INTRODUCTION: The aim of this study was to evaluate the results of surgical treatment of intrahepatic cholangiocarcinoma (IHCHCA) in terms of overall survival and disease-free survival, and to analyse and find potential prognostic factors affecting overall survival and disease-free survival. METHODS: Retrospective evaluation was performed of consecutively enrolled patients operated for IHCHCA from January 2005 to January 2022 (17 years) had undergone surgery. During the monitored period, 38 surgical procedures were performed, of which liver resection was done in 25 cases (65.8%). RESULTS: The 5-year survival in the radically resected group was 44%, and the 5-year disease-free survival was 32%. Based on univariate and multivariate analysis, radicality of surgery (p=0.01116) and lymph node involvement (p=0.00576) were assessed as negative prognostic factors for overall survival. Radicality of surgery (p=0.018) and administration of adjuvant chemotherapy (p=0.044) were significant negative prognostic factors affecting disease-free survival. However, they lost their significance in the multivariate analysis. CONCLUSION: Radical surgical resection of the liver remains an essential treatment option for intrahepatic cholangiocarcinoma aimed at achieving a radical procedure with microscopically negative margins. KEY WORDS: cholangiocarcinoma, resection, recurrence, survival.
- Klíčová slova
- Prognosis, cholangiocarcinoma, heart failure, recurrence, resection, survival,
- MeSH
- cholangiokarcinom * chirurgie patologie MeSH
- hepatektomie metody MeSH
- lidé MeSH
- míra přežití MeSH
- nádory žlučových cest * chirurgie patologie MeSH
- prognóza MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- výsledek terapie MeSH
- žlučové cesty intrahepatální patologie chirurgie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Triple-positive breast cancer (TPBC), i.e. HER2-positive (HER2+) and hormone receptors-positive breast cancer, is a specific subgroup of breast cancers. TPBC biology is characterized by strong mutual interactions between signaling pathways stimulated by estrogens and HER2 amplification. The present study aims to carry out a population-based analysis of treatment outcomes in a cohort of hormone receptor (HR) positive and negative breast cancer patients who were treated with anti-HER2 therapy in the Czech Republic. The BREAST research database was used as the data source for this retrospective analysis. The database covers approximately 95% of breast cancer patients treated with targeted therapies in the Czech Republic. The analysis included 6,122 HER2-positive patients. The patients were divided into two groups, based on estrogen receptor (ER) or progesterone receptor (PR) positivity: hormone receptor negative (HR-) patients had both ER- and PR-negative tumors (n=2,518), unlike positive (HR+) patients (n=3,604). HR+ patients were more often diagnosed premenopausal at the time of diagnosis, presented more often at stage I or II and their tumors were less commonly poorly differentiated. The overall survival (OS) was significantly higher in subgroups of HR+ patients according to treatment setting. When evaluated by stages, significantly higher OS was observed in HR+ patients diagnosed at stages II, III, and IV and regardless of tumor grade.
- MeSH
- lidé MeSH
- míra přežití MeSH
- nádorové biomarkery MeSH
- nádory prsu * farmakoterapie genetika MeSH
- prognóza MeSH
- receptor erbB-2 antagonisté a inhibitory genetika MeSH
- receptory pro estrogeny genetika MeSH
- receptory progesteronu genetika MeSH
- retrospektivní studie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Názvy látek
- ERBB2 protein, human MeSH Prohlížeč
- nádorové biomarkery MeSH
- receptor erbB-2 MeSH
- receptory pro estrogeny MeSH
- receptory progesteronu MeSH
Sinonasal carcinomas are head and neck tumours arising from the nasal cavity and paranasal sinuses characterized by unfavourable outcome, difficult treatment, diagnosis and prognosis. MicroRNAs are key molecules in the regulation of development and progression of cancer and their expression profiles could be used as prognostic biomarkers, to predict the patients' survival and response to treatment. In this study, we used quantitative real‑time PCR with TaqMan® Advanced miRNA Assays to investigate the relative expression values of selected micro- RNAs in a unique set of formalin-fixed paraffin-embedded tissue samples obtained from 46 patients with sinonasal squamous cell carcinoma. Our results showed statistically significant up-regulation of three mature microRNAs: miR-9-5p (fold change: 6.80), miR-9-3p (fold change: 3.07) and let-7d (fold change: 3.93) in sinonasal carcinoma patients. Kaplan-Meier survival analysis and logrank test identified association between higher expression of miR-9-5p and longer survival of the patients (P = 0.0264). Lower expression of let-7d was detected in the patients with impaired survival, and higher expression of miR-137 was linked to shorter survival of the patients. We also identified several correlations between expression of the studied microRNAs and recorded clinicopathological data. Higher expression of miR-137 and lower expression of let-7d correlated with local recurrence (P = 0.045 and P = 0.025); lower expression of miR-9-5p and higher expression of miR-155-5p correlated with regional recurrence (P = 0.045 and P = 0.036). Higher expression of miR-9-3p correlated with occupational risk (P = 0.031), presence of vascular invasion (P = 0.013) and perineural invasion (P = 0.031). Higher expression of miR-155-5p was present in the samples originating from maxillary sinus (P = 0.011), cN1-3 classified tumours (P = 0.009) and G2-3 classified tumours (P = 0.017). In conclusion, our study supports the hypothesis of future prospect to use expression of miRNAs as prognostic biomarkers of squamous cell sinonasal carcinoma. In particular, miR-9-5p and miR-9-3p seem to be important members of the sinonasal cancer pathogenesis.
