Publications by authors named "Zbigniew Kojs"

30 Publications

  • Page 1 of 1

The association between lymph node metastases and long-term survival in patients with epithelial ovarian cancer.

Contemp Oncol (Pozn) 2020 20;24(3):163-171. Epub 2020 Sep 20.

nd Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Warsaw, Poland.

Introduction: A key survival prognosis factor for patients treated for ovarian cancer is complete cytoreductive surgery where all macroscopic neoplastic implants, including enlarged metastatic lymph nodes, are removed. We presume that investigating the involvement of the lymphatic system can result in a more individualized approach to the treatment of ovarian cancer patients. The main aim of our study was to analyze the relationship between the presence, number and types of lymph node metastases and ovarian cancer patient prognosis.

Material And Methods: We carried out a retrospective analysis of patients who underwent cytoreduction due to primary ovarian cancer, between 2010 and 2015. We analyzed the number of metastatic lymph nodes, the lymph node ratio defined as the ratio of the number of metastatic lymph nodes to the total number of lymph nodes removed, extracapsular involvement, and the histopathological pattern of metastases.

Results: The study group included 651 patients. Of these, 377 had lymphadenectomy, 144 presented with lymph node metastases, and 233 had no lymph node metastases. We also included a group of 274 patients who did not have lymphadenectomy. Patients with more than 4 metastatic lymph nodes and a lymph node ratio of ≥ 0.1 had significantly poorer overall survival. Extracapsular involvement had no relation to patient overall survival. Multivariant survival analysis indicated that a lymph node ratio of ≥ 0.1 was an independent predictor of poor survival.

Conclusions: The analysis of lymph node metastases in ovarian cancer patients can have predictive value for patient overall survival.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5114/wo.2020.99029DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670182PMC
September 2020

Role of vitamin D in selected malignant neoplasms.

Nutrition 2020 Nov - Dec;79-80:110964. Epub 2020 Jul 30.

Department of Medical Chemistry, Faculty of Chemistry, Adam Mickiewicz University, Poznań, Poland. Electronic address:

Vitamin D is a fat-soluble essential nutrient that affects multiple biologic functions in the organism through calcitriol and the vitamin D receptor. This review article focuses on the results of studies on the relationship between the level of vitamin D and cancer incidence or mortality, but also on the anticancer properties of vitamin D that support its significant role in the prevention, clinical course, and overall survival rates of selected cancers (colorectal, prostate, breast, ovarian, endometrial, bladder, and malignant melanoma). The mechanisms of vitamin D action involve, among others, polymorphism of vitamin D receptor, cell cycle, caspases, and cancer stem cells. The level of vitamin D has been also demonstrated to serve as a biomarker in some cancers, and high levels of vitamin D can be conducive to successful cancer therapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.nut.2020.110964DOI Listing
July 2020

Quantitative Assessment of Contrast Enhancement on Contrast Enhancement Spectral Mammography (CESM) and Comparison With Qualitative Assessment.

Anticancer Res 2020 May;40(5):2925-2932

University of Rzeszow, Faculty of Medicine, Rzeszow, Poland

Background/aim: Contrast enhanced spectral mammography (CESM) is a novel method of breast cancer diagnosis. Benign lesions are enhanced after contrast injection on both CESM and breast magnetic resonance imaging (MRI). Kinetic curves on breast MRI facilitate differentiation between benign and malignant lesions, while on CESM there is no such possibility and we need to asses lesions based only on their level of enhancement and its patterns. The aim of this study was to compare two subjective assessments of enhancement level on CESM with numerical values measured using the region of interests (ROIs) and to categorize obtained enhancement level values.

Patients And Methods: Patients with suspicious findings on previously performed examinations were qualified for CESM. The qualitative assessment was based on the subjective classification of visible contrast enhancement as weak, medium or strong. The quantitative assessment was obtained by measurements of an average enhancement value and sigma value within the ellipsoidal shape ROI, inserted into the evaluated contrast enhancing lesion.

