Background and objectives: Cancer incidence is growing with younger patients diagnosed with this disease every year. Improved cancer diagnostics and treatment lead to better survival of cancer patients. However, after aggressive chemo- or radiotherapy, cancer survivors suffer from various degrees of subfertility or infertility. Several fertility preservation technologies have been developed for young cancer patients: cryopreservation of germ cells, embryos, or reproductive tissues. The best results have been shown by cryopreservation of sperm and embryos. Yet the success of using cryopreserved oocytes or reproductive tissues (ovarian and testicular) is still insufficient. Therefore, this study was designed to assess the vitality, viability, general quality, and safety of frozen–thawed human ovarian tissue for retransplantation using modern molecular tests. Materials and Methods: The new miRNA array test was used to evaluate miRNA expression in thawed ovarian tissue in combination with standard xenotransplantation and pathological examination of microslides. Results: Our results demonstrated that slow freezing is an efficient way (80%) to cryopreserve ovarian tissue with no structural damage afterwards. We have shown that xenotransplantation into immunodeficient mice, histology, and immunohistochemistry could be potentially replaced by more recent molecular methods. Conclusions: The latter method has shown that altered expression of miRNAs might be used as identifiers of normal/damaged tissue after further analysis. Newer, safer, and more specific approaches need to be developed in order to eliminate the risk of disease reoccurrence.

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Background. The aim of this study was to evaluate the feasibility of laparoscopic ovarian transposition prior to radiation therapy on the preservation of hormonal function in the treatment of pelvic cancer. Materials and methods. A chart review of premenopausal women diag nosed with pelvic cancer, who underwent laparoscopic ovarian transposition to paracolic gutters, then received preoperative radiotherapy at the Center of Oncosurgery, Oncology Institute of Vilnius, from January 2010 to July 2013. Results. A total of 14 patients underwent laparoscopic ovarian transposition. Patients were divided into two groups by localisation of can cer: 2 (14.29%) patients diagnosed with rectal cancer and 12 (85.71%) with cervical cancer. Patients' age was from 24 to 42 years with a mean age of 33.71 (SD ± 5.22) years. The average age of the patients in the first group was 26 (SD ± 2.83) years. In the second group women, aged 29 and 42 years with a mean age of 35 (SD ± 4.35) years, were analyzed. Rectal cancer of stage III was diagnosed in both women of the first group. Tumor stage distribution in the second group, respectively: stage I-2 cases (16.67%), stage II-3 cases (25%), stage III-7 cases (58.33%). Seven (58.33%) patients of the second group underwent complete endoscopic staging. In these groups of 14 patients there were 2 (14.3%) complications (injury of the inferior vena cava and postoperative abnormal vaginal bleeding). No postoperative exitus occurred. The mean duration of the operation was 2 hours 26 minutes ± 55 minutes (60-245 minutes), respectively, 2 hours 40 minutes ± 49 minutes (95-245 minutes) when laparoscopic staging and ovarian transposition was performed and 2 hours 12 minutes ± 1 hour 1 minute (60-245 minutes) when only ovarian transposition was performed. The hospitalization period ranged from 5 to 52 days (average 12 days). Conclusions. Laparoscopic ovarian transposition is a relatively safe and effective procedure for preserving ovarian function. This procedure should be considered in all reproductive age female patients who need to undergo pelvic irradiation as part of pelvic cancer treatment.

Background. Radical vulvectomy accompanied by bilateral inguinal lymph nodes dissection (ILND) has been performed to treat cancer for a long time but, due to various short and long term postoperative complications, alternatives have been found. The objective was to compare the clinical results of vulvar cancer treatment in early stages based on sentinel lymph node(s) biopsy (SLNB) and classic surgical treatment and to evaluate the radiological safety of SLNB.Materials and methods. Retrospective study involved 26 patients with clinical stage I-II of vulvar carcinoma treated in the Institute of Oncology, Vilnius University, between 2011 and 2013. The women were divided into two groups: 14 patients underwent a reduced surgical treatment based on the SLNB method, and 12 patients underwent a classic surgical treatment.Results. After SLNB and intraoperative histological examination, 9 patients in the first group underwent radical tumour excision, while the others underwent ipsilateral or bilateral ILND. Final histological examination detected metastases in lymph nodes in 4 patients from the first group and 3 patients from the second group. The average surgery duration on the patients undergoing only SLNB and radical tumour excision was 77.2 minutes, and the classical surgery took 177.7 minutes. Average exposure levels measured in the first group reached up to 1 µSv/hour.Conclusions. Surgery treatment based on SLNB for patients with early stages of vulvar carcinoma can reduce the extent of surgical interventions. Exposure limits to the patients and staff were safe.

