Porównanie urazu tkanek podczas brzusznej, pochwowej i laparoskopowej histerektomii

Objective: The aim of the study was to compare the extent of tissue trauma after abdominal hysterectomy(AH), vaginal hysterectomy (VH), and total laparoscopic hysterectomy (TLH) using biochemical markers. Material and methods: Seventy-one patients requiring hysterectomy for benign uterine diseases were enrolled in the study and divided into three treatment groups: AH (n=24), VH (n=23), and TLH (n=24). Blood samples for assay of interleukin-6 (IL-6) and creatine phosphokinase (CPK) were collected pre-, intra-operatively, and 2, 6 and 24 h after surgery. Results: Serum levels of IL-6, and CPK were significantly elevated over basal values after surgery in all groups. IL-6 and CPK levels were significantly higher after AH as compared to VH and TLH. IL-6 concentrations were significantly higher in the VH group than the TLH group (p=0.001). There were no significant differences in CPK levels between the VH and TLH groups (p=0.824). TLH group had the smallest decrease in blood hemoglobin concentration and the shortest hospital stay. Conclusions: AH causes more tissue trauma as compared to VH and TLH. Owing to the fact that TLH is associated with less tissue trauma and offers significant clinical benefits, including less blood loss and shorter hospital stay, it should be considered in women with benign gynecologic conditions, especially in experienced centers.Cel pracy: Celem badania było porównanie rozległości urazu tkanek podczas brzusznej histerektomii (AH), pochwowej (VH) i laparoskopowej (TLH) przy pomocy biochemicznych markerów. Materiał i metoda: Do badania włączono siedemdziesiąt jeden pacjentek wymagających usunięcia macicy z powodu niezłośliwej patologii, które podzielono na trzy grupy badane: AH (n=24), VH (n=23), i TLH (n=24). Próbki krwi do badania w kierunku interleukiny 6 i kinazy fosfokreatynowej (CPK) pobierano przed-, podczas operacji, I 2,6 oraz 24 godziny po zabiegu. Wyniki: Poziom Il-6 i CPK w surowicy po operacji był istotnie podwyższony w porównaniu do poziomu wyjściowego we wszystkich grupach badanych. Poziom IL-6 i CPK były istotnie wyższe po AH niż po VH i TLH. Stężenie IL-6 było istotnie wyższe w grupie VH niż w grupie TLH (p=0.001). Nie stwierdzono istotnych różnic w poziomie CPK pomiędzy grupą VH i TLH (p=0.824). W grupie TLH odnotowano najmniejszy spadek hemoglobin I najkrótszy pobyt w szpitalu. Wnioski: AH powoduje większy uraz tkanek niż VH i TLH. Dzięki temu, że TLH jest związane z mniejszym urazem tkanek i daje istotne klinicznie korzyści, między innymi mniejszą utratę krwi i krótszy pobyt w szpitalu, powinno być rozważane u kobiet z niezłośliwą patologią, zwłaszcza w doświadczonych ośrodkach

A study of the combination of oxaliplatin, capecitabine, and trastuzumab and chemo-radiotherapy in the adjuvant setting in operated patients with HER2+gastric or gastroesophageal junction cancer (TOXAG study).

Gastrointestinal Cancers Symposium of the American-Society-of-Clinical-Oncology (ASCO) -- JAN 18-20, 2018 -- San Francisco, CA[Abstract Not Available]Amer Soc Clin Onco

GENERAL CHARACTERISTICS AND TREATMENT OPTIONS OF THE PATIENTS WITH GASTROINTESTINAL STROMAL TUMOR

Background: Gastrointestinal stromal tumors (GIST) are rare mesenchimal tumors may develop in any site in the gastrointestinal system. KIT gene mutations are detected in 95% of cases. In this study, we aimed to assess treatment options and general characteristics of patients with GIST. Methods: GIST patients admitted to Abdurrahman Yurtaslan Oncology Education and Training hospital’s oncology clinic between February 2009 and May 2012 are observed retrospectively. Demographic characteristics of the patients and the treatment they received were recorded from hospital’s database. Results: Eighteen patients included to study havinng Mean age of 57.8 years (32-78).  Five (28%) of the patients were female and thirteen (72%) were male. Diagnosis were made in 16 patients by pathological assessment of surgical material. Trucut biopsy and gastroscopic biopsy used for diagnosis in remaining two patients. Localizations of the tumor were as follows: small intestine in 9 patients, colon in 5 patients, stomach in 4 patients. All of the patients were KIT positive. Tumor was defined at high risk in 62%, at moderate risk in 17% and at low risk in 21% of the cases. Imatinib was administered in 5 patients with metastatic disease. Mean follow up period for the patients was 48 months. Relapse or progression developed in 4 of all patients in follow up period. Only one of the five patients with metastaic disease developed progression. Other 3 cases were relapsed. Conclusion: Surgical resection of tumor without fragmentatin is the main treatment of localized GIST cases. Imatinib, a tyrosine kinase inhibitor, is used in metastatic/ inoperable tumors and in cases at high risk for metastasis, recently. In conclusion, after surgical resection of the tumor, we suggest Imatinib treatment in patients considered at high risk