Results: The study group included 151 patients with total of 195 lesions diagnosed. It was verified how the classification based on the threshold values of %RS (percentage signal difference between enhancing lesion and background) and SDNR (signal-difference-to-noise Ratio) corresponds to a subjective assessment.

Conclusion: Quantitative assessment of contrast enhancement on CESM is helpful in making decisions whether a lesion requires a biopsy. This can reduce the number of unnecessary biopsy procedures and reduce the cost of diagnostics.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.21873/anticanres.14270DOI Listing
May 2020

Metastatic and non-metastatic sentinel inguinofemoral lymph nodes in vulvar cancer show an increased lymphangiogenesis.

Ann Agric Environ Med 2020 Mar 26;27(1):123-128. Epub 2019 Mar 26.

Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland.

Introduction And Objective: Lymph node involvement is a strong predictor of disease recurrence and patient survival in vulvar cancer. The aim of the study was to evaluate the feasibility of sentinel lymph node (SLN) screening, the incidence of skip metastases, and lymph node lymphangiogenesis.

Material And Methods: Fifty-five patients participated in this prospective, single centre study. A double SLN screening method was employed using radiocolloid (technetium-99 sulfur colloid) and 1.0% Isosulfan Blue. Immunohistochemistry, using a mouse monoclonal antibody against D2-40, was used to evaluate lymphatic vessel density (LVD). All calculations were performed using STATISTICA software v. 10 (StatSoft, USA, 2011); p < 0.05 was considered significant.

Results: Using both methods of SLN detection, 100% accuracy was achieved, and skip metastases were diagnosed in only one woman (1.82%). Peri-tumour median LVD was significantly increased compared with matched intra-tumour samples (p < 0.001), while median LVD was significantly lower in negative, compared with positive SLN, regardless of whether matched non-SLN were negative (p < 0.001) or positive (p = 0.005). Metastatic SLN exhibited significantly higher median LVD compared with matched negative non-SLN (p = 0.015), while no significant difference in median LVD was detected between positive SLN and matched positive non-SLN. However, negative SLN had a significantly higher median LVD compared with matched negative non-SLN (p = 0.012).

Conclusions: SLN detection is a safe and feasible procedure in vulvar cancer. In patients without nodular involvement, SLN, compared with non-SLN, exhibited significantly higher median LVD, which may be an indication of its preparation to host metastases, and thus requires further investigation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.26444/aaem/105925DOI Listing
March 2020

Correlation Between Enhancement Intensity in Contrast Enhancement Spectral Mammography and Types of Kinetic Curves in Magnetic Resonance Imaging.

Med Sci Monit 2020 Mar 4;26:e920742. Epub 2020 Mar 4.

Department of Radiology, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow, Poland.

BACKGROUND Due to the decreased sensitivity of mammography in glandular breasts, new diagnostic modalities, like contrast-enhanced spectral mammography (CESM) and digital breast tomosynthesis (DBT) have been developed. The aim of this study was to compare qualitative enhancement levels on CESM with type of kinetic enhancement curves on MRI examination. MATERIAL AND METHODS Patients qualified for the CESM examination presented some diagnostic doubts - suspected multifocality, multicentricity, or having dense glandular breast tissue. The enhancement level on CESM was described as weak, medium, or strong. Enhancement on achieved MR images was assessed on the basis of enhancement kinetic curves. The level of enhancement on CESM was associated with enhancement curves type on MRI. All lesions detected on CESM and MRI were histopathologically verified. RESULTS The study involved 107 lesions diagnosed in 94 patients: 71 lesions (66%) appeared to be infiltrating on histopathological examination, 9 lesions (8%) were non-infiltrating cancers, and 27 lesions (25%) were benign. Data analysis revealed that lesions with wash-out curve on MRI most often presented strong enhancement on CESM, while in lesions with progressive enhancement curve, strong enhancement on CESM was the rarest. The relationship between enhancement level on CESM and curve type on contrast-enhanced MRI depends on the nature of the lesion. The type of MRI curve was found to be associated with enhancement level on CESM. CONCLUSIONS We compared subjective assessments of contrast enhancement on CESM with enhancement kinetic curves on MRI. The results showed that the level of enhancement on CESM and type of kinetic curves on MRI depends on the lesion type.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.12659/MSM.920742DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071734PMC
March 2020

Cobas 4800 HPV detection in cervical samples of Polish women.

