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Sladojevic J, Dotlic J, Gazibara T, Matkovic S, Maksimovic N. Longitudinal evaluation of health-related quality of life after removal of high-risk melanoma in a setting where adjuvant therapy is not available. Arch Dermatol Res 2023; 316:27. [PMID: 38060051 DOI: 10.1007/s00403-023-02766-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 08/07/2023] [Accepted: 10/05/2023] [Indexed: 12/08/2023]
Abstract
To evaluate health-related quality of life (HRQoL) of people with a high-risk skin melanoma after completion of the primary surgical treatment over time, as well as, to identify factors associated with better HRQoL at the beginning and at the end of follow-up. The study included subjects with histopathologically confirmed high-risk skin melanoma in clinical stages IIC, IIIA, IIIB, and IIIC, in whom clinical and radiographic signs of the disease were not confirmed after primary surgical treatment. The HRQoL was evaluated using Short Form-36 (SF-36) after completion of primary surgical treatment (start of follow-up) and after 6 to 12 months (end of follow-up). A total of 71 people completed SF-36 at both points in time. There were no significant differences between the initial and the follow-up total HRQoL score (t = 1.118; p = 0.267). At the start of follow-up, having fewer depressive symptoms, better functional status and lower vitamin D serum levels were associated with a better total HRQoL score. At the end of follow-up, having lower Breslow depth and being employed at the start of follow-up, having fewer depressive symptoms and lower C-reactive protein (CRP) serum levels at follow-up, and not developing metastases over follow-up were associated with a higher total HRQoL scores. The HRQoL of people with high-risk melanoma did not change in the year following the complete removal of the tumor. However, presence of depressive symptoms and metastases seem to have the strongest impact on poorer quality of life after surgery.
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Affiliation(s)
| | - Jelena Dotlic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Obstetrics and Gynecology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Tatjana Gazibara
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Visegradska 26A, 11000, Belgrade, Serbia
| | - Suzana Matkovic
- Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Natasa Maksimovic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Visegradska 26A, 11000, Belgrade, Serbia.
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Nikic P, Babovic N, Dzamic Z, Salma S, Stojanovic V, Matkovic S, Pejcic Z, Juskic K, Soldatovic I. Real World Overall Survival of Patients With Metastatic Renal Cell Carcinoma Treated With Only Available Sunitinib and Pazopanib in First-Line Setting. Front Oncol 2022; 12:892156. [PMID: 35756652 PMCID: PMC9213683 DOI: 10.3389/fonc.2022.892156] [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: 03/08/2022] [Accepted: 05/17/2022] [Indexed: 12/04/2022] Open
Abstract
Background The emerging new standard of care for metastatic clear cell renal carcinoma (mRCC) becomes a challenge when access to new drugs is limited. In Serbia, sunitinib and pazopanib are the only available first-line therapies. The second-line treatment for mRCC has never been and is still not available. We aimed to assess overall survival (OS) in patients with mRCC who received first-line sunitinib or pazopanib when access to second-line treatment was not available. Methods This retrospective observational study analyzed data from a nationally representative cohort of 759 patients who started on first-line sunitinib or pazopanib between 1 January 2012 and 30 June 2019, in 4 centers in Serbia. The data cut-off date was 31 December 2019. Key eligibility criteria were clear cell RCC histology, measurable metastatic disease, performance status 0 or 1, and the Memorial Sloan Kettering Cancer Center favorable or intermediate prognosis. The primary outcome was OS from the start of first-line treatment to death or data cut-off date. Results The study population included 759 patients with mRCC who started with first-line sunitinib (n = 673; [88.7%]) or pazopanib (n = 86; [11.3%]). Overall, the mean age was 61.0 ± 9.7 years at treatment baseline, and 547 (72%) were men. mRCC was primarily diagnosed in 230 (30%) patients, and most of them underwent cytoreductive nephrectomy prior to systemic therapy (n = 181 [79%]). Additional treatment of metastases prior to and/or during treatment was used in 169 patients (22.3%). Grade 3 and 4 adverse events occurred in 168 (22.1%) and 47 patients (6.2%), respectively, and treatment was permanently stopped because of toxicity in 41 (6.9%). The OS was calculated from the start of first-line treatment, and the median follow-up was 14 months (range, 0–97). The median OS in the entire cohort was 17 months (95% CI, 14.6–19.4). Conclusions With only available sunitinib and pazopanib in first-line treatment, modest improvements are seen in the overall survival of patients with mRCC in real world clinical practice. In circumstances of limited availability of cancer medicines, our results can contribute to accelerating patient access to novel cancer therapies that have been shown to prolong survival in mRCC.
