BACKGROUND AND PURPOSE: Radiation-induced intestinal injury (RIII) compromises the clinical utility of pelvic radiotherapy (RT). We aimed to explore the protective effect and underlying mechanism of (-)-epigallocatechin-3-gallate (EGCG) on RIII. MATERIALS AND METHODS: We evaluated the protective effect of EGCG on intestine in RIII mouse model and pelvic cancer patients, while explored the underlying mechanism through (1) 16S rRNA sequencing, (2) metabolomic profiles, (3) fresh sterile fecal filtrate (SFF) transplantation, and (4) transcriptome sequencing. RESULTS: EGCG efficiently prevented RIII in mouse, as reflected by improved survival, alleviated intestinal structure damage, promoted intestinal regeneration, and ameliorated gut microbiota dysbiosis. Prophylactic EGCG intervention reduced the severity of RIII in patients receiving pelvic RT. Mechanistically, the protective effect of EGCG could be transferred to other mice by SFF transplantation. EGCG enriched gut microbiota-derived metabolite D-tagatose, and oral administration of D-tagatose reproduced the radio-protective effect of EGCG via activating AMPK. CONCLUSION: Oral EGCG may be a promising strategy for preventing RIII clinically, and warrant further investigation in prospective randomized phase III trials.

• MeSH
• katechin * analogy a deriváty   farmakologie   MeSH
• lidé MeSH
• myši inbrední C57BL MeSH
• myši MeSH
• nádory pánve * radioterapie   MeSH
• proteinkinasy aktivované AMP metabolismus   MeSH
• radiační poranění * prevence a kontrola   MeSH
• radioprotektivní látky farmakologie   terapeutické užití   MeSH
• střeva účinky záření   účinky léků   mikrobiologie   MeSH
• střevní mikroflóra * účinky léků   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• myši MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

Léčba metastazujícího karcinomu prsu s pozitivitou receptoru pro lidský epidermální růstový faktor (human epidermal growth factor receptor, HER) prochází v současné době velkým rozvojem co do nabídky léčiv i jejich účinku. Uvádíme kazuistiku 45leté pacientky s metastazujícím HER pozitivním nádorem prsu, silně předléčené chemoterapií antracykliny a taxany a po anti-HER léčbě pertuzumabem, trastuzumabem i lapatinibem s rozsáhlým symptomatickým postižením plic a pohrudnice. Léčbou trastuzumab deruxrtecanem bylo u této pacientky ve třetí linii paliativní léčby dosaženo parciální remise a významného klinického zlepšení stavu. Zatím účinek trvá 18 měsíců a pokračujeme v udržovací léčbě stejnou dávkou 5,4 mg/kg tělesné hmotnosti. Nezaznamenali jsme žádné závažné projevy toxicity G3/4, ani kardiální, ani hematologické. Léčba trastuzumab deruxtecanem je velmi účinnou možností s přijatelnou toxicitou i u silně předléčených pacientek.

The treatment of metastatic HER-positive breast cancer is currently undergoing great development in terms of the range of drugs and their effect. We present the case report of a 45-year-old female patient with HER-positive metastatic breast cancer, heavily pretreated with anthracycline and taxanes chemotherapy and after anti-HER treatment with pertuzumab, trastuzumab and lapatinib and with extensive symptomatic involvement of the lungs and pleura. Treatment with trastuzumab deruxtecan in this patient in the third line of palliative treatment resulted in a partial remission and significant clinical improvement. So far, the effect lasts 18 months and we continue the maintenance treatment with the same dose 5.4 mg/kg body weight. We did not observe any serious G3/4 manifestations of either cardiac or hematological toxicity. Treatment with trastuzumab deruxtecan is a very effective option with acceptable toxicity even in heavily pretreated patients.

