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Markowska A, Kojs Z, Twardawa D, Pietras J, Markowska J. Selected markers of ovarian cancer and their relation to targeted therapy (Review). Exp Ther Med 2024; 27:236. [PMID: 38628658 PMCID: PMC11019661 DOI: 10.3892/etm.2024.12523] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/15/2024] [Indexed: 04/19/2024] Open
Abstract
Despite advances in surgical treatment techniques and chemotherapy-including anti-angiogenic and immune poly (ADP-ribose) polymerase inhibitors, the 5-year survival rate in ovarian cancer (OC) remains low. The reasons for this are the diagnosis of cancer in advanced clinical stages, chemoresistance and cancer recurrence. New therapeutic approaches are being developed, including the search for new biomarkers that are also targets for targeted therapy. The present review describes new molecular markers with relevance to targeted therapy, which to date have been studied only in experimental research. These include the angiogenic protein angiopoietin-2, the transmembrane glycoprotein ectonucleotide pyrophosphatase/phosphodiesterase 1, the adhesion protein E-cadherin, the TIMP metallopeptidase inhibitor 1 and Kruppel-like factor 7. Drugs affecting cancer stem cells (CSCs) in OC, such as metformin and salinomycin, as well as inhibitors of CSCs markers aldehyde dehydrogenase 1 (with the drug ATRA) and the transcription factor Nanog homeobox (microRNA) are also discussed. A new approach to prevention and possible therapies under investigation such as development of vaccines containing a subpopulation of CD117(+) and CD44(+) stem cells with a promising option for use in women with OC was described.
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Affiliation(s)
- Anna Markowska
- Department of Perinatology and Women's Diseases, Poznan University of Medical Sciences, 60-535 Poznan, Poland
| | - Zbigniew Kojs
- Department of Gynecology and Obstetrics with Gynecologic Oncology, Ludwik Rydygier Memorial Specialized Hospital, 31-826 Kraków, Poland
| | - Damian Twardawa
- Medical Department, Bausch Health Poland, 02-674 Warsaw, Poland
| | - Joanna Pietras
- Department of Perinatology and Women's Diseases, Poznan University of Medical Sciences, 60-535 Poznan, Poland
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Opławski M, Grabarek BO, Średnicka A, Czarniecka J, Panfil A, Kojs Z, Boroń D. The Impact of Surgical Treatment with Adjuvant Chemotherapy for Ovarian Cancer on Disorders in the Urinary System and Quality of Life in Women. J Clin Med 2022; 11:jcm11051300. [PMID: 35268391 PMCID: PMC8911254 DOI: 10.3390/jcm11051300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 02/04/2023] Open
Abstract
Ovarian cancer is the fourth-most-common cause of death among all malignant cancers in women in Poland. This study aimed to compare the functioning of the urinary system and quality of life in women in the 12-month period following the completion of surgery or adjuvant treatment for ovarian cancer, with patients who underwent a hysterectomy for non-oncological reasons (control group). The study group consisted of 50 patients diagnosed with stage I−III ovarian cancer. Among 38 patients with type II ovarian cancer (group A), surgery followed by first-line chemotherapy was performed. Within this group of patients, 20 had stage I ovarian cancer, while 18 had stage II ovarian cancer. The study was performed at least 6 months after the final chemotherapy cycle, with no clinical, marker or radiological recurrence determined. On the other hand, in 12 patients with stage I type I ovarian cancer, oncological treatment consisted of only surgery, without the need for adjuvant chemotherapy, due to the low stage of the lesions (group B). In turn, the control group consisted of 50 women who underwent uterine removal for non-oncological reasons (group C). The assessment of quality of life was conducted using the questionnaires: Satisfaction with Life Scale (SWLS); Incontinence Impact Questionnaire, short form (IIQ-7); Urogenital Distress Inventory (UDI-6); and the Sexual Satisfaction Scale for 3, 6, 9, and 12 months after the conclusion of oncological treatment. During the follow-up, a significant reduction in the quality of everyday life and sexual life was noted among patients with ovarian cancer, more pronounced in group B, compared to the control group (p < 0.05). The risk of urinary incontinence is independent of the treatment regimen chosen for ovarian cancer. It is necessary to consider comprehensive psychological care and sexual therapy in patients with ovarian cancer and their families.
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Affiliation(s)
- Marcin Opławski
- Department of Gynecology and Obstetrics with Gynecologic Oncology, Ludwik Rydygier Memorial Specialized Hospital, 31-826 Kraków, Poland; (B.O.G.); (A.Ś.); (Z.K.); (D.B.)
- Department of Gynecology and Obstetrics, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski University in Cracow, 30-705 Cracow, Poland
- Correspondence:
| | - Beniamin Oskar Grabarek
- Department of Gynecology and Obstetrics with Gynecologic Oncology, Ludwik Rydygier Memorial Specialized Hospital, 31-826 Kraków, Poland; (B.O.G.); (A.Ś.); (Z.K.); (D.B.)
- Department of Histology, Cytophysiology and Embryology in Zabrze, Faculty of Medicine in Zabrze, University of Technology, Academy of Silesia in Katowice, 41-800 Zabrze, Poland; (J.C.); (A.P.)
- Department of Gynecology and Obstetrics in Zabrze, Faculty of Medicine in Zabrze, University of Technology, Academy of Silesia in Katowice, 41-800 Zabrze, Poland
| | - Agata Średnicka
- Department of Gynecology and Obstetrics with Gynecologic Oncology, Ludwik Rydygier Memorial Specialized Hospital, 31-826 Kraków, Poland; (B.O.G.); (A.Ś.); (Z.K.); (D.B.)
- Department of Gynecology and Obstetrics, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski University in Cracow, 30-705 Cracow, Poland
| | - Justyna Czarniecka
- Department of Histology, Cytophysiology and Embryology in Zabrze, Faculty of Medicine in Zabrze, University of Technology, Academy of Silesia in Katowice, 41-800 Zabrze, Poland; (J.C.); (A.P.)
| | - Agata Panfil
- Department of Histology, Cytophysiology and Embryology in Zabrze, Faculty of Medicine in Zabrze, University of Technology, Academy of Silesia in Katowice, 41-800 Zabrze, Poland; (J.C.); (A.P.)
| | - Zbigniew Kojs
- Department of Gynecology and Obstetrics with Gynecologic Oncology, Ludwik Rydygier Memorial Specialized Hospital, 31-826 Kraków, Poland; (B.O.G.); (A.Ś.); (Z.K.); (D.B.)
| | - Dariusz Boroń
- Department of Gynecology and Obstetrics with Gynecologic Oncology, Ludwik Rydygier Memorial Specialized Hospital, 31-826 Kraków, Poland; (B.O.G.); (A.Ś.); (Z.K.); (D.B.)
- Department of Histology, Cytophysiology and Embryology in Zabrze, Faculty of Medicine in Zabrze, University of Technology, Academy of Silesia in Katowice, 41-800 Zabrze, Poland; (J.C.); (A.P.)
- Department of Gynecology and Obstetrics in Zabrze, Faculty of Medicine in Zabrze, University of Technology, Academy of Silesia in Katowice, 41-800 Zabrze, Poland
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Rudnicki W, Heinze S, Popiela T, Kojs Z, Luczynska E. Quantitative Assessment of Contrast Enhancement on Contrast Enhancement Spectral Mammography (CESM) and Comparison With Qualitative Assessment. Anticancer Res 2020; 40:2925-2932. [PMID: 32366444 DOI: 10.21873/anticanres.14270] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/06/2020] [Accepted: 04/14/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Contrast enhanced spectral mammography (CESM) is a novel method of breast cancer diagnosis. Benign lesions are enhanced after contrast injection on both CESM and breast magnetic resonance imaging (MRI). Kinetic curves on breast MRI facilitate differentiation between benign and malignant lesions, while on CESM there is no such possibility and we need to asses lesions based only on their level of enhancement and its patterns. The aim of this study was to compare two subjective assessments of enhancement level on CESM with numerical values measured using the region of interests (ROIs) and to categorize obtained enhancement level values. PATIENTS AND METHODS Patients with suspicious findings on previously performed examinations were qualified for CESM. The qualitative assessment was based on the subjective classification of visible contrast enhancement as weak, medium or strong. The quantitative assessment was obtained by measurements of an average enhancement value and sigma value within the ellipsoidal shape ROI, inserted into the evaluated contrast enhancing lesion. RESULTS The study group included 151 patients with total of 195 lesions diagnosed. It was verified how the classification based on the threshold values of %RS (percentage signal difference between enhancing lesion and background) and SDNR (signal-difference-to-noise Ratio) corresponds to a subjective assessment. CONCLUSION Quantitative assessment of contrast enhancement on CESM is helpful in making decisions whether a lesion requires a biopsy. This can reduce the number of unnecessary biopsy procedures and reduce the cost of diagnostics.