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Affiliation(s)
- Predrag Nikic
- Clinic of Urology, University Clinical Center of Serbia, Belgrade, Serbia.,University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Nada Babovic
- Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Zoran Dzamic
- Clinic of Urology, University Clinical Center of Serbia, Belgrade, Serbia.,University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Svetlana Salma
- Oncology Institute of Vojvodina, Sremska Kamenica, Serbia
| | | | - Suzana Matkovic
- Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Zoran Pejcic
- Oncology Institute of Vojvodina, Sremska Kamenica, Serbia
| | - Kristina Juskic
- Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Ivan Soldatovic
- University of Belgrade, Faculty of Medicine, Belgrade, Serbia.,Institute of Medical Statistics and Informatics, Belgrade, Serbia
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Matkovic S, Dotlic J, Gazibara T, Maric G, Nikolic V, Maksimovic N. Functional assessment of cancer therapy questionnaire for melanoma in the Serbian population: A factor analytic approach. PLoS One 2021; 16:e0253937. [PMID: 34191859 PMCID: PMC8244891 DOI: 10.1371/journal.pone.0253937] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 06/15/2021] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to examine the psychometric properties of the Functional Assessment Cancer Therapy—Melanoma (FACT-M) questionnaire in the Serbian language. The FACT-M was translated into Serbian using the standard methodology after obtaining the licence from the Functional Assessment of Chronic Illness Therapy (FACIT) translation project team. This version of FACT-M was distributed to a cohort of consecutive patients with histologically confirmed high-risk skin melanoma treated at the tertiary referral center. To examine construct validity of the FACT-M in Serbian, we performed exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The FACT-General (FACT-G) did not fit the original 4-domain structure. Instead, we accepted a 7-domain structure which, aside from physical, emotional, social and functional well-being, had domains of ‘friends’ support’, ‘illness acceptance’ and ‘fear of death’. Melanoma scale (MS) and Melanoma surgery scale (MSS) did not fit the original one-dimensional structure. The MS was observed to have 4 domains: ‘pain’, ‘skin problems’, ‘abdominal metastases’ and ‘other problems’. The MSS was observed to have 2 domains: ‘having symptoms’ and ‘no symptoms’. It is suggested that the FACT-M questionnaire is analyzed using the newly extracted domains to examine quality of life of people with high-risk melanoma in Serbia.
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Affiliation(s)
- Suzana Matkovic
- Institute of Oncology and Radiology of Serbia, Clinical Center of Serbia, Belgrade, Serbia
| | - Jelena Dotlic
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Tatjana Gazibara
- Faculty of Medicine, Institute of Epidemiology, University of Belgrade, Belgrade, Serbia
| | - Gorica Maric
- Faculty of Medicine, Institute of Epidemiology, University of Belgrade, Belgrade, Serbia
| | - Vladimir Nikolic
- Faculty of Medicine, Institute of Epidemiology, University of Belgrade, Belgrade, Serbia
| | - Natasa Maksimovic
- Faculty of Medicine, Institute of Epidemiology, University of Belgrade, Belgrade, Serbia
- * E-mail:
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Besu Zizak I, Jelic S, Matkovic S, Mihaljevic B, Jankovic L. 133: Oral cavity changes in lymphoma patients. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50113-x] [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: 11/26/2022]
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Milanovic N, Matkovic S, Ristic D, Jelic S, Petrovic M. Significance of tumor burden, vascular endothelial growth factor, lactate dehydrogenase and beta-2 microglobulin serum levels in advanced diffuse large B cell lymphoma. J BUON 2012; 17:497-501. [PMID: 23033288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE Lactate dehydrogenase (LDH) and beta-2 microglobulin (B2M) are incorporated in the so-called "serologic staging system", as independent parameters for predicting time to treatment failure (TTF) and overall survival (OS) for aggressive non-Hodgkin's lymphoma (NHL) patients. Elevated values of serum vascular endothelial growth factor (sVEGF) was associated with poor survival in the largest histological subgroup, the diffuse large B cell (DLBCL) and immunoblastic lymphomas. sVEGF has independent influence on survival in multivariate models when tested together with the components of the International Prognostic Index (IPI). The purpose of this study was to define possible correlations between LDH, B2M levels and the novel prognostic parameter sVEGF, with assessed tumor burden, as another parameter of aggressiveness for advanced-stage DLBCLs. METHODS Serum samples were collected from 29 patients with DLBCL, Ann Arbor clinical stages III and IV, to measure pretreatment serum levels of LDH, B2M and sVEGF. Tumor burden was defined as low and high according to criteria's defined by Jagannath and colleagues. RESULTS A trend toward significant correlation between high initial levels of sVEGF and high tumor burden was observed (p=0.077). High serum LDH level was strongly associated with high tumor burden (p=0.0091), but B2M correlation with either low or high tumor burden was not confirmed (p=0.249). Complete response (CR) rates (CR vs. non CR) and OS according to tumor burden (low vs. high) showed no statistically significant differences (p=0.245 and p=0.202). CONCLUSION Our preliminary data confirmed association between serum LDH level and DLBCL burden with a satisfactory sensitivity-specificity relationship. The other two parameters, sVEGF and B2M, failed to demonstrate significant relationship with tumor burden.
