BACKGROUND: The evaluation of treatment outcomes and toxicity in patients with metastatic castration-resistant prostate cancer (mCRPC) treated by enzalutamide or abiraterone after previous docetaxel. PATIENTS AND METHODS: We analyzed 66 patients with mCRPC treated by enzalutamide (55 patients) or abiraterone (11 patients) after previous therapy with docetaxel. The median follow-up was 31.2 months. Enzalutamide and abiraterone were administered in daily doses of 160 mg and 1,000 mg per day, respectively. The progression free survival (PFS) and overall survival (OS) were estimated by Kaplan-Meier analysis. The prognostic influence of the factors on OS was evaluated by regression analysis. RESULTS: The progression was observed in 55 (83%) patients, and mPFS was 12.1 (95% CI 7.7-16.4) months. In total, 43 patients died, and he median OS was 21.9 (95% CI 12.2-31.7) months. In the regression analysis, we observed statistical favorable influence of the following factors on OS: PSA decrease ≥ 50%, in patients with early decrease of prostatic specific antigen (PSA) ≥ 50% in 3 months after initiation of enzalutamide or abiraterone treatment, in patients with visceral metastatic sites, in patients treated with only one regimen of previous chemotherapy and in those without anemia. We observed the toxicity grades 3-4 in 45.5% and 36.3% patients treated with enzalutamide and abiraterone, respectively. CONCLUSION: Our analysis demonstrated efficacy and good tolerance in patients with mCRPC treated with enzalutamide and abiraterone after previous docetaxel therapy.

• Klíčová slova
• Chemotherapy, abiraterone, androgen receptor, castration-resistant prostate cancer, chemother­apy, enzalutamide, metastases, neoplasm metastasis, targeted therapy,
• MeSH
• docetaxel MeSH
• lidé MeSH
• nádory prostaty rezistentní na kastraci * farmakoterapie   MeSH
• prostatický specifický antigen MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• abiraterone MeSH Prohlížeč
• docetaxel MeSH
• enzalutamide MeSH Prohlížeč
• prostatický specifický antigen MeSH

BACKGROUND: Current standard treatments for patients with metastatic renal cell carcinoma (mRCC) involve tyrosine kinase inhibitors (TKI) that inhibit angiogenesis. Cabozantinib is a multi TKI used for the treatment of mRCC in the first- and second-line setting. PURPOSE: The aim of this study was the final analysis of treatment outcomes in patients with metastatic renal cell carcinoma (mRCC) treated with cabozantinib after previous targeted therapy. PATIENTS AND METHODS: A total of 54 patients with mRCC from four oncology centers in the Czech Republic were evaluated retrospectively; the median follow-up was 18.5 months. Cabozantinib was administered in a dose of 60mg/day, a subset of patients received an initial dose of 40mg/day. The treatment was administered until the progression. The Kaplan-Meier analysis was used to calculate progression free survival (PFS) and overall survival (OS). We performed a multivariate analysis of risk factors for treatment outcomes (PFS, OS) by regression analysis. All statistics were evaluated at the significance level α = 0.05. RESULTS: The median PFS in all patients was 9.3 months (95% CI 7.2 - 11.4). The median OS in all patients was 21.9 months (95% CI 15.5 - 28.4). The median PFS in patients with bone metastases was not statistically significantly different compared with patients without bone metastases (9.3 vs 8.7 months, P = 0.53). The median OS in patients with bone metastases was statistically significantly shorter compared with patients without bone metastases (17.7 vs 26.8 months, P = 0.021). A treatment response was observed in 40.7 % of cases, including one complete remission. The regression analysis demonstrated a significant effect on OS in patients with the presence of subsequent treatment (P = 0.001), patients with treatment duration of first line therapy 6 months (P = 0.019) and 12 months (P = 0.003) and in patients without bone metastases (P = 0.021). CONCLUSION: Our final analysis of patients with mRCC treated with cabozantinib after previous targeted therapy confirmed its effectiveness.