• Klíčová slova
• Transtuzumab deruxtexan,
• MeSH
• antracykliny terapeutické užití   MeSH
• dospělí MeSH
• geny erbB-2 * účinky léků   MeSH
• humanizované monoklonální protilátky škodlivé účinky   terapeutické užití   MeSH
• kardiotoxicita diagnostické zobrazování   farmakoterapie   prevence a kontrola   MeSH
• lidé MeSH
• nádory pánve radioterapie   sekundární   MeSH
• nádory plic radioterapie   sekundární   MeSH
• nádory prsu * chirurgie   diagnóza   farmakoterapie   genetika   MeSH
• přežití MeSH
• taxoidy terapeutické užití   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Metastazující karcinom endometria má velmi nepříznivou prognózu s mediánem přežití kolem jednoho roku. Dosavadní standardy systémové léčby byly omezeny na chemoterapii a hormonoterapii, bez adekvátní účinné léčby pro druhou a vyšší linii léčby. Zavedení molekulárního testování s významným prognostickým i prediktivním dopadem výrazně ovlivňuje rozhodovací proces při léčbě pacientek s karcinomem endometria v klinické praxi. Tato kazuistika popisuje průběh léčby pacientky s iniciálně pokročilým karcinomem endometria agresivního biologického chování, který výrazně limitoval celkový stav pacientky. Individualizovaný a multimodální přístup s postupným využitím radioterapie, chemoterapie, molekulárně cílené léčby, hormonoterapie a v neposlední řadě imunoterapie vedl ke zlepšení celkového stavu pacientky a nepochybně i k prodloužení jejího života.

Metastatic endometrial cancer has a very poor prognosis with a median survival about one year. Possibilities of current treatment have been limited to chemotherapy and endocrine therapy, without standard of care for next line therapy. Molecular testing has brought significant prognostic and predicrtive impact and has influenced decision-making process in a treatment of patients with endometrial cancer in clinical practice. This case report describes treatment of a patient with primary advanced endometrial cancer with aggressive biological behavior which significantly limited patient's overall condition. This individualized and multimodal approach using radiotherapy, chemotherapy, molecular targeted treatment, endocrine therapy and immunotherapy led to an improvement in patient's overall condition and undoubtedly to an extension of her life.

• MeSH
• biologická terapie MeSH
• hormony, hormonální náhražky a antagonisté terapeutické užití   MeSH
• lidé MeSH
• lymfatické metastázy radioterapie   MeSH
• molekulární patologie MeSH
• nádory endometria * chirurgie   diagnóza   farmakoterapie   radioterapie   MeSH
• nádory kůže sekundární   MeSH
• nádory pánve sekundární   MeSH
• nádory plic sekundární   MeSH
• přežití bez známek nemoci MeSH
• protokoly protinádorové kombinované chemoterapie * MeSH
• senioři MeSH
• staging nádorů MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

OBJECTIVE: Uterine sarcomas are a rare and heterogeneous group of malignancies that include different histological sub-types. The aim of this study was to identify and evaluate the impact of the different prognostic factors on overall survival and disease-free survival of patients with uterine sarcoma. METHODS: This international multicenter retrospective study included 683 patients diagnosed with uterine sarcoma at 46 different institutions between January 2001 and December 2007. RESULTS: The 5-year overall survival for leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma, and adenosarcoma was 65.3%, 78.3%, 52.4%, and 89.5%, respectively, and the 5-year disease-free survival was 54.3%, 68.1%, 40.3%, and 85.3%, respectively. The 10-year overall survival for leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma and adenosarcoma was 52.6%, 64.8%, 52.4%, and 79.5%, respectively, and the 10-year disease-free survival was 44.7%, 53.3%, 40.3%, and 77.5%, respectively. The most significant factor associated with overall survival in all types of sarcoma except for adenosarcoma was the presence of residual disease after primary treatment. In adenosarcoma, disease stage at diagnosis was the most important factor (hazard ratio 17.7; 95% CI 2.86 to 109.93). CONCLUSION: Incomplete cytoreduction, tumor persistence, advanced stage, extra-uterine and tumor margin involvement, and the presence of necrosis were relevant prognostic factors significantly affecting overall survival in uterine sarcoma. The presence of lymph vascular space involvement and administration of adjuvant chemotherapy were significantly associated with a higher risk of relapse.

