Prikaz novootkrivenih karcinoma dojke, liječenih u Općoj bolnici Pula u razdoblju od 2008-2010 godine (s posebnim osvrtom na male karcinome)

Prognosis in breast carcinoma mostly depends of clinical staging at time of diagnosis. National screening mammography program is orientated to find breast cancer in earlyest stage, when prognosis and therapy is favourable. This program that way can directly have influence in reducing number of people who die because of cancer. We showed our results with new-founded breast carcinoma, treated in General Hospital Pula, with special review on small carcinoma, that measured less than 1 cm

Smjernice za dijagnostiku i liječenje bolesnika oboljelih od raka debelog crijeva u Općoj bolnici Pula

Cancers of the colon and rectum altogether are the third most common tumour type worldwide. The prognosis for the survival after disease progression is usually poor and directly depends on early detection. National program for colorectal cancer screening was started by ministry of health and supported by health program of istrian county. Standardization of health protection recommend making of guidelines in screening, diagnosis, therapy, and surveillance of 10 most frequently clinical diseases so this guidelines has goals to improve clinical work to health professionals and to provide additional safety to patients

CANCER PATIENTS FOLLOW-UP – CROATIAN SOCIETY OF MEDICAL ONCOLOGY CLINICAL GUIDELINES Part II: renal cell cancer, urinary bladder cancer, prostate cancer, testicular cancer

Liječenje onkoloških bolesnika mora se temeljiti na multidisciplinarnom pristupu, a provodi se u specijaliziranim onkološkim centrima. Nakon završetka specifičnog onkološkog liječenja daljnje praćenje uglavnom provode onkolozi, ali je uloga liječnika primarne zdravstvene zaštite (PZZ) sve važnija i potrebno ju je jasno definirati. Trenutačno se većina preporuka za praćenje ne temelji na prospektivnim studijama, već se zasniva na stručnim mišljenjima pojedinih onkoloških centara ili specijalista. Hrvatsko društvo za internističku onkologiju (HDIO) ovim preporukama želi standardizirati i racionalizirati dijagnostičke postupke u praćenju onkoloških bolesnika nakon završetka primarnog liječenja, u bolesnika s ­rakom bubrega, rakom mokraćnog mjehura, rakom prostate i rakom testisa.The treatment of oncological patients must be based upon multidisciplinary approach, and takes place in specialized oncological centers. By the end of a specific oncological treatment further follow-up is being managed mostly by the oncologists, but the role of the general practitioners becomes more important every day and therefore should be precisely defined. Nowadays, most of the existing follow-up guidelines are not based on prospective studies, but on the experts opinion of individual oncological centers or specialists. The aim of the Croatian Society of Medical Oncology (CSMO) with these recommendations is to standardize and rationalize the diagnostic procedures algorithm in the follow–up of ­oncological patients after primary treatment, in patients with renal cell cancer, urinary bladder cancer, prostate cancer and testicular cancer

Praćenje onkoloških bolesnika – kliničke preporuke Hrvatskog društva za internističku onkologiju HLZ-a II. dio: rak bubrega, rak mokraćnog mjehura, rak prostate, rak testisa [Cancer patients follow-up – Croatian society of medical oncology clinical guidelines Part II: renal cell cancer, urinary bladder cancer, prostate cancer, testicular cancer]

The treatment of oncological patients must be based upon multidisciplinary approach, and takes place in specialized oncological centers. By the end of a specific oncological treatment further follow-up is being managed mostly by the oncologists, but the role of the general practitioners becomes more important every day and therefore should be precisely defined. Nowadays, most of the existing follow-up guidelines are not based on prospective studies, but on the experts opinion of individual oncological centers or specialists. The aim of the Croatian Society of Medical Oncology (CSMO) with these recommendations is to standardize and rationalize the diagnostic procedures algorithm in the follow–up of ­oncological patients after primary treatment, in patients with renal cell cancer, urinary bladder cancer, prostate cancer and testicular cancer

Mjesto i važnost nekliničkih bolničkih centara u liječenju bolesnika sa zloćudnim bolestima u Republici Hrvatskoj

Onkologija predstavlja važan segment sveukupnoga hrvatskoga zdravstvenog sustava. Sama onkologija jedna je od trenutačno najpropulzivnijih medicinskih struka te smo svakodnevno svjedoci ekspanzivnog rasta novih modaliteta onkološkog liječenja. Ove činjenice nameću imperativ stvaranja onkološke mreže koja bi kao zadatak imala standardiziranje onkološkog liječenja i osiguravanje dostupnosti novih modaliteta liječenja za sve oboljele od zloćudnih bolesti, neovisno o njihovom mjestu boravka.¹ Hrvatska već ima prepoznate i definirane regionalne onkološke centre u sklopu kliničkih bolničkih centara u Zagrebu, Rijeci, Osijeku i Splitu. Nasreću, u Hrvatskoj postoji tradicija, stara nekoliko desetljeća, razvoja onkoloških centara u općim i županijskim bolnicama. Poimence, to su neklinički onkološki centri u Županijskoj bolnici Čakovec, Općoj bolnici Dubrovnik, Općoj bolnici Karlovac, Općoj bolnici Koprivnica, Općoj bolnici Pula, Općoj bolnici Slavonski Brod, Općoj bolnici Šibenik, Općoj bolnici Varaždin i Općoj bolnici Zadar. Svrha ovoga istraživanja, provedenog u svim nekliničkim onkološkim centrima Hrvatske te korištenjem podataka Državnog zavoda za statistiku i Hrvatskog zavoda za zdravstveno osiguranje, bila je uvidjeti kako je trenutno organizirana onkološka skrb u Republici Hrvatskoj i koja je uloga nekliničkih onkoloških centara u liječenju bolesnika sa zloćudnim bolestima u Republici Hrvatskoj

