Difference in the Incidence of Early Complications of Teletherapy of Cervical Cancer between 2D and 3D Planned Patients

Liječenje raka vrata maternice ovisi o mnogim faktorima pa je tako jedna od metoda izbora, osim kirurškog liječenja, i radioterapijsko liječenje. Radioterapija je vještina uporabe ionizirajućeg zračenja u liječenju zloćudnih te nekih dobroćudnih bolesti, a cilj joj je s pomoću zračenja uništiti tumorske stanice te pri tome sačuvati okolno zdravo tkivo, u čemu veliki značaj ima 2D radioterapija, a u današnje vrijeme i 3D radioterapija. Cilj istraživanja bio je utvrditi razliku u pojavnosti ranih komplikacija odnosno reakcija na perkutano zračenje između pacijentica čije je liječenje planirano 2D tehnikom i pacijentica čije je liječenje planirano 3D tehnikom. U istraživanju smo usporedili rezultate liječenja 40 pacijentica koje su bolovale od raka vrata maternice (stadij II.B ili III.B). Kod 20 od njih liječenje je planirano 2D tehnikom, a ostalih 20 3D tehnikom. Istraživanje je provedeno kao sondaža podataka kako bi se utvrdilo postoje li razlike u pojavnosti ranih komplikacija teleterapije raka vrata maternice između pacijentica čije je liječenje planirano 2D i 3D tehnikom, što bi ukazalo na potrebu istraživanja na većem broju pacijentica. Iako se očekivala znatna razlika između navedenih načina planiranja, kako u odgovoru na liječenje tako i u učestalosti komplikacija, istraživanjem smo prikazali da se to ipak nije dogodilo.Treatment of cervical cancer depends on many factors and one of the treatment methods, besides surgical treatment, is radiotherapy. Radiotherapy is the use of ionizing radiation in the treatment of malignant and some benign diseases, aimed at destroying tumour cells with radiation, thus preserving surrounding healthy tissue. 2D radiotherapy and nowadays 3D radiotherapy are significant in this regard. The aim of this research was to determine the difference in the incidence of early complications (reactions) of teletherapy between 2D planned patients and 3D planned patients. In this research, we compared the treatment results of 40 patients that had cervical cancer (stage IIB or IIIB) of which 20 patients were planned with 2D therapy and the remaining 20 were planned with 3D therapy. The research was conducted as a survey in order to determine if there is a difference in the incidence of early complications of teletherapy of cervical cancer between 2D and 3D planned patients, which would suggest the need for research on a larger number of patients. Although a significant difference between the aforementioned planning methods was expected, both in response to treatment and in the incidence of complications, this research showed that this did not happen