ĮžangaPer pastaruosius 30 metų vis daugiau jaunų moterų suserga kolorektaliniu vėžiu. Tokioms pacientėms, nustačius didesnę nei pirmą tiesiosios žarnos vėžio stadiją, dažniausiai pasirenkamas kompleksinis gydymo metodas: derinamas chemospindulinis ir chirurginis gydymas. Todėl dauguma jauno amžiaus moterų po vėžio gydymo susiduria su nevaisingumo ir jatrogeninės ankstyvos menopauzės problema. Pacientės nepakankamai informuojamos apie neigiamą chemoterapijos ir radioterapijos poveikį reprodukcinei sistemai bei galimybes išsaugoti pakankamą reprodukcinės sistemos veiklą ir normalizuoti kiaušidžių funkciją po gydymo. Aprašome klinikinį atvejį norėdami supažindinti Lietuvos gydytojų visuomenę ir pacientus su vaisingumo ir kiaušidžių funkcijos išsaugojimo galimybe gydant tiesiosios žarnos vėžį -atliekant kiaušidžių transpoziciją bei kiauši-džių audinio krioprezervaciją. Klinikinis atvejis 27 metų pacientei 2015 m. spalio 12 d. buvo diagnozuotas tiesiosios žarnos vėžys. Endoskopiniais ir radiologiniais tyrimais buvo nustatyta III klinikinė stadija. Daugiadalykio aptarimo metu buvo nutarta gydymą pradėti nuo priešoperacinės chemospindulinės terapijos, prieš tai atlikus laterokolinę kiaušidžių transpoziciją ir kiaušidžių audinio krioprezervaciją, kuri buvo atlikta 2015 m. lapkričio 25 d. Paskui pacientei buvo paskirtas priešoperacinis chemospindulinis gydymas. Jį baigus, konstatuotas patenkinamas terapinis efektas ir 2016 m. vasario 25 d. buvo atlikta laparoskopinė tiesiosios žarnos rezekcija. Navikas pašalintas radikaliai. Šiuo metu tęsiama adjuvantinė chemoterapija. Išvados Naudojant kiaušidžių transpozicijos ir kiaušidės audinio krioprezervacijos metodus pacientei buvo suteikta galimybė išvengti gydymo sukeltos (jatrogeninės) ankstyvos menopauzės bei tikėtinai išsaugoti vaisingumo funkciją. Reikšminiai žodžiai: kiaušidžių audinio krioprezervacija, kiaušidžių transpozicija, kolorektalinis vėžys Klinikinė praktika 91Jatrogeninės menopauzės prevencijos ir vaisingumo išsaugojimo būdai moterims, sergančioms kolorektaliniu vėžiu IntroductionIn the last 30 years it was identified an increased incidence of colorectal cancer in young woman. Those women who develop rectal cancer may necessitate use of chemotherapy and radiation therapy in combination. For this reason many young women face infertility and iatrogenic premature ovarian failure problems. They are not regularly informed about the risks of chemoradiotherapy on their reproductive system and the possibilities of fertility preservation and restoring ovarian function. So our aim is to introduce the Lithuanian society and our patients with fertility preservation possibility while treating rectal cancer, using ovarian transposition and ovarian tissue cryopreservation. Case report 27-year-old woman was diagnosed with rectal cancer in 2015.10.12. III clinical stage of rectal cancer was found using endoscopic and radiological tests. Multidisciplinary team discussed this case and decided to begin the treatment with neoadjuvant chemotherapy and radiotherapy after laparoscopic ...