Evaluation of Risk Factors for Mortality in Febrile Neutropenia

Introduction: We aimed to evaluate the epidemiology of infections and factors associated with mortality in patients with febrile neutropenia (FEN). Methodology: The adult patients, who developed FEN after chemotherapy due to a hematologic malignancy or a solid tumor in a training and research hospital were evaluated, retrospectively. The demographic data of the patients, underlying malignancy, administered antimicrobial therapy, microbiological findings, and other risk factors associated with mortality were evaluated. Results: A total of 135 FEN episodes of 115 patients, who comprised of 72 (63%) patients with 89 FEN episodes due to hematologic malignancies (hemato-group) and 43 (37%) patients with 46 FEN episodes due to solid organ cancers (onco-group), were evaluated in the study. The median age was 47 years (range: 17-75 years) and 66 (57%) patients were male. A total of 12 patients (8.8%) died during 135 episodes of FEN including nine cases from hemato-group and three cases from onco-group. Those factors including a presence of pneumonia, advanced age, persistent fever despite an antimicrobial treatment, and need for mechanical ventilation in intensive care unit (ICU) with were determined as risk factors associated with mortality. Conclusions: Morbidity and mortality are more common in patients with hematological malignancies compared to patients with solid organ cancers due to prolonged neutropenia. In case of persistent fever, an invasive fungal infection (IFI) should be kept in mind in patients with hematologic malignancies and then antifungal treatment should be initiated. Although a persistent fever is also common in patients with solid tumors, the necessity of antifungal therapy is rare due to the short duration of neutropenia

Teleoncology or telemedicine for oncology patients during the COVID-19 pandemic: the new normal for breast cancer survivors?

Background: Telemedicine is seen as a savior during the COVID-19 pandemic. Materials &amp; methods: This study is a descriptive cross-sectional study conducted with cancer patients who were interviewed via telemedicine from a tertiary care comprehensive oncology center. Results: A total of 421 patients were included in the study and 118 of them (28.0%) were &gt;65 years old. Communication was provided most frequently by voice call (n = 213; 50.5%). The majority of the patients contacted by telemedicine had breast cancer (n = 270; 64.1%). For 135 patients (32.1%) no further examination or intervention was required and the previously planned follow-up visit was postponed by the clinician. Conclusion: This study showed that telemedicine could open a new era for medical oncology specialists. </jats:p

Prognostic & predictive factors for planning adjuvant chemotherapy of early-stage breast cancer

Breast cancer is a heterogeneous disease and may present with different clinical and biological characteristics. At present, breast cancer is divided into molecular subgroups besides its histopathological classification. Decision for adjuvant chemotherapy is made based on not only histopathological characteristics but also molecular and genomic characteristics using indices, guidelines and calculators in early-stage breast cancer. Making a treatment plan through all these prognostic and predictive methods according to risk categories aims at preventing unnecessary or useless treatments. In this review, an attempt to make a general assessment of prognostic and predictive methods is made which may be used for planning individualized therapy and also the comments of the guidelines used by the oncologists worldwide on these methods

Kemoterapi Tedavisi Gören Meme Kanserli Hastalarda Oral Mukozitin Önlenmesinde ve Semptom Yönetiminde Oral Kriyoterapi ve Soğuk Suyla Gargara Yapmanın Etkisi: Değerlendirici-Kör, Paralel Gruplu, Üç-Kollu, Randomize Kontrollü Çalışma

Amaç: Kemoterapi gören meme kanserli hastalarda oral mukozitin (OM) önlenmesi ve semptom yönetiminde oral kriyoterapi (OK) ve so ğuk suyla gargara (SSG) yapman ın etkisini belirlemek. Gereç ve Yöntemler: Bu paralel gruplu, üç-kollu, randomize ve değerlendiricinin kör olduğu araş- tırmada müdahale gruplar ına OK ve SSG uyguland ı. Meme kanseri olan 105 uygun hasta 3 gruba ayrıldı. Müdahale grupları için OK (n=35) ve SSG (n=35) 3 aşamada gerçekleştirildi: I) Hastanedeki araştırmacı tarafından ve- rilen talimatlar; II) hastanede araştırmacı eşliğinde uygulama; III) Hastala- rın evde bireysel uygulaması. Kontrol grubundaki hastalar (n=35) standart bakım aldı. Ayrıca hastalara “Hasta Bilgi Formu”, “Edmonton Semptom Değerlendirme Ölçe ği”, “Dünya Sa ğlık Örgütü (DSÖ) Mukozit Ölçe ği [World Health Organization Mucositis Scale (OTS)]” ve “Görsel Analog Skala (VAS)” uygulandı. Bulgular: OTS ve VAS ölçeklerinde, OK grubu, başlangıç 21 günlük süre boyunca SSG yapan grup ve kontrol gruplar ına göre anlamlı düzeyde daha etkiliydi. OTS ve VAS ölçeklerinin değerlendi- rilmesinin ilk 16 günü boyunca SSG grupları, kontrol grubuna göre önemli ölçüde daha fazla etkinlik gösterdi. Sonuç: OM tedavisinde tek başına OK etkili ve güvenlidir. Bu çalışmanın sonuçları, OM tedavisinde OK’nin kli- nik olarak uygulanabilirliğini gösterdi. OK ve SSG yapan bireylerde, ilk 16 günde ağrı ve toksisite ölçeğini önemli ölçüde azalttı. SSG ve kontrol grup- ları arasında 16-21 gün arasında anlamlı bir fark yoktur.Objective: To determine the effects of oral cryotherapy (OC) and gargling with cold water (GCW) in the prevention and symptom man- agement of oral mucositis (OM) in patients with breast cancer undergoing chemotherapy. Material and Methods: This parallel-grouped, three-arm, randomized, and assessor-blinded trial used the OC and GCW. 105 eligible patients with breast cancer were assigned to 3 groups. OC (n=35) and GCW (n=35) for intervention groups were performed in three stages: I) instructions on by the investigator at the hospital; II) the implementation accompanied by the investigator at the hospital; III) the individual application of at home by patients. The patients in the control group (n=35) received standard care. Ad- ditionally, “Patient Information Form ”, “Edmonton Symptom Assessment Scale”, “World Health Organization Mucositis Scale (OTS)”, and “Visual Analog Scale (VAS)” were conducted. Results: OTS and VAS scales, the OC group was significantly more effective than the GCW and control groups throughout the beginning 21-day period. During the 1st 16 days of evaluat- ing the OTS and VAS conditions, the GCW groups showed significantly more effectiveness than the control group. Conclusion: OC alone was effective and safe for treating OM. The results of this study showed the clinical appli- cability of OC in the management of OM. OC and GCW significantly re- duced the pain and toxicity scale in the first 16 days. There was no significant difference between the GCW and control groups between the 16-21 days

Examination of family caregivers of advanced cancer patients within the scope of the cancer family caregiving experience model: An embedded mixed-methods design

Objective This study aimed to examine the stressors and contextual factors that affect the quality of life (QoL) of caregivers of advanced cancer patients and to address their caregiving experiences. Methods The study had an embedded mixed-methods design and was conducted in the medical oncology unit of a training and research hospital in Turkey. In the quantitative phase, 125 patients with advanced cancer and their family caregivers were included. In the qualitative phase, 21 family caregivers were included. The analysis of quantitative data was carried out using SPSS 25.0 statistical program, and qualitative data were carried out using Collaizi's seven-step descriptive analysis approach. QoL was determined as the dependent variable and evaluated with Caregiver QoL Index-Cancer (CQOLC). Results The symptoms, care dependency of patients, and preparedness to the care of caregivers showed a direct impact on the CQOLC. Income level, employment status, and daily caregiving hours demonstrated a direct effect on the CQOLC. Four themes emerged from the interviews: Understanding the dynamics of the caregiving process, losing control of life during the caregiving process, limitation of socio-economic freedom in the caregiving process, and the effort to hold on to life in the caregiving process. Conclusion The cancer family caregiving experience model is a useful model for evaluating the QoL of caregivers from a multidimensional perspective. Health care professionals should not forget that the QoL of family caregivers should be evaluated in multiple ways, and education programmes for family members should be structured