COMPARISON OF CYTOLOGIC FINDINGS OF NIPPLE DISCHARGE WITH GALACTOGRAPHIC FINDINGS

Uvod. Jedan od simptoma raka dojke je i iscjedak iz dojki. Citološki nalaz hiperplastičnih stanica bez anizocitoze te s anizocitozom, eritrociti i maligne stanice u iscjetku indikacija su za daljnju obradu – galaktografijom. Galaktografija je kontrastna pretraga tijekom koje se kanalić iz kojega je dobiven iscjedak ispuni kontrastom i slika. Prema nalazu galaktografije indicira se operativni zahvat. Cilj rada. U radu se željelo pokazati kolika je podudarnost između boje iscjetka, citološkog nalaza te galaktografskog nalaza. Materijal i metode. U razdoblju od 01. 01. 1993.do 31. 12. 2007. godine, u Ambulanti za bolesti dojke Klinike za ženske bolesti i porode KBC-a Zagreb učinjena je nakon citološke obrade iscjetka 91 galaktografija. Citologija iscjetka prema kojoj je indicirana galaktografija bio je nalaz hiperplastičnih stanica, bez ili s anizocitozom ili eritrociti, odnosno kombinacija oba nalaza. Tijekom očitavanja galaktografije promatrana je širina i pravilnost grananja kanalića, uz analizu stijenke i defekata punjenja unutar kanalića. Ukoliko se našao defekt punjenja, nepravilna proširenja kanalića ili oboje, bolesnica je bila upućena na biopsiju. Rezultati. Prema boji iscjedak je bio podijeljen u 5 kategorija: serozni i mliječni iscjedak nađen je u po 10 bolesnica (22%), njih 29 (31,8%) imalo je obojeni iscjedak (zelenkast, smeđi, žućkast), u 2 (2,2%) bolesnice bio je gnojni iscjedak dok je najveći broj bolesnica, njih 40 (44%), imalo krvavi iscjedak. Citološkom analizom iscjetka dobiveni su sljedeći rezultati: samo eritrociti nađeni su u 18 (19,8%) bolesnica, 19 (20,8%) bolesnica imalo je u iscjetku papilarne nakupine hiperplastičnih duktalnih stanica, u 7 (7,8%) bolesnica nađene su papilarne nakupine duktalnih stanica i anizocitoza, a u 47 (51,6%) bolesnica uz eritrocite su nađene i papilarne nakupine hiperplastičnih stanica. Razlikovale su se tri kategorije galaktografskih nalaza: uredan nalaz (19 bolesnica, 20,8%), hiperplazija – proširenja kanalića uz neravnosti stjenke (56 bolesnica, 61,6%), te suspektan nalaz – defekti punjenja kanalića, izrasline (16 bolesnica, 17,6%). Bolesnice sa suspektnim nalazom, njih 16, bile su upućene na biopsiju. Patohistološki nalaz u operiranih bolesnica bio je: u četiri (25%) papilom, 10 (62,5%) bolesnica imalo je duktalnu hiperplaziju, a u dvije (12,5%) nađen je karcinom. Prosječna dob bolesnica u kojih je bila indicirana galaktografija je bila 48 godina, dok je u bolesnica s karcinomom bila 63 godine. Zaključak. Naši rezultati upućuju na dobru korelaciju citološkog i galaktografskog nalaza. Hiperplazija duktalnih stanica u citološkom razmazu potvrđena je galaktografski u 62,5% ispitanica. Citološki, u svih 16 bolesnica u kojih su nađeni eritrociti uz hiperplaziju, što je upućivalo na intraduktalni proces, nalaz je ujedno dokazan i galaktografski. Sve ove ispitanice imale su krvavi iscjedak već pri uzimanju uzorka.Introduction. Nipple discharge is one of the symptoms of the breast cancer. Hemorrhagic discharge are always arousing suspicion for intraductal process (papilloma, carcinoma). The cytologic finding of red blood cells, atypical ductal cells and malignant cells in the discharge are indication for further analysis – including galactography. Objective. The aim was to show connection between colours of nipple discharge, cytologic findings and galactographic findings. Materials and methods. During the period January 1, 1993 and December 31, 2007 91 galactography were performed in Outpatient Clinic for breast disease, Department Gynaecology and Obstetrics, University Hospital Zagreb. Galactography was performed after cytological analysis of the discharge. Indication for galactography was the presence of red blood cells and atypical duct cells or combination of both. During the reading we observed the width and irregularity of ducts branching together with analysis of the wall and defects of filling (charging) within the ducts. In case of some irregularities the patients were referred to the biopsy. Results. Discharge was divided into 5 categories according to the colour: colourless or serous discharge was found in ten patients (11%), the same number had milky discharge, the largest number, 29 (31.8%) had coloured discharge (greenish, brownish, yellowish) and in 2 (2.2%) purulent discharge was found while in 40 (44%) patients the discharge was bloody. Cytological analysis gave the following results: red blood cells alone were found in 18 (19.8%) of the patients, papillary hyperplastic duct cells were found in 19 (20.8%) of the discharges and tight papillary clusters with anisocytosis were found in 7 (7.8%) patients and in 47 (51.6%) patients together with red blood cells, tight papillary cluster cell groups were found. Galactographical findings were divided into three categories: normal (19 patients – 20.8%), hyperplasia – proliferation of ducts with roughness of the wall (56 patients – 61.6%), and suspicious – defects in filling of the duct, tumours (16 patients – 17.6%). Patients with suspicious findings, 16 of them, were referred to surgery. Pathohisiological finding was papilloma in 4 (25%) of the surgical specimens, 10 (62.5%) had duct hyperplasia and carcinoma was found in 2 (12.5%) patients. Conclusion. Our results show good correlation between cytological and galactographical finding. It has been noticed that the presence of hyperplasia of duct cells in cytological smear is connected with hyperplasic changes of the ducts in 62.5% of the patients. In all 16 patients where red blood cells together with duct cells hyperplasia were found, cytological finding indicated to intraductal process, the finding was at the same time proven galactographgically as well