Contemp Oncol (Pozn) 2019 13;23(2):92-95. Epub 2019 Jun 13.

Department of Obstetrics and Gynaecology and Gynaecological Oncology, Regional Hospital in Kalisz, Poland.

Introduction: Long-term infection with human papillomavirus (HPV) is the cause of cervical cancer and its precursor - cervical intraepithelial neoplasia (CIN). The presence of HPV infection can be presumed in more than 99% of cases of cervical cancer worldwide. The introduction of DNA testing for the presence of HPV has increased the effectiveness of screening programs for the detection of this cancer. This study aimed to analyze the prevalence of high risk HPV DNA (HR HPV) in females from Poland.

Material And Methods: The study was performed on 280 cervical smear samples. In this work we used the Roche Cobas 4800 HPV test to detect the HR HPV in cervical smear samples.

Results: 56 patients (20%) proved to be positive regarding HPV-16 DNA and 40 patients (14.28%) regarding HPV-18 DNA. In overall assessment, in 94 patients (33.57%) we detected oncogenic HPV subtypes, other than the two mentioned above. In 90 patients (32.14%) no high risk HPV was detected.

Conclusions: The Roche Cobas 4800 HPV test is a viable, effective, easy and quick tool in detecting high risk HPV DNA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5114/wo.2019.85880DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6630389PMC
June 2019

Correlation between quantitative assessment of contrast enhancement in contrast-enhanced spectral mammography (CESM) and histopathology-preliminary results.

Eur Radiol 2019 Nov 14;29(11):6220-6226. Epub 2019 May 14.

Department of Radiology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow, Poland.

Objectives: Contrast-enhanced spectral mammography (CESM) is a novel method for breast cancer detection. The aim of this study is to check if there is a possibility of quantitative assessment of contrast enhancement in CESM and if there is any correlation between quantitative assessment of contrast enhancement in CESM and histopathology.

Methods: A total of 167 female patients underwent CESM. All subjects previously had suspicious lesions found on mammography, breast ultrasound, or both. After imaging, the following parameters were evaluated: number of enhancing lesions in each breast and size and degree of enhancement of each lesion. Based on the collected data, the percentage signal difference between enhancing lesion and background (%RS) and signal-difference-to-noise ratio (SDNR) were measured for each lesion.

Results: The number of lesions detected in the study population was 195. Among all diagnosed lesions, 120 (62%) were assessed to be infiltrating cancers, 16 (8%) non-infiltrating cancers, and 59 (30%) were benign. Thirteen (7%) lesions did not enhance in CESM; all non-enhancing lesions were confirmed to be benign under histopathological examination. Analysis of enhancement indices showed that signal values within lesions and signal values within background ROIs (regions of interest) were similar in CC (craniocaudal) and MLO (mediolateral) projections. Mean %RS values were correlated with the type of enhancing lesion, infiltrating cancers having the highest values, benign lesions the lowest.

Conclusions: This work has demonstrated a significant correlation between the degree of lesion enhancement in CESM and malignancy. Quantitative analysis of enhancement levels in CESM can distinguish between invasive cancers and benign or in situ lesions.

Key Points: • There is a possibility of quantitative assessment of contrast enhancement in CESM. • Correlation between quantitative assessment of contrast enhancement in CESM and histopathology was observed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00330-019-06232-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795639PMC
November 2019

The potential predictive value of serum srCaS1 levels for overall survival in endometrial cancer.

Ginekol Pol 2019 ;90(3):134-140

Center of Oncology, M. Sklodowska-Curie Memorial Institute, Cracow Branch, Poland.