Evaluation of Contrast-Enhanced Mammography and Development of Flowchart for BI-RADS Classification of Breast Lesions

This study aimed to evaluate contrast-enhanced mammography (CEM) and to compare breast lesions on CEM and breast magnetic resonance imaging (MRI) using 5 features. We propose a flowchart for BI-RADS classification of breast lesions on CEM based on the Kaiser score (KS) flowchart for breast MRI. Sixty-eight subjects (women and men; median age 61.4 ± 11.6 years) who were suspected of having a malignant process in the breast based on digital mammography (MG) findings were included in the study. The patients underwent breast ultrasound (US), CEM, MRI and biopsy of the suspicious lesion. There were 47 patients with malignant lesions confirmed by biopsy and 21 patients with benign lesions, for each of which a KS was calculated. In the patients with malignant lesions, the MRI-derived KS was 9 (IQR 8–9); its CEM equivalent was 9 (IQR 8–9); and BI-RADS was 5 (IQR 4–5). In patients with benign lesions, MRI-derived KS was 3 (IQR 2–3); its CEM equivalent was 3 (IQR 1.7–5); and BI-RADS was 3 (IQR 0–4). There was no significant difference between the ROC-AUC of CEM and MRI (p = 0.749). In conclusion, there were no significant differences in KS results between CEM and breast MRI. The KS flowchart is useful for evaluating breast lesions on CEM

Impact of the coronavirus disease pandemic on cancer care in Croatia: a multicentre cross-sectional study

Purpose: The coronavirus disease (COVID-19) pandemic has greatly affected the oncology community worldwide. Lockdowns, an epidemiological measure, have made it difficult for oncologists to provide care. In this study, we analysed the impact of the COVID-19 pandemic on Croatian cancer care. ----- Methods: This was a multicentre cross-sectional observational study of 422 patients who received systemic oncology therapy during the pandemic. The patients completed a survey to capture their views on the impact of the COVID-19 pandemic on their cancer care. Univariate descriptive and bivariate analyses were performed to analyse the relationship between the patients' perspective on the impact of the COVID-19 pandemic on cancer care and the quality of Croatian cancer care and their clinical and sociodemographic data. ----- Results: Discontinuation or change in cancer treatment during the COVID-19 pandemic was observed in 10.2% of cases. Most did not change their place of treatment owing to the lockdown (97.6%). 14.7% of the patients felt that the quality of cancer care received had changed during the pandemic. ----- Conclusions: In the first few months of the pandemic, Croatia had a favourable epidemiological situation. However, 25% of patients with cancer reported that the pandemic affected cancer treatment and the quality of cancer care

Clinical guidelines for diagnosis, treatment and monitoring of patients with invasive breast cancer – Croatian Oncology Society (BC-3 COS)

Rak dojke je najčešći zloćudni tumor u žena koji se može probirom, redovitim kontrolama i zdravstvenim odgojem otkriti u ranim stadijima bolesti i uspješno liječiti. Metode liječenja uključuju kirurgiju, kemoterapiju, radioterapiju, endokrinu terapiju, imunoterapiju, ciljanu terapiju te simptomatsko-suportivnu terapiju, koja se primjenjuje ovisno o stadiju bolesti, biološkim obilježjima tumora i općem stanju, dobi i komorbidetima bolesnica. Plan liječenja definira multidisciplinarni tim. S obzirom na pojavnost ove bolesti, mogućnost ranog otkrivanja i mogućeg značajnog učinka terapijskih postupaka na tijek bolesti, potrebno je definirati i pravilno standardizirati pristup u dijagnostici, liječenju i praćenju ovih bolesnica. U tekstu su iznesene smjernice s ciljem primjene standardiziranih postupaka u svakodnevnom radu s bolesnicama s rakom dojke u Republici Hrvatskoj.Breast cancer is the most common cancer in women, which can be diagnosed early through screening, early detection and through education. When diagnosed early, it can be successfully treated. Treatment modalities include surgery, chemotherapy, radiotherapy, endocrine therapy, immunotherapy, targeted therapy and supportive therapy applied depending on the stage of the disease, tumor and patient´s characteristics. Treatment should be defined by a multidisciplinary team. Due to the incidence of this disease, opportunity of early detection and possible significant influence of various treatment modalities on the course of the disease, it is important to define and implement a standardized approach for diagnosis , treatment and monitoring algorithm. The following text presents the clinical guidelines in order to standardize the procedures and criteria for diagnosis,treatment and monitoring of breast cancer patients in the Republic of Croatia