• Klíčová slova
• cabozantinib, metastases, molecular targeted therapy, neoplasm metastasis, renal carcinoma, targeted treatment, treatment results,
• MeSH
• analýza dat MeSH
• anilidy terapeutické užití   MeSH
• antitumorózní látky terapeutické užití   MeSH
• dospělí MeSH
• inhibitory proteinkinas terapeutické užití   MeSH
• Kaplanův-Meierův odhad MeSH
• karcinom z renálních buněk farmakoterapie   mortalita   patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory kostí farmakoterapie   mortalita   sekundární   MeSH
• nádory ledvin farmakoterapie   mortalita   patologie   MeSH
• onkologická péče - zařízení MeSH
• pyridiny terapeutické užití   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• anilidy MeSH
• antitumorózní látky MeSH
• cabozantinib MeSH Prohlížeč
• inhibitory proteinkinas MeSH
• pyridiny MeSH

INTRODUCTION: The primary goal of this study was to evaluate peroperative and early postoperative results of laparoscopic and robotic surgery for rectal cancer with total mesorectal excision (TME) and with primary anastomosis. METHODS: 404 patients were enrolled in the study, divided in two cohorts and compared retrospectively: a laparoscopic group (n=236) versus a robotic (TME + primary coloanal anastomosis) group (n=168). The evaluated cohorts were comparable in sex, age, BMI, ASA score, distal tumor margin from anal verge and neoadjuvant chemoradiotherapy. More advanced tumor stages were observed in the robotic group (p=0.009). RESULTS: The duration of robotic resection was significantly longer compared to laparoscopic resection (p.

• Klíčová slova
• rectal cancer, robotic resection, total mesorectal excission,
• MeSH
• laparoskopie * MeSH
• lidé MeSH
• nádory rekta * chirurgie   MeSH
• retrospektivní studie MeSH
• roboticky asistované výkony * MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Over the last decades outcomes for rectal cancer surgery have improved with increasing survival and lower recurrence rates. Nevertheless, functional disorders are still frequent. Low anterior resection with total mesorectal excision (TME) in patients with rectal cancer has improved oncological outcomes. However, most of them will have significant changes in quality of life, including varying degree of bowel dysfunction. Aim of this study was to analyse prevalence of LARS (low anterior resection syndrome) in patients with rectal cancer after miniinvasive restorative resection and to define its risk factors. METHODS: Between March 2016 and June 2018, patients who underwent elective miniinvasive (laparoscopic or robotic) rectal resection were enrolled. Bowel dysfunction was evaluated by LARS questionnaire and filled out 6, 12, and 24 months after primary operation or after ileostomy closure. 98 patients completed the questionnaires - 58 laparoscopic operations, 34 robotic and 6 open procedures. 69 patients underwent TME, tumor-specific mesorectal excision 21 patients. 8 patients underwent transanal TME. The clinical characteristics, surgical perioperative and postoperative outcomes did not differ between these groups. Only, significantly more patients underwent neoadjuvant radiotherapy in the robotic group (p=0.004). RESULTS: 59.8% patients reported major LARS 6 months after surgery and 29.7% after 24 months. Protentional risk factors are age (p.