COMPARISON OF CYTOLOGIC FINDINGS OF NIPPLE DISCHARGE WITH GALACTOGRAPHIC FINDINGS

Uvod. Jedan od simptoma raka dojke je i iscjedak iz dojki. Citološki nalaz hiperplastičnih stanica bez anizocitoze te s anizocitozom, eritrociti i maligne stanice u iscjetku indikacija su za daljnju obradu – galaktografijom. Galaktografija je kontrastna pretraga tijekom koje se kanalić iz kojega je dobiven iscjedak ispuni kontrastom i slika. Prema nalazu galaktografije indicira se operativni zahvat. Cilj rada. U radu se željelo pokazati kolika je podudarnost između boje iscjetka, citološkog nalaza te galaktografskog nalaza. Materijal i metode. U razdoblju od 01. 01. 1993.do 31. 12. 2007. godine, u Ambulanti za bolesti dojke Klinike za ženske bolesti i porode KBC-a Zagreb učinjena je nakon citološke obrade iscjetka 91 galaktografija. Citologija iscjetka prema kojoj je indicirana galaktografija bio je nalaz hiperplastičnih stanica, bez ili s anizocitozom ili eritrociti, odnosno kombinacija oba nalaza. Tijekom očitavanja galaktografije promatrana je širina i pravilnost grananja kanalića, uz analizu stijenke i defekata punjenja unutar kanalića. Ukoliko se našao defekt punjenja, nepravilna proširenja kanalića ili oboje, bolesnica je bila upućena na biopsiju. Rezultati. Prema boji iscjedak je bio podijeljen u 5 kategorija: serozni i mliječni iscjedak nađen je u po 10 bolesnica (22%), njih 29 (31,8%) imalo je obojeni iscjedak (zelenkast, smeđi, žućkast), u 2 (2,2%) bolesnice bio je gnojni iscjedak dok je najveći broj bolesnica, njih 40 (44%), imalo krvavi iscjedak. Citološkom analizom iscjetka dobiveni su sljedeći rezultati: samo eritrociti nađeni su u 18 (19,8%) bolesnica, 19 (20,8%) bolesnica imalo je u iscjetku papilarne nakupine hiperplastičnih duktalnih stanica, u 7 (7,8%) bolesnica nađene su papilarne nakupine duktalnih stanica i anizocitoza, a u 47 (51,6%) bolesnica uz eritrocite su nađene i papilarne nakupine hiperplastičnih stanica. Razlikovale su se tri kategorije galaktografskih nalaza: uredan nalaz (19 bolesnica, 20,8%), hiperplazija – proširenja kanalića uz neravnosti stjenke (56 bolesnica, 61,6%), te suspektan nalaz – defekti punjenja kanalića, izrasline (16 bolesnica, 17,6%). Bolesnice sa suspektnim nalazom, njih 16, bile su upućene na biopsiju. Patohistološki nalaz u operiranih bolesnica bio je: u četiri (25%) papilom, 10 (62,5%) bolesnica imalo je duktalnu hiperplaziju, a u dvije (12,5%) nađen je karcinom. Prosječna dob bolesnica u kojih je bila indicirana galaktografija je bila 48 godina, dok je u bolesnica s karcinomom bila 63 godine. Zaključak. Naši rezultati upućuju na dobru korelaciju citološkog i galaktografskog nalaza. Hiperplazija duktalnih stanica u citološkom razmazu potvrđena je galaktografski u 62,5% ispitanica. Citološki, u svih 16 bolesnica u kojih su nađeni eritrociti uz hiperplaziju, što je upućivalo na intraduktalni proces, nalaz je ujedno dokazan i galaktografski. Sve ove ispitanice imale su krvavi iscjedak već pri uzimanju uzorka.Introduction. Nipple discharge is one of the symptoms of the breast cancer. Hemorrhagic discharge are always arousing suspicion for intraductal process (papilloma, carcinoma). The cytologic finding of red blood cells, atypical ductal cells and malignant cells in the discharge are indication for further analysis – including galactography. Objective. The aim was to show connection between colours of nipple discharge, cytologic findings and galactographic findings. Materials and methods. During the period January 1, 1993 and December 31, 2007 91 galactography were performed in Outpatient Clinic for breast disease, Department Gynaecology and Obstetrics, University Hospital Zagreb. Galactography was performed after cytological analysis of the discharge. Indication for galactography was the presence of red blood cells and atypical duct cells or combination of both. During the reading we observed the width and irregularity of ducts branching together with analysis of the wall and defects of filling (charging) within the ducts. In case of some irregularities the patients were referred to the biopsy. Results. Discharge was divided into 5 categories according to the colour: colourless or serous discharge was found in ten patients (11%), the same number had milky discharge, the largest number, 29 (31.8%) had coloured discharge (greenish, brownish, yellowish) and in 2 (2.2%) purulent discharge was found while in 40 (44%) patients the discharge was bloody. Cytological analysis gave the following results: red blood cells alone were found in 18 (19.8%) of the patients, papillary hyperplastic duct cells were found in 19 (20.8%) of the discharges and tight papillary clusters with anisocytosis were found in 7 (7.8%) patients and in 47 (51.6%) patients together with red blood cells, tight papillary cluster cell groups were found. Galactographical findings were divided into three categories: normal (19 patients – 20.8%), hyperplasia – proliferation of ducts with roughness of the wall (56 patients – 61.6%), and suspicious – defects in filling of the duct, tumours (16 patients – 17.6%). Patients with suspicious findings, 16 of them, were referred to surgery. Pathohisiological finding was papilloma in 4 (25%) of the surgical specimens, 10 (62.5%) had duct hyperplasia and carcinoma was found in 2 (12.5%) patients. Conclusion. Our results show good correlation between cytological and galactographical finding. It has been noticed that the presence of hyperplasia of duct cells in cytological smear is connected with hyperplasic changes of the ducts in 62.5% of the patients. In all 16 patients where red blood cells together with duct cells hyperplasia were found, cytological finding indicated to intraductal process, the finding was at the same time proven galactographgically as well

