Preliminary assessment of results obtained by the Endoscope Department of Great Poland Cancer Centre, Poznań, in the framework of the Screening Programme for Early Diagnostics of Colon Cancer in years 2004-2005

BackgroundColonoscopy screening and polypectomy are one of the most effective ways to reduce the incidence of colon cancer. One of the best achievements in Poland is the Colorectal Screening Programme that was started in 2000.AimThe aim of our study is to present the results of the examination made by the Endoscope Department of Great Poland Cancer Centre in the framework of the Polish Screening Programme for early diagnosis of colon cancer in the years 2004 and 2005.Materials/MethodsWe admitted to the screening programme asymptomatic persons aged 50–65 years (main group), persons between 40 and 65 years old with familial history of colorectal cancer, and people aged 25–65 from HNPCC or FAP families.ResultsWe examined 1000 individuals. 982 total colonoscopies (98.2% effectiveness) were done, and finally 806 polyps were removed. Adenomas were found in 83 removed polyps (10%), including neoplastics lesions in 24 (28.9%) cases: tubulovillous adenomas in 15 (18.1%), villous adenomas in 5 (6.0%) and serrated adenomas in 4 (4.8%) cases. Two of the removed polyps (0.2%) were malignant. Summarized colorectal neoplasia was detected in 26 (2.6%) participants. We observed a 0.9% complication rate among all the participants.ConclusionsThe fundamental importance and consequence of early cancer detection and removal of premalignant adenomatous polyps has been shown to prevent death due to colorectal cancer and to reduce colorectal cancer incidence. Screening by colonoscopy with polypectomy can be an excellent and safe procedure with good levels of acceptability and high level yield for advanced colorectal neoplasia

Planoepitheliale cell carcinoma arising from ampullo-pancreatic unit

BackgroundWe report a case of planoepitheliale cell carcinoma located in the ampulla of Vater. We report the surgical results and pathological findings of a patient with an ampullary planoepitheliale cell carcinoma. From what we know it is the first case with successful surgical treatment.Case ReportA 58-year-old woman who presented with jaundice and preoperative endoscopic and radiological procedures could not show whether the tumour was carcinoma planoepitheliale. The clinical presentation, biochemical, radiographic and endoscopic investigation pronounced advanced pancreatic adenocarcinoma.ResultsWe performed pancreaticoduodenectomy with curative intension. Histological examination revealed: planoepitheliale cell carcinoma of the ampullo-pancreatic unit.ConclusionsIn conclusion, preoperative endoscopic and radiological evaluations can all prove insufficient to distinguish between benign and malignant tumour. Thus, for malignant tumours surgeons may be forced to perform extensive surgery

An unusual case of synchronous lymphoma and adenocarcinoma occurring as a collision tumour in the stomach – a case report

The occurrence of malignant gastric lymphoma and adenocarcinoma in the same patient is very rare. Here we report a case of synchronous gastric carcinoma and gastric lymphoma with a follicular growth pattern associated in a 73-year-old man. Preliminary diagnosis gastric tumour was suggested so laparotomy was performed for the purpose of treatment resection of the stomach. In the operation field, there was a main lesion spreading through the whole of the stomach and additional multiple lymph node enlargements at the hepato-duodenal, retro-pancreatic and the para-aortic lymph nodes. A short-term intraoperative examination of one of the metastatic lymph nodes showed lymphoma of the stomach. Palliative total gastrectomy Roux-en-Y was performed. Finally the pathology of the specimen revealed two different collided tumours: adenocarcinoma solidum and non-Hodgkin's lymphoma malignum with follicular growth pattern. Following surgery and chemotherapy, the patient is now in a disease progress state

Prognostic index in lobular breast cancer

BackgroundThe topic of this study was lobular carcinoma, the second most frequently diagnosed cancer of the breast, which is less well known and is more problematic, diagnostically.AimTo define a prognostic index for patients with lobular carcinoma of the breast through application of a multivariate analysis, Cox's proportional hazard model.Materials/MethodsAn immunohistochemistry based analysis was carried out on paraffin embedded materials taken from 75 women who underwent surgery for lobular carcinoma of the breast in the Oncological Surgery Department, Poznań University of Medical Sciences, during the period of 1990–1997.ResultsA statistically significant relationship was found between the size of tumour (p=0.044), lymph node status (p=0.011), expression of progesterone receptors (p=0.034), and survival time. In support of the above parameters, the multivariate analysis allowed the formulation of a prognostic index: I=T+2N-2PgR, where T (tumour)=tumour size, N (nodulus)=lymph node status, and PgR=expression of progesterone receptors.ConclusionsThe formulated prognostic index for lobular carcinoma of the breast allows for the differential prognosis of survival time, in representative risk groups. The index may be useful in the process of qualifying patients for adjuvant therapy