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Affiliation(s)
| | - Sylwia Heinze
- Department of Radiology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow, Poland
| | - Tadeusz Popiela
- Jagiellonian University Medical College, Chair of Radiology, Cracow, Poland
| | - Zbigniew Kojs
- Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow, Poland
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Piechowicz M, Mikos M, Banas T, Okon K, Pietrus M, Balajewicz-Nowak M, Szczudlik L, Kojs Z, Czerw A, Juszczyk G, Pityński K. Metastatic and non-metastatic sentinel inguinofemoral lymph nodes in vulvar cancer show an increased lymphangiogenesis. Ann Agric Environ Med 2020; 27:123-128. [PMID: 32208590 DOI: 10.26444/aaem/105925] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION AND OBJECTIVE Lymph node involvement is a strong predictor of disease recurrence and patient survival in vulvar cancer. The aim of the study was to evaluate the feasibility of sentinel lymph node (SLN) screening, the incidence of skip metastases, and lymph node lymphangiogenesis. MATERIAL AND METHODS Fifty-five patients participated in this prospective, single centre study. A double SLN screening method was employed using radiocolloid (technetium-99 sulfur colloid) and 1.0% Isosulfan Blue. Immunohistochemistry, using a mouse monoclonal antibody against D2-40, was used to evaluate lymphatic vessel density (LVD). All calculations were performed using STATISTICA software v. 10 (StatSoft, USA, 2011); p < 0.05 was considered significant. RESULTS Using both methods of SLN detection, 100% accuracy was achieved, and skip metastases were diagnosed in only one woman (1.82%). Peri-tumour median LVD was significantly increased compared with matched intra-tumour samples (p < 0.001), while median LVD was significantly lower in negative, compared with positive SLN, regardless of whether matched non-SLN were negative (p < 0.001) or positive (p = 0.005). Metastatic SLN exhibited significantly higher median LVD compared with matched negative non-SLN (p = 0.015), while no significant difference in median LVD was detected between positive SLN and matched positive non-SLN. However, negative SLN had a significantly higher median LVD compared with matched negative non-SLN (p = 0.012). CONCLUSIONS SLN detection is a safe and feasible procedure in vulvar cancer. In patients without nodular involvement, SLN, compared with non-SLN, exhibited significantly higher median LVD, which may be an indication of its preparation to host metastases, and thus requires further investigation.
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Affiliation(s)
- Magda Piechowicz
- Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland
| | - Marcin Mikos
- Faculty of Medicine and Health and Medical Science, Andrzej Frycz Modrzewski University, Krakow Poland
| | - Tomasz Banas
- Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland
| | - Krzysztof Okon
- Department of Pathomorphology, Jagiellonian University Medical College, Krakow, Poland
| | - Milosz Pietrus
- Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland
| | - Marta Balajewicz-Nowak
- Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland
| | - Lukasz Szczudlik
- Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland
| | - Zbigniew Kojs
- Oncology Centre - M. Skłodowska-Curie Institute, Krakow, Poland
| | - Aleksandra Czerw
- Department of Economic and System Analyses, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
| | - Grzegorz Juszczyk
- Department of Public Health, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland
| | - Kazimierz Pityński
- Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland
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Rudnicki W, Heinze S, Piegza T, Pawlak M, Kojs Z, Łuczyńska E. Correlation Between Enhancement Intensity in Contrast Enhancement Spectral Mammography and Types of Kinetic Curves in Magnetic Resonance Imaging. Med Sci Monit 2020; 26:e920742. [PMID: 32173716 PMCID: PMC7071734 DOI: 10.12659/msm.920742] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Due to the decreased sensitivity of mammography in glandular breasts, new diagnostic modalities, like contrast-enhanced spectral mammography (CESM) and digital breast tomosynthesis (DBT) have been developed. The aim of this study was to compare qualitative enhancement levels on CESM with type of kinetic enhancement curves on MRI examination. Material/Methods Patients qualified for the CESM examination presented some diagnostic doubts – suspected multifocality, multicentricity, or having dense glandular breast tissue. The enhancement level on CESM was described as weak, medium, or strong. Enhancement on achieved MR images was assessed on the basis of enhancement kinetic curves. The level of enhancement on CESM was associated with enhancement curves type on MRI. All lesions detected on CESM and MRI were histopathologically verified. Results The study involved 107 lesions diagnosed in 94 patients: 71 lesions (66%) appeared to be infiltrating on histopathological examination, 9 lesions (8%) were non-infiltrating cancers, and 27 lesions (25%) were benign. Data analysis revealed that lesions with wash-out curve on MRI most often presented strong enhancement on CESM, while in lesions with progressive enhancement curve, strong enhancement on CESM was the rarest. The relationship between enhancement level on CESM and curve type on contrast-enhanced MRI depends on the nature of the lesion. The type of MRI curve was found to be associated with enhancement level on CESM. Conclusions We compared subjective assessments of contrast enhancement on CESM with enhancement kinetic curves on MRI. The results showed that the level of enhancement on CESM and type of kinetic curves on MRI depends on the lesion type.
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Affiliation(s)
- Wojciech Rudnicki
- Department of Radiology, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow, Poland
| | - Sylwia Heinze
- Department of Radiology, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow, Poland
| | - Tomasz Piegza
- Department of Radiology, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow, Poland
| | - Marta Pawlak
- Department of Radiology, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow, Poland
| | - Zbigniew Kojs
- Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow, Poland
| | - Elżbieta Łuczyńska
- Department of Radiology, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow, Poland
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Szubert S, Koper K, Dutsch-Wicherek MM, Kojs Z. The potential predictive value of serum srCaS1 levels for overall survival in endometrial cancer. Ginekol Pol 2019; 90:134-140. [PMID: 30950002 DOI: 10.5603/gp.2019.0024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 01/11/2019] [Revised: 02/18/2019] [Accepted: 02/22/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The main aim of the study was to evaluate the impact of levels of serum soluble receptor-binding cancer antigen expressed on SiSo cells (sRCAS1) on the overall survival (OS) rates in patients with endometrial cancer. Furthermore, we analyzed sRCAS1 levels according to the clinicopathological characteristics of the disease. MATERIAL AND METHODS The study group comprised 43 patients who were being treated for endometrial cancer. We included 10 low-risk, 20 intermediate-risk and 13 high-risk endometrial cancers using the criteria of the European Society for Medical Oncology (ESMO), the European Society for Radiotherapy & Oncology (ESTRO) and the European Society of Gynaecological Oncology (ESGO). Serum sRCAS1 levels were obtained before and after surgery. Serum sRCAS1 levels were assessed using the ELISA method. RESULTS In our univariate analysis, both the pre- and post-surgery high sRCAS1 groups of patients with endometrial cancer indicated a shortened OS. However, in our multivariate analysis, when patients' age and disease-related risk was taken into consideration, only the post-surgery sRCAS1 levels remained as independent prognostic factors of a poor OS. Pre-treatment serum sRCAS1 levels were statistically significantly higher than post-surgery sRCAS1 levels; however, the difference between pre- and post-surgery sRCAS1 levels did not influence the patients' OS rate. Pre- and post-surgery sRCAS1 levels did not differ according to tumor grade, stage of the disease or the disease-related risk group. CONCLUSIONS High post-surgery serum sRCAS1 levels seem to be an independent indicator of shortened overall survival in patients with endometrial cancer.
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Affiliation(s)
- Sebastian Szubert
- Clinical Department of Gynaecological Oncology, The Franciszek Lukaszczyk Oncological Center, Bydgoszcz, Poland.
| | - Krzysztof Koper
- Chair of Oncology, Radiotherapy and Gynecologic-Oncology of the Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University, Poland
| | | | - Zbigniew Kojs
- Center of Oncology, M. Sklodowska-Curie Memorial Institute, Cracow Branch, Poland
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Menkiszak J, Chudecka-Głaz A, Cymbaluk-Płoska A, Celewicz A, Kojs Z, Szajda M, Świniarska M, Bedner R, Jurczak A, Celewicz M, Cieszyńska M, Lubiński J, Gronwald J. Selected features of breast and peritoneal cancers diagnosed in BRCA1 carriers after risk-reducing salpingo-oophorectomy. Hered Cancer Clin Pract 2019; 17:10. [PMID: 30918533 PMCID: PMC6419350 DOI: 10.1186/s13053-019-0109-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 03/05/2019] [Indexed: 11/10/2022] Open
Abstract
Background Since more than two decades Risk-reducing salpingo-oophorectomy (RRSO) is recommended and widely accepted by BRCA1/2 carriers as a method reducing ovarian cancer risk and improving survival rate. After RRSO, there remains a risk of breast cancer and peritoneal cancer. The characteristics of these neoplasms are not well known. In this study, we determined the selected parameters such as age at cancer diagnosis, time from RRSO to the diagnosis of cancer, and significance of BRCA1 mutation type in patients diagnosed with breast or peritoneal cancer during postoperative follow-up. Methods The material comprised of 195 BRCA1 carriers who performed RRSO between years 1999-2012. In this period, 16 patients developed cancer (6-primary breast cancer, 3-contralateral breast cancer, 5-relapse of breast cancer, 2-peritoneal cancer). They were subject of the further analysis. Results During the follow-up period mean age of patients after RRSO at the time of cancer diagnosis was 53.19. The mean age of patients diagnosed with primary breast cancer was 50, contralateral breast cancer - 58.67, recurrence of breast cancer - 51 and peritoneal cancer 60. The mean time periods from RRSO to the diagnosis of primary, contralateral, recurrence breast cancer were 53, 58.67 and 25,4 months respectively and of peritoneal cancer 46 months. BRCA1 c.5266dupC mutation carriers demonstrated significantly shorter time of cancer development compared to patients carrying c.181T > G and c.4035delA mutations. Peritoneal cancer was only observed in two c.181T > G BRCA1 mutation carriers. Conclusions The mean age of cancer diagnosis and the mean time periods from RRSO to the diagnosis of cancer are similar to those observed by other researchers. The carriers of c.181T > G and c.5266dupC BRCA1 mutation should be the subject further studies in context of breast and peritoneal cancer risk or time of cancer development after RRSO, respectively.