- MeSH
- Kaplanův-Meierův odhad MeSH
- lidé středního věku MeSH
- lidé MeSH
- mikro RNA genetika metabolismus MeSH
- nádorové biomarkery genetika metabolismus MeSH
- nádory sinu maxillaris genetika patologie MeSH
- prognóza MeSH
- regresní analýza MeSH
- regulace genové exprese u nádorů * MeSH
- spinocelulární karcinom genetika patologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- mikro RNA MeSH
- nádorové biomarkery MeSH
INTRODUCTION: Analysis and comparison of short-term results of laparoscopic liver resections (LLR) and open liver resections (OLR) for colorectal cancer liver metastases (CRCLM). METHODS: Retrospective analysis of patients operated for CRCLM in the time period from May 2007 to May 2019 (12 years) at the department of surgery, University Hospital Hradec Králové and University Hospital Královské Vinohrady. RESULTS: 206 liver resections were performed; 167 (81.1%) OLR and 39 (18.9%) LLR procedures. Conversion to open surgery was necessary in 6 cases (15.4%). LLR was associated with a longer operation time (194±107 min) vs (129±58 min) for OLR. The ICU stay, 3.5±4.3 days for OLR and 4.1±8.1 days for LLR, and the hospital stay, 11.9±8.3 days (OLR) vs 12.1±11.3 days (LLR), were comparable. Perioperative blood loss was lower in the LLR group, 189±166 ml vs 360±410 ml. Total transfusion rate was similar, 10.8% (OLR) vs 12.8% (LLR). Oncologic radicality was also comparable in both groups; negative resection margin was achieved in 78% (OLR) and 80% (LLR). Postoperative morbidity and mortality was comparable in both groups; morbidity was 33% (OLR) vs 31% (LLR), while mortality was 1.8% (OLR) vs 2.6% (LLR). CONCLUSION: LLR for CRCLM provided comparable short-term results compared to OLR in our group of patients even in the learning curve period. However, it should be noted that the study group is a highly selected group of patients.
- Klíčová slova
- colorectal cancer, liver, liver resection, metastases,
- MeSH
- délka pobytu MeSH
- hepatektomie * metody MeSH
- kolorektální nádory * patologie MeSH
- laparoskopie * MeSH
- lidé MeSH
- nádory jater * sekundární chirurgie MeSH
- retrospektivní studie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
The incidence of adenocarcinoma of oesophagus or gastro-oesophageal junction is increasing in Europe and other regions of the Western world. Research of possible causes has shifted to the molecular level. This study evaluated human papillomavirus (HPV) using real-time PCR and mutational status of selected genes using the multiparallel sequencing method (NGS) in DNA extracted from paraffin-embedded tumour tissue of 56 patients with oesophageal or gastro-oesophageal junction adenocarcinoma. The genetic material was in sufficient quality for the analysis in 37 cases (66 %). No HPV-positive sample was found. NGS revealed higher frequency of mutations in TP53, ARID1A, PIK3CA, SMAD4, ERBB2, MSH6, BRCA2, and RET genes. Association between gene mutations and histological grade, subtype according to Lauren, or primary tumour site was not statistically significant. In conclusion, the study did not confirm any HPV-positive sample of oesophageal and gastro-oesophageal junction adenocarcinoma. The study confirmed the usefulness of NGS analysis of paraffin-embedded tissue of these tumours, and it could be used in clinical studies to evaluate the prognostic and/or predictive value of the tested mutations. The association between gene mutations and histological features should be tested in larger patient cohorts.