• Klíčová slova
• LARS, TME, doppler ultrasound of uterine artery, rectal cancer, risk factors,
• MeSH
• kvalita života MeSH
• lidé MeSH
• nádory rekta * chirurgie   MeSH
• pooperační komplikace * epidemiologie   etiologie   MeSH
• rektum chirurgie   MeSH
• rizikové faktory MeSH
• syndrom MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Near-infrared (NIR) fluorescence angiography (FA) is an augmented reality (AR) technique. When used in the operating room, it allows colorectal surgeons to visualize and evaluate intestinal blood flow in real time, identify lymph nodes, ureters, or peritoneal metastases. Evaluation of perfusion with FA in augmented reality mode has an impact on reducing the ALR (anastomotic leakage rate) in rectal resections. METHODS: Data analysis of patients after minimally invasive surgery (MIS) for middle and lower rectal adenocarcinoma with total mesorectal excision (TME) using fluorescent angiography (FA) with indocyanine green (ICG) (100 patients, 20152019) were subsequently compared with a historical control group (100 patients) operated on for the same diagnosis before the introduction of the FA-ICG method (20122015) using minimally invasive approach (MIS). The patients were operated on consequently at one workplace. RESULTS: In fifteen patients (15%), the resection line was shifted due to insufficient perfusion detected by FA-ICG. The incidence of AL was lower in the group with FA compared to the group without FA (9% vs. 19%, p=0.042, χ test). A retrospective analysis of the group revealed a significant risk factor (RF) for the anastomotic leak, namely diabetes (p=0.036) and, among others, a protective factor, application of the transanal drain (NoCoil) (p=0.032). CONCLUSION: The introduction of new procedures and the use of new technologies, such as the use of the FA method in the AR mode in resections of the rectum with TME for cancer can lead to a reduction in the incidence of anastomotic leakage.

• Klíčová slova
• anastomotic leakage − rectal resections − fluorescence angiography − augmented reality,
• MeSH
• anastomóza chirurgická škodlivé účinky   MeSH
• augmentovaná realita * MeSH
• fluoresceinová angiografie MeSH
• indokyanová zeleň MeSH
• kolorektální chirurgie * MeSH
• lidé MeSH
• nádory rekta * chirurgie   MeSH
• netěsnost anastomózy etiologie   MeSH
• operační sály MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• indokyanová zeleň MeSH

INTRODUCTION: Negative pressure wound therapy is a healing modality utilizing continuous or intermittently applied vacuum to the wound bed. Nowadays is available a vacuum system supported by an automated instillation with volumetric control. It`s main therapeutic benefit is the dilution of the exudate, which reduces the viscosity and secures the «delicate» necrectomy. METHOD: Presentation of the temporary results of a prospective randomized study comparing the effectiveness of both therapeutic techniques. Entirely 41 patients were enrolled in the study from November 2016 to September 2018. The primary goal of the project is to compare the length of therapy, the number of surgical debridements and evaluation the financial costs. Secondary targets are observed changes in biological load and bacterial spectrum. RESULTS: The duration of the therapy was 2 days shorter in the experimental group compared to the control sample. However, the average number of applications was higher. Defects with the instillation system were characterized by a shorter cleaning phase (p=0.057). The secondary suture was reached in the experimental group at 84.2% and in the control group at 72.7%. The differences in these parameters were not statistically significant. Fascial disruption was observed in the trial group in 2 patients. The financial costs of the material used was significantly higher in patients with irrigation system (p.

• Klíčová slova
• bacterial load, bacterial spectrum, vacuum therapy, wound Infection,
• MeSH
• debridement MeSH
• fasciitida * terapie   MeSH
• hojení ran MeSH
• laparotomie * MeSH
• lidé MeSH
• prospektivní studie MeSH
• terapie ran pomocí řízeného podtlaku * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

AIM: The aim of this retrospective study was to compare the efficacy of the sequence docetaxel-cabazitaxel-enzalutamide vs. docetaxel-enzalutamide in patients with metastatic castration-resistant prostate cancer. PATIENTS AND METHODS: Of the cohort of 35 patients, 11 were treated with the sequence docetaxel-cabazitaxel-enzalutamide and 24 were treated with the sequence docetaxel-enzalutamide. The doses were as follows: docetaxel, 75 mg/m2; cabazitaxel, 25 mg/m2; and enzalutamide, 160 mg/day. Overall survival (OS) was defined as the interval between the initial dose of docetaxel and death or the date of the last control for survivors (censored). OS was assessed using the Kaplan-Meier method, and the two arms were compared using the log-rank test. The significance level for all statistical tests was set at α = 0.05. RESULTS: The median OS of patients treated with the sequence docetaxel-cabazitaxel-enzalutamide was 28.8 months, vs. 24.4 months in patients treated with the sequence docetaxel-enzalutamide. No statistically significance differences in OS were found between the two arms (HR 0.678, 95% CI 0.264-1.744; p = 0.418). Grade 3-4 toxicity was observed for each drug, as follows: docetaxel: fatigue and peripheral neuropathy in six patients, nausea in three patients, and diarrhea and neutropenia in one patient; cabazitaxel: anemia in two patients and neutropenia in one patient; and enzalutamide: anemia in six patients, thrombocytopenia in two patients, and cerebral hemorrhage in one patient. CONCLUSION: No statistically significant differences in OS were found between the sequences docetaxel-cabazitaxel-enzalutamide and docetaxel-enzalutamide.Key words: prostate cancer - metastasis - chemotherapy - targeted hormonal treatment The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 13. 2. 2017Accepted: 20. 3. 2017.