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Affiliation(s)
- Janusz Menkiszak
- 1Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Anita Chudecka-Głaz
- 1Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Aneta Cymbaluk-Płoska
- 1Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Aleksander Celewicz
- 1Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Zbigniew Kojs
- 2Department of Gynecologic Oncology, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Branch, Cracow, Poland
| | - Mariusz Szajda
- 3International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Maria Świniarska
- Department of the Clinical Oncology the West Pomeranian Centre of the Oncology in Szczecin, Szczecin, Poland
| | - Ryszard Bedner
- 1Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Anna Jurczak
- 5Department of Clinical Nursing, Pomeranian Medical University, Szczecin, Poland
| | - Marta Celewicz
- 6Department of Obstetrics and Gynecology, Pomeranian Medical University, Szczecin, Poland
| | - Monika Cieszyńska
- 3International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Jan Lubiński
- 3International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Jacek Gronwald
- 3International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
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Wreczycka-Cegielny P, Cegielny T, Oplawski M, Sawicki W, Kojs Z. Current treatment options for advanced choriocarcinoma on the basis of own case and review of the literature. Ginekol Pol 2018; 89:711-715. [DOI: 10.5603/gp.a2018.0120] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 09/28/2018] [Accepted: 11/06/2018] [Indexed: 11/25/2022] Open
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Szymankiewicz M, Koper K, Dziobek K, Kojs Z, Wicherek L. Microbiological monitoring in patients with advanced ovarian cancer before and after cytoreductive surgery – a preliminary report. Current Issues in Pharmacy and Medical Sciences 2018. [DOI: 10.1515/cipms-2017-0038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Multidrug-resistant organisms (MDROs) are becoming an increasing problem in hospitals. It is believed that screening patients for the incidence of MDROs prior to hospital admission not only allows for the proper management of infection following medical procedures, but can also potentially reduce the transmission of these bacteria to other patients.
The aim of this study was to assess the carriers of selected MDROs in the gastrointestinal tract among patients with advanced ovarian cancer admitted to the hospital for cytoreductive surgery and to estimate the possible relationship between rectal colonization with these organisms and nosocomial infections.
From December 2013 to May 2014, we evaluated the colonization with VRE (vancomycin-resistant Enterococcus), E. coli KPC+ (class A carbapenemase producing Escherichia coli), E. coli MBL+ (class B carbapenemase, metallo-ß lactamase producing Escherichia coli), and E. coli ESBL+ (extended-spectrum ß-lactamase producing Escherichia coli) in 42 patients. The patients were divided into two subgroups corresponding to the extent of their surgery: the first subgroup consisted of patients with large bowel resection (n=18) and the second subgroup of patients without resection (n=24). A rectal swab was taken within 24 hours of admission. Perioperative infectious complications were analyzed for the first 90 days following surgery with regard to the type of infection and the occurrence of examined MDROs.
In our study, 2.4 % of all patients (23.8/1,000 hospitalizations) were colonized with ESBL - producing Escherichia coli: 0.0 % in the first subgroup and 4.2% in the second subgroup, respectively. We did not identify any patients who were colonized with VRE, E. coli MBL+, or E. coli KPC+. Surgical site infections were seen in 8 (19.1%) out of 42 patients. We were, therefore, unable to confirm a relationship between MDROs colonizing the large bowel and the etiological agents of perioperative infections. However, despite the lack of identification of MDROs as etiological agents of postoperative infection, the risk of serious infectious complications, combined with the changing epidemiological situation, means that microbiological monitoring should be performed in patients with ovarian cancer before and after cytoreductive surgery.
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Affiliation(s)
- Maria Szymankiewicz
- Department of Microbiology, Professor Franciszek Lukaszczyk Oncology Center , Bydgoszcz, Romanowskiej 2, 85-796 Bydgoszcz , Poland
| | - Krzysztof Koper
- Department of Oncology, Professor Franciszek Lukaszczyk Oncology Center , Bydgoszcz, Romanowskiej 2, 85-796 Bydgoszcz , Poland
- Department of Oncology, Radiotherapy and Oncological Gynecology, Ludwik Rydygier Collegium Medicum , Nicolaus Copernicus University , Bydgoszcz, Romanowskiej 2, 85-796 Bydgoszcz , Poland
| | - Konrad Dziobek
- Department of Gynecologic Oncology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology in Warsaw , Division in Krakow, Garncarska 11, 31-115 Krakow , Poland
| | - Zbigniew Kojs
- Department of Gynecologic Oncology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology in Warsaw , Division in Krakow, Garncarska 11, 31-115 Krakow , Poland
| | - Lukasz Wicherek
- Clinical Department of Gynecologic Oncology, Professor Franciszek Lukaszczyk Oncology Center , Bydgoszcz, Romanowskiej 2, 85-796 Bydgoszcz , Poland
- Department of Oncology, Radiotherapy and Oncological Gynecology, Ludwik Rydygier Collegium Medicum , Nicolaus Copernicus University , Bydgoszcz, Romanowskiej 2, 85-796 Bydgoszcz , Poland
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Jach R, Pabian W, Spaczyński R, Szamatowicz J, Zbroch T, Knapp P, Smolarczyk R, Kolawa W, Bodnar L, Kurzawa R, Zawirska D, Krzakowski M, Radowicki S, Fijuth J, Wielgoś M, Wysocki P, Kozioł K, Zalewski K, Warzocha K, Hałaburda K, Rdwan M, Radwan P, Jabłoński MJ, Kojs Z, Wołczyński S, Pawelczyk L, Kluz T, Lukaszuk K. Recommendations of the Fertility Preservation Working Group in Oncological, Hematological and Other Patients Treated With Gonadotoxic Therapies "ONCOFERTILITY" (GROF) of the Polish Society of Oncological Gynecology. J Adolesc Young Adult Oncol 2017; 6:388-395. [PMID: 28657411 DOI: 10.1089/jayao.2017.0039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Robert Jach
- 1 Department of Endocrinologic Gynecology and Gynecology, University Hospital in Krakow , Krakow, Poland
| | - Wojciech Pabian
- 1 Department of Endocrinologic Gynecology and Gynecology, University Hospital in Krakow , Krakow, Poland
| | - Robert Spaczyński
- 2 Gynaecology and Obstetrics Clinical Hospital of K. Marcinkowski Medical University in Poznań , Poznań, Poland
| | | | - Tomasz Zbroch
- 4 Artemida-Gynaecology, Endocrinology and Reproductive Medicine Centre , Białystok, Poland
| | - Paweł Knapp
- 3 Medical University of Białystok , Białystok, Poland
| | - Roman Smolarczyk
- 5 Princess Anna Mazowiecka Clinical Hospital in Warsaw , Warsaw, Poland
| | - Wojciech Kolawa
- 6 G. Narutowicz Municipal Specialist Hospital in Krakow , Krakow, Poland
| | | | | | - Daria Zawirska
- 1 Department of Endocrinologic Gynecology and Gynecology, University Hospital in Krakow , Krakow, Poland
| | | | | | - Jacek Fijuth
- 10 Oncological Haematology Centre in Łódź , Łódź, Poland
| | | | - Piotr Wysocki
- 1 Department of Endocrinologic Gynecology and Gynecology, University Hospital in Krakow , Krakow, Poland
| | | | | | | | | | - Michał Rdwan
- 15 GAMETA Infertility Treatment Clinic , Rzgów, Poland
| | - Paweł Radwan
- 15 GAMETA Infertility Treatment Clinic , Rzgów, Poland
| | | | - Zbigniew Kojs
- 17 Oncology Centre-M. Skłodowska-Curie Institute , Krakow, Poland
| | | | - Leszek Pawelczyk
- 2 Gynaecology and Obstetrics Clinical Hospital of K. Marcinkowski Medical University in Poznań , Poznań, Poland
| | - Tomasz Kluz
- 18 Department of Obstetrics and Gynecology, Fryderyk Chopin University Hospital No 1, Faculty of Medicine, Rzeszow University , Rzeszow, Poland
| | - Krzysztof Lukaszuk
- 10 Oncological Haematology Centre in Łódź , Łódź, Poland,11 Medical University of Warsaw , Warsaw, Poland,12 "nOvum" Medical Clinic , Warsaw, Poland,13 Świętokrzyskie Oncology Centre , Kielce, Poland
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11
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Jaszczyński J, Kojs Z, Stelmach A, Wohadło Ł, Łuczyńska E, Heinze S, Rys J, Jakubowicz J, Chłosta P. Post-Irradiation Bladder Syndrome After Radiotherapy of Malignant Neoplasm of Small Pelvis Organs: An Observational, Non-Interventional Clinical Study Assessing VESIcare®/Solifenacin Treatment Results. Med Sci Monit 2016; 22:2691-8. [PMID: 27474270 PMCID: PMC4976757 DOI: 10.12659/msm.899327] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Background Radiotherapy is explicitly indicated as one of the excluding factors in diagnosing overactive bladder syndrome (OAB). Nevertheless, symptoms of OAB such as urgent episodes, incontinence, pollakiuria, and nocturia, which are consequences of irradiation, led us to test the effectiveness of VESIcare®/Solifenacin in patients demonstrating these symptoms after radiation therapy of small pelvis organs due to malignant neoplasm. Material/Methods We conducted an observatory clinical study including 300 consecutive patients with symptoms of post-irradiation bladder; 271 of those patients completed the study. The observation time was 6 months and consisted of 3 consecutive visits taking place at 12-week intervals. We used VESIcare® at a dose of 5 mg a day. Every sixth patient was examined urodynamically at the beginning and at the end of the observation period, with an inflow speed of 50 ml/s. Results We noticed improvement and decline in the average number of episodes a day in the following parameters: number of micturitions a day (−36%, P<0.01), nocturia (−50%, P<0.01), urgent episodes (−41%, P<0.03), and episodes of incontinence (−43%, P<0.01). The patients’ quality of life improved. The average maximal cystometric volume increased by 34 ml (21%, p<0.01), average bladder volume of “first desire” increased by 42 ml (49%, P<0.01), and average detrusor muscle pressure at maximal cystometric volume diminished by 9 cmH2O (−36%, P<0.03). Conclusions The substance is well-tolerated. Solifenacin administered long-term to patients with symptoms of OAB after radiotherapy of a malignant neoplasm of the small pelvis organs has a daily impact in decreasing number of urgent episodes, incontinence, pollakiuria, and nocturia.