THERAPY OF OVARIAN CANCER WITH PACLITAXEL Our Results

Cilj istraživanja. Standardna kemoterapija u bolesnica s lokalno uznapredovalim rakom jajnika stadija II do IVa je kombinacija paklitaksela s cisplatinom/karboplatinom. Više od 75% bolesnica javlja se upravo u tim stadijima bolesti. Početkom 90-tih godina prošlog stoljeća ova kombinacija lijekova koristila se u recidivima nakon incijalne kemo-terapije s cisplatinom/karboplatinom, u kombinaciji s ciklofosfamidom i/ili adriamicinom, da bi se nakon zadovoljavajućih rezultata nakon 1995. godine počela koristiti i u »prvoj« liniji liječenja. Metode. U Zavodu za ginekološku onkologiju Klinike za ženske bolesti i porode KBC-a Zagreb započeli smo primjenom paklitaksela 1994. godine. Od 1994.–1996. godine davali smo ga isključivo u slučaju recidiva da bismo 1996. godine prvi puta započeli liječenje spomenutom kombi-nacijom kao prvom linijom. Od 1994. do 2002. godine ukupno je liječeno 65 bolesnica; paklitaksel je ušao na listu lijekova Hrvatskog Zavoda za zdravstveno osiguranje (HZZO) za recidiv bolesti 1997. godine, a tek 1998. godine za prvu liniju uz posebne zamolbe HZZO-u. Svaka je bolesnica primila između 4–10 ciklusa kemoterapije te je ukupno primijenjeno preko 650 ciklusa kemoterapije. Rezultati. Tijekom primjene ni u jedne bolesnice nismo imali smrtni ishod, a samo kod dvije (3%) ozbiljnije alergijske reakcije koje su uspješno zbrinute, pa je nastavljeno s kemoterapijom. Zaključak. Na temelju našega iskustva možemo reći da je paklitaksel u kombinaciji s cisplatinom/karboplatinom vrlo učinkovit citostatik te da se naši rezultati liječenja ne razlikuju od rezultata objavljenih u svjetskoj literaturi.The aim of investigation. Standard chemotherapy in patients with locally advanced ovarian cancer stage II to stage IV is the combination of paclitaxel with cisplatin/carboplatin. More than 75% of patients are diagnosed at these stage of disease. At the begining of the 90’s of last century this combination of agents was used in recurrencies after initial chemotherapy with cisplatin/carboplatin with cyclophosphamide and/or adriamycin and has, proving to have satisfactory results, since 1995 been used in the first-line therapy. Methods. At Gynecologic Cancer Center, University Hospital Zagreb the use of paclitaxel started in 1994; from 1994 to 1996 paclitaxel was exclusively used for patients with recurrent disease. The use of paclitaxel plus cisplatin/carboplatin combination began as the first-line therapy in 1996. From 1994 to 2002 a total of 65 patients were treated with this combination. In 1997 paclitaxel was listed by the Croatian Health Insurance Agency (HZZO) as therapy for recurrent disease; in 1998 was the special request to HZZO for the first-line therapy and in 2002 separate funds were allocated for the treatment of patients with ovarian cancer stage II to IV with paclitaxel. From 1994 to 2001 paclitaxel was used in 23 patients, of which 5 in the first-line therapy and 18 after recurrencies as second-line therapy. In 2002, 42 patients were treated with paclitaxel – 32 in the first-line and 10 in the second-line therapy. Considering the fact that each patient was treated with between 4 to 10 cycles of chemoterapy, it has amounted to a total of more than 650 cycles of chemotherapy. Results. No treatment had a death outcome, only two patients (3%) experienced a serious allergic reaction but were successfully managed and chemotherapy was continued. Conclusion. Our experience confirms that paclitaxel in combination with cisplatin/carboplatin is a very effective drug and our results of chemotherapy do not differ from the results published in the world literature