• MeSH
• benzamidy MeSH
• docetaxel aplikace a dávkování   MeSH
• fenylthiohydantoin aplikace a dávkování   analogy a deriváty   MeSH
• Kaplanův-Meierův odhad MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory prostaty rezistentní na kastraci farmakoterapie   mortalita   MeSH
• nauzea chemicky indukované   MeSH
• nemoci periferního nervového systému chemicky indukované   MeSH
• neutropenie chemicky indukované   MeSH
• nitrily MeSH
• protokoly antitumorózní kombinované chemoterapie škodlivé účinky   terapeutické užití   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• taxoidy aplikace a dávkování   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• benzamidy MeSH
• cabazitaxel MeSH Prohlížeč
• docetaxel MeSH
• enzalutamide MeSH Prohlížeč
• fenylthiohydantoin MeSH
• nitrily MeSH
• taxoidy MeSH

BACKGROUND: Prostate cancer is one of the most common malignancies in men. Chemotherapy has an important role in the management of prostate cancer, especially for the treatment of castrate resistant prostate cancer (mCRPC). According to recently published studies, chemotherapy can also be used to treat advanced hormone sensitive disease. AIM: The aim of this report is to review the currently available options for chemotherapy of prostate cancer. RESULTS: Docetaxel is a chemotherapeutic agent used for standard treatment of mCRPC as 1st line therapy. In TAX 327 and SWOG 9916 studies reported in 2004, docetaxel, the first cytostatic agent indicated for this disease, prolonged overall survival. As a 2nd line mCRPC treatment, kabazitaxel resulted in longer overall survival than mitoxantrone, according to the results of the TROPIC study. Targeted hormone treatment, radium-223 irradiation, and immunotherapy are other treatment options for patients with mCRPC. Currently, the main focus is to develop an optimal sequence of treatments. Standard androgen deprivation therapy (ADT) is the standard option for patients with advanced hormone sensitive prostate cancer. According to recently published studies (CHAARTED, STAMPEDE), docetaxel with ADT increases overall survival in this group of patients. In the Czech Republic, this option is still off-label. Chemotherapy is not indicated in patients with early prostate cancer after radical prostatectomy or radiotherapy.Key words: prostate cancer - metastasis - chemotherapy - docetaxel - cabazitaxelThe authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 9. 5. 2016Accepted: 6. 6. 2016.

• MeSH
• antagonisté androgenů terapeutické užití   MeSH
• antitumorózní látky terapeutické užití   MeSH
• docetaxel MeSH
• hormony terapeutické užití   MeSH
• lidé MeSH
• mitoxantron terapeutické užití   MeSH
• nádory prostaty rezistentní na kastraci farmakoterapie   MeSH
• taxoidy terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• antagonisté androgenů MeSH
• antitumorózní látky MeSH
• cabazitaxel MeSH Prohlížeč
• docetaxel MeSH
• hormony MeSH
• mitoxantron MeSH
• taxoidy MeSH