- MeSH
- adenokarcinom genetika virologie MeSH
- dospělí MeSH
- frekvence genu genetika MeSH
- gastroezofageální junkce patologie virologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mutace genetika MeSH
- mutační analýza DNA * MeSH
- nádory jícnu genetika virologie MeSH
- Papillomaviridae genetika MeSH
- senioři MeSH
- vysoce účinné nukleotidové sekvenování * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Epigenetic changes are considered to be a frequent event during tumour development. Hypermethylation of promoter CpG islands represents an alternative mechanism for inactivation of tumour suppressor genes, DNA repair genes, cell cycle regulators and transcription factors. The aim of this study was to investigate promoter methylation of specific genes in samples of sinonasal carcinoma by comparison with normal sinonasal tissue. To search for epigenetic events we used methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) to compare the methylation status of 64 tissue samples of sinonasal carcinomas with 19 control samples. We also compared the human papilloma virus (HPV) status with DNA methylation. Using a 20% cut-off for methylation, we observed significantly higher methylation in RASSF1, CDH13, ESR1 and TP73 genes in the sinonasal cancer group compared with the control group. HPV positivity was found in 15/64 (23.4 %) of all samples in the carcinoma group and in no sample in the control group. No correlation was found between DNA methylation and HPV status. In conclusion, our study showed that there are significant differences in promoter methylation in the RASSF1, ESR 1, TP73 and CDH13 genes between sinonasal carcinoma and normal sinonasal tissue, suggesting the importance of epigenetic changes in these genes in carcinogenesis of the sinonasal area. These findings could be used as prognostic factors and may have implications for future individualised therapies based on epigenetic changes.
- MeSH
- aktivace enzymů MeSH
- dlaždicobuněčné karcinomy hlavy a krku MeSH
- DNA-(cytosin-5-)methyltransferasa genetika metabolismus MeSH
- DNA-(cytosin-5)-methyltransferasa 1 MeSH
- epigenomika MeSH
- kadheriny genetika metabolismus MeSH
- lidé MeSH
- metylace DNA * MeSH
- nádory hlavy a krku diagnóza genetika patofyziologie virologie MeSH
- Papillomaviridae izolace a purifikace MeSH
- prognóza MeSH
- promotorové oblasti (genetika) genetika MeSH
- spinocelulární karcinom diagnóza genetika patofyziologie virologie MeSH
- tumor supresorové geny * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- DNA-(cytosin-5-)methyltransferasa MeSH
- DNA-(cytosin-5)-methyltransferasa 1 MeSH
- H-cadherin MeSH Prohlížeč
- kadheriny MeSH
BACKGROUND: The aim of this study was to determine the percentage of discordance between clinical (c) and pathological (p) TNM classifications in cases of oropharyngeal carcinoma and whether it influences recurrence rate and prognosis of primary disease. MATERIALS AND METHODS: Fifty-one patients with oropharyngeal carcinoma who underwent primary surgical treatment were included in this retrospective study. Clinical TNM was determined on the basis of clinical examinations and imaging (US, CT, or MRI), and pathological TNM was determined by a histopathologist (analysis of the primary tumor and neck lymph nodes). Concordance and discordance were statistically evaluated. As potential prognostic factors, we statistically analyzed tumor recurrence, specific and nonspecific patient survival, patient age, extent of primary tumor, lymph node positivity, number of removed lymph nodes, and positive tumor margins. RESULTS: Discordance in the TNM classification was found in 27 cases. Disease-free survival was shorter in patients with discordance in T, and this was statistically significant (p = 0.034). Six patients died due to primary disease (11.8%). Disease-specific survival was at the limit of statistical significance (p = 0.069). CONCLUSIONS: Discordance between clinical and pathological TNM classifications was 52.9% patients with oropharyngeal carcinoma. Discordance in T is a potential prognostic factor. Improvement in cancer treatment to some extent relies on preoperative staging and should influence the decision about whether or not to administer adjuvant oncological treatment.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru MeSH
- nádory orofaryngu mortalita patologie MeSH
- přežití po terapii bez příznaků nemoci MeSH
- prognóza MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- staging nádorů 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
- anglický abstrakt MeSH
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: Patients with head and neck cancer are predominantnly at the risk for malnutrition. Monitoring of nutritional status and pre-treatment variables can favorably observe many prognostic indicators for overall survival in head and neck cancer before and during oncological treatment up to three years in head and neck cancer pacients. MATERIALS AND METHODS: In 726 patients diagnosed head and neck cancer patients with curative intent, were collected data according to the monitoring scheme of observation. As a clinical important of uninteded weight loss was defined weight loss 10% in input (T0). Differences in groups were analysed by Coxs regression with adjustments for important demografic and tumor-related data. RESULTS: The acceptance of the percutaneous endoscopic gastrostomy was a key factor for less complications and to improve tolerance of anticancer treatment. Men-smokers have the highest risk of cardiovascular mortality. Men-stop-smokers have the most significant life extension of 11 to 22 months; p < 0.007. Men-non-smokers have a life extension of 15 to 23 months (p < 0.005) and having its lowest cardiovascular mortality (11%). Women tolerate cancer better, have minor subjective complaints and a lower number of complications but significantly higher consumption of antidepressants (p < 0.003). While men have higher analgesic consumption (p < 0.001). Weight loss > 10% significantly correlates with the clinical manifestations of malnutrition and is associated with an increase in complications and mortality dependent cancer (p < 0.008). CONCLUSION: Consistent assessment of nutritional status with early intervention is considered as an essential part of comprehensive anticancer treatment. An independent risk factor for cancer-dependent mortality is considered weight loss of > 5% with a BMI < 21 at time T0 or weight loss > 10% weight T0 in BMI 21- 29 and continuing weight loss to T12 and also BMI 30. The highest-risk profile has a male sex-smoker, age > 63, hypopharyngeal carcinoma, stage III- IV, weight loss of > 10% and non-acceptance of percutaneous endoscopic gastrostomy. Another long-term observation of monitored nutritional status with intervention, clinical status and quality of life are needed.