Objectives: The main aim of the study was to evaluate the impact of levels of serum soluble receptor-binding cancer antigen expressed on SiSo cells (sRCAS1) on the overall survival (OS) rates in patients with endometrial cancer. Furthermore, we analyzed sRCAS1 levels according to the clinicopathological characteristics of the disease.

Material And Methods: The study group comprised 43 patients who were being treated for endometrial cancer. We included 10 low-risk, 20 intermediate-risk and 13 high-risk endometrial cancers using the criteria of the European Society for Medical Oncology (ESMO), the European Society for Radiotherapy & Oncology (ESTRO) and the European Society of Gynaecological Oncology (ESGO). Serum sRCAS1 levels were obtained before and after surgery. Serum sRCAS1 levels were assessed using the ELISA method.

Results: In our univariate analysis, both the pre- and post-surgery high sRCAS1 groups of patients with endometrial cancer indicated a shortened OS. However, in our multivariate analysis, when patients' age and disease-related risk was taken into consideration, only the post-surgery sRCAS1 levels remained as independent prognostic factors of a poor OS. Pre-treatment serum sRCAS1 levels were statistically significantly higher than post-surgery sRCAS1 levels; however, the difference between pre- and post-surgery sRCAS1 levels did not influence the patients' OS rate. Pre- and post-surgery sRCAS1 levels did not differ according to tumor grade, stage of the disease or the disease-related risk group.

Conclusions: High post-surgery serum sRCAS1 levels seem to be an independent indicator of shortened overall survival in patients with endometrial cancer.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5603/GP.2019.0024DOI Listing
February 2020

Selected features of breast and peritoneal cancers diagnosed in carriers after risk-reducing salpingo-oophorectomy.

Hered Cancer Clin Pract 2019 14;17:10. Epub 2019 Mar 14.

3International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland.

Background: Since more than two decades Risk-reducing salpingo-oophorectomy (RRSO) is recommended and widely accepted by BRCA1/2 carriers as a method reducing ovarian cancer risk and improving survival rate. After RRSO, there remains a risk of breast cancer and peritoneal cancer. The characteristics of these neoplasms are not well known. In this study, we determined the selected parameters such as age at cancer diagnosis, time from RRSO to the diagnosis of cancer, and significance of mutation type in patients diagnosed with breast or peritoneal cancer during postoperative follow-up.

Methods: The material comprised of 195 carriers who performed RRSO between years 1999-2012. In this period, 16 patients developed cancer (6-primary breast cancer, 3-contralateral breast cancer, 5-relapse of breast cancer, 2-peritoneal cancer). They were subject of the further analysis.

Results: During the follow-up period mean age of patients after RRSO at the time of cancer diagnosis was 53.19. The mean age of patients diagnosed with primary breast cancer was 50, contralateral breast cancer - 58.67, recurrence of breast cancer - 51 and peritoneal cancer 60. The mean time periods from RRSO to the diagnosis of primary, contralateral, recurrence breast cancer were 53, 58.67 and 25,4 months respectively and of peritoneal cancer 46 months. c.5266dupC mutation carriers demonstrated significantly shorter time of cancer development compared to patients carrying c.181T > G and c.4035delA mutations. Peritoneal cancer was only observed in two c.181T > G mutation carriers.

Conclusions: The mean age of cancer diagnosis and the mean time periods from RRSO to the diagnosis of cancer are similar to those observed by other researchers. The carriers of c.181T > G and c.5266dupC mutation should be the subject further studies in context of breast and peritoneal cancer risk or time of cancer development after RRSO, respectively.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13053-019-0109-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419350PMC
March 2019

Current treatment options for advanced choriocarcinoma on the basis of own case and review of the literature.

Ginekol Pol 2018 ;89(12):711-715

The Chair and Clinic of Obstetrics, Gynaecologic Diseases and Oncological Gynaecology of the Second Faculty of Medicine of Warsaw Medical University, Poland.

