrate the complex effect of single or multiple contaminants exposure at cellular and molecular level, with significant implications that might lead to the activation of pathological mechanisms. A better understanding of the effects of co-contamination is mandatory in developing novel exposure regulations and prevention measures.
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Affiliation(s)
- Cornelia Braicu
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Marinescu 23 Street, No. 23, Cluj-Napoca, 400012, Romania.,Department of Functional Genomics and Experimental Pathology, The Oncological Institute "Prof. Dr. Ion Chiricuta", Republicii Street, No. 34-36, Cluj-Napoca, 401015, Romania
| | - Sonia Selicean
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Marinescu 23 Street, No. 23, Cluj-Napoca, 400012, Romania
| | - Roxana Cojocneanu-Petric
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Marinescu 23 Street, No. 23, Cluj-Napoca, 400012, Romania
| | - Raduly Lajos
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Marinescu 23 Street, No. 23, Cluj-Napoca, 400012, Romania.,Department of Physiopathology, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Calea Mănăștur 3-5, Cluj-Napoca, 400372, Romania
| | - Ovidiu Balacescu
- Department of Functional Genomics and Experimental Pathology, The Oncological Institute "Prof. Dr. Ion Chiricuta", Republicii Street, No. 34-36, Cluj-Napoca, 401015, Romania
| | - Ionelia Taranu
- Laboratory of Animal Biology, National Institute for Research and Development for Biology and Animal Nutrition, Calea Bucuresti No. 1, Balotesti, Ilfov, 077015, Romania
| | - Daniela Eliza Marin
- Laboratory of Animal Biology, National Institute for Research and Development for Biology and Animal Nutrition, Calea Bucuresti No. 1, Balotesti, Ilfov, 077015, Romania
| | - Monica Motiu
- Laboratory of Animal Biology, National Institute for Research and Development for Biology and Animal Nutrition, Calea Bucuresti No. 1, Balotesti, Ilfov, 077015, Romania
| | - Ancuta Jurj
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Marinescu 23 Street, No. 23, Cluj-Napoca, 400012, Romania
| | - Patriciu Achimas-Cadariu
- Department of Surgery, The Oncology Institute "Prof. Dr. Ion Chiricuta", Republicii Street, No. 34-36, Cluj-Napoca, 401015, Romania. .,Department of Surgical Oncology and Gynaecological Oncology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 8 Babeş Street, Cluj-Napoca, 400012, Romania.
| | - Ioana Berindan-Neagoe
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Marinescu 23 Street, No. 23, Cluj-Napoca, 400012, Romania. .,Department of Functional Genomics and Experimental Pathology, The Oncological Institute "Prof. Dr. Ion Chiricuta", Republicii Street, No. 34-36, Cluj-Napoca, 401015, Romania. .,Research Center for Functional Genomics and Translational Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 23 Marinescu Street, Cluj-Napoca, 40015, Romania.
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Vlad C, Kubelac P, Onisim A, Fetica B, Fulop A, Irimie A, Achimas-Cadariu P. Expression of CDCP1 and ADAM12 in the ovarian cancer microenvironment. J BUON 2016; 21:973-978. [PMID: 27685922] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
PURPOSE The tumor microenvironment in ovarian cancer (OC) seems to play an important role, and besides tumor cells, biomarkers can derive from endothelial cells. We investigated CDCP1 and ADAM12 expression in relation with other clinical and pathological characteristics in OC patients. METHODS We retrospectively evaluated patient files between 2006-2011. A histochemical score was developed to evaluate tumor staining, the microvessel density (MVD), and stromal expression patterns for both ADAM12 and CDCP1. A CD34 antibody was used to assess tumor MVD. RESULTS 102 patients were selected and 83% had FIGO stage III/IV. A high CDCP1 tumor score correlated significantly with a shorter overall survival (OS) (p<0.01). Cases with positive CDCP1 had an elevated CD34 MVD (p<0.01). An absent/low ADAM12 tumor score correlated with significantly improved OS (p<0.01). Mean CD34 MVD was higher in cases with positive ADAM12 MVD (p=0.012). CONCLUSIONS Our results indicate that both tumor markers are negative prognostic factors for overall survival and additional studies are required to validate their future potential.