BACKGROUND: Malnutrition in head and neck cancer (HNC) patients decreases survival, quality of life (QOL) and oncological outcomes. The aim of the prospective three-year study was to compare QOL, clinical symptoms and variables (complications, survival and mortality rates in HNC patients). PATIENTS AND METHODS: A total of 726 patients aged 55 to 72 years with treatable HNC were included from January 2004 to December 2009; these patients were randomized to either group with PEG and enteral nutrition and nonPEG group with nutritional counselling according to nutritional care. We used EORTC questionnaires QOL C-30 and Head and neck module (HN-35) for measuring of QOL. The following variables due to expectable influence on QOL (demographic data, oncological data, nutritional screening, Clinical symptom score, Karnofsky performance status score, Charlson comorbidity index) were included. Monitoring was done five times in three years. RESULTS: In the first six months, we found decrease of weight and body mass index (BMI). After this critical time point and finish of oncological treatment, a marked difference in the development of patients treated with PEG. Negative factors influencing patients survival, QOL, clinical status were males aged > 63 years, hypopharyngeal cancer (stage III- IV), smoking, weight loss > 10%, BMI < 21 and disallowance of PEG. CONCLUSIONS: QOL is an essential factor for cancer patients. Our study showed that nutritional intervention with early enteral nutrition may improve QOL and survival in HNC patients. The PEG group better tolerated oncological treatment, had lower incidence of complications, shorter time to re-entry of permanent increase in weight, lower rate of rehospitalization and its shorter length. We found QOL questionnaires to be very important for better understanding and communication and a key instrument for improving solution of patients difficulties during their therapy in multidisciplinary approach.
- MeSH
- enterální výživa metody MeSH
- gastrostomie metody MeSH
- index tělesné hmotnosti MeSH
- kvalita života * MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory hlavy a krku mortalita psychologie terapie MeSH
- následné studie MeSH
- nutriční stav * MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
INTRODUCTION: Deciding on the strategy in rectal cancer´s treatment requires a complex and multidisciplinary approach. The primary rectal resection is indicated in early stages, while locally advanced tumors should be pretreated by one of the modes of neoadjuvant (chemo) radiotherapy. The main goal of this study was to explore the therapeutic strategy in patients with rectal cancer in the Czech Republic. The second aim was to determine the incidence of the pathological complete response after neoadjuvant therapy. METHODS: This is a retrospective multicenter clinical study, which includes data from all patients with rectal cancer who were treated at participating centers in the period from 01/01/2011 to 31/12/2012. The required data has been passed into the online registry PATOD C20.Three issues have been set up: 1. Characteristics of the center and cooperation with the oncological department; 2. Characteristics of the treatment of patients with rectal cancer; and 3. Detailed analysis of the group of patients with complete pathological response. The analysis was performed with regard to the nature of individual departments, i.e. departments of surgery in university hospitals with complex oncological centres, departments of surgery within complex oncologic centers, and departments of surgery outside complex oncologic centers. RESULTS: In total, 21 departments of surgery in the Czech Republic provided data about 1860 patients with rectal cancer for the study. The treatment strategy for rectal cancer was determined at multidisciplinary seminars at 19 centers (90.5%). Statistically significant differences between the centers were found in the indication for neoadjuvant treatment (p<0.001), rectal resection with anastomosis (p=0.048), and resection without anastomosis (p=0.022). Complete pathological response was found in 61 (8.7%) patients. Positivity of mesorectal lymph nodes (ypN+) was found in the case of ypT0 stage in 7 (9.7%) patients. CONCLUSION: PATOD study showed that therapy of rectal cancer is highly heterogeneous in the Czech Republic. Despite the best conditions provided, university hospitals and large departments within complex oncologic centers do not fully utilize this benefit.
- MeSH
- anastomóza chirurgická statistika a číselné údaje MeSH
- chirurgické stomie statistika a číselné údaje MeSH
- lidé MeSH
- lymfatické metastázy MeSH
- nádory rekta patologie terapie MeSH
- neoadjuvantní terapie * MeSH
- retrospektivní studie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Česká republika MeSH
