27 research outputs found

    Abdominal Aortic Aneurysm and Malignancies

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    Concomitant AAA and abdominal malignancy are always very complicated conditions requiring early management of both pathologies. This is undoubtedly a dilemma for a surgeon who cannot currently rely on any large randomized trials or mandatory guidelines. When making decisions, a surgeon most often relies on personal experience, the experience of his/her center and/or limited literary guidelines and recommendations. Efforts should be aimed at achieving a consensual multidisciplinary decision about which pathology requires “more acute” management. The decision-making process is easier if one of the pathologies is life-threatening, and such pathology should be managed first. In most cases, however, AAA is asymptomatic and a malignancy is found randomly, as a secondary finding during the follow-up of AAA patients, or vice versa, AAA is found randomly during the staging of cancer patients. In these cases, the therapeutic algorithm already admits several possible variants. Endovascular repair of AAA (EVAR) resulted in an absolute change in the management of these patients. EVAR can be used in simultaneous or stage procedures with minimal time delay. Also, surgical open resection is an option (simultaneously or staged). It is necessary to know the advantages and risks of all approaches

    Hormone receptor conversion in metastatic breast cancer

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    Background/Objective: Hormone receptor (HR) status is one of the key factors in determining the treatment of breast cancer. Previous studies suggested that HR status may change in metastatic tissue. However, available studies focused mainly on primary biopsies and there are only few trials comparing HR status in the primary tumour and the metastasis using material from complete resection. The aim of the study was to determine the frequency of HR alterations in metastatic breast cancer. Materials and methods: The study retrospectively examines a total of 50 patients who underwent brain, lung, or liver metastasectomy for metastatic breast cancer between January 2000 and January 2019. Results: HR conversion was observed in a total of 30 cases (60.0%), while HER-2/neu (human epidermal growth factor receptor 2) discrepancy surprisingly occurred only in one case (2.0%). A change in immunophenotype occurred in 28% of cases. Triple-negativity was more frequent in brain metastases (p = 0.039). Conclusions: We have confirmed that HR conversion between the primary tumour and its metastases occurs in a significant number of cases, which has important implications for further treatment decisions
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