Choriocarcinoma is one of rare neoplasms of female reproductive organs. In the last decade only a few cases of this disease have been registered in Poland. The paper presents the current principles of diagnosis and treatment options for this rare disease based on the authors' clinical experience (description of the case) and literature review. This paper provides basic information on epidemiology, FIGO classification, and also discusses the chemotherapy regimens used in the medical treatment of choriocarcinoma. Surgical options were also considered. A thematic review of the most important papers published in international journals in recent years has also been made.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5603/GP.a2018.0120DOI Listing
August 2019

Post-Irradiation Bladder Syndrome After Radiotherapy of Malignant Neoplasm of Small Pelvis Organs: An Observational, Non-Interventional Clinical Study Assessing VESIcare®/Solifenacin Treatment Results.

Med Sci Monit 2016 Jul 30;22:2691-8. Epub 2016 Jul 30.

Urology Clinic, Collegium Medicum Jagiellonian University, Cracow, Poland.

BACKGROUND Radiotherapy is explicitly indicated as one of the excluding factors in diagnosing overactive bladder syndrome (OAB). Nevertheless, symptoms of OAB such as urgent episodes, incontinence, pollakiuria, and nocturia, which are consequences of irradiation, led us to test the effectiveness of VESIcare®/Solifenacin in patients demonstrating these symptoms after radiation therapy of small pelvis organs due to malignant neoplasm. MATERIAL AND METHODS We conducted an observatory clinical study including 300 consecutive patients with symptoms of post-irradiation bladder; 271 of those patients completed the study. The observation time was 6 months and consisted of 3 consecutive visits taking place at 12-week intervals. We used VESIcare® at a dose of 5 mg a day. Every sixth patient was examined urodynamically at the beginning and at the end of the observation period, with an inflow speed of 50 ml/s. RESULTS We noticed improvement and decline in the average number of episodes a day in the following parameters: number of micturitions a day (-36%, P<0.01), nocturia (-50%, P<0.01), urgent episodes (-41%, P<0.03), and episodes of incontinence (-43%, P<0.01). The patients' quality of life improved. The average maximal cystometric volume increased by 34 ml (21%, p<0.01), average bladder volume of "first desire" increased by 42 ml (49%, P<0.01), and average detrusor muscle pressure at maximal cystometric volume diminished by 9 cmH2O (-36%, P<0.03). CONCLUSIONS The substance is well-tolerated. Solifenacin administered long-term to patients with symptoms of OAB after radiotherapy of a malignant neoplasm of the small pelvis organs has a daily impact in decreasing number of urgent episodes, incontinence, pollakiuria, and nocturia.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976757PMC
http://dx.doi.org/10.12659/msm.899327DOI Listing
July 2016

[Primary diffuse large B-cell lymphoma of the uterine cervix - case report].

Ginekol Pol 2016 ;87(4):318-20

We present a case of a 54-year-old woman treated for stage IIAE primary diffuse large B-cell lymphoma (DLBCL) of the uterine cervix. The CHOP chemotherapy regimen was started. After the diagnosis of lymphoma of DLBCL CD20+ type was confirmed, rituximab was added to the therapy. Within systemic therapy, the patient received two cycles of CHOP and six cycles of R-CHOP altogether. After treatment completion, total remission of the lesions was observed on computed tomography. Twenty-four months after therapy completion, the patient is disease-free with no signs of recurrence.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.17772/gp/62355DOI Listing
July 2018

Prophylactic salpingo-oophorectomy in BRCA1 mutation carriers and postoperative incidence of peritoneal and breast cancers.

J Ovarian Res 2016 Feb 29;9:11. Epub 2016 Feb 29.

Department of Gynecologic Oncology, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Cracow Branch, Garncarska 11, 31-115, Kraków, Poland.

Background: There are no effective methods of diagnosis of early-stage ovarian cancer. Conservative care over patients at high risk of ovarian and breast cancers is ineffective. Prophylactic surgery is considered the best prophylaxis among BRCA1/BRCA2 carriers.

Methods: One hundred ninety-five patients, carriers of one of three most common mutations of the BRCA1 gene (Am J Hum Genet: 66: (6)1963-1968, 2000) in the Polish population (5382insC, 4153delA and C61G), who undergone prophylactic salpingo-oophorectomy. The study group consisted of consecutive mutation carriers living in Poland, in the West Pomeranian province. Histopathological examination of the surgical material failed to reveal presence of malignancy.

Results: During follow-up we diagnosed two peritoneal cancers and 14 breast cancers. Diagnosis of breast cancer before prophylactic surgery increased the risk of peritoneal cancer almost three times. Time from diagnosis of breast cancer to prophylactic surgery increased the risk of peritoneal cancer after prophylactic surgery. This was strongly expressed (HR = 5.0; p = 0.030) in cases of over five-year-long delay in prophylactic surgery. Diagnosis of breast cancer before prophylactic surgery correlated with the risk of death (p = 0.00010). Presence of 5382insC mutation decreased and C61G mutation increased the risk of peritoneal cancer (p = 0.049 vs. p = 0.013).

Conclusions: Occurrence of primary peritoneal cancer after prophylactic surgery is similar to that reported in international literature. Primary breast cancer occurred less often than in international literature. We suspect that the risk of development of breast cancer among BRCA1 carriers undergoing prophylactic surgery can differ in a population. The next goal should be to study the molecular basis for the risk of development of malignancies in any population. Carriers of BRCA1 gene diagnosed with breast cancer should undergo prophylactic surgery within five years from the diagnosis of breast cancer.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13048-016-0220-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772302PMC
February 2016

The biological role of Treg cells in ectopic endometrium homeostasis.

Histol Histopathol 2014 Oct 15;29(10):1217-33. Epub 2014 May 15.

Department of Gynecology and Oncology, Lukaszczyk Oncological Center, Bydgoszcz, and Chair of Gynecology, Oncology and Gynecological Nursing, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Torun, Poland.

Although retrograde menstruation is observed in up to 90% of women, endometriosis actually develops in only 15% of women. There is considerable evidence in the literature that ectopic endometrial cells are able to evade immune surveillance and that the immune response in the microenvironment of ectopic lesions is limited. Endometriosis develops when a deficiency in the local immune response has been generated, and progression of the disease is related to the intensity of this process. Over the last couple of decades it has been well known that T regulatory lymphocytes (Tregs) play a crucial role in controlling a variety of physiological and pathological immune responses. In this review we have focused on the physiological alteration of Treg cell infiltration into the endometrium during the reproductive processes of women. We discuss how a disturbance in Treg cell expansion is involved in generating such pathological processes as miscarriage and ectopic pregnancy development. We hypothesize about the role Treg cells might play in the survival of endometriosis foci in ectopic localization and in the evasion of such lesions from host immune surveillance.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14670/HH-29.1217DOI Listing
October 2014

Analysis of RCAS1 immunoreactivity within hydatidiform mole cells and decidual cells according to the applied therapeutic strategy: surgery or surgery followed by chemotherapy.

Gynecol Obstet Invest 2012 24;73(2):106-12. Epub 2012 Jan 24.

Departments of Gynecology and Oncology, Lukaszczyk Oncological Center, Bydgoszcz, Poland.

Introduction: Trophoblast cells cooperate with both maternal immune cells and decidual cells to help develop the suppressive microenvironment of the endometrium. The maternal immune response against hydatidiform mole depends on this suppressive endometrial profile. Since RCAS1 is one of the molecular factors participating in the development of the suppressive profile of the endometrium we decided to examine the immunoreactivity of the RCAS1 within both the trophoblast and decidual cells during the development of hydatidiform mole.

Methods: We analyzed the immunoreactivity of RCAS1 on both trophoblast and decidual cells derived from patients who underwent curettage because of hydatidiform mole. These patients were then divided into two subgroups according to whether or not they required chemotherapy after the surgical procedure.

Result: We observed significantly lower immunoreactivity levels of both RCAS1 within the complete molar lesions of the patients on whom surgery alone was performed when compared to the levels found in those for whom surgery was followed by chemotherapy.