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Affiliation(s)
- Catalin Vlad
- Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Pop LA, Pileczki V, Cojocneanu-Petric RM, Petrut B, Braicu C, Jurj AM, Buiga R, Achimas-Cadariu P, Berindan-Neagoe I. Normalization of gene expression measurement of tissue samples obtained by transurethral resection of bladder tumors. Onco Targets Ther 2016; 9:3369-80. [PMID: 27330317 PMCID: PMC4898429 DOI: 10.2147/ott.s97519] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background Sample processing is a crucial step for all types of genomic studies. A major challenge for researchers is to understand and predict how RNA quality affects the identification of transcriptional differences (by introducing either false-positive or false-negative errors). Nanotechnologies help improve the quality and quantity control for gene expression studies. Patients and methods The study was performed on 14 tumor and matched normal pairs of tissue from patients with bladder urothelial carcinomas. We assessed the RNA quantity by using the NanoDrop spectrophotometer and the quality by nano-microfluidic capillary electrophoresis technology provided by Agilent 2100 Bioanalyzer. We evaluated the amplification status of three housekeeping genes and one small nuclear RNA gene using the ViiA 7 platform, with specific primers. Results Every step of the sample handling protocol, which begins with sample harvest and ends with the data analysis, is of utmost importance due to the fact that it is time consuming, labor intensive, and highly expensive. High temperature of the surgical procedure does not affect the small nucleic acid sequences in comparison with the mRNA. Conclusion Gene expression is clearly affected by the RNA quality, but less affected in the case of small nuclear RNAs. We proved that the high-temperature, highly invasive transurethral resection of bladder tumor procedure damages the tissue and affects the integrity of the RNA from biological specimens.
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Affiliation(s)
- Laura A Pop
- The Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania
| | - Valentina Pileczki
- The Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania; Department of Analytical Chemistry, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania
| | - Roxana M Cojocneanu-Petric
- The Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania
| | - Bogdan Petrut
- Department of Surgery II - Urology, The Oncology Institute "Prof Dr Ion Chiricuţă", Cluj-Napoca, Cluj, Romania; Department of Urology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania
| | - Cornelia Braicu
- The Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania
| | - Ancuta M Jurj
- The Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania
| | - Rares Buiga
- Department of Pathology, The Oncology Institute "Prof. Dr Ion Chiricuţă", Cluj-Napoca, Cluj, Romania
| | - Patriciu Achimas-Cadariu
- Department of Surgery, The Oncology Institute "Prof Dr Ion Chiricuţă", Cluj-Napoca, Cluj, Romania; Department of Surgical Oncology and Gynecological Oncology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania
| | - Ioana Berindan-Neagoe
- The Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania; Department of Functional Genomics and Experimental Pathology, The Oncology Institute "Prof Dr Ion Chiricuţă", Cluj-Napoca, Cluj, Romania
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Vlad C, Kubelac P, Alexandru I, Achimas-Cadariu P. The role of primary debulking in advanced ovarian cancer patients. J BUON 2016; 21:1320. [PMID: 27837639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Catalin Vlad
- Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania
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Onisim A, Iancu M, Vlad C, Kubelac P, Fetica B, Fulop A, Achimas-Cadariu A, Achimas-Cadariu P. Expression of Nestin and CD133 in serous ovarian carcinoma. J BUON 2016; 21:1168-1175. [PMID: 27837619] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
UNLABELLED Pupose: Nestin and CD133 are regarded as putative markers of cancer stem cells (CSCs) and related to poor prognosis in various cancer sites. Since few studies have focused on their role in ovarian cancer, we aimed to investigate their predictive value and association with neoangiogenesis. METHODS Immunohistochemical analysis for nestin and CD133 was performed on 85 serous ovarian carcinoma tumor samples using tissue microarray technique. Nestin immunoreactivity was detected in both tumor and endothelial cells, whilst CD133 was only identified in tumor cells. CD34 endothelial expression was used to assess intratumor microvessel density (MVD). RESULTS Of the tissue samples 49.4% were nestin-positive and 24.7% were positive for CD133. In both univariate and multivariate analysis nestin or CD133 expressions in tumor cells were not significantly associated with clinicopathological parameters (age, serum CA125, peritoneal carcinomatosis, malignant ascites, tumor grade). However, in multivariate analysis nestin expression in tumor cells proved to be an independent prognostic factor, associated with poorer survival and time to progression (p=0.025 and p=0.05, respectively). This has not been achieved for CD133. Furthermore, a significant concordance between nestin endothelial expression (nestin-determined MVD) and CD34-determined MVD was achieved. CONCLUSION In addition to the well-known clinicopathological characteristics, tumor expression of nestin might be a valuable prognostic factor for survival in patients with advanced ovarian cancer. With regard to its endothelial expression, nestin might be as reliable as CD34 for quantifying tumor angiogenesis. Further investigation is justified in order to better clarify the role of these biomarkers.