CLINICAL RECOMMENDATIONS FOR DIAGNOSING, TREATMENT AND MONITORING OF PATIENTS WITH OVARIAN CANCER – CROATIAN ONCOLOGY SOCIETY AND CROATIAN SOCIETY FOR GYNECOLOGY AND OBSTETRICS AS CROATIAN MEDICAL ASSOCIATION UNITS AND CROATIAN SOCIETY OF GYNECOLOGICAL ONCOLOGY

Rak jajnika i jajovoda po učestalosti je peta zloćudna bolest žena u Hrvatskoj. Histološki je rak jajnika najčešće epitelnog podrijetla, i to seroznog podtipa. Rjeđi su različiti neepitelni malignomi jajnika, a posebnu skupinu čine epitelni karcinomi niskoga zloćudnog potencijala karakterizirani neinvazivnošću, klinički indolentnim tijekom i dobrom prognozom te primarni rak potrbušnice i rak jajovoda. Klinički su ovi zloćudni tumori u ranim stadijima razvoja uglavnom asimptomatski, zbog čega se najčešće dijagnosticiraju u kasnijim stadijima bolesti. Dijagnoza se potvrđuje patohistološkim nalazom, a iznimno citološkim nalazom nakon provedene dijagnostičke obrade. O liječenju odlučuje multidisciplinarni tim uzimajući u obzir dob, opće stanje i komorbiditete bolesnice, kao i obilježja samog tumora uključujući stadij bolesti, histološki tip i gradus tumora. Principi liječenja primarnog raka potrbušnice i jajovoda temelje se na principima liječenja epitelnog raka jajnika koji obuhvaćaju primjenu kirurških zahvata, kemoterapije, imunoterapije i hormonske terapije, kao i suportivno-simptomatskih mjera tijekom cijelog liječenja. Razlikuje se terapijski pristup rjeđim, neepitelnim histološkim tipovima tumora koji se češće dijagnosticiraju u ranim stadijima bolesti, imaju indolentniji tijek pa se kod ovih bolesnica češće primjenjuju poštedni kirurški zahvati s ciljem očuvanja plodnosti. U tekstu koji slijedi predstavljene su kliničke upute s ciljem standardizacije postupaka i kriterija postavljanja dijagnoze, liječenja te praćenja bolesnica s rakom jajnika, jajovoda i potrbušnice u Republici Hrvatskoj.Ovarian cancer together with fallopian tube represents the fifth most common female cancer in the Republic of Croatia. Epithelial ovarian cancer, serous subtype, encompasses most of malignant ovarian neoplasms. Less common are various non-epithelial ovarian malignancies. A special group consists of epithelial carcinomas of low malignant potential with clinically indolent flow, good prognosis and no invasion, and primary cancer of the peritoneum and fallopian tube cancer. Clinically, these malignant tumors are generally asymptomatic in early stages, and usually diagnosed in advanced stages. The diagnosis is confirmed by pathological examination, and occasionally, cytological findings after completing diagnostic procedures. Multidisciplinary team makes treatment decisions, taking into account age, general condition and comorbidities of the patient and characteristics of the tumor itself, including disease stage, histological type and grade of the tumor. The principles of treatment of primary peritoneal and fallopian tube cancer are based on the principles of treatment of epithelial ovarian cancer involving surgery, chemotherapy, immune and hormone therapy, and symptomatic-supportive care throughout the treatment. Less common histological types have a different treatment approach being more frequently diagnosed in the early stages of the disease, have more indolent flow, so in these patients conservative surgeries with the goal of preserving fertility are more often employed. The following text presents the clinical guidelines in order to standardize the procedures and criteria for the diagnosis, management, treatment and monitoring of patients with ovarian carcinoma, fallopian tube and primary peritoneal cancer in the Republic of Croatia