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Affiliation(s)
- Janusz Jaszczyński
- Department of Urology, Center of Oncology Maria Skłodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland
| | - Zbigniew Kojs
- Department of Gynecologic Oncology, Center of Oncology Maria Skłodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland
| | - Andrzej Stelmach
- Department of Surgical Oncology, Center of Oncology Maria Skłodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland
| | - Łukasz Wohadło
- Department of Surgical Oncology, Center of Oncology Maria Skłodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland
| | - Elzbieta Łuczyńska
- Department of Radiology, Center of Oncology Maria Skłodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland
| | - Sylwia Heinze
- Department of Radiology, Center of Oncology Maria Skłodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland
| | - Janusz Rys
- Department of Pathology, Center of Oncology Maria Skłodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland
| | - Jerzy Jakubowicz
- Department of Radiotherapy, Center of Oncology Maria Skłodowska-Curie Memorial Institute, Cracow Branch, Cracow, Poland
| | - Piotr Chłosta
- Urology Clinic, Collegium Medicum Jagiellonian University, Cracow, Poland
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12
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Menkiszak J, Chudecka-Głaz A, Gronwald J, Cymbaluk-Płoska A, Celewicz A, Świniarska M, Wężowska M, Bedner R, Zielińska D, Tarnowska P, Jakubowicz J, Kojs Z. Prophylactic salpingo-oophorectomy in BRCA1 mutation carriers and postoperative incidence of peritoneal and breast cancers. J Ovarian Res 2016; 9:11. [PMID: 26928677 PMCID: PMC4772302 DOI: 10.1186/s13048-016-0220-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 02/19/2016] [Indexed: 02/06/2023] Open
Abstract
Background There are no effective methods of diagnosis of early-stage ovarian cancer. Conservative care over patients at high risk of ovarian and breast cancers is ineffective. Prophylactic surgery is considered the best prophylaxis among BRCA1/BRCA2 carriers. Methods One hundred ninety-five patients, carriers of one of three most common mutations of the BRCA1 gene (Am J Hum Genet: 66: (6)1963-1968, 2000) in the Polish population (5382insC, 4153delA and C61G), who undergone prophylactic salpingo-oophorectomy. The study group consisted of consecutive mutation carriers living in Poland, in the West Pomeranian province. Histopathological examination of the surgical material failed to reveal presence of malignancy. Results During follow-up we diagnosed two peritoneal cancers and 14 breast cancers. Diagnosis of breast cancer before prophylactic surgery increased the risk of peritoneal cancer almost three times. Time from diagnosis of breast cancer to prophylactic surgery increased the risk of peritoneal cancer after prophylactic surgery. This was strongly expressed (HR = 5.0; p = 0.030) in cases of over five-year-long delay in prophylactic surgery. Diagnosis of breast cancer before prophylactic surgery correlated with the risk of death (p = 0.00010). Presence of 5382insC mutation decreased and C61G mutation increased the risk of peritoneal cancer (p = 0.049 vs. p = 0.013). Conclusions Occurrence of primary peritoneal cancer after prophylactic surgery is similar to that reported in international literature. Primary breast cancer occurred less often than in international literature. We suspect that the risk of development of breast cancer among BRCA1 carriers undergoing prophylactic surgery can differ in a population. The next goal should be to study the molecular basis for the risk of development of malignancies in any population. Carriers of BRCA1 gene diagnosed with breast cancer should undergo prophylactic surgery within five years from the diagnosis of breast cancer.
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Affiliation(s)
- Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, SPSK-2, 70-111 Szczecin Al. Powstańców Wielkopolskich 72, Szczecin, Poland.
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, SPSK-2, 70-111 Szczecin Al. Powstańców Wielkopolskich 72, Szczecin, Poland.
| | - Jacek Gronwald
- Department of Genetics and Pathology; International Hereditary Cancer Center, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland.
| | - Aneta Cymbaluk-Płoska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, SPSK-2, 70-111 Szczecin Al. Powstańców Wielkopolskich 72, Szczecin, Poland.
| | - Aleksander Celewicz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, SPSK-2, 70-111 Szczecin Al. Powstańców Wielkopolskich 72, Szczecin, Poland.
| | - Maria Świniarska
- Department of the Clinical Oncology the West Pomeranian Centre of the Oncology in Szczecin, ul. Strzałowska 22, 71-730, Szczecin, Poland.
| | - Małgorzata Wężowska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, SPSK-2, 70-111 Szczecin Al. Powstańców Wielkopolskich 72, Szczecin, Poland.
| | - Ryszard Bedner
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, SPSK-2, 70-111 Szczecin Al. Powstańców Wielkopolskich 72, Szczecin, Poland.
| | - Dorota Zielińska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, SPSK-2, 70-111 Szczecin Al. Powstańców Wielkopolskich 72, Szczecin, Poland.
| | - Paulina Tarnowska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, SPSK-2, 70-111 Szczecin Al. Powstańców Wielkopolskich 72, Szczecin, Poland.
| | - Jerzy Jakubowicz
- Radiation Oncology Department, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute Cracow Branch, Garncarska 11, 31-115, Kraków, Poland.
| | - Zbigniew Kojs
- Department of Gynecologic Oncology, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Cracow Branch, Garncarska 11, 31-115, Kraków, Poland.
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Koper K, Wicherek L, Kojs Z, Chamier-Cieminska A, Roszkowski K. The analysis of sHLA-G antigen blood serum concentration levels during radical therapy for gynecological malignancies. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e22192] [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: 11/20/2022] Open
Affiliation(s)
- Krzysztof Koper
- Gynecology and Oncology Department of the Lukaszczyk Oncological Center, Bydgoszcz, Poland
| | - Lukasz Wicherek
- Gynecology, Oncology and Gynecological Nursing of the Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Zbigniew Kojs
- Gynecology and Oncology Department of the Lukaszczyk Oncological Center, Bydgoszcz, Poland
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14
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Basta P, Koper K, Kazmierczak W, Wisniewski M, Makarewicz A, Dutsch-Wicherek M, Kojs Z, Popiela TJ, Slusarz R, Dubiel M, Wicherek L. The biological role of Treg cells in ectopic endometrium homeostasis. Histol Histopathol 2014; 29:1217-33. [PMID: 24831778 DOI: 10.14670/hh-29.1217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Although retrograde menstruation is observed in up to 90% of women, endometriosis actually develops in only 15% of women. There is considerable evidence in the literature that ectopic endometrial cells are able to evade immune surveillance and that the immune response in the microenvironment of ectopic lesions is limited. Endometriosis develops when a deficiency in the local immune response has been generated, and progression of the disease is related to the intensity of this process. Over the last couple of decades it has been well known that T regulatory lymphocytes (Tregs) play a crucial role in controlling a variety of physiological and pathological immune responses. In this review we have focused on the physiological alteration of Treg cell infiltration into the endometrium during the reproductive processes of women. We discuss how a disturbance in Treg cell expansion is involved in generating such pathological processes as miscarriage and ectopic pregnancy development. We hypothesize about the role Treg cells might play in the survival of endometriosis foci in ectopic localization and in the evasion of such lesions from host immune surveillance.
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Affiliation(s)
- Pawel Basta
- Department of Gynecology and Oncology, Lukaszczyk Oncological Center, Bydgoszcz, Poland
| | - Krzysztof Koper
- Department of Gynecology and Oncology, Lukaszczyk Oncological Center, Bydgoszcz, and Chair of Gynecology, Oncology and Gynecological Nursing, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Torun, Poland
| | - Wojciech Kazmierczak
- Outpatient Unit of Otolaryngology, The Lukaszczyk Oncological Center, Bydgoszcz, Poland
| | - Michal Wisniewski
- Outpatient Chemotherapy Department, The Lukaszczyk Oncological Center, Bydgoszcz, Poland
| | - Adrianna Makarewicz
- Outpatient Chemotherapy Department, The Lukaszczyk Oncological Center, Bydgoszcz, and Chair and Clinic of Oncology and Brachytherapy of the Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Torun, Poland
| | | | - Zbigniew Kojs
- Center of Oncology, Gynecologic Oncology Department, M. Sklodowska-Curie Memorial Institute, Krakow, Poland
| | - Tadeusz J Popiela
- Center of Oncology, Gynecologic Oncology Department, M. Sklodowska-Curie Memorial Institute, Krakow, Poland
| | - Robert Slusarz
- Chair of Gynecology, Oncology and Gynecological Nursing, Ludwik Rydygier Collegium Medicum, and Department of Neurological and Neurosurgical Nursing, Gynecology and Neonatology Collegium Medicum, Nicolaus Copernicus University, Torun, Poland
| | - Mariusz Dubiel
- Chair of Gynecology, Oncology and Gynecological Nursing, Ludwik Rydygier Collegium Medicum, and 9. Department of Maternal-Fetal Medicine, Gynecology and Neonatology Collegium Medicum, Nicolaus Copernicus University, Torun, Poland
| | - Lukasz Wicherek
- Department of Gynecology and Oncology, Lukaszczyk Oncological Center, Bydgoszcz, and Chair of Gynecology, Oncology and Gynecological Nursing, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Torun, Poland.