Conclusion: RCAS1 staining may provide information regarding the intensity of the immunosuppressive microenvironment of both the molar lesion and the endometrium. This information can prove significant in determining the clinical course of hydatidiform mole.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000328509DOI Listing
August 2012

Irradiation-induced bone sarcoma in a patient treated for cervix cancer 28 years earlier.

Contemp Oncol (Pozn) 2012 29;16(1):56-9. Epub 2012 Feb 29.

Gynaecology Oncology Department, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Kraków, Poland.

Aim Of The Study: To present a case of a patient with cervical carcinoma in stage IIA who was diagnosed with pelvic bone sarcoma 28 years after radiotherapy.

Case Presentation: A 37-year-old woman with IIA cervix cancer was treated with external beam irradiation and brachytherapy. The patient had undergone conventionally fractionated external beam irradiation using the "box" technique, with the total dose of 50 Gy and brachytherapy with radium applicators (intrauterine tube and fornix applicator) with the dose of 60 Gy calculated at point A. After treatment she was followed up for 2 years. Twenty-six years later, inoperable pelvic bone sarcoma was diagnosed within the irradiated field. The clinical course was aggressive and rapid progression during chemotherapy was observed.

Conclusions: For patients receiving radiotherapy, long-term careful follow-up is mandatory due to second cancer risk. In the case of any suspicious symptoms, such patients need proper diagnosis to detect any disease as early as possible.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5114/wo.2012.27338DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3687376PMC
June 2013

Differences in the soluble HLA-G blood serum concentration levels in patients with ovarian cancer and ovarian and deep endometriosis.

Am J Reprod Immunol 2010 May 8;63(5):387-95. Epub 2010 Feb 8.

Department of Gynecology, Obstetrics and Oncology of the Jagiellonian University, Krakow, Poland.

Problem: The relationship between endometriosis and cancer has been widely discussed in the literature but is still not well clarified. Perhaps significantly, soluble human leukocyte antigen-G (sHLA-G) has been identified in the microenvironment of both ovarian cancer and endometrioma. The aim of this study has been to evaluate the sHLA-G levels in the blood sera of women with deep endometriosis and ovarian endometrioma over the course of the menstrual cycle and to compare to the levels of sHLA-G in the blood sera of women with ovarian cancer.

Method Of Study: In our study, we examined the blood sera obtained from 123 patients operated on because of ovarian cancer (65 cases), ovarian endometrioma (30 cases), and deep endometriosis (28 cases). We decided to compare the levels of sHLA-G in patients with endometriosis to those found in patients with ovarian cancer with respect to the menstrual cycle phases. The sHLA-G concentration level was measured by enzyme-linked immunosorbent assay kit.

Results: The level of sHLA-G concentration in the blood serum of patients with deep endometriosis fluctuates over the course of the menstrual cycle, and during the proliferative and secretory phases, it remains at a high level comparable to that found in patients with ovarian cancer. By contrast, the level of sHLA-G concentration in the blood serum of patients with ovarian endometrioma fluctuates minimally over the course of the different menstrual cycle phases and, as in patients with ovarian cancer, it remains at high level during the proliferative phase.

Conclusion: sHLA-G blood serum concentration levels would seem to provide important information regarding the degree of immune system regulation disturbance in both ectopic endometrial cells and the cancer cell suppressive microenvironment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/j.1600-0897.2009.00806.xDOI Listing
May 2010

Comparison of chromosomal radiosensitivity of normal cells with and without HRS-like response and normal tissue reactions in patients with cervix cancer.

Int J Radiat Biol 2008 May;84(5):421-8

Department of Applied Radiobiology, Centre of Oncology, Garncarska, Kraków, Poland.

Purpose: In our previous study, using the micronucleus (MN) assay, the low- and high-dose radiation response of fibroblasts and keratinocytes from cancer patients was assessed. We reported that a hyper-radiosensitivity (HRS)-like phenomenon was observed for fibroblasts of two and keratinocytes of four of the 40 patients studied. In this paper, we report the comparison of these in vitro results and normal tissue reactions in patients with cervix cancer and answer the question of the predictive value of the MN assay.

Materials And