Liječenje germinativnog raka testisa

Germ-cell testicular cancer (GCTC) is a malignant neoplasm derived from the primordial germ cell. Although it accounts for approximately 1% of all malignancies in men, it is the most common cancer of younger male population, with the highest incidence between ages 15 and 35. Testicular cancer incidence rate has risen globally over the past several decades, with the average increase in the incidence of testicular cancer in Croatia of 7% per annum from the year 1983 to 2007. Two main groups are seminomas and non-seminomas, each accounting for 50% of cases, and they differ in treatment modalities and response to therapy. Despite increase in the incidence rate, a promising circumstance is that GCTC has become a model of curable cancer. Because of advances in diagnostic procedures, sophisticated radiation techniques and especially the introduction of cisplatin based chemotherapy protocols together with advanced postchemotherapy surgical techniques, curability is expected in about 95% of all patients diagnosed with testicular cancer and over 70% of patients with advanced disease. In this review, we will focus on treatment strategies of primary GCTC.Germinativni rak testisa je maligna novotvorina podrijetla primordijalne zametne stanice. Iako čini oko 1% svih malignih novotvorina muškaraca, najčešći je malignom mlađe muške populacije s najvećom incidencijom u dobi od 15 do 35 godina. Incidencija raka testisa povećala se globalno posljednjih nekoliko desetljeća, s prosječnim porastom u incidenciji od 7% godišnje u Hrvatskoj u razdoblju od 1983. do 2007. godine. S obzirom na histološku sliku, germinativni rak testisa dijeli se na seminome i neseminome koji se razlikuju u načinu liječenja i odgovoru na terapiju. Unatoč porastu u incidenciji, obećavajuća okolnost je da je rak testisa postao model izlječivog tumora. Zbog napretka u dijagnostičkim postupcima, sofisticiranih tehnika zračenja, a osobito uvođenja kemoterapijskih protokola baziranih na platini zajedno s naprednim postkemoterapijskim kirurškim tehnikama, izlječivost se očekuje u oko 95% svih dijagnosticiranih bolesnika s rakom testisa i oko 70% bolesnika s uznapredovalom bolešću. U ovom preglednom radu usredotočit ćemo se na strategije liječenja germinativnog raka testisa

Point prevalence of significant nutritional risk among cancer patients in Croatia – research study of the Section of young oncologists, Croatian society for medical oncology of Croatian medical association

Cilj istraživanja: Utvrditi trenutačnu prevalenciju znatnoga nutritivnog rizika među onkološkim bolesnicima u Republici Hrvatskoj. Ispitanici i metode: Ova presječna studija ugniježđena je u prospektivnu kohortnu studiju Sekcije mladih onkologa HDIO-a HLZ-a, koja je provedena u Hrvatskoj tijekom 2017. godine na susljednom uzorku onkoloških bolesnika biranome prema redoslijedu dolaska na liječenje. Nutritivni probir proveli smo uporabom upitnika za procjenu nutritivnog rizika NRS-2002. Prema njemu, bolesnik se smatra nutritivno ugroženim ako je rezultat ≥ 3. Rezultati: U istraživanje je uključeno 275 bolesnika, medijana (interkvartilnog raspona) dobi od 61 godine (51 – 68), među kojima je bila 161 žena (58,5%). Bolesnici su liječeni u jedanaest onkoloških centara u Hrvatskoj. U 60 bolesnika (21,8%; 95%-tni CI 17,1 – 27,2%) utvrđen je znatan nutritivni rizik (NRS-2002 ≥ 3) koji indicira potrebu za nutritivnom intervencijom. Bilo kakvu nepovoljnu promjenu tijekom 30 dana prije uključivanja, dakle, gubitak tjelesne mase ili smanjen unos hrane, primijetilo je 127 (46,2%) sudionika. Zaključak: Naše istraživanje potvrdilo je da znatan broj onkoloških bolesnika u Hrvatskoj ima neki stupanj nutritivnog rizika te da je u više od četvrtine potrebna nutritivna intervencija. Nutritivni probir prvi je korak u dugoročnoj kontroli komplikacija vezanih uz promijenjen unos hrane i nutritivni rizik, kao i pri poboljšanju kvalitete života onkoloških bolesnika te prognoze ishoda bolesti pa bi ga, s obzirom na prikazane rezultate, trebalo rutinski provoditi.Objective of the Study: To determine the point prevalence of significant nutritional risk among cancer patients in Croatia. Subjects and Methods: This cross-sectional study was nested in the prospective cohort study of the Section of Young Oncologists of the Croatian Society for Medical Oncology, Croatian Medical Association, conducted in Croatia during 2017 on the consecutive sample of cancer patients selected by the order of their arrival to the exam.Nutritional screening was performed using the NRS-2002, According to NRS-2002, the patient is considered to be at significant nutritional risk if the result is ≥3. Results: We included 275 patients treated at eleven cancer centers in Croatia. In 60 patients (21.8%, 95% CI 17.1% -27.2%) we identified the significant nutritional risk (NRS-2002 ≥3) what indicates the need for the nutritional intervention. Any change during 30 days prior to screening, such as loss of body weight or reduced intake of food, was expressed by 127 (46.2%) participants. Conclusion: Our study has confirmed that a significant number of cancer patients in Croatia are in some degree at nutritional risk, and that more than one quarter need nutritional intervention. Nutritional screen poing is the first step in the long-term control of complications associated with altered food intake and nutritional risk, as well as in improving the overall quality of life of cancer patients and the prognosis of disease outcomes, so regarding the presented results, it should be routinely implemented