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15
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Klimek M, Wilk W, Szostek S, Łuczyńska E, Bieda T, Kojs Z, Ryś J. Irradiation-induced bone sarcoma in a patient treated for cervix cancer 28 years earlier. Contemp Oncol (Pozn) 2012; 16:56-9. [PMID: 23788856 PMCID: PMC3687376 DOI: 10.5114/wo.2012.27338] [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: 01/15/2011] [Revised: 11/06/2011] [Accepted: 01/18/2012] [Indexed: 11/17/2022] Open
Abstract
AIM OF THE STUDY To present a case of a patient with cervical carcinoma in stage IIA who was diagnosed with pelvic bone sarcoma 28 years after radiotherapy. CASE PRESENTATION A 37-year-old woman with IIA cervix cancer was treated with external beam irradiation and brachytherapy. The patient had undergone conventionally fractionated external beam irradiation using the "box" technique, with the total dose of 50 Gy and brachytherapy with radium applicators (intrauterine tube and fornix applicator) with the dose of 60 Gy calculated at point A. After treatment she was followed up for 2 years. Twenty-six years later, inoperable pelvic bone sarcoma was diagnosed within the irradiated field. The clinical course was aggressive and rapid progression during chemotherapy was observed. CONCLUSIONS For patients receiving radiotherapy, long-term careful follow-up is mandatory due to second cancer risk. In the case of any suspicious symptoms, such patients need proper diagnosis to detect any disease as early as possible.
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Affiliation(s)
- Małgorzata Klimek
- Gynaecology Oncology Department, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Kraków, Poland
| | - Wacław Wilk
- Pathology Department, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Kraków, Poland
| | - Sława Szostek
- Virusology Division, Chair of Microbiology, Jagiellonian University Medical Faculty, Kraków, Poland
| | - Elżbieta Łuczyńska
- Radiology Department, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Kraków, Poland
| | - Tomasz Bieda
- Gynaecology Oncology Department, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Kraków, Poland
| | - Zbigniew Kojs
- Gynaecology Oncology Department, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Kraków, Poland
| | - Janusz Ryś
- Pathology Department, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Kraków, Poland
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16
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Wicherek L, Basta P, Wertel I, Kojs Z, Malkowski B, Grabiec M, Pietrus M, Krystyna G. Analysis of RCAS1 immunoreactivity within hydatidiform mole cells and decidual cells according to the applied therapeutic strategy: surgery or surgery followed by chemotherapy. Gynecol Obstet Invest 2012; 73:106-12. [PMID: 22269478 DOI: 10.1159/000328509] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2010] [Accepted: 04/15/2011] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Trophoblast cells cooperate with both maternal immune cells and decidual cells to help develop the suppressive microenvironment of the endometrium. The maternal immune response against hydatidiform mole depends on this suppressive endometrial profile. Since RCAS1 is one of the molecular factors participating in the development of the suppressive profile of the endometrium we decided to examine the immunoreactivity of the RCAS1 within both the trophoblast and decidual cells during the development of hydatidiform mole. METHODS We analyzed the immunoreactivity of RCAS1 on both trophoblast and decidual cells derived from patients who underwent curettage because of hydatidiform mole. These patients were then divided into two subgroups according to whether or not they required chemotherapy after the surgical procedure. RESULT We observed significantly lower immunoreactivity levels of both RCAS1 within the complete molar lesions of the patients on whom surgery alone was performed when compared to the levels found in those for whom surgery was followed by chemotherapy. CONCLUSION RCAS1 staining may provide information regarding the intensity of the immunosuppressive microenvironment of both the molar lesion and the endometrium. This information can prove significant in determining the clinical course of hydatidiform mole.
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Affiliation(s)
- Lukasz Wicherek
- Departments of Gynecology and Oncology, Lukaszczyk Oncological Center, Bydgoszcz, Poland.
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17
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Mach P, Blecharz P, Basta P, Marianowski P, Skret-Magierlo J, Kojs Z, Grabiec M, Wicherek L. Differences in the soluble HLA-G blood serum concentration levels in patients with ovarian cancer and ovarian and deep endometriosis. Am J Reprod Immunol 2010; 63:387-95. [PMID: 20146732 DOI: 10.1111/j.1600-0897.2009.00806.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
PROBLEM The relationship between endometriosis and cancer has been widely discussed in the literature but is still not well clarified. Perhaps significantly, soluble human leukocyte antigen-G (sHLA-G) has been identified in the microenvironment of both ovarian cancer and endometrioma. The aim of this study has been to evaluate the sHLA-G levels in the blood sera of women with deep endometriosis and ovarian endometrioma over the course of the menstrual cycle and to compare to the levels of sHLA-G in the blood sera of women with ovarian cancer. METHOD OF STUDY In our study, we examined the blood sera obtained from 123 patients operated on because of ovarian cancer (65 cases), ovarian endometrioma (30 cases), and deep endometriosis (28 cases). We decided to compare the levels of sHLA-G in patients with endometriosis to those found in patients with ovarian cancer with respect to the menstrual cycle phases. The sHLA-G concentration level was measured by enzyme-linked immunosorbent assay kit. RESULTS The level of sHLA-G concentration in the blood serum of patients with deep endometriosis fluctuates over the course of the menstrual cycle, and during the proliferative and secretory phases, it remains at a high level comparable to that found in patients with ovarian cancer. By contrast, the level of sHLA-G concentration in the blood serum of patients with ovarian endometrioma fluctuates minimally over the course of the different menstrual cycle phases and, as in patients with ovarian cancer, it remains at high level during the proliferative phase. CONCLUSION sHLA-G blood serum concentration levels would seem to provide important information regarding the degree of immune system regulation disturbance in both ectopic endometrial cells and the cancer cell suppressive microenvironment.
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Affiliation(s)
- Pawel Mach
- Department of Gynecology, Obstetrics and Oncology of the Jagiellonian University, Krakow, Poland
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18
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Słonina D, Biesaga B, Urbański K, Kojs Z. Comparison of chromosomal radiosensitivity of normal cells with and without HRS-like response and normal tissue reactions in patients with cervix cancer. Int J Radiat Biol 2009; 84:421-8. [DOI: 10.1080/09553000802029910] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ryś J, Karolewski K, Pudełek J, Kruczak A, Wasilewska A, Vogelgesang M, Kojs Z. Perivascular epithelioid tumor (PEComa) of the falciform/ broad ligament. POL J PATHOL 2008; 59:211-215. [PMID: 19391488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
PEComas localized in the region of falciform ligament and broad ligament are exceedingly rare. Most of them are built of spindle neoplastic cells. We report a case of epithelioid PEComa of the falciform ligament and/or broad ligament. There is only one report of such neoplasm in English-language literature. Histologically, the tumor was composed of nests of epithelioid clear cells stained positively for vimentin, HMB45, and SMA. Because of morphological features of the tumour (4 mitoses /20HPF, focal necrosis, and vascular invasion) we assess the neoplasm as potentially malignant.
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Affiliation(s)
- Janusz Ryś
- Department of Tumor Pathology, Cracow Center of Oncology, Kraków.
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20
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Słonina D, Biesaga B, Urbański K, Kojs Z. The Response of Primary Keratinocytes and Fibroblasts from Cancer Patients to Multiple Low-Dose Irradiations. Radiat Res 2007; 168:631-6. [DOI: 10.1667/rr1001.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2007] [Accepted: 07/06/2007] [Indexed: 11/03/2022]
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Słonina D, Biesaga B, Urbański K, Kojs Z. Low-Dose Radiation Response of Primary Keratinocytes and Fibroblasts from Patients with Cervix Cancer. Radiat Res 2007; 167:251-9. [PMID: 17316072 DOI: 10.1667/rr0649] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2006] [Accepted: 10/16/2006] [Indexed: 11/03/2022]
Abstract
The aim of the present study was to examine, using the micronucleus (MN) assay, the low-dose radiation response of normal skin cells from cancer patients and to determine whether the hyper-radiosensitivity (HRS)-like phenomenon occurs in cells of these patients. Primary skin fibroblasts and keratinocytes derived from 40 patients with cervix cancer were studied. After in vitro gamma irradiation with single doses ranging from 0.05 to 4 Gy, MN induction was assessed. For each patient, the linear-quadratic (LQ) model and the induced repair (IR) model were fitted over the whole data set. In fits of the IR model, an HRS-like response after low doses (seen as the deviation over the LQ curve) was demonstrated for the fibroblasts of two patients and for the keratinocytes of four other patients. The alpha(s)/alpha(r) ratio for the six patients ranged from 2.7 to 15.4, whereas the values of the parameter d(c) ranged from 0.13 to 0.36 Gy. No relationship was observed between chromosomal radiosensitivity of fibroblasts and keratinocytes derived from the same donor in the low-dose (0.1-0.25 Gy) region. In conclusion, the fact that low-dose chromosomal hypersensitivity was observed for cells of only six of the patients studied suggests that it is not a common finding in human normal cells and can represent an individual characteristic.
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Affiliation(s)
- Dorota Słonina
- Department of Applied Radiobiology, Centre of Oncology, Garncarska 11, 31-115 Kraków, Poland.
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Markowska J, Grabowski JP, Tomaszewska K, Kojs Z, Pudelek J, Skrzypczak M, Sobotkowski J, Emerich J, Olejek A, Filas V. Significance of hypoxia in uterine cervical cancer. Multicentre study. EUR J GYNAECOL ONCOL 2007; 28:386-388. [PMID: 17966218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
PURPOSE The aim of the study was to evaluate hypoxia markers (VEGF, GLUT-1, and HIF-1alpha) in cervical cancer tissue depending on staging (FIGO) and grading. We also analyzed the adverse effects of radiotherapy according to expression levels of hypoxic markers in the studied tissue. MATERIAL AND METHODS Expression of hypoxia-inducible factor-1alpha (HIF-1alpha), glucose transporter 1 (GLUT-1) and vascular endothelial growth factor (VEGF, also known as proangiogenic factor) were estimated in biopsy or surgical specimens from 106 patients diagnosed with uterine cervical cancer. Immunohistochemical methods with EbVision+ complex using monoclonal antibodies anti-VEGF and anti-HIF-1alpha and polyclonal antibody anti-GLUT-1 were applied. RESULTS AND CONCLUSIONS Hypoxia features measured by percentage of cells undergoing reaction with antibodies anti-HIF-1alpha, anti-GLUT-1 and anti-VEGF were similar in all clinical stages; however the biggest hypoxia features were shown in low differentiated cancers G2 and G3. The 5-year survival for FIGO Stage III patients was shorter in cases with a high expression of hypoxic markers. We observed adverse effects in 45.3% of patients, which occurred more often in patients with higher expression of the studied factors. The presence of hypoxic cells is established as one of the most important factors affecting resistance against tumor radiotherapy and patient prognosis.
