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Autor: Matoušek, Petr

174 záznamů v Medvik Filtry

Kapitola

Kontroverze v chirurgické léčbě kraniofaryngeomů

Lipina, Radim, 1971-
Autor Autorita Neurochirurgická klinika LF OU a FN Ostrava
Matoušek, Petr, 1973-
Autor Autorita Klinika otorinolaryngologie a chirurgie hlavy a krku LF OU a FN Ostrava

Kraniofaryngeomy. 2024 ; () : 135-152.

ISBN 978-80-7345-783-9
Medvik
Zdroj

Klíčová slova
resekce nádoru, kontroverze,
MeSH
endoskopie klasifikace metody MeSH
kraniofaryngeom * chirurgie diagnóza terapie MeSH
lidé MeSH
magnetická rezonanční tomografie metody MeSH
management nemoci MeSH
neurochirurgické výkony * klasifikace metody přístrojové vybavení MeSH
Check Tag
lidé MeSH
Publikační typ
přehledy MeSH

Článek

High PD-L1 expression on immune cells along with increased density of tumor-infiltrating lymphocytes predicts a favorable survival outcome for patients with loco-regionally advanced head and neck cancer: early results from a prospective study

Frontiers in oncology. 2024 ; 14 (-) : 1346793. [pub] 20240404

Front Oncol
ISSN 2234-943X
Medvik
Zdroj

INTRODUCTION: In the era of personalized medicine and treatment optimization, use of immune biomarkers holds promise for estimating the prognosis of patients with head and neck squamous cell carcinoma (HNSCC) undergoing definitive treatment. METHODS: To evaluate the prognostic potential of immune biomarkers, we conducted a prospective monocentric cohort study with loco-regionally advanced HNSCC patients indicated for definitive radiotherapy/radiochemotherapy at the Department of Oncology, Ostrava University Hospital, Czech Republic, between June 2020 and August 2023. We focused on the expression of programmed death ligand 1 (PD-L1) and tumor-infiltrating lymphocytes (TILs) relative to overall survival (OS) and specific survival rates. Associations between biomarkers and survival rates were assessed by crude and adjusted hazard ratios (cHR, aHR, respectively) obtained from Cox proportional hazards regression. RESULTS: Among a total of 55 patients within a median follow-up of 19.7 months, there were 21 (38.2%) all-cause deaths and 15 (27.3%) cancer-related deaths. An overall survival (OS) rate of 61.8% and a disease-specific survival (DSS) rate of 72.7% were recorded. A significant association between survival rates and a ≥10% difference in PD-L1 expression on immune versus tumor cells (high PD-L1IC expression) was documented regardless of the type of analysis (univariate or multivariate). In addition, a stronger association was confirmed for OS and the composite biomarker high PD-L1IC expression along with either median-higher CD8+ TIL count or increased TIL density ≥30%, as indicated by an aHR of 0.08 (95% CI, 0.01 to 0.52) and 0.07 (95% CI, 0.01 to 0.46), respectively. Similar results were demonstrated for other specific survival rates. DISCUSSION: The early outcomes of the present study suggest the utility of a strong prognostic factor involving a composite biomarker high PD-L1IC expression along with increased TIL density in HNSCC patients undergoing definitive radiotherapy and radiochemotherapy. TRIAL REGISTRATION: The study is registered with Clinicaltrials.gov. - NCT05941676.

Publikační typ
časopisecké články MeSH

Článek

Transnasal Endoscopic Pituitary Surgery-The Role of a CT Scan in Individual Tailoring of Posterior Septum Size Resection

Tomography. 2023 ; 9 (6) : 2222-2232. [pub] 20231212

ISSN 2379-139X
Medvik
Zdroj

OBJECTIVE: This study was designed to evaluate the possibility of predicting the minimum size of septal resection for safe tumor extraction in transnasal paraseptal pituitary adenoma resection from preoperative computed tomography scans. METHODS: A retrospective CT scan analysis was performed on 20 patients who underwent endoscopic pituitary surgery at the University Hospital in Ostrava. Virtual insertion of the straight instrument into the sphenoid cavity was simulated using a CT scan. The minimum septal resection size was predicted and compared to various diameters in the nasal cavity. The results were then compared with cadaveric dissections, in which septal resections were performed at 1 cm and 2 cm distances from the anterior sphenoid wall. The association between cadaver dissections and CT scan results was studied. RESULTS: A total of 20 patients who underwent endoscopic transnasal surgery for pituitary adenoma between the years 2020 and 2021 were enrolled in the study. The mean virtual posterior septal size resection needed to reach the medial edge of the ICA with the straight instrument, without infracturing the nasal septum, was 13.2 mm. In cadavers with a 1 cm posterior septal resection, the medial edge of the ICA was reached with the straight instrument. In 2 cm resections, it was possible to reach beyond the lateral edge of the ICA. CONCLUSION: There is no significant correlation between the minimum septal size resection and measured diameters in the nasal cavity. According to our study, a 1 cm resection is sufficient for a non-extended pituitary tumor extraction. More extensive septal resections allow for better maneuverability and overview in the surgical field.