• MeSH
• adenosarkom * terapie   patologie   MeSH
• endometriální stromální sarkom * terapie   patologie   MeSH
• leiomyosarkom * patologie   MeSH
• lidé MeSH
• lokální recidiva nádoru MeSH
• nádory dělohy * patologie   MeSH
• nádory endometria * patologie   MeSH
• nádory pánve * MeSH
• prognóza MeSH
• retrospektivní studie MeSH
• sarkom * diagnóza   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

• Klíčová slova
• ribociclib,
• MeSH
• geny erbB-2 MeSH
• lidé středního věku MeSH
• lidé MeSH
• metastázy nádorů MeSH
• nádory pánve farmakoterapie   sekundární   MeSH
• nádory páteře farmakoterapie   sekundární   MeSH
• nádory prsu * farmakoterapie   MeSH
• protokoly protinádorové kombinované chemoterapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Úvod: Neurinomy jsou skupinou dobře diferencovaných benigních tumorů vycházejících ze Schwannových buněk periferních nervů. Jejich výskyt v oblasti pánve je vzácný. Expandující neurinomy se mohou projevovat pestrou neurologickou symptomatologií nebo útlakem orgánů pánve. Kazuistika: Autoři prezentují případ 60leté pacientky s objemným symptomatickým hluboce uloženým neurinomem pánve. Nemocná podstoupila roboticky asistovanou operaci s kompletní exstirpací tumoru. Pooperační průběh byl nekomplikovaný s dimisí druhý pooperační den. Histologicky byla potvrzena diagnóza neurinomu. Pacientka je 11 měsíců od operace bez obtíží a bez neurologického deficitu. Závěr: Roboticky asistovaná operace umožňuje bezpečnou a efektivní chirurgickou léčbu ve špatně přístupných anatomických prostorech. Magnetická rezonance je obligatorní metodou při předoperačním zobrazení neurogenních nádorů. V případě průkazu neurinomu není histologická verifikace doporučována. Nutná je multidisciplinární spolupráce s dedikovaným týmem se zkušeností s miniinvazivní pánevní chirurgií.

Introduction: Schwannomas are a group of well differentiated benign tumors originating from the Schwann cells of the peripheral nervous system. Their localization in the pelvis is very rare. Schwannomas with expansive growth can cause wide neurologic symptoms or oppression of pelvic organs. Case report: The authors present a case study of a 60-year-old woman with a large, symptomatic deep pelvic schwannoma. The patient underwent robotic-assisted surgery resulting in complete tumor extirpation. The patient’s postoperative course was uneventful with a total of two hospitalization days. The diagnosis of a schwannoma was confirmed by histopathologic analysis. At 11-month follow-up surveillance the patient did not present any neurological deficit or other symptoms. Conclusion: Robotic-assisted surgery allows safe and effective surgical treatment in difficult-to-access anatomical areas. Magnetic resonance imaging is required for preoperative imaging of neurogenic tumors. Histological verification is not recommended in cases where evidence of a schwannoma is found. Multidisciplinary cooperation of a dedicated team experienced in minimally invasive pelvic surgery is necessary.

• MeSH
• lidé středního věku MeSH
• lidé MeSH
• miniinvazivní chirurgické výkony MeSH
• nádory pánve * chirurgie   diagnóza   MeSH
• neurilemom * chirurgie   diagnóza   MeSH
• roboticky asistované výkony MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH
• práce podpořená grantem MeSH