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Affiliation(s)
- J Markowska
- Gynecological Oncology Division, Department of Oncology, University of Medical Sciences, Poznan, Poland
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Kojs Z, Glinski B, Pudelek J, Urbanski K, Karolewski K, Mitus J, Reinfuss M. [Follow-up of 70 patients with advanced ovarian cancer after negative second-look laparotomy]. ACTA ACUST UNITED AC 2006; 35:16-22. [PMID: 16446607 DOI: 10.1016/s0368-2315(06)76367-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To analyze the results of treatment of 70 patients with stage III and IV ovarian cancer after second look laparotomy with negative findings and to identify causes of failure and prognostic factors. MATERIALS AND METHODS Between 1985 and 1998, seventy patients with ovarian cancer stage III and IV were treated with surgery and at least six courses of chemotherapy with cisplatin doxarubicin and cyclophosphamide. Then a second look laparotomy was performed. RESULTS The actuarial survival rate without evidence of disease was 50% at 5 years. Locoregional failure was observed in 31 patients (88%) and distant metastases in 9, but they were the sole reason for unsuccessful treatment in only 4 (12%). Adverse prognostic factors were: grade 3 differentiation, primary stage IIIC and IV, and residual infiltration exceeding 2 cm after first laparotomy. CONCLUSION Our results are comparable with reports in the literature. The actuarial survival rate without evidence of disease at 5 years in patients with advanced ovarian cancer after second look negative laparotomy is 50%.
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Affiliation(s)
- Z Kojs
- Service de Gynécologie Oncologique, Pologne.
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Karolewski K, Kojs Z, Urbański K, Jakubowicz J, Blecharz P, Dymek P, Reinfuss M. The efficiency of treatment in patients with uterine-confined endometrial cancer. EUR J GYNAECOL ONCOL 2006; 27:579-84. [PMID: 17290586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
AIM To present our experience regarding the efficiency of treatment in patients with uterine-confined endometrial cancer. PATIENTS AND METHODS 775 patients with uterine-confined endometrial cancer (UCEC) were treated between July 1985 and June 2000 in the Krakow Branch of Sklodowska Memorial Institute. RESULTS Among the 775 patients, 5-year disease-free survival was observed in 82.8% patients; 96% patients with low risk of disease recurrence, 93.6% patients with intermediate risk and 78.3% patients with high risk survived five years with no evidence of disease. In the group with a high-risk disease recurrence rate, 5-year disease-free survival was statistically higher among patients treated with adjuvant brachytherapy plus external beam radiotherapy (EBRT) in comparison to patients treated with adjuvant brachytherapy (BRT) alone (82.4% vs 72.1%). CONCLUSIONS The recommended treatment in patients with high and moderate differentiation of UCEC with FIGO Stage IA is surgery alone. Surgery with adjuvant EBRT in the group of patients with intermediate risk of cancer recurrence allows over 90% of patients to be cured. In the group of patients with a high risk of disease recurrence adjuvant BRT with EBRT is statistically more efficient in comparison to BRT alone.
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Affiliation(s)
- K Karolewski
- Department of Gynecologic Oncology, Maria Sklodowska-Curie Memorial Institute, Kraków, Poland
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Słonina D, Biesaga B, Urbanski K, Kojs Z, Waligórski M. Evidence of low-dose hyper-radiosensitivity in normal cells of cervix cancer patients? Radiat Prot Dosimetry 2006; 122:282-4. [PMID: 17132675 DOI: 10.1093/rpd/ncl427] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The aim of the present study was to examine the low-dose radiation response of human normal cells using the micronucleus assay. Skin fibroblasts and keratinocytes derived from 40 cervix cancer patients were studied. After in vitro gamma irradiation with single doses ranging from 0.05 to 4 Gy, the fraction of binucleated cells with micronuclei was assessed. For each patient, the Linear-Quadratic (LQ) model and the Induced-Repair (IR) model were fitted over the whole data set (0.05-4 Gy). In conclusion, the present study showed some evidence of low-dose hypersensitivity in the fibroblasts of two patients and in the keratinocytes of four of the forty patients studied.
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Affiliation(s)
- D Słonina
- Department of Applied Radiobiology, Centre of Oncology, Garncarska 11, 31-115 Kraków, Poland.
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Karolewski K, Kojs Z, Jakubowicz J, Urbański K, Dymek P, Reinfuss M, Jóźwik P. [Analysis of treatment outcome in patients with endometrial cancer limited to the uterus]. Ginekol Pol 2005; 76:100-7. [PMID: 15847076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
OBJECTIVES The aim of study was to analyse results of treatment patients with uterine-confined endometrial cancer which underwent surgery and postoperative radiotherapy in Center of Oncology in Kraków between 1985 and 1997. MATERIAL AND METHODS The research included a group of 650 women. All patients undergo total abdominal hysterectomy with bilateral salpingo-oophorectomy and postoperative radiotherapy. 155 patients with intermediate-risk of recurrence (IA-G3, IB-G1, G2) received postoperative whole pelvic irradiation only. In the group of 495 patients with high-risk of recurrence (IB-G3, IC, II) 210 patients received brachytherapy vaginal cuff only and 285 patients whole pelvic and vaginal cuff irradiation. RESULTS In the group of patients with intermediate-risk of recurrence five NED survival was 93.5%. In the group of patients with high-risk of recurrence five NED survival was statistically lower in patients treated with brachytherapy vaginal cuff only (83.2% vs. 71.9%). CONCLUSION In uterine-confined endometrial cancer patients, with intermediate-risk of recurrence treated with surgery and postoperative whole pelvis irradiation, 5-year NED survival is above of 90%. In the group of patients with high-risk of recurrence the adjuvant treatment of choice is whole pelvic and vaginal cuff irradiation.
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Karolewski K, Kojs Z, Jakubowicz J, Urbański K, Reinfuss M, Dymek P, Jóźwik P. [Prognostic factors in patients with cervical--confined endometrial carcinoma treated with surgery and postoperative radiotherapy]. Przegl Lek 2005; 62:1444-6. [PMID: 16786769] [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: 05/10/2023]
Abstract
OBJECTIVE The aim of the study was to determine prognostic factors in the group of the patients with uterine--confined endometrial carcinoma treated with surgery and postoperative radiotherapy. MATERIAL AND METHODS The authors analyzed 102 patients (mean age 58 years) with stage 1 (74 patients) and stage 11 (28 patients) endometrial carcinoma. All patients were treated with surgery (abdominal hysterectomy and bilateral adnexectomy) and postoperative radiotherapy: external beam pelvic irradiation (20 patients), vaginal cuff irradiation (33 patients) and combination (49 patients). Analysed were prognostic factors as follows: age, stage, tumor grade, depth of myometrial invasion, hormone receptors, expression of the tumor suppressor gene p53, Her 2/neu and MIB-1 (ki-67 paraffin). RESULTS In our group of patients, multivariate analysis has identified tumor grade, progesterone receptors status and MIB-1 as independent significant prognostic factors.
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Affiliation(s)
- Kazimierz Karolewski
- Klinika Ginekologii Onkologicznej, Krakowskiego Oddziału Centrum Onkologii, Instytutu im. M. Skłodowskiej-Curie.
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Karolewski K, Kojs Z, Jakubowicz J, Urbański K. [Effectiveness of surgical treatment of patients with stage IA endometrial cancer]. Ginekol Pol 2004; 75:937-40. [PMID: 15751214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
OBJECTIVES The aim of the study was to analyse results of surgical treatment patients with stage IA-G1, G2 endometrial cancer treated in Center of Oncology in Kraków between 1985 and 1997. MATERIALS AND METHODS The research included a group of 44 women. All patients underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH and BSO) without complementary treatment. RESULTS Five NED survival was 95.5%. During the 5-year follow-up period 2 patients died, I of myocardial infarction and 1 of cerebral hemorrhage. CONCLUSION Total abdominal hysterectomy and bilateral salpingo-oophorectomy are the treatment of choice for stage IA-G1, G2 endometrial cancer.
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Affiliation(s)
- Kazimierz Karolewski
- Klinika Ginekologii Onkologicznej krakowskiego Oddziału Centrum Onkologii-Instytutu im. M. Sklodowskiej-Curie
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Pudełek J, Kojs Z, Urbański K, Mituś J, Reinfuss M, Klimek M. [Patients with advanced ovarian cancer after negative second-look laparoscopy--follow up study]. Ginekol Pol 2004; 75:85-90. [PMID: 15108578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
OBJECTIVES Follow-up in 65 patients with stage III-IV ovarian cancer after negative second-look laparotomy. Prognostic factors and causes of failure were also discussed. MATERIAL AND METHODS 65 patients with ovarian cancer stage III-IV were treated with surgery and at least six courses of chemotherapy (cisplatin, adriamycin, cyclophosphamide) and second-look laparotomy. Results of the treatment are presented in a form of 5-year NED (no evidence of disease) survival. Dependence between analyzed factors and survival was assessment based on proportional hazard Cox model. RESULTS In 30 patients (46.1%) recurrence during 5 year follow-up was observed. In 28 patients out of them (93.3%) it was loco-regional failure and in 2 patients distant metastases were the sole reason of unsuccessful results of the treatment. Adverse prognostic factors found in statistical analysis were: advanced primary stage, residual infiltrations after first laparotomy exceeding 2 cm and low grade of differentiation. CONCLUSIONS 1. In about 50% of patient with advanced ovarian cancer loco-regional recurrence was observed, 2. Adverse prognostic factors were: advanced primary stage, residual masses after first laparotomy above 2 cm and low grade of differentiation.