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Affiliation(s)
- N Milanovic
- Institute for Oncology and Radiology of Serbia, Medical Oncology Service, Department of Hematological Oncology, Belgrade, Serbia
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Besu I, Konic-Ristic A, Jelic S, Matkovic S, Minic I, Djordjevic M, Juranic Z. 313 Immunity to phytohemagglutinin in some NHL patients. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)71117-4] [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: 10/19/2022] Open
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Juranic Z, Radic J, Konic-Ristic A, Jelic S, Mihaljevic B, Stankovic I, Matkovic S, Besu I, Gavrilović D. Humoral immunoreactivity to gliadin and to tissue transglutaminase is present in some patients with multiple myeloma. BMC Immunol 2008; 9:22. [PMID: 18507842 PMCID: PMC2414991 DOI: 10.1186/1471-2172-9-22] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2008] [Accepted: 05/28/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multiple myeloma (MM) is a clonal B-cell disorder with many immunological disturbances. The aim of this work was to assess whether some of food antigens contribute to the imbalance of immune response by screening the sera of MM patients for their immunoreactivity to food constituent gliadin, to tissue transglutaminase-2 (tTG-2) and to Ro/SSA antigen.Sera from 61 patients with MM in various stages of disease, before, or after some cycles of conventional therapy were analyzed by commercial Binding Site ELISA tests. The control group consisted of 50 healthy volunteers. Statistical analysis of data obtained was performed by Mann Whitney Test. RESULTS The higher serum IgA immunoreactivity to gliadin was found in 14/56 patients and in one of control people. The enhanced serum IgG immunoreactivity to gliadin was found in only two of tested patients and in two controls. The enhanced IgA immunoreactivity to tTG-2 was found in 10/49 patients' sera, while 4/45 patients had higher serum IgG immunoreactivity. The enhanced serum IgG immunoreactivity to RoSSA antigen was found in 9/47 analyzed MM patients' sera. Statistical analysis of data obtained revealed that only the levels of anti-tTG-2 IgA immunoreactivity in patients with MM were significantly higher than these obtained in healthy controls (P < 0.02) CONCLUSION Data obtained showed the existence of the enhanced serum immunoreactivity to gliadin, tTG-2 and Ro/SSA antigens in some patients with MM. These at least partially could contribute to the immunological imbalance frequently found in this disease.
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Affiliation(s)
- Zorica Juranic
- Institute for Oncology and Radiology of Serbia, Pasterova 14, Belgrade, Serbia
| | - Jelena Radic
- Institute for Oncology and Radiology of Serbia, Pasterova 14, Belgrade, Serbia
| | | | - Svetislav Jelic
- Institute for Oncology and Radiology of Serbia, Pasterova 14, Belgrade, Serbia
| | | | - Ivan Stankovic
- Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Suzana Matkovic
- Institute for Oncology and Radiology of Serbia, Pasterova 14, Belgrade, Serbia
| | - Irina Besu
- Institute for Oncology and Radiology of Serbia, Pasterova 14, Belgrade, Serbia
| | - Dušica Gavrilović
- Institute for Oncology and Radiology of Serbia, Pasterova 14, Belgrade, Serbia
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Ristic B, Jakovljevic B, Matkovic S. [Transmeatal direct myringoplasty]. VOJNOSANIT PREGL 2001; 58:595-8. [PMID: 11858013] [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: 02/23/2023] Open
Abstract
A surgical method of transmeatal direct myringoplasty (TDM) was performed in 30 patients. Out of those, 21 patients were previously treated for chronic otitis media, 4 patients were with dry perforations of neomembrane following myringoplasty, and 5 patients were with blasttraumatic ruptures of the eardrum. Fascia of the temporal muscle was used in the defect reconstruction. Graft healing and closure of the eardrum defect were observed in all patients 3 months after the surgery. Postoperative improvement of hearing in an interval of 15-20 dB was found in 21 patients. Milder sensorineural hearing damage was found in 1 patient, while in the others the hearing was on the preoperative level. Simplicity of the method, minimal surgical procedure and favorable postoperative results were the reason why the authors recommended TDM as the method of choice in the reconstruction of the eardrum defects caused by an inflammation or blasttraumatic damages of the eardrum.
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