Esophageal and periesophageal lymph nodes metastases of renal cancer 30 years after nephrectomy

Rak jasnokomórkowy nerki, mimo znacznego postępu medycyny, nadal sprawia problemy zarówno na etapie pierwotnej diagnozy oraz leczenia, jak i późniejszych badań kontrolnych. Przedstawiono przypadek przerzutu raka jasnokomórkowego nerki do przełyku i węzłów chłonnych okołoprzełykowych u 76-letniego chorego 30 lat po zabiegu nefrektomii.Despite the significant progress in modern medicine, the renal cell carcinoma (RCC) still causes many problems at the stage of primary diagnosis and treatment as well as during further follow up. A rare case of renal cell carcinoma metastases to esophageus and periesophageal lymph nodes in 76-year old patient 30 years after nephrectomy was described

Leiomyosarcoma in adrenal gland

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Polish clinical practice guidelines on Hyperthermic Intraperitoneal Chemotherapy (HIPEC) with Cytoreductice Surgery (CRS) in peritoneal malignancy treatment

Leczenie nowotworów powierzchni otrzewnej stanowi istotny problem w onkologii. Wykazano, że skojarzenie maksymalnej cytoredukcji chirurgicznej z dootrzewnową chemioterapią w hipertermii (HIPEC; hyperthermic intraoperative peritoneal chemotherapy) może prowadzić do długotrwałej kontroli choroby lub wydłużenia przeżyć u odpowiednio wybranych chorych. Celem niniejszego opracowania są zalecenia dla optymalnego zakresu wskazań i sposobu prowadzenia HIPEC w Polsce.The management of peritoneal surface malignancy is a signifi cant clinical problem. The hyperthermic intraperitoneal chemotherapy (HIPEC) combined with cytoreductive surgery seems to be the most promising method, leading to better local control or improved overall survival in selected patients with a peritoneal neoplasm. In this paper the authors present a consensus for the optimal indications and technical guidelines for performing HIPEC in Poland

Zasady stosowania dootrzewnowej chemioterapii w hipertermii (HIPEC) w leczeniu nowotworów złośliwych powierzchni otrzewnej w połączeniu z zabiegami cytoredukcyjnymi: zalecenia krajowe

The management of peritoneal surface malignancy is a significant clinical problem. The hyperthermic intraperitoneal chemotherapy (HIPEC) combined with cytoreductive surgery seems to be the most promising method, leading to better local control or improved overall survival in selected patients with a peritoneal neoplasm. In this paper the authors present a consensus for the optimal indications and technical guidelines for performing HIPEC in Poland.Leczenie nowotworów powierzchni otrzewnej stanowi istotny problem w onkologii. Wykazano, że skojarzenie maksymalnej cytoredukcji chirurgicznej z dootrzewnową chemioterapią w hipertermii (HIPEC; hyperthermic intraoperative peritoneal chemotherapy) może prowadzić do długotrwałej kontroli choroby lub wydłużenia przeżyć u odpowiednio wybranych chorych. Celem niniejszego opracowania są zalecenia dla optymalnego zakresu wskazań i sposobu prowadzenia HIPEC w Polsc

Surgical treatment of rectal cancer in Poland — a report from a prospective, multi-centre observational study PSSO_01 conducted under the auspices of the Polish Society of Surgical Oncology

