Trends in prostate cancer incidence and mortality in Croatia, 1988 to 2008

AIM: To describe and interpret prostate cancer incidence and mortality trends in Croatia between 1988 and 2008. ----- METHODS: Incidence data for the period 1988-2008 were obtained from the Croatian National Cancer Registry. The number of prostate cancer deaths was obtained from the World Health Organization mortality database. We also used population estimates for Croatia from the Population Division of the Department of Economic and Social Affairs of the United Nations. Age standardized incidence and mortality rates were calculated by the direct standardization method. To describe time trends of incidence and mortality, joinpoint regression analysis was used. ----- RESULTS: Average age-standardized incidence rate between the first and last five-year period doubled, from 19.0/100,000 in 1988-1992 to 39.1 per 100,000 in 2004-2008. Age-standardized mortality rate increased by 6.9%, from 14.5 to 15.5 per 100,000. Joinpoint analysis of incidence identified two joinpoints. The increasing incidence trend started from 1997, with the estimated annual percent of change (EAPC) of 12.9% from 1997-2002 and of 4.1% from 2002-2008. Joinpoint analyses of mortality identified one joinpoint. Mortality trend first decreased, with EAPC of -3.0% from 1988-1995 to increase later with EAPC of 2.0% from 1995-2008. ----- CONCLUSION: The incidence of prostate cancer in Croatia has been on the increase since 1997. Trend in mortality is increasing, contrary to the trends in some higher-income countries. An improvement in the availability of different treatment modalities as well as establishing prostate cancer units could have a positive impact on prostate cancer mortality in Croatia

TUMORSKI ANTIGENI U KARCINOMU PROSTATE, STRESNI KOMUNIKATIVNI PROBLEMI SUVREMENOG ČOVJEKA

This study investigated the immunohistochemical expression of the cancer testis antigen SSX in prostate cancer. SSX expression, with varying staining intensities, was observed in 83% of cancer samples. Substantial heterogeneity of expression was observed within individual samples. SSX expression was significantly higher in Gleason score 7 than in Gleason score 6 cancer (p=0.008). Tumours demonstrating capsular invasion had higher SSX expression than did tumours without capsular invasion (p=0.005). SSX expression did not correlate significantly with prostate-specific antigen level or tumour size. Further studies are needed to investigate SSX expression in prostate cancer and its potential implications for diagnosis and immunotherapy.U ovom radu istraživali smo imunohistokemijsku ekspresiju karcinom testis antigena SSX u karcinomu prostate. SSX ekspresija različitog intenziteta je pokazana u 83% uzoraka karcinoma. Pokazana je također i značajna heterogenost ekspresije unutar individaulnih uzoraka. SSX ekspresija je bila značajno više u Gleason zbroju 7, nego u Gleason zbroju 6 karcinoma prostate (p=0.008). Tumori koji su zahvatili kapsulu prostate imali su također značajniju SSX ekspresiju nego tumori koji nisu zahvatili kapsulu (p=0.005). SSX ekspresija nije korelirala značajno s vrijednostima prostata-specifičnog antigena ili veličinom tumora. Daljnje studije su potrebna da bi se istražila ekpresija SSX antigena u karcinomu prostate s potencijalnim implikacijama i na dijagnostiku i na imunoterapiju karcinoma prostate

TUMORSKI ANTIGENI U KARCINOMU PROSTATE, STRESNI KOMUNIKATIVNI PROBLEMI SUVREMENOG ČOVJEKA

This study investigated the immunohistochemical expression of the cancer testis antigen SSX in prostate cancer. SSX expression, with varying staining intensities, was observed in 83% of cancer samples. Substantial heterogeneity of expression was observed within individual samples. SSX expression was significantly higher in Gleason score 7 than in Gleason score 6 cancer (p=0.008). Tumours demonstrating capsular invasion had higher SSX expression than did tumours without capsular invasion (p=0.005). SSX expression did not correlate significantly with prostate-specific antigen level or tumour size. Further studies are needed to investigate SSX expression in prostate cancer and its potential implications for diagnosis and immunotherapy.U ovom radu istraživali smo imunohistokemijsku ekspresiju karcinom testis antigena SSX u karcinomu prostate. SSX ekspresija različitog intenziteta je pokazana u 83% uzoraka karcinoma. Pokazana je također i značajna heterogenost ekspresije unutar individaulnih uzoraka. SSX ekspresija je bila značajno više u Gleason zbroju 7, nego u Gleason zbroju 6 karcinoma prostate (p=0.008). Tumori koji su zahvatili kapsulu prostate imali su također značajniju SSX ekspresiju nego tumori koji nisu zahvatili kapsulu (p=0.005). SSX ekspresija nije korelirala značajno s vrijednostima prostata-specifičnog antigena ili veličinom tumora. Daljnje studije su potrebna da bi se istražila ekpresija SSX antigena u karcinomu prostate s potencijalnim implikacijama i na dijagnostiku i na imunoterapiju karcinoma prostate

Laparoskopska parcijalna adrenalektomija: serija slučajeva

The aim is to present our case series documenting indications, laparoscopic technique, surgical and endocrinologic outcomes of laparoscopic partial adrenalectomy. In the period from April 2011 until October 2021, we performed 39 procedures. The patients were divided into three groups: unilateral adrenal gland tumor with a normal contralateral gland (group 1), tumor of the solitary adrenal gland (group 2), and adrenal cysts (group 3). There were 20 patients in group 1, 6 patients in group 2, and 13 patients in group 3. The most common histology in group 1 was adenoma (40%), all tumors in group 2 were renal cell carcinoma metastases, and all cysts in group 3 were benign. There were no major complications (Clavien Dindo grade ≥2) in the whole cohort. All patients in groups 1 and 3 had favorable endocrinologic outcomes, and 50% of group 2 patients required lifelong hydrocortisone replacement therapy. The procedure is safe and feasible with favorable outcomes in the hands of a high volume adrenal surgeon.Cilj je predstaviti našu seriju slučajeva koja dokumentira indikacije, laparoskopsku tehniku, kirurške i endokrinološke ishode laparoskopske parcijalne adrenalektomije (LPA). U razdoblju od travnja 2011. do listopada 2021. godine učinili smo 39 zahvata. Bolesnici su podijeljeni u tri skupine: jednostrani tumor nadbubrežne žlijezde s normalnom kontralateralnom žlijezdom (skupina 1.), tumor solitarne nadbubrežne žlijezde (skupina 2.) i ciste nadbubrežne žlijezde (skupina 3.). U skupini 1. bilo je 20, u skupini 2. šest i u skupini 3. trinaest bolesnika. Najčešća patohistološka dijagnoza u skupini 1. bio je adenom (40%), svi tumori u skupini 2. bili su metastaze karcinoma bubrega, a sve ciste u skupini 3. su bile benigne. U cijeloj kohorti nije bilo značajnijih komplikacija (Clavien Dindov stupanj ≥2). Svi bolesnici u skupinama 1. i 3. imali su povoljan endokrinološki ishod, a 50% bolesnika u skupini 2. zahtijevalo je doživotnu nadomjesnu terapiju hidrokortizonom. LPA je učinkovit i siguran zahvat s povoljnim ishodima u rukama urologa s iskustvom u kirurgiji nadbubrežne žlijezde