Accelerated Partial Breast Irradiation in the treatment of breast cancer — current status and treatment methods

Podstawowym powodem opracowania techniki przyspieszonego częściowego napromieniania raka piersi (AcceleratedPartial Breast Irradiation — APBI) było założenie, że prowadzi ono do uzyskania równorzędnego odsetkakontroli miejscowej wraz z mniejszą toksycznością leczenia w porównaniu z napromienianiem całej piersi wiązkamizewnętrznymi (Whole Breast Radiation Therapy — WBRT) po chirurgicznym leczeniu oszczędzającym (Breast ConservingSurgery — BCS). Jest to metoda radioterapii skierowana do wyselekcjonowanej grupy pacjentek we wczesnej faziezaawansowania choroby. Głównym powodem wprowadzenia do praktyki klinicznej APBI było niskie ryzyko wznowymiejscowej w tej samej piersi poza pierwotnie zajętym kwadrantem. Opublikowano szereg badań sugerującychmożliwość rezygnacji z WBRT. Dotychczas dostępne są wyniki 3 badań randomizowanych i 19 nierandomizowanych,w których badano skuteczność APBI. W poszczególnych badaniach klinicznych stosowano różne techniki APBI, dawkii frakcjonowanie, ale zasadnicza różnica w stosowanych technikach dotyczyła określenia obszaru do napromieniania(Clinical Target Volume — CTV i Planning Target Volume — PTV). Obecnie czekamy na wyniki siedmiu randomizowanychbadań klinicznych dotyczących zastosowania APBI w raku piersi po leczeniu oszczędzającym. W artykule dokonanoprzeglądu stosowanych technik, zasad kwalifi kacji oraz wyników leczenia metodą APBI.Breast conserving surgery (BCS) with following radiotherapy (EBRT) of the conserved breast became widely acceptedin the last decades for the treatment of early invasive breast cancer. The standard technique of EBRT after BCS is totreat the whole breast up to a total dose of 45 Gy to 50 Gy. Additional dose is given to the treated volume after EBRTto boost a portion of the breast to a higher dose. However, over the past 10 years, the application of radiotherapy inbreast cancer has changed. In early stage breast cancer, research has shown that the area requiring radiation treatmentto prevent the cancer from local recurrence is the breast tissue that surrounds the area where the initial cancerwas removed. Because this typically includes only a part of the breast, APBI is now used to treat the targeted portionof the breast and as a result allows accelerated delivery of the radiation dose in four to fi ve days. Published resultsof APBI techniques are very promising. In this article the current status, indications, technical aspects and recentlypublished results of APBI in breast cancer treatment are presented

Detection of a second primary cancer in a 18F-fluorocholine PET/CT – multicentre retrospective analysis on a group of 1345 prostate cancer patients

Background: Aim of this study was to evaluate the rate of incidental detection of second primary cancer (SPC) at 18F-fluorocholine ([18F]FCH) positron emission tomography/computed tomography (PET/CT) performed in prostate cancer patients. Material and methods: A retrospective analysis was performed on a group of 1345 prostate cancer patients, who underwent [18F]FCH PET/CT study because of suspicion of recurrence (n = 937) or for initial staging (n = 408). Images were acquired after intravenous injection [18F]FCH with a mean activity of 200 ± 75 MBq (5.4 ± 2 mCi), from the top of the head to the half of the thigh. The confirmation of second primary cancer was obtained from the cancer registry. Results: Based on the [18F]FCH PET/CT scans, a second primary cancer was suspected in 89 patients (6.6%). Of these, a malignancy was histologically confirmed in 26 patients (29% of all suspected findings and 1.9% of the complete cohort). Lung cancer (including adenocarcinoma, neuroendocrine cancer) was diagnosed in 13 patients (50%) and hematologic neoplasm (including chronic lymphocytic leukemia, Hodgkin lymphoma, follicular lymphoma, and multiple myeloma) in 5 patients (19%). 18F-fluorocholine PET/CT also revealed esophageal cancer, mesothelioma, testicular, renal, bladder, and colorectal cancer inindividual patients, non-keratinizing squamous cell carcinoma (SCC) of the skin as well as head and neck SCC with unknown primary. Conclusion: We conclude that incidental detection of a second primary cancer in prostate cancer patients using [18F]FCH PET/CT is not very common and that lung cancer and hematologic malignancies are most frequently detected