CLINICAL RECOMMENDATIONS FOR DIAGNOSING, TREATMENT AND MONITORING OF PATIENTS WITH UTERINE CERVICAL CANCER – CROATIAN ONCOLOGY SOCIETY AND CROATIAN SOCIETY FOR GYNECOLOGY AND OBSTETRICS AS CROATIAN MEDICAL ASSOCIATION UNITS AND CROATIAN SOCIETY OF GYNECOLOGICAL ONCOLOGY

Rak vrata maternice, u odnosu na malignome drugih ginekoloških sijela, jest bolest mlađih žena koja se može redovitim kontrolama i zdravstvenim odgojem prevenirati, a u slučaju pojave bolesti učinkovito liječiti. Metode liječenja uključuju kirurgiju, radioterapiju i kemoterapiju, ovisno o stadiju bolesti i općem stanju bolesnica. Odluku o liječenju donosi multidisciplinarni tim. S obzirom na važnost ove bolesti, potrebno je definirati i provoditi standardizirani pristup u dijagnostici, liječenju i praćenju ovih bolesnica. U tekstu koji slijedi iznesene su kliničke smjernice s ciljem implementacije standardiziranih postupaka u radu s bolesnicama s rakom vrata maternice u Republici Hrvatskoj.Cervical cancer, in comparison with other gynecological malignancies, mainly affects younger women. It can be prevented trough educational programs, screening and early detection. It also can be efficiently treated when it appears. Treatment modalities include surgery, chemotherapy and radiotherapy, according to the stage of the disease and patient condition. Treatment decisions should be made after multidisciplinary team discussion. Due to the significance of this disease it is important to define and implement standardized approach for diagnostic, treatment and monitoring algorithm as well. The following text presents the clinical guidelines in order to standardize the procedures and criteria for the diagnosis, management, treatment and monitoring of patients with uterine cervical cancer in the Republic of Croatia

CLINICAL RECOMMENDATIONS FOR DIAGNOSING, TREATMENT AND MONITORING OF PATIENTS WITH ENDOMETRIAL CANCER – CROATIAN ONCOLOGY SOCIETY AND CROATIAN SOCIETY FOR GYNECOLOGY AND OBSTETRICS AS CROATIAN MEDICAL ASSOCIATION UNITS AND CROATIAN SOCIETY OF GYNECOLOGICAL ONCOLOGY

Rak trupa maternice javlja se u većini slučajeva u poslijemenopauzalnih žena, a najčešće se očituje ginekološkim krvarenjem. Nakon raka jajnika i vrata maternice treći je uzrok smrti žena od raka spolnog sustava. Dijagnoza se postavlja patohistološkim pregledom kiretmana ili bioptata, a definitivni stadij bolesti utvrđuje se analizom uzoraka dobivenih histerektomijom i obostranom salpingoovariektomijom sa zdjeličnom i paraaortalnom limfadenektomijom. U tekstu koji slijedi sadržane su kliničke upute s ciljem standardizacije postupaka i kriterija postavljanja dijagnoze, liječenja i praćenja bolesnica s rakom trupa maternice u Republici Hrvatskoj.Uterine cancer occurs mainly in postmenopausal women, usually as vaginal bleeding. Following ovarian and cervical cancer it is the third most common cause of female reproductive system cancer death. Diagnosis is set by analyzing samples obtained via hysterectomy with salpingo-oophorectomy and pelvic / paraaortal lymphadenectomy. The following text presents the clinical guidelines in order to standardize the procedures and criteria for the diagnosis, treatment and monitoring of patients with uterine cancer in the Republic of Croatia

INFLUENCE OF BODY HEIGHT, BODY WEIGHT AND THE AGE ON THE RESULTS ACHIEVED BY MAN-MARATHONERS IN A MARATHON RACE

The research is conducted on a sample of 100 successful man marathoners who has taken part in ten of the most popular marathon races. The sample of entities includes ten of the best placed marathoners in each race held during the year 2008. The aim of the research is to assess the influence of the body height, weight and the age of the marathoners on the final result in the race. The collected data is processed by the basic descriptive parameters. The entities have the average weight of 56.94 kg, with the average height of 168.98 cm, at the average age of 29.75, with the achieved average result of 2:13.23 hours in the race. In the intercorrelation matrix only one significant coefficient of correlation is obtained (p<0.001) between the body height and body weight. By the regressive analysis the influence of the predictory variables (height, weight and age) on the criteria variable – sig. =0, 21 (the result of the marathon) is not confirmed, which provides only 15% (RO²=.302) of analysis in the common ground of variability. The rest of 91% in analysing the total variability of the criteria variable can be ascribed to some other anthropologic characteristics, and mainly to the functional characteristics of anaerobic type

Kliničke upute za dijagnostiku, liječenje i praćenje bolesnica oboljelih od raka jajnika Hrvatskoga onkološkog društva i Hrvatskog društva za ginekologiju i opstetriciju Hrvatskoga liječničkog zbora te Hrvatskoga ginekološkoonkološkog društva [Clinical recommendations for diagnosing, treatment and monitoring of patients with ovarian cancer - Croatian Oncology Society and Croatian Society for Gynecology and Obstetrics as Croatian Medical Association units and Croatian Society of Gynecological Oncology]

Ovarian cancer together with fallopian tube represents the fifth most common female cancer in the Republic of Croatia. Epithelial ovarian cancer, serous subtype, encompasses most of malignant ovarian neoplasms. Less common are various non-epithelial ovarian malignancies. A special group consists of epithelial carcinomas of low malignant potential with clinically indolent flow, good prognosis and no invasion, and primary cancer of the peritoneum and fallopian tube cancer. Clinically, these malignant tumors are generally asymptomatic in early stages, and usually diagnosed in advanced stages. The diagnosis is confirmed by pathological examination, and occasionally, cytological findings after completing diagnostic procedures. Multidisciplinary team makes treatment decisions, taking into account age, general condition and comorbidities of the patient and characteristics of the tumor itself, including disease stage, histological type and grade of the tumor. The principles of treatment of primary peritoneal and fallopian tube cancer are based on the principles of treatment of epithelial ovarian cancer involving surgery, chemotherapy, immune and hormone therapy, and symptomatic-supportive care throughout the treatment. Less common histological types have a different treatment approach being more frequently diagnosed in the early stages of the disease, have more indolent flow, so in these patients conservative surgeries with the goal of preserving fertility are more often employed. The following text presents the clinical guidelines in order to standardize the procedures and criteria for the diagnosis, management, treatment and monitoring of patients with ovarian carcinoma, fallopian tube and primary peritoneal cancer in the Republic of Croatia

CLINICAL RECOMMENDATIONS FOR DIAGNOSING, TREATMENT AND MONITORING OF PATIENTS WITH ENDOMETRIAL CANCER – CROATIAN ONCOLOGY SOCIETY AND CROATIAN SOCIETY FOR GYNECOLOGY AND OBSTETRICS AS CROATIAN MEDICAL ASSOCIATION UNITS AND CROATIAN SOCIETY OF GYNECOLOGICAL ONCOLOGY

Rak trupa maternice javlja se u većini slučajeva u poslijemenopauzalnih žena, a najčešće se očituje ginekološkim krvarenjem. Nakon raka jajnika i vrata maternice treći je uzrok smrti žena od raka spolnog sustava. Dijagnoza se postavlja patohistološkim pregledom kiretmana ili bioptata, a definitivni stadij bolesti utvrđuje se analizom uzoraka dobivenih histerektomijom i obostranom salpingoovariektomijom sa zdjeličnom i paraaortalnom limfadenektomijom. U tekstu koji slijedi sadržane su kliničke upute s ciljem standardizacije postupaka i kriterija postavljanja dijagnoze, liječenja i praćenja bolesnica s rakom trupa maternice u Republici Hrvatskoj.Uterine cancer occurs mainly in postmenopausal women, usually as vaginal bleeding. Following ovarian and cervical cancer it is the third most common cause of female reproductive system cancer death. Diagnosis is set by analyzing samples obtained via hysterectomy with salpingo-oophorectomy and pelvic / paraaortal lymphadenectomy. The following text presents the clinical guidelines in order to standardize the procedures and criteria for the diagnosis, treatment and monitoring of patients with uterine cancer in the Republic of Croatia