AIM: Enzalutamide and abiraterone represent new therapeutical options in the treatment of metastatic castration-resistant prostate cancer (mCRPC). The aim of the presented study was retrospective analysis of clinical experience and efficacy of enzalutamide or abiraterone in the postchemo indication in patients with mCRPC. PATIENTS AND METHODS: A total of 32 mCRPC patients were evaluated. All patients received one or more lines of chemotherapy. Twenty-three patients were treated by enzalutamide, nine patients were treated by abiraterone. We defined two parameters: over all survival and progression-free survival. RESULTS: The median follow-up was 6.5 months. A total of 10 patients treated by enzalutamide progressed (43.47%) and eight patients died (34.78%). A total of five patients treated by abiraterone progressed (55.56%) and one patient died (11.11%). We did not observe any statistical difference in over all survival (HR 0.2362, 95% CI 0.0295- 1.8942; p = 0.102) and in progression-free survival (HR 0.9853, 95% CI 0.2934- 3.308; p = 0.939) between enzalutamide and abirateron. CONCLUSION: Our retrospective study demonstrated similar efficacy of enzalutamide and abiraterone in mCRPC patients previously treated by chemotherapy.

• MeSH
• androsteny terapeutické užití   MeSH
• antitumorózní látky terapeutické užití   MeSH
• benzamidy MeSH
• fenylthiohydantoin analogy a deriváty   terapeutické užití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• metastázy nádorů MeSH
• nádory prostaty rezistentní na kastraci farmakoterapie   mortalita   patologie   MeSH
• nitrily MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• abiraterone MeSH Prohlížeč
• androsteny MeSH
• antitumorózní látky MeSH
• benzamidy MeSH
• enzalutamide MeSH Prohlížeč
• fenylthiohydantoin MeSH
• nitrily MeSH

INTRODUCTION: The aim of the study was to evaluate the results of fluorescence angiography for assessing anastomotic perfusion after resection of the sigmoid colon and rectum since its introduction into clinical practice at the authors´ workplace and to evaluate the incidence of necessary resection line repositioning based on the quality of perfusion, and also to record any complications in anastomotic healing. METHOD: Retrospective unicentric analysis of prospectively collected data from patients with resection of the sigmoid colon and rectum with primary anastomosis. The patient set included 50 patients, 27 males and 23 females; the median age was 64.5 years (33-80). Forty-four patients were indicated for resection for cancer of the sigmoid colon or rectum, while 6 patients had a benign disease. Twenty-nine patients underwent total mesorectal excision with coloanal mechanical or hand-sewn anastomosis and 21 underwent resection of the sigmoid colon or upper rectum with mechanical anastomosis. Prior to the construction of the anastomosis, assessment of perfusion of the anastomotic segments by near infrared (NIR) indocyanine green (ICG) fluorescence angiography was performed in all patients. The quality of perfusion of the mesocolon and bowel wall and its impact on moving the resection line and complications of anastomotic healing 30 days postoperatively were all evaluated. RESULTS: Assessment of perfusion using fluorescence angiography was technically successfully performed in all 50 patients. In 5 cases (10%) the resection line had to be moved for signs of poor perfusion of the bowel wall. Postoperatively, healing of the anastomosis was complicated in four patients (8%). Dehiscence was recorded in 3 patients (10.3%) with total mesorectal excision and in 1 patient (4.8%) after resection of the sigmoid colon and upper rectum. CONCLUSION: The presented results indicate that fluorescence angiography may lead to a decrease in the incidence of anastomotic dehiscence after colorectal resections by mapping in detail the perfusion of the anastomosed segments.Key words: fluorescence angiography - indocyanine green - anastomotic leak - colorectal resection.

• MeSH
• anastomóza chirurgická metody   MeSH
• chirurgie trávicího traktu MeSH
• colon sigmoideum krevní zásobení   chirurgie   MeSH
• dehiscence operační rány epidemiologie   MeSH
• dospělí MeSH
• fluoresceinová angiografie MeSH
• kolektomie metody   MeSH
• kolorektální nádory chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mezokolon krevní zásobení   MeSH
• netěsnost anastomózy epidemiologie   MeSH
• perfuzní zobrazování MeSH
• rektum krevní zásobení   chirurgie   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH