Recommendation of the Polish Society of Oncological Gynaecology on the diagnosis and treatment of epithelial ovarian cancer

The Recommendations of the Polish Society of Oncological Gynaecology offers evidence-based advice on the care and treatment of women with ovarian cancer and low malignant potential/borderline tumour

Recommendation of the Polish Society of Oncological Gynecology on the diagnosis and treatment of epithelial ovarian cancer

Zalecenia Polskiego Towarzystwa Ginekologii Onkologicznej są opartym na faktach zbiorem informacji dotyczących rozpoznawania i leczenia nowotworów nabłonkowych jajnika wraz z guzami o granicznej złośliwości.The Recommendations of the Polish Society of Oncological Gynaecology offers evidence-based advice on the care and treatment of women with ovarian cancer and low malignant potential/borderline tumour

Lend me your ear: Frank’s sign as a non-invasive method of vascular disease risk assessment

Cardiovascular diseases are the most common cause of unfitness for work and mortality in Polish people. The recommendations of all scientific associations emphasise the key role of primary prevention of diseases of affluence; however, demographic forecasts and the actual data concerning prevention do not indicate any trend for reduced morbidity and mortality in Poland. The article discusses Frank’s sign (earlobe crease), which appears on the earlobe in the fifth or sixth decade of life and correlates with atherosclerosis-related vascular diseases. The article presents the most important epidemiological data, description of the sign as well as important information from the literature on this simple physical assessment for the diagnosis of atherosclerosis-related vascular diseases. Checking whether the patient has Frank’s sign is a non-invasive and cost-free diagnostic tool for screening for atherosclerosis complications. Sensitivity of 62% indicates a chance for early detection of ischaemic heart disease in the asymptomatic population

Primary peritoneal serous carcinoma – diagnosis, management and prognosis

Primary peritoneal serous carcinoma (PPSC) is a rarely diagnosed malignancy. Furthermore, use of different terminology and classifications in reporting particular cases precludes collection and presentation of reliable epidemiological data. As a consequence, we lack adequate experience, enabling confident management of patients with this diagnosis. On histological grounds, PPSC is a neoplasm identical to invasive epithelial ovarian cancer. Also, patients present a similar profile of clinical symptoms. Most often these include abdominal pain, gastrointestinal disorders and weight loss. Clinical staging is based on surgical-pathological criteria of advanced ovarian cancer. Therapeutic management, i.e. combination of cytoreductive surgery and chemotherapy, is similar to that used in the treatment of late-stage ovarian cancer. Systemic adjuvant and palliative treatment includes chemotherapy protocols based on platinum derivates, recently combined with paclitaxel. Proper administration of combined treatment yields a high response rate and mean survival time of about 40 weeks. Prognosis in PPSC is not fully elucidated. Some studies indicate that prognosis is similar to that seen in late-stage ovarian cancer, while others report worse outcomes and shorter survival. Unfavourable prognostic factors include: suboptimal cytoreduction, poor general condition, advanced age of patient and 4th clinical stage. Data gathered hitherto point to highly similar natural course of PPSC and ovarian cancer, justifying the same therapeutic approach in both these conditions.Pierwotny surowiczy rak otrzewnej (primaryperitonealserous carcinoma, PPSC) jest nowotworem rzadko rozpoznawanym. Jednocześnie stosowanie różnej terminologii i klasyfikacji poszczególnych przypadków nie pozwala na przedstawienie wiarygodnych danych epidemiologicznych. W związku z powyższym brak jest wystarczającego doświadczenia w postępowaniu z chorymi z tym rozpoznaniem. PPSC histopatologicznie jest nowotworem o utkaniu identycznym z inwazyjnym nabłonkowym rakiem jajnika. Pacjentki manifestują także podobny profil objawów klinicznych. Najczęściej są to dolegliwości bólowe ze strony jamy brzusznej, zaburzenia pracy przewodu pokarmowego, ubytek masy ciała. Do oceny stopnia zaawansowania wykorzystuje się kyteria oceny chirurgiczno-patologicznej zaawansowanego raka jajnika. Również postępowanie terapeutyczne skojarzenie operacji cytoredukcyjnej z chemioterapią, jest analogiczne do leczenia zaawansowanego raka jajnika. W systemowym leczeniu uzupełniającym i paliatywnym stosowane są schematy chemioterapii oparte na pochodnych platyny, obecnie w połączeniu z paklitakselem. Właściwe przeprowadzenie leczenia skojarzonego pozwala na uzyskanie wysokiego odsetka odpowiedzi i średnich przeżyć sięgających 40 miesięcy. Nie jest do końca wyjaśniona kwestia rokowania w PPSC. Niektóre badania wskazują na podobieństwo do rokowania w zaawansowanym raku jajnika, natomiast inne donoszą o gorszych wynikach leczenia i krótszym przeżyciu chorych. Do niekorzystnych czynników prognostycznych należą: nieoptymalna cytoredukcja, gorszy stan ogólny, starszy wiek pacjentek oraz IV stopień zaawansowania choroby. Dotychczas zgromadzone dane przemawiają za znacznym podobieństwem przebiegu naturalnego PPSC i raka jajnika, co upoważnia do stosowania takiego samego postępowania terapeutycznego w obu tych jednostkach chorobowych

On the analysis of a mathematical model of CAR-T cell therapy for glioblastoma: Insights from a mathematical model

Chimeric antigen receptor T (CAR-T) cell therapy has been proven to be successful against different leukaemias and lymphomas. Its success has led, in recent years, to its use being tested for different solid tumours, including glioblastoma, a type of primary brain tumour, characterised by aggressiveness and recurrence. This paper presents an analytical study of a mathematical model describing the competition of CAR-T and glioblastoma tumour cells, taking into account their immunosuppressive capacity. The model is formulated in a general way, and its basic properties are investigated. However, most of the analysis considers the model with exponential tumour growth, assuming this growth type for simplicity. The existence and stability of steady states are studied, and the subsequent focus is on two different types of treatment: constant and periodic. Finally, protocols for CAR-T cell therapy of glioblastoma are numerically derived; these are aimed at preventing the tumour from reaching a critical size and at prolonging the patients’ survival time as much as possible. The analytical and numerical results provide theoretical support for the treatment of glioblastoma using CAR-T cells

Serum Sulfhydryl Groups, Malondialdehyde, Uric Acid, and Bilirubin as Predictors of Adverse Outcome in Heart Failure Patients due to Ischemic or Nonischemic Cardiomyopathy

Oxidative stress plays a significant role in the pathogenesis of heart failure (HF). The aim of the study was to investigate the prognostic value of oxidation-reduction (redox) markers in patients with HF due to ischemic and nonischemic cardiomyopathy. The study included 707 patients of HF allocated into two groups depending on ethology: ischemic cardiomyopathy (ICM) (n=435) and nonischemic cardiomyopathy (nICM) (n=272), who were followed up for one year. The endpoint occurrence (mortality or heart transplantation) in a 1-year follow-up was similar in the ICM and nICM group. The predictive value of endpoint occurrence of oxidative stress biomarkers such as the serum protein sulfhydryl groups (PSH), malondialdehyde (MDA), uric acid (UA), bilirubin, and MDA/PSH ratio and other clinical and laboratory data were assessed in both groups (ICM and nICM) separately using univariate and multivariate Cox regression analyses. In multivariate analysis, the higher concentrations of UA (p=0.015, HR=1.024, 95% CI (1.005-1.044)) and MDA (p=0.004, HR=2.202, 95% CI (1.296-3.741)) were significantly associated with adverse prognosis in patients with ICM. Contrastingly, in patients with nICM, we observed that higher bilirubin concentration (p=0.026, HR=1.034, 95% CI (1.004-1.064)) and MDA/PSH ratio (p=0.034, HR=3.360, 95% CI (1.096-10.302)) were significantly associated with increased risk of death or HT. The results showed the association of different oxidative biomarkers on the unfavorable course of heart failure depending on etiology

The Prognostic Role of CDK9 in Bladder Cancer

Introduction: Most patients with urothelial carcinoma are diagnosed with non-invasive tumors, but the prognosis worsens with the progression of the disease. Overexpression of cyclin-dependent kinase 9 has been recently linked to increased cancer proliferation, faster progression, and worse prognosis. However, some cancers seem to contradict this rule. In this work, we explored the prognostic role of CDK9 expression in urothelial carcinoma. Materials and Methods: We performed immunohistochemical analysis on 72 bladder cancer samples. To assess a larger group of patients, the Cancer Genome Atlas (TCGA) database containing 406 cases and transcriptomics information through the Human Pathology Atlas were analyzed. Results: CDK9 is overexpressed in urothelial cancer tissues when compared to normal urothelial tissues (p < 0.05). High CDK9 expression was observed in low-stage, low-grade, and non-muscle-invasive tumors (p < 0.05). The patients with high CDK9 expression had a significantly higher 5-year overall survival rate than those with low CDK9 expression (77.54% vs. 53.6% in the TMA group and 57.75% vs. 35.44% in the TCGA group, respectively) (p < 0.05). The results were consistent in both cohorts. Multivariate Cox regression analysis indicated that low CDK9 status was an independent predictor for poor prognosis in the TCGA cohort (HR 1.60, CL95% 1.1–2.33, p = 0.014). Conclusions: High CDK9 expression predicts a favorable prognosis in urothelial carcinoma and is associated with clinicopathological features characteristic for early-stage disease. The decrease in CDK9 expression can be associated with the build-up of genetic instability and may indicate a key role for CDK9 in the early stages of urothelial carcinoma

The Polish Society of Gynecological Oncology Guidelines for the Diagnosis and Treatment of Endometrial Carcinoma (2023)

Background: Due to the increasing amount of published data suggesting that endometrial carcinoma is a heterogenic entity with possible different treatment sequences and post-treatment follow-up, the Polish Society of Gynecological Oncology (PSGO) has developed new guidelines. Aim: to summarize the current evidence for diagnosis, treatment, and follow-up of endometrial carcinoma and to provide evidence-based recommendations for clinical practice. Methods: The guidelines have been developed according to standards set by the guideline evaluation tool AGREE II (Appraisal of Guidelines for Research and Evaluation). The strength of scientific evidence has been defined in agreement with The Agency for Health Technology Assessment and Tariff System (AOTMiT) guidelines for scientific evidence classification. The grades of recommendation have been based on the strength of evidence and the level of consensus of the PSGO development group. Conclusion: Based on current evidence, both the implementation of the molecular classification of endometrial cancer patients at the beginning of the treatment sequence and the extension of the final postoperative pathological report of additional biomarkers are needed to optimize and improve treatment results as well as to pave the route for future clinical trials on targeted therapies

Recommendations of the Polish Gynecological Oncology Society for the diagnosis and treatment of cervical cancer

Recommendations of the Polish Gynecological Oncology Society for the diagnosis and treatment of cervical cance