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Affiliation(s)
- Jacek Pudełek
- Kliniki Ginekologii Onkologicznej Krakowskiego Oddziału Centrum Onkologii
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Gasinska A, Adamczyk A, Kojs Z, Szumiel I. Are stromal fibroblasts from cervical tumors suitable to predict normal tissue radiation reaction? Neoplasma 2004; 51:285-92. [PMID: 15254660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
We examined the effect of gamma-irradiation (4 Gy) alone or combined with estrogen (17beta-estradiol 15 microM) treatment on the radiation response of stromal fibroblasts from cervical tumors. The fibroblasts were derived from tumors of 9 younger (<50 years) and 9 older (>50 years) cervical cancer patients. A normal fibroblast GSH+/+ cell strain was used as a reference cell. The end-points examined 2 days after irradiation were cell cycle distribution and apoptosis as measured of the cellular response to gamma-radiation. The response of examined fibroblast groups to gamma-rays alone was comparable but apoptotic death was more marked in fibroblasts derived from the younger patients with TNM 1+2 tumors than from the older ones. There was a considerable estrogen effect on the response to gamma-rays that differed between stromal fibroblasts from the examined age groups and was dependent on the tumor stage. In particular, we found a marked decrease in the number of apoptotic cells and debris after estrogen + irradiation, as compared to irradiation alone, only in younger patients and TNM 1+2 tumors. These results indicate that the response of stromal fibroblasts to gamma-rays to a considerable extent depends on donors age and tumor stage. Since stromal fibroblasts have been used for prediction of normal tissue late effects in patients treated with radiotherapy, we conclude that they may not be an adequate model for this purpose.
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Affiliation(s)
- A Gasinska
- Department of Radiation Therapy, Centre of Oncology, Laboratory of Radiation Biology, Krakow, Poland.
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Klimek M, Kojs Z, Urbański K, Gruchała A, Miller G, Blecharz P. Mięsak popromienny trzonu macicy – opis przypadku. Rep Pract Oncol Radiother 2004. [DOI: 10.1016/s1507-1367(04)71042-1] [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: 10/18/2022] Open
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Gasinska A, Urbanski K, Gruchala A, Biesaga B, Kojs Z. A ratio of apoptosis to mitosis, proliferation pattern and prediction of radiotherapy response in cervical carcinoma. Neoplasma 2003; 49:379-86. [PMID: 12584585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
The prognostic significance of apoptotic (AI) and mitotic (MI) indices, and the ratio of these parameters (AI/MI), MIB-1 labeling index (MIB-1LI) and proliferation pattern was studied in 130 (FIGO stage IB-IIIB) squamous cervical cancer patients before radiotherapy. Also the influence of the patients age and tumors pathological features (stage, grade, degree of keratinization) and DNA ploidy on the biological parameters were analysed. AI and MI were assessed on histological sections stained with hematoxylin and eosin, and the MIB-1LI on specimens stained with rabbit anti-human Ki-67 antibody (DAKO Ltd). Sections stained with MIB-1 antibody were used for assessment of the tumor proliferation pattern. The median age of the patients was 55 years (29-80). The median values for MIB-1LI, AI, MI, AI/MI, were: 52.3%, 1.1%, 1.5, and 0.9, respectively. In the univariate analysis median values for cut-off points were used for MIB-1LI, and AI, however, for other parameters significant cut-off points have been chosen. For MI it was 2.6 and for the AI/MI ratio 0.7. The median time of follow-up was 29 months, with a range of 2-145 months. The univariate analysis showed that tumor stage (p=0.7009), grade (p=0.6660) and AI (p=0.9378) had negligible influence on patients survival. However, MI >2.6 (p=0.0442), AI/MI <or=0.7 (p=0.0190), and random or mixed type of proliferation (p=0.0163) were significant prognostic factors. Cox multivariate analysis showed that MI, AI/MI, degree of keratinization and type of proliferation were significant prognostic factors for cervical cancer patients treated with radiotherapy.
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Affiliation(s)
- A Gasinska
- Laboratory of Radiation Biology, Centre of Oncology, Krakow, Poland.
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Adamczyk A, Gasińska A, Kojs Z. 156. Influence of estrogen and/or irradiation on apoptosis and cell cycle of fibroblasts derived from squamous cell carcinoma of the cervix. Rep Pract Oncol Radiother 2003. [DOI: 10.1016/s1507-1367(03)70640-3] [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: 10/18/2022] Open
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Dymek P, Kowalska T, Reinfuss M, Walasek T, Zareba-Szlubowska M, Mituś J, Skotnicki P, Kojs Z, Weiss M, Dabrowski T, Zawiła K. [The efficacy of adjuvant thoracic radiation therapy in NSCLC patients with ipsilateral mediastinal/hilar lymph nodes involvement (clinical trial)]. Pneumonol Alergol Pol 2003; 71:496-503. [PMID: 15305654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
Between 1992 and 1999 at the Oncology Centre in Cracow 138 NSCLC patients after complete resection of the tumour with mediastinal/hilar node involvement were included in the prospective clinical trial. The analysis of the results did not show any improvement of survival in the postoperatively irradiated group. Three-year survival rates with no symptoms of disease in postoperative radiotherapy patients compared to surgery alone group were 30% and 29% respectively. In this study adjuvant radiotherapy significantly improved local recurrence rate from 28% in surgery only group to 9% in postoperatively treated patients.
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Affiliation(s)
- Paweł Dymek
- Zaklad Teleradioterapii, Centrum Onkologii, Oddział Kraków
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Walasek T, Kowalska T, Reinfuss M, Dymek P, Mituś J, Skotnicki P, Pecak M, Kojs Z, Brandys P, Dabrowski T. [The effectiveness of postoperative external beam radiotherapy for incompletely resected non-small cell lung cancer]. Pneumonol Alergol Pol 2003; 71:488-95. [PMID: 15305653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
In a retrospective analysis of 150 incompletely resected NSCLC patients treated with adjuvant external beam radiotherapy 32 (21.3%) survived 3 years with no symptoms of disease. Ipsilateral mediastinal/hilar lymph node involvement and macroscopic incomplete surgery were the prognostic factors that unfavourably influenced survival in Cox's proportional hazards model. Postoperative external beam radiotherapy was the efficient adjuvant treatment method in microscopically incompletely resected NSCLC, predominantly with no nodes involvement, but had no benefit in those with macroscopic incomplete surgery.
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Affiliation(s)
- Tomasz Walasek
- Zakład Teleradioterapii, Centrum Onkologii, Oddział Kraków
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Kojs Z, Klimek M, Mituś J, Reinfuss M. [A case of multiple malignancies]. Ginekol Pol 2002; 73:543-5. [PMID: 12185721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
A case of fourfold cancer: of the vulva and larynx diagnosed synchronously and the breast and lung diagnosed metachronously is presented.
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Affiliation(s)
- Zbigniew Kojs
- Kliniki Ginekologii Onkologicznej Centrum Onkologii Instytutu im. Marii Skłodowskiej-Curie, Oddział w Krakowie
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Kojs Z, Urbański K, Fabisiak W, Reinfuss M. [Prognostic factors in the primary invasive vaginal carcinoma]. Ginekol Pol 2002; 73:163-6. [PMID: 12092247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
In the period 1965-1988, 125 women with primary invasive vaginal carcinoma were treated with radiotherapy. 53 (42.4%) survived 5-year without evidence of disease. In the Cox multivariate analysis three variables were independently related to survival: age of the patients, grade of differentiation of tumor and the clinical stage of illness.
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Kojs Z, Glinski B, Reinfuss M, Pudelek J, Urbanski K, Kowalska T, Kulpa J. [Results of a randomized prospective trial comparing postoperative abdominopelvic radiotherapy with postoperative chemotherapy in early ovarian cancer]. Cancer Radiother 2001; 5:5-11. [PMID: 11236537 DOI: 10.1016/s1278-3218(00)00022-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE In a prospective randomized trial, our aim was to evaluate and compare the tolerance and efficacy of postoperative radiotherapy and chemotherapy in the treatment of early ovarian cancer. MATERIAL AND METHODS Between 1990 and 1996, 150 patients with ovarian cancer stage IA, IB grades G2-3, and all patients classified IC and IIA, who did not have evidence of residual disease after surgery, were randomized to two treatment branches: radiotherapy or chemotherapy (CH). In the radiotherapy branch (76 patients), a whole abdomen irradiation of 30 Gy in 24 fractions over 5 weeks, with a pelvic boost to 50 Gy, was delivered. In the chemotherapy branch (74 patients), there were six series of polychemotherapy separated with 3-weeks interval. In each series patients received association of cisplatin (50 mg/m2, d1), adriamycin (50 mg/m2, d1) and cyclophosphamide (500 mg/m2, d1). RESULTS The tolerance of the treatment was good and comparable in both groups. In the radiotherapy branch, three late grade G3 intestinal complications were observed (three bowel obstructions, which required surgery in two cases). The actuarial survival rate without evidence of disease was 81% at 5 years for both groups. In our series we found that histological grade had the strongest influence on survival prognosis; it was the only significant factor in a multivariate analysis. Patients with grade G3 tumors had the worst survival. CONCLUSION These data suggest that efficacy of postoperative radiotherapy and chemotherapy administered to our patients with early ovarian cancer gave approximately identical results.
