Objectives: About 20% of endometrial cancer (EC) patients have advanced disease (FIGO III & IV) at the moment of diagnosis. An attempt to evaluate the prognostic value of biochemical markers of inflammation and classic endometrial cancer prognostic factors in the group of advanced EC (aEC) patients has been made in this study. Material and methods: Records of 266 patients treated in the Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow Branch between the year 2006 and 2018 were included in the study. Follow-up ranged from 1 to 138 months. Progression free survival (PFS) and overall survival (OS) have been set as endpoints. Tests such as: chi-squared, Fisher, log-rank, Mann-Whitney, Kruskal-Wallis and Cox proportional hazard ratio were used in the statistical analyses. Results: In the analysed group high total platelet count (PLT) before operative treatment and high levels of white blood cells (WBC), PLT, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) before adjuvant therapy (AT) have been significantly associated with shorter PFS and OS. After setting the cutoff values of NLR and PLR a statistically significant correlation between those parameters and PFS as well as OS has been shown. Multivariate analysis has indicated that NLR is an independent prognostic factor of the course of aEC. Conclusions: NLR and PLR correlate significantly with OS and PFS in aEC. NLR is an independent prognostic factor in this group. It is possible to distinguish 3 risk groups, among aEC patients, based on NRL and PLR.
The paper presents a case of a uterus-like mass (ULM), a rare type of tumour of the female reproductive system, which did not present any clinical symptoms described in other cases of ULMs. There are 35 reported cases of this type of tumour. It is defined as a lesion composed of smooth muscle-like stromal cells with a central cavity lined with endometrial type epithelium. There are three theories on the pathogenesis of ULMs which we discuss along with clinical presentation, diagnostic features, treatment options and potential oncological implications of this type of tumour, based on our case, and the review of the literature.
Results:The 5-year overall survival rate was 42.9% for BRCA1-OC patients and 34.3% for SOC patients (p = 0.354). Mean time to progression was 22.7 and 14.5 months for BRCA1-OC and SOC group, respectively (p = 0.05). Complete response to primary surgery and first line chemotherapy was obtained in 42.5% and 37.9% of cases, respectively; the difference, however, did not reach the statistical significance. Conclusions:Results of combined treatment in the group of BRCA1-related OC patients seem to be better than in the group of sporadic ovarian cancer patients.
Quality of life studies in medicine, particularly in oncology, have become a basic tool used to assess patient’s performance in different types of cancer and different modalities of treatment. The aim of this study was a subjective evaluation of the quality of life in cervical cancer patients treated with radiotherapy. The study has a longitudinal character and comprises four stages: before treatment, at the end of treatment, 5 months and 5 years after treatment. Standardized questionnaires such as EORTC QoL C30, HADS (European Organisation for Research and Treatment of Cancer Quality of life C30 Hospital Anxiety and Depression Scale) and the authors demographic–clinical assessment survey were the study tools. Physical functioning was assessed as the highest before treatment and depreciated to the lowest value 5 years after treatment. Emotional functioning was the lowest before treatment and then decreased again in the fourth stage of the assessment. Global quality of life was the lowest in the fourth stage of the study. Memory and concentration were fairly good at every stage of the study, with the highest score at the end of the treatment. At stages 3 and 4, the respondent’s social functioning was the best, followed by the ability to fulfil their social role. General health and quality of life were assessed by the respondents on a level slightly above average, though five years after treatment the score was slightly below average.
Celem prezentowanej pracy było porównanie metod oceny grubości naciekania mięśniówki trzonu macicy u pacjentek z rakiem trzonu macicy. Przeanalizowano zgodność wyników rezonansu magnetycznego miednicy i śródoperacyjnej oceny naciekania miometrium dokonanej przez patologa z ostatecznym wynikiem badania histopatologicznego. Materiał i metody: Analiza materiału klinicznego obejmuje chore na raka endometrium leczone pierwotnie chirurgicznie w krakowskim oddziale Centrum Onkologii w latach 2012-2014. Przedoperacyjnie wykonywano rezonans magnetyczny miednicy z oceną naciekania miometrium. W trakcie zabiegu przekazywano wyciętą macicę do badania doraźnego. Przeanalizowano zgodność wyników oceny naciekania miometrium w rezonansie magnetycznym miednicy i śródoperacyjnej oceny patologa z ostatecznym wynikiem histopatologicznym. W analizie statystycznej wykorzystano współczynnik kappa Cohena. Wyniki: Uwzględniono historie choroby 128 pacjentek z rakiem endometrium. Czułość wykonanych przedoperacyjnie badań rezonansu magnetycznego wyniosła 81%, a czułość badania śródoperacyjnego -84,11%. Współczynnik kappa Cohena to odpowiednio 0,61% i 0,655%, co oznacza dużą zgodność. Obie metody są bardziej dokładne w przewidywaniu nacieku <1/2 grubości miometrium. Ocena naciekania miometrium podczas badania doraźnego okazała się metodą o wyższej czułości, ale niższej swoistości niż rezonans magnetyczny. Wnioski: Dokładność oceny naciekania miometrium w badaniu rezonansu magnetycznego i śródoperacyjnej ocenie patologa jest zbliżona. Użyteczność kliniczna obu metod wczesnej oceny naciekania mięśniówki trzonu macicy przemawia na korzyść metody tańszej i szybszej, czyli badania śródoperacyjnego.
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