OBJECTIVE: To describe the clinical and sonographic characteristics of benign, retroperitoneal, pelvic peripheral-nerve-sheath tumors (PNSTs). METHODS: This was a retrospective study of patients with a benign, retroperitoneal, pelvic PNST who had undergone preoperative ultrasound examination at a single gynecologic oncology center between 1 January 2018 and 31 August 2022. All ultrasound images, videoclips and final histological specimens of benign PNSTs were reviewed side-by-side in order to: describe the ultrasound appearance of the tumors, using the terminology of the International Ovarian Tumor Analysis (IOTA), Morphological Uterus Sonographic Assessment (MUSA) and Vulvar International Tumor Analysis (VITA) groups, following a predefined ultrasound assessment form; describe their origin in relation to nerves and pelvic anatomy; and assess the association between their ultrasound features and histotopography. A review of the literature reporting benign, retroperitoneal, pelvic PNSTs with preoperative ultrasound examination was performed. RESULTS: Five women (mean age, 53 years) with a benign, retroperitoneal, pelvic PNST were identified, four with a schwannoma and one with a neurofibroma, of which all were sporadic and solitary. All patients had good-quality ultrasound images and videoclips and final biopsy of surgically excised tumors, except one patient managed conservatively who had only a core needle biopsy. In all cases, the findings were incidental. The five PNSTs ranged in maximum diameter from 31 to 50 mm. All five PNSTs were solid, moderately vascular tumors, with non-uniform echogenicity, well-circumscribed by hyperechogenic epineurium and with no acoustic shadowing. Most of the masses were round (n = 4 (80%)), and contained small, irregular, anechoic, cystic areas (n = 3 (60%)) and hyperechogenic foci (n = 5 (100%)). In the woman with a schwannoma in whom surgery was not performed, follow-up over a 3-year period showed minimal growth (1.5 mm/year) of the mass. We also summarize the findings of 47 cases of benign retroperitoneal schwannoma and neurofibroma identified in a literature search. CONCLUSIONS: On ultrasound examination, no imaging characteristics differentiate reliably between benign schwannomas and neurofibromas. Moreover, benign PNSTs show some similar features to malignant retroperitoneal tumors. They are solid lesions with intralesional blood vessels and show degenerative changes such as cystic areas and hyperechogenic foci. Therefore, ultrasound-guided biopsy may play a pivotal role in their diagnosis. If confirmed to be benign PNSTs, these tumors can be managed conservatively, with ultrasound surveillance. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

• MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory nervové pochvy * diagnóza   patologie   chirurgie   MeSH
• nádory pánve * MeSH
• neurilemom * diagnostické zobrazování   patologie   MeSH
• neurofibrom * diagnóza   patologie   chirurgie   MeSH
• retroperitoneální nádory * diagnostické zobrazování   MeSH
• retrospektivní studie MeSH
• ultrasonografie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Dráha fosfatidyLinositol-3-kinázy (phosphatidylinositol-3-kinase, PI3K) se stává novým molekulárním cílem terapie solidních nádorů. Jedná se o jednu z nejvíce dysregulovaných drah, často dochází k její patologické aktivaci cestou onkogenních mutací nebo epigenetických poruch. Poměrně obvykle se jedná o dysregulaci genu PIK3CA (u 10 % solidních nádorů, až cca u 30 % karcinomů prsů s pozitivními hormonálními receptory).1 Kazuistika popisuje případ pacientky s generalizovaným hormonálně dependentním karcinomem prsu s negativitou receptoru 2 pro lidský epidermální růstový faktor (human epidermal growth factor receptor 2, HER2) a mutací PIK3CA, která je úspěšně léčena alpelisibem ve druhé linii paliativní terapie po selhání inhibitoru cyklin dependentní kinázy 4/6 (cyclin-dependent kinase 4/6, CDK4/6).

The phosphatidylinositol-3-kinase (PI3K) pathway is becoming a new molecular target for solid tumor therapy. It is one of the most dysregulated pathways, it is often pathologically activated through oncogenic mutations or epigenetic disorders, usually a dysregulation of the PIK3CA gene (in 10% of solid tumors, up to about 30% of breast cancers with positive hormone receptors).1 The case report describes the case of a patient with metastatic hormone-dependent human epidermal growth factor receptor 2-negative (HER2-negative) breast cancer with PIK3CA mutation, who is successfully treated with alpelisib in 2nd line palliative therapy after failure of a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor.

• Klíčová slova
• alpelisib,
• MeSH
• cílená molekulární terapie metody   MeSH
• fulvestrant aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory pánve diagnostické zobrazování   farmakoterapie   sekundární   MeSH
• nádory páteře diagnostické zobrazování   farmakoterapie   sekundární   MeSH
• nádory prsu * diagnóza   farmakoterapie   genetika   patologie   MeSH
• PET/CT MeSH
• protokoly protinádorové kombinované chemoterapie terapeutické užití   MeSH
• thiazoly aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