Introduction. Since 2016, as part of the PSSO_01 multi-centre research project conducted under the auspices of the Polish Society of Surgical Oncology, clinical data on rectal cancer treatment have been collected. The objective of the study was to illustrate the state of early results of surgical treatment. Material and methods. The research project is multi-centre in nature. Data shall be collected electronically. The study protocol does not impose or suggest any course of procedure. It only systematizes the way data are collected for scientific purposes. The analysis of early results of surgical treatment was compared with the results of population studies from other European countries (Netherlands, Belgium). Results. By the end of June 2018, 736 patients were registered in the study. In 399 (54.2%) an anterior resection was performed. More than half of patients undergoing subsequent surgical treatment (54.2%) receive neoadjuvant treatment, with the percentage of patients undergoing radiotherapy or radiochemical treatment for lower rectal cancer being about 70%. Most patients (96%) are operated in elective procedure. The percentage of laparoscopic surgeries is low (8.6%). Postoperative complications are observed in 21.1% of patients. Severe complications (grades III–V according to Clavien-Dindo classification) occur in 7.6% of patients undergoing surgery. Postoperative mortality is 1.1%. Discussion. Although the project does not have the character of a registry and does not allow for drawing wider conclusions concerning the compliance with the standards of qualification for neoadjuvant treatment, the important information is that more than half of rectal cancer patients receive preoperative treatment, and the percentage of severe postoperative complications does not exceed 10%. Conclusions. The results of the PSSO_01 project are representative and reflect the actual situation concerning surgical treatment of rectal cancer patients in Poland

The surgical treatment of rectal cancer in Poland. The findings of a multi-center observational study by the Polish Society of Surgical Oncology (PSSO-01)

Introduction. PSSO-01, a Polish prospective multi-center project on rectal cancer, started in 2016 with participation on a voluntary basis. This study evaluates the early outcome of the surgical treatment of rectal cancer in Poland according to hospital volume. Material and methods. The dataset derives from 17 clinical centers registered in the PSSO-01 study. From 2016 to 2020, the data of 1,607 patients were collected. Taking into account the number of patients enrolled in the study, the centers were divided into three categories: high volume, medium volume, and low volume. Nominal variables were compared between different categories of centers using the chi-square test. The STROBE guidelines were used to guarantee the reporting of this observational study. Results. More patients with metastatic disease were operated on in the low volume centers (p = 0.020). Neoadjuvant treatment was used in 35%, 52%, and 66% of patients operated on in low, medium, and high volume centers respectively (p < 0.001). Laparoscopic resection in medium volume centers was performed more often than in other centers (p < 0.001). The total rate of postoperative complications related to high, medium, and low centers was 22%, 26%, 18% (p = 0.044). One year following surgery, a stoma was present in 63% of patients. A defunctioning stoma following anterior resection was reversed in only 55% of patients. Anastomotic leakage was the main reason for a non-reversal diverting stoma. Conclusions. The representation of low volume centers in the PSSO-01 study was understated. However, the outcomes may show the actual situation of surgical treatment of rectal cancer in high and medium volume centers in Poland

Variant alleles of the CYP1B1 gene are associated with colorectal cancer susceptibility

<p>Abstract</p> <p>Background</p> <p>CYP1B1 is a P450 enzyme which is involved in the activation of pro-carcinogens to carcinogens as well as sex hormone metabolism. Because differences in the activity of the enzyme have been correlated with variant alleles of single nucleotide polymorphisms (SNPs), it represents an attractive candidate gene for studies into colorectal cancer susceptibility.</p> <p>Methods</p> <p>We genotyped 597 cancer patients and 597controls for three CYP1B1 SNPs, which have previously been shown to be associated with altered enzymatic activity. Using the three SNPs, eight different haplotypes were constructed. The haplotype frequencies were estimated in cases and controls and then compared. The odds ratio for each tumour type, associated with each haplotype was estimated, with reference to the most common haplotype observed in the controls.</p> <p>Results</p> <p>The three SNPs rs10012, rs1056827 and rs1056836 alone did not provide any significant evidence of association with colorectal cancer risk. Haplotypes of rs1056827 and rs10012 or rs1056827 and rs1056836 revealed an association with colorectal cancer which was significantly stronger in the homozygous carriers. One haplotype was under represented in the colorectal cancer patient group compared to the control population suggesting a protective effect.</p> <p>Conclusion</p> <p>Genetic variants within the CYP1B1 that are associated with altered function appear to influence susceptibility to a colorectal cancer in Poland. Three haplotypes were associated with altered cancer risk; one conferred protection and two were associated with an increased risk of disease. These observations should be confirmed in other populations.</p

Leczenie chirurgiczne raka odbytnicy w Polsce — raport z prospektywnego, wieloośrodkowego badania obserwacyjnego PSSO_01 prowadzonego pod auspicjami Polskiego Towarzystwa Chirurgii Onkologicznej

Wstęp. Od 2016 roku w ramach wieloośrodkowego projektu badawczego PSSO_01 prowadzonego pod auspicjami Polskiego Towarzystwa Chirurgii Onkologicznej, gromadzone są dane kliniczne dotyczące leczenia raka odbytnicy. Celem pracy było zobrazowanie stanu dotyczącego wczesnych wyników leczenia chirurgicznego. Materiał i metody. Projekt badawczy ma charakter wieloośrodkowy. Dane gromadzone są elektronicznie. Protokół badania nie narzuca ani nie sugeruje żadnego sposobu postępowania, systematyzuje jedynie sposób zbierania danych w celach naukowych. Analiza dotycząca wczesnych wyników leczenia chirurgicznego została porównana z rezultatami populacyjnych badań z innych krajów europejskich (Holandia, Belgia). Wyniki. Do końca czerwca 2018 roku w badaniu zarejestrowano 736 chorych. U 399 (54,2%) wykonano resekcję przednią. Leczenie neoadiuwantowe otrzymała ponad połowa chorych, poddanych następnie leczeniu operacyjne­mu (54,2%), przy czym odsetek pacjentów poddanych radio- bądź radiochemioterapii z powodu raka dolnej części odbytnicy wyniósł około 70%. Większość chorych (96%) operowana była w trybie planowym. Odsetek operacji wykonanych techniką laparoskopową jest niski (8,6%). Powikłania pooperacyjne zaobserwowano u 21,1% chorych. Ciężkie powikłania (III–V st. wg klasyfikacji Claviena-Dindo) sięgały 7,6% operowanych chorych. Śmiertelność po­operacyjna wyniosła 1,1%. Dyskusja. Chociaż projekt nie ma charakteru rejestru i nie pozwala na wyciągniecie szerszych wniosków dotyczących przestrzegania standardów kwalifikacji do leczenia neoadiuwantowego, istotną informacją jest to, że ponad połowa chorych na raka odbytnicy otrzymuje leczenie przedoperacyjne, a odsetek ciężkich powikłań pooperacyjnych nie przekracza 10%. Wnioski. Wyniki projektu PSSO_01 są reprezentatywne i odzwierciedlają faktyczną sytuację dotyczącą leczenia chirurgicznego chorych na raka odbytnicy w Polsce

Inflammatory response gene polymorphisms and their relationship with colorectal cancer risk

<p>Abstract</p> <p>Backgroud</p> <p>Patients with chronic inflammatory bowel disease (IBD) are at an increased risk of colorectal cancer (CRC) and it is estimated that one in six persons diagnosed with IBD will develop CRC. This fact suggests that genetic variations in inflammatory response genes may act as CRC disease risk modifiers.</p> <p>Methods</p> <p>In order to test this hypothesis we investigated a series of polymorphisms in 6 genes (NOD2, DLG5, OCTN1, OCTN2, IL4, TNFα) associated with the inflammatory response on a group of 607 consecutive newly diagnosed colorectal cancer patients and compared the results to controls (350 consecutive newborns and 607 age, sex and geographically matched controls).</p> <p>Results</p> <p>Of the six genes only one polymorphism in TNFα(-1031T/T) showed any tendency to be associated with disease risk (64.9% for controls and 71.4% for CRC) which we further characterized on a larger cohort of CRC patients and found a more profound relationship between the TNFα -1031T/T genotype and disease (64.5% for controls vs 74.7% for CRC cases above 70 yrs). Then, we investigated this result and identified a suggestive tendency, linking the TNFα -1031T/T genotype and a previously identified change in the CARD15/NOD2 gene (OR = 1.87; p = 0,02 for CRC cases above 60 yrs).</p> <p>Conclusion</p> <p>The association of polymorphisms in genes involved in the inflammatory response and CRC onset suggest that there are genetic changes capable of influencing disease risk in older persons.</p