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Affiliation(s)
- Z Kojs
- Service de gynécologie oncologique, institut oncologique, 11, rue Garncarska, 31-115 Cracovie, Pologne
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Klimek M, Urbański K, Góra E, Kojs Z, Karolewski K, Jakubowicz J, Pudełek J. Rak trzonu macicy – wstępna ocena tolerancji pooperacyjnej pulsacyjnej brachyterapii. Rep Pract Oncol Radiother 2001. [DOI: 10.1016/s1507-1367(01)70465-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Karolewski K, Korzeniowski S, Sokołowski A, Urbański K, Kojs Z. Prognostic significance of pretherapeutic and therapeutic factors in patients with advanced cancer of the uterine cervix treated with radical radiotherapy alone. Acta Oncol 1999; 38:461-8. [PMID: 10418713 DOI: 10.1080/028418699431997] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
The prognostic importance of various pretherapeutic and therapeutic factors was analysed in a group of 413 cervical cancer patients with stage IIB (183 pts) and IIIB (230 pts) treated with radical radiotherapy, which consisted of external irradiation and intracavitary brachytherapy. Univariate analysis of pretherapeutic factors revealed the prognostic significance of patient age, history of abortion, stage, haemoglobin and hematocrit levels. Five-year overall survival rate in stage IIB patients was 51%, in stage IIIB 40% and the respective rates for local control at each stage were 61%, and 46%. Univariate analysis of therapeutic factors showed that survival and local control rates increased with the dose, but a significant difference was found only in the case of a paracentral (point A) dose. In a multivariate analysis only patient age, abortions, and clinical stage appeared to have a significant and independent impact on survival. Linear regression analysis results indicated that prolongation of treatment time between 33 and 108 days caused a loss of local control of 0.36% per day.
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Affiliation(s)
- K Karolewski
- Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Department of Gynecol.-Oncology, Kracow, Poland
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Jakubowicz J, Urbański K, Kojs Z, Karolewski K. 74 Ocena skuteczności leczenia przerzutów odległych u chorych na miejscowo wyleczonego raka szyjki macicy. Rep Pract Oncol Radiother 1999. [DOI: 10.1016/s1507-1367(99)70073-8] [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: 10/18/2022] Open
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Stelmach A, Mituś J, Kojs Z, Skotnicki P, Reinfuss M. [Adenoid cystic carcinoma of the breast. Analysis of 7 patients]. Ginekol Pol 1998; 69:188-90. [PMID: 9640863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
A retrospective analysis of 7 patients with adenoid cystic carcinoma of the breast operated at Center of Oncology in Kraków is presented. Ten years without evidence of disease survived 6 (85.7%) patients. One patient only, with poorly differentiated carcinoma, presented axillary metastases and died of metastases to the lungs and hepar.
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Affiliation(s)
- A Stelmach
- Kliniki Chirurgii Onkologicznej Centrum Onkologii Instytutu im. M. Skłodowskiej-Curie, Oddział w Krakowie
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Kojs Z, Urbański K, Mituś J, Reinfuss M, Pudełek J, Walasek T. Pure immature teratoma of the ovary: analysis of 22 cases. EUR J GYNAECOL ONCOL 1998; 18:534-6. [PMID: 9443030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Between 1970 and 1991, 22 patients with pure immature teratoma were treated at the Center of Oncology in Krakow. Sixteen (72.7%) patients had stage I, four (18.2%) stage II, and two (9.1%) stage III of disease, nine (40.9%) patients had grade 1, 11 (50%) grade 2, and two (9.1%) grade 3 tumors. Eight stage Ia, grade 1 patients were treated with surgery only, the remaining 14 (63.6%) received postoperative chemotherapy. Five-year NED (no evidence of disease) survival was achieved in 81.8% of patients. Out of 16 stage I patients, 15 (93.8%) survived 5-year NED, out of six stage II and III, three (50%) patients only survived this period. We cured all grade 1 patients, and 81.8% (9/11) grade 2; two grade 3 patients died because of tumors. We also cured all six stage Ia patients, treated with unilateral salpingo-oophorectomy (with or without chemotherapy), and all eight stage Ia grade 1 patients treated with surgery only.
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Affiliation(s)
- Z Kojs
- Center of Oncology, Maria Sklodowska, Curie Memorial Institute, Krakow, Poland
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Karolewski K, Korzeniowski S, Sokołowski A, Urbański K, Kojs Z. 38P Wpływ całkowitego czasu leczenia na wyniki radioterapii zaawansowanego raka szyjki macicy. Rep Pract Oncol Radiother 1998. [DOI: 10.1016/s1507-1367(98)70244-5] [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: 11/25/2022] Open
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Kojs Z, Urbański K, Reinfuss M, Karolewski K, Klimek M, Pudełerk J, Mituś J. Whole abdominal external beam radiation in the treatment of primary carcinoma of the fallopian tube. Gynecol Oncol 1997; 65:473-7. [PMID: 9190978 DOI: 10.1006/gyno.1997.4663] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Thirty-two patients with adenocarcinoma of the fallopian tube, treated between 1975 and 1990, were studied. Thirteen patients had stage I disease, 9 stage II, and 10 stage III. All patients underwent bilateral salpingo-oophorectomy, total abdominal hysterectomy, and subcolic omentectomy. All patients received postoperative primary whole abdominal external beam radiotherapy. Seventeen patients (53.1%) of the treated group survived NED for at least 5 years. Survival was 76.9% for stage I, 55.6% for stage II, and 20% for stage III. In the Cox multivariate analysis, two variables were independently related to survival: stage of disease and size of residual disease after surgery. Postoperative teleradiotherapy was totally ineffective in gross residual (>2 cm in diameter) disease (0% 5-year NED survivors) and not effective enough in small residual disease (<2 cm in diameter) (33% 5-year NED survivors). Despite postoperative whole abdominal external beam radiotherapy, 3 patients with microscopic, 4 with small, and 4 with gross residual disease did fail within the peritoneal cavity.
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Affiliation(s)
- Z Kojs
- Department of Gynecologic Oncology, Center of Oncology, Maria Skłodowska-Curie Memorial Institute, Kraków, Poland
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Kojs Z, Urbański K, Karolewski K, Reinfuss M, Mituś J. [Primary fallopian tube carcinoma. Analysis of 32 cases]. Ginekol Pol 1996; 67:612-4. [PMID: 9289455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
A retrospective analysis of 32 patients with primary fallopian tube carcinoma treated at Center of Oncology in Kraków is presented. In all cases therapy consisted of primary total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by adjunctive radiotherapy. Five year without evidence of disease survived 53.1% of the patients. Stage of disease was the only prognostic factor: survival at 5 years was 76.9% for stage Io, 55.6% for stage IIo, and 20% for stage III.
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Affiliation(s)
- Z Kojs
- Kliniki Ginekologii Onkologicznej Centrum Onkologii Instytutu im. M. Skłodowskiej-Curie, Oddział w Krakowie
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Kojs Z, Urbański K, Karolewski K, Klimek M, Pudełek J, Reinfuss M. [Cervix neoplasms in women younger than 36 years of age]. Ginekol Pol 1996; 67:557-60. [PMID: 9289442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Between 1970 and 1986, 252 women under 36 years of age with cervical carcinoma were treated in the Center of Oncology in Cracow. The five-year disease-free survival for all patients was 52.8%. In the multivariate analysis tumor stage IIB and III and the age under 30 years were adverse prognostic factors.
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Affiliation(s)
- Z Kojs
- Kliniki Ginekologii Onkologicznej Centrum Onkologii Instytutu im. M. Skłodowskiej-Curie, Oddział w Krakowie
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Abstract
Between 1965 and 1988, 125 patients with primary invasive vaginal carcinoma were treated with radiation therapy at the Center of Oncology in Kraków. Twenty-two superficial stage I patients received radium or cesium intracavitary radiation alone. The remaining 11 patients with stage I disease whose lesions were either large or thick and 77 patients with stages II and III were treated with a combination of external irradiation followed by intracavitary brachytherapy. Fifteen patients with stage IVA received external irradiation only. Five-year NED survival was achieved in 42.4% of patients. In the Cox multivariate analysis three variable were independently related to beneficial survival: grade G1 + G2, stage I + II, and age below 60 years. Of 66 patients who died of vaginal cancer, locoregional failure was found in 51 (77.3%), locoregional and distant in 5 (7.6%), and distant only in 10 (15.1%) patients. Late radiation morbidity occurred in 16 (12.8%) patients.
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Affiliation(s)
- K Urbański
- Department of Gynecologic Oncology, Maria Skłodowska-Curie Memorial Institute, Kraków, Poland
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Urbański K, Karolewski K, Kojs Z, Klimek M, Jakubowicz J, Pudelek J. 402Comparison between two or three fractions of Selectron-LDR combined with external beam radiotherapy in cervical cancer patients. Radiother Oncol 1996. [DOI: 10.1016/s0167-8140(96)80411-7] [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: 11/29/2022]
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Kojs Z, Karolewski K, Jakubowicz J, Reinfuss M. [Teratoma of the ovary. Analysis of prognostic factors]. Ginekol Pol 1995; 66:416-9. [PMID: 8655008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Forty-one patients with teratoma of the ovary were operated in the Center of Oncology in Kraków. The five-year disease-free survival for all patients was 68.3%. The histological grading appear to be an important prognostic factor. The five-year disease-free survival for patients with grade 0 was 100%, grade I--80%, grade II and III--14.3%.
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Affiliation(s)
- Z Kojs
- Kliniki Ginekologii Onkologicznej Oddziału Krakowskiego Centrum Onkologii im. M. Skłodowskiej-Curie
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