BACKGROUND: The aim of the study was to compare health-related quality of life (QoL) and oncological outcome between gynaecological cancer patients undergoing pelvic exenteration (PE) and extended pelvic exenteration (EPE). EPEs were defined as extensive procedures including, in addition to standard PE extent, the resection of internal, external, or common iliac vessels; pelvic side-wall muscles; large pelvic nerves (sciatic or femoral); and/or pelvic bones. METHODS: Data from 74 patients who underwent PE (42) or EPE (32) between 2004 and 2019 at a single tertiary gynae-oncology centre in Prague were analysed. QoL assessment was performed using EORTC QLQ-C30, EORTC CX-24, and QOLPEX questionnaires specifically developed for patients after (E)PE. RESULTS: No significant differences in survival were observed between the groups (P > 0.999), with median overall and disease-specific survival in the whole cohort of 45 and 49 months, respectively. Thirty-one survivors participated in the QoL surveys (20 PE, 11 EPE). No significant differences were observed in global health status (P = 0.951) or in any of the functional scales. The groups were not differing in therapy satisfaction (P = 0.502), and both expressed similar, high willingness to undergo treatment again if they were to decide again (P = 0.317). CONCLUSIONS: EPEs had post-treatment QoL and oncological outcome comparable to traditional PE. These procedures offer a potentially curative treatment option for patients with persistent or recurrent pelvic tumour invading into pelvic wall structures without further compromise of patients ́ QoL.