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MESH Headings
- AC133 Antigen/analysis
- Adult
- Aged
- Antigens, CD34/analysis
- Biomarkers, Tumor/analysis
- Carcinoma/chemistry
- Carcinoma/pathology
- Carcinoma/therapy
- Chi-Square Distribution
- Endothelial Cells/chemistry
- Endothelial Cells/pathology
- Female
- Humans
- Immunohistochemistry
- Kaplan-Meier Estimate
- Middle Aged
- Multivariate Analysis
- Neoplasms, Cystic, Mucinous, and Serous/blood supply
- Neoplasms, Cystic, Mucinous, and Serous/chemistry
- Neoplasms, Cystic, Mucinous, and Serous/pathology
- Neoplasms, Cystic, Mucinous, and Serous/therapy
- Neovascularization, Pathologic
- Nestin/analysis
- Odds Ratio
- Ovarian Neoplasms/blood supply
- Ovarian Neoplasms/chemistry
- Ovarian Neoplasms/pathology
- Ovarian Neoplasms/therapy
- Predictive Value of Tests
- Prognosis
- Proportional Hazards Models
- Risk Factors
- Tissue Array Analysis
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Affiliation(s)
- Andrea Onisim
- Department of Medical Oncology, The Oncology Institute, "Prof. Dr. Ion Chiricuta", Cluj-Napoca, Romania
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Braicu O, Pileczki V, Braicu C, Achimas-Cadariu P, Irimie A, Berindan-Neagoe I. p53 siRNA - a therapeutic tool with significant implication in the modulation of apoptosis and angiogenic pathways. ACTA ACUST UNITED AC 2015; 88:333-7. [PMID: 26609266 PMCID: PMC4632892 DOI: 10.15386/cjmed-434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 03/24/2015] [Revised: 05/04/2015] [Accepted: 05/09/2015] [Indexed: 12/28/2022]
Abstract
Background and aims siRNAs represent an encouraging novel alternative in cancer therapy as a result of targeting the mutated tumour suppressor genes or activated oncogenes. Targeting oncogenic signals, as the mutated p53 gene that gains oncogenic role, we observed inhibition of migration, a downregulation of specific genes involved in apoptosis but also in angiogenesis, connected with a reduction in invasion rate in the case of p53siRNA therapy. Methods The study was designed to assess the role of p53 by using RNAi (RNA interference) in Hela in vitro cell culture model. Therefore cell migration rate was assessed by using xCELLigence Systems, gene expression for a panel of genes involved in apoptosis and angiogenesis, and validation of gene expression data at protein level. Results On the selected in vitro model p53 siRNA therapy was correlated with the reduction of cell migration. The downregulation of p53, PTEN, TNFα, NFkB, BCL-2, ICAM-2, VEGF, and FGFb was evidenced as response to p53 inhibition. Conclusion RNAi may be a valuable technology in order to restore the normal cellular phenotype. The results in the current research may also have an important significance outside the context of cervical cancer, by using specific inhibitors for p53 for increasing the therapeutic response in a wide range of tumoral pathology.
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Affiliation(s)
- Ovidiu Braicu
- Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania ; Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania ; Department of Surgical Oncology, The Oncological Institute Prof. Dr. Ion Chiricuta, Cluj-Napoca, Romania
| | - Valentina Pileczki
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cornelia Braicu
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Patriciu Achimas-Cadariu
- Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania ; Department of Surgical Oncology, The Oncological Institute Prof. Dr. Ion Chiricuta, Cluj-Napoca, Romania
| | - Alexandru Irimie
- Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania ; Department of Surgical Oncology, The Oncological Institute Prof. Dr. Ion Chiricuta, Cluj-Napoca, Romania
| | - Ioana Berindan-Neagoe
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania ; Department of Functional Genomics and Experimental Pathology, The Oncological Institute Prof. Dr. Ion Chiricuta, Cluj-Napoca, Romania
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