Differences between TNM classification and 2-[18F]FDG PET parameters of primary tumor in NSCLC patients

BACKGROUND: The aim of the study was to compare the TNM classification with 2-[18F]FDG PET biological parameters of primary tumor in patients with NSCLC. MATERIALS AND METHODS: Retrospective analysis was performed on a group of 79 newly diagnosed NSCLC patients. PET scans were acquired on Gemini TF PET/CT scanner 60–70 min after injection of 2-[18F]FDG with the mean activity of 364 ± 75 MBq, with the area being examined from the vertex to mid-thigh. The reconstructed PET images were evaluated using MIM 7.0 Software for SUVmax, MTV and TLG values. RESULTS: The analysis of the cancer stage according to TNM 8th edition showed stage IA2 in 8 patients, stage IA3 — 6 patients, stage IB — 4 patients, IIA — 3 patients, 15 patients with stage IIB, stage IIIA — 17 patients, IIIB — 5, IIIC — 5, IVA in 7 patients and stage IVB in 9 patients. The lowest TLG values of primary tumor were observed in stage IA2 (11.31 ± 15.27) and the highest in stage IIIC (1003.20 ± 953.59). The lowest value of primary tumor in SUVmax and MTV were found in stage IA2 (6.8 ± 3.8 and 1.37 ± 0.42, respectively), while the highest SUVmax of primary tumor was found in stage IIA (13.4 ± 11.4) and MTV in stage IIIC (108.15 ± 127.24). CONCLUSION: TNM stages are characterized by different primary tumor 2-[18F]FDG PET parameters, which might complement patient outcome

The Influence of pH and Temperature on the Stability of N

The influence of pH and temperature on the stability of N-[(piperidine)methylene]daunorubicin hydrochloride (PPD) was investigated. Degradation was studied using an HPLC method. Specific acid-base catalysis of PPD involves hydrolysis of protonated molecules of PPD catalyzed by hydrogen ions and spontaneous hydrolysis under the influence of water zwitterions, unprotonated molecules, and monoanions of PPD. The thermodynamic parameters of these reactions, energy, enthalpy, and entropy, were calculated. Also, the stability of daunorubicin and its new amidine derivatives (piperidine, morpholine, pyrrolidine, and hexahydroazepin-1-yl) in aqueous solutions was compared and discussed

COVID-19. Pandemic surgery guidance

Abstract – Based on high quality surgery and scientific data, scientists and surgeons are committed to protecting patients as well as healthcare staff and hereby provide this Guidance to address the special issues circumstances related to the exponential spread of the Coronavirus disease 2019 (COVID-19) during this pandemic. As a basis, the authors used the British Intercollegiate General Surgery Guidance as well as recommendations from the USA, Asia, and Italy. The aim is to take responsibility and to provide guidance for surgery during the COVID-19 crisis in a simplified way addressing the practice of surgery, healthcare staff and patient safety and care. It is the responsibility of scientists and the surgical team to specify what is needed for the protection of patients and the affiliated healthcare team. During crises, such as the COVID-19 pandemic, the responsibility and duty to provide the necessary resources such as filters, Personal Protective Equipment (PPE) consisting of gloves, fluid resistant (Type IIR) surgical face masks (FRSM), filtering face pieces, class 3 (FFP3 masks), face shields and gowns (plastic ponchos), is typically left up to the hospital administration and government. Various scientists and clinicians from disparate specialties provided a Pandemic Surgery Guidance for surgical procedures by distinct surgical disciplines such as numerous cancer surgery disciplines, cardiothoracic surgery, ENT, eye, dermatology, emergency, endocrine surgery, general surgery, gynecology, neurosurgery, orthopedics, pediatric surgery, reconstructive and plastic surgery, surgical critical care, transplantation surgery, trauma surgery and urology, performing different surgeries, as well as laparoscopy, thoracoscopy and endoscopy. Any suggestions and corrections from colleagues will be very welcome as we are all involved and locked in a rapidly evolving process on increasing COVID-19 knowledg

Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts