Úvod: Vlastnosti hepatocelulárneho karcinómu (HCC) z rôznych geografických oblastí sú odlišné. Cieľ: Analyzovať kohortu pacientov v nemocnici 3. stupňa. Metodológia: Retrospektívna analýza za sebou idúcich pacientov. Vstupné kritériá: HCC; vylučovacie kritériá: nedostatok dát; interval: roky 2007–2016. Výsledky: Súbor 207 pacientov, 95 % s cirhózou, 76 % mužov; vek 62 rokov. Etiológia hepatálneho ochorenia: Alkohol (ALD) 106 (48 %), hepatitída C 17 %, hepatitída B 13 %, nealkoholová steatohepatitída 10 %, kryptogénna 7 %, necirhotická 4 %, iná 1 %. Diagnóza prostredníctvom surveillance 24 %, bez surveillance 67 %, neznámy spôsob diagnózy 9 %. Priemer ložiska pri diagnóze SUR-HCC 5 cm, bez SUR-HCC 8,6 cm (p = 0,001). BCLC štádium: A – 30 pacientov (15 %), B – 29 %, C – 36 %, D – 20 %; BCLC podľa diagnózy (SUR-HCC vs. non-SUR-HCC): A – 15/49 (31 %) vs. 12/140 (9 %), B 43 vs. 27 %, C – 16 vs. 39 %, D – 10 vs. 25 %. Terapia: Chirurgická resekcia 17 pacientov (7 %), transplantácia pečene 14 (6 %), rádiofrekvenčná ablácia 20 (8 %), transarteriálna chemoembolizácia 60 (24 %), sorafenib 88 (35 %), suportívna starostlivosť 46 (19 %), 3 pacienti sú čakateľmi na transplantaci pečene. Priemerné prežívanie 17 (0,06–112) mesiacov, prežívanie podľa BCLC: A – 37 (2–112), B – 21 (0,6–86), C – 14 (0,06–92), D – 3 (0,06–24) mesiacov. Záver: Demografické údaje v našej kohorte sú porovnateľné s krajinami západnej Európy a Severnej Ameriky. ALD bola najčastejšou etiológiou základného ochorenia pečene, 95 % pacientov malo cirhózu. Len 24 % pacientov bolo zachytených prostredníctvom SUR-HCC, preto bol zaznamenaný výrazný posun doprava v BCLC štádiách, čo viedlo k suboptimálnej alokácii radikálnej liečby a následne aj k horšiemu prežívaniu. Súhrnne sú tieto výsledky porovnateľné s údajmi z Európy a Severnej Ameriky.
Introduction: The features of hepatocellular carcinoma (HCC) differ between geographical regions. Aim: To analyze a cohort from a tertiary referral centre. Methodology: The study employed a retrospective analysis of consecutive outpatients. The inclusion criterion was patients with HCC and the exclusion criterion was insufficient data. The study interval was 2007–2016. Results: Cohort 207 patients, 95% with cirrhosis, 76% men; age 62 years. Etiology of liver disease: Alcoholic 106 (48%), hepatitis C 17%, hepatitis B 13%, non-alcoholic steatohepatitis 10%, cryptogenic 7%, non-cirrhotic 4%, other 1%. Diagnosis by surveillance 24%, otherwise 67%, unknown 9%. Diameter if diagnosis by SUR-HCC 5 cm, otherwise 8.6 cm (p = 0,001). BCLC stages: A – 30 patients (15%), B – 29%, C – 36%, D – 20%; BCLC according to diagnosis (SUR-HCC vs. otherwise): A – 15/49 (31%) vs. 12/140 (9%), B – 43 vs. 27%, C – 16 vs. 39%, D – 10 vs. 25%. Treatment: Surgical resection in 17 patients (7%); liver transplantation 14 (6%); radiofrequency ablation 20 (8%); transarterial chemoembolization 60 (24%); sorafenib 88 (35%); best of supportive care 46 (19%), 3 patients were awaiting liver transplantation. Mean survival 17 (0.06–112) months; survival according to BCLC: A – 37 (2–112), B – 21 (0.6–86), C – 14 (0.06–92), D – 3 (0.06–24). Conclusion: The demographics in our cohort resembled those of Western Europe and North America. Alcoholic liver disease was the most common etiology for underlying liver disease; 95% of patients had cirrhosis. Only 24% of cases were detected by SUR-HCC; therefore, a marked shift to the right in the BCLC stage distribution was seen, what resulted in a suboptimal allocation of curative treatments and subsequently to worse survival. The treatment results and the management of HCC in our region are comparable with standard of care in West Europe and North America.
PURPOSE: Epidermal growth factor receptor-targeted monoclonal antibodies are active as monotherapy beyond second-line treatment. Skin toxicities (STs) are common during treatment, and a positive association between ST severity and patient outcome has been reported. This study collected information on panitumumab monotherapy use in patients with KRAS exon 2 wild-type metastatic colorectal cancer in clinical practice. METHODS: This open-label, prospective, observational, noninterventional study included adult patients who had failed prior chemotherapy with 5-fluorouracil, oxaliplatin, and irinotecan. Patients received panitumumab monotherapy (6 mg/kg every 2 weeks) for ≤18 cycles. Effectiveness was assessed as disease control rate (DCR), tumor response, and freedom from progression. The incidence of ST and other adverse drug reactions (ADRs) was recorded, as were Eastern Cooperative Oncology Group performance status (ECOG PS) and quality of life. The KRAS analysis process was also evaluated. FINDINGS: The full analysis set included 632 patients (64.6% male; mean age, 62.3 years), who completed a mean of 9.6 panitumumab cycles. ST, mainly grade 1/2, occurred in 84.3% of patients, 82.7% of whom required treatment. Nonskin ADRs occurred in 3.5% of patients. By the end of treatment, the DCR was 58.9% overall, and was 53.8% and 62.7%, respectively in patients with ST grade 0/1 and grade 2/3. Significant associations were observed between maximum ST grade and best response (P=0.0009), DCR (P=0.0046), tumor response (P=0.0002), and freedom from progression (P=0.0084). At the end of the study, 67.4% of the patients had an ECOG PS of 0/1. Quality of life was rated as "very good" or "good" in 70.3% of patients. Mean time to obtain KRAS results was 18.2 days; satisfaction with different aspects of KRAS testing was "very good" or "good" in 80%-97% of patients. CONCLUSION: Panitumumab monotherapy showed adequate effectiveness and safety in patients with heavily pretreated KRAS exon 2 wild-type metastatic colorectal cancer. The most common ADR was grade 1/2 ST.
- Publikační typ
- časopisecké články MeSH
- MeSH
- adjuvantní chemoterapie využití MeSH
- karcinom komplikace radioterapie MeSH
- lidé MeSH
- nádory močového měchýře terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