• MeSH
• exenterace pánve * metody   MeSH
• kvalita života MeSH
• lidé MeSH
• nádory pánve * chirurgie   MeSH
• průzkumy a dotazníky MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Local treatment of pelvic Ewing's sarcoma may be challenging, and intergroup studies have focused on improving systemic treatments rather than prospectively evaluating aspects of local tumor control. The Euro-EWING99 trial provided a substantial number of patients with localized pelvic tumors treated with the same chemotherapy protocol. Because local control included surgical resection, radiation therapy, or a combination of both, we wanted to investigate local control and survival with respect to the local modality in this study cohort. QUESTIONS/PURPOSES: (1) Do patients with localized sacral tumors have a lower risk of local recurrence and higher survival compared with patients with localized tumors of the innominate bones? (2) Is the local treatment modality associated with local control and survival in patients with sacral and nonsacral tumors? (3) Which local tumor- and treatment-related factors, such as response to neoadjuvant chemotherapy, institution where the biopsy was performed, and surgical complications, are associated with local recurrence and patient survival in nonsacral tumors? (4) Which factors, such as persistent extraosseous tumor growth after chemotherapy or extent of bony resection, are independently associated with overall survival in patients with bone tumors undergoing surgical treatment? METHODS: Between 1998 and 2009, 1411 patients with previously untreated, histologically confirmed Ewing's sarcoma were registered in the German Society for Pediatric Oncology and Hematology Ewing's sarcoma database and treated in the Euro-EWING99 trial. In all, 24% (339 of 1411) of these patients presented with a pelvic primary sarcoma, 47% (159 of 339) of which had macroscopic metastases at diagnosis and were excluded from this analysis. The data from the remaining 180 patients were reviewed retrospectively, based on follow-up data as of July 2016. The median (range) follow-up was 54 months (5 to 191) for all patients and 84 months (11 to 191) for surviving patients. The study endpoints were overall survival, local recurrence and event-free survival probability, which were calculated with the Kaplan-Meier method and compared using the log-rank test. Hazard ratios (HRs) with their respective 95% CIs were estimated in a multivariate Cox regression model. RESULTS: Sacral tumors were associated with a reduced probability of local recurrence (12% [95% CI 1 to 22] versus 28% [95% CI 20 to 36] at 5 years, p = 0.032), a higher event-free survival probability (66% [95% CI 51 to 81] versus 50% [95% CI 41 to 58] at 5 years, p = 0.026) and a higher overall survival probability (72% [95% CI 57 to 87] versus 56% [95% CI 47 to 64] at 5 years, p = 0.025) compared with nonsacral tumors. With the numbers available, we found no differences between patients with sacral tumors who underwent definitive radiotherapy and those who underwent combined surgery and radiotherapy in terms of local recurrence (17% [95% CI 0 to 34] versus 0% [95% CI 0 to 20] at 5 years, p = 0.125) and overall survival probability (73% [95% CI 52 to 94] versus 78% [95% CI 56 to 99] at 5 years, p = 0.764). In nonsacral tumors, combined local treatment was associated with a lower local recurrence probability (14% [95% CI 5 to 23] versus 33% [95% CI 19 to 47] at 5 years, p = 0.015) and a higher overall survival probability (72% [95% CI 61 to 83] versus 47% [95% CI 33 to 62] at 5 years, p = 0.024) compared with surgery alone. Even in a subgroup of patients with wide surgical margins and a good histologic response to induction treatment, the combined local treatment was associated with a higher overall survival probability (87% [95% CI 74 to 100] versus 51% [95% CI 33 to 69] at 5 years, p = 0.009), compared with surgery alone.A poor histologic response to induction chemotherapy in nonsacral tumors (39% [95% CI 19 to 59] versus 64% [95% CI 52 to 76] at 5 years, p = 0.014) and the development of surgical complications after tumor resection (35% [95% CI 11 to 59] versus 68% [95% CI 58 to 78] at 5 years, p = 0.004) were associated with a lower overall survival probability in nonsacral tumors, while a tumor biopsy performed at the same institution where the tumor resection was performed was associated with lower local recurrence probability (14% [95% CI 4 to 24] versus 32% [95% CI 16 to 48] at 5 years, p = 0.035), respectively.In patients with bone tumors who underwent surgical treatment, we found that after controlling for tumor localization in the pelvis, tumor volume, and surgical margin status, patients who did not undergo complete (defined as a Type I/II resection for iliac bone tumors, a Type II/III resection for pubic bone and ischium tumors and a Type I/II/III resection for tumors involving the acetabulum, according to the Enneking classification) removal of the affected bone (HR 5.04 [95% CI 2.07 to 12.24]; p < 0.001), patients with a poor histologic response to induction chemotherapy (HR 3.72 [95% CI 1.51 to 9.21]; p = 0.004), and patients who did not receive additional radiotherapy (HR 4.34 [95% CI 1.71 to 11.05]; p = 0.002) had a higher risk of death. The analysis suggested that the same might be the case in patients with a persistent extraosseous tumor extension after induction chemotherapy (HR 4.61 [95% CI 1.03 to 20.67]; p = 0.046), although the wide CIs pointing at a possible sparse-data bias precluded any definitive conclusions. CONCLUSION: Patients with sacral Ewing's sarcoma appear to have a lower probability for local recurrence and a higher overall survival probability compared with patients with tumors of the innominate bones. Our results seem to support a recent recommendation of the Scandinavian Sarcoma Group to locally treat most sacral Ewing's sarcomas with definitive radiotherapy. Combined surgical resection and radiotherapy appear to be associated with a higher overall survival probability in nonsacral tumors compared with surgery alone, even in patients with a wide resection and a good histologic response to neoadjuvant chemotherapy. Complete removal of the involved bone, as defined above, in patients with nonsacral tumors may be associated with a decreased likelihood of local recurrence and improved overall survival. Persistent extraosseous tumor growth after induction treatment in patients with nonsacral bone tumors undergoing surgical treatment might be an important indicator of poorer overall survival probability, but the possibility of sparse-data bias in our cohort means that this factor should first be validated in future studies. LEVEL OF EVIDENCE: Level III, therapeutic study.

• MeSH
• adjuvantní chemoterapie MeSH
• adjuvantní radioterapie MeSH
• časové faktory MeSH
• dítě MeSH
• doba přežití bez progrese choroby MeSH
• dospělí MeSH
• Ewingův sarkom diagnostické zobrazování   mortalita   patologie   terapie   MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• lokální recidiva nádoru MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nádory kostí diagnostické zobrazování   mortalita   patologie   terapie   MeSH
• nádory pánve diagnostické zobrazování   mortalita   patologie   terapie   MeSH
• neoadjuvantní terapie MeSH
• novorozenec MeSH
• osteotomie * škodlivé účinky   mortalita   MeSH
• předškolní dítě MeSH
• randomizované kontrolované studie jako téma MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• srovnávací studie MeSH
• Geografické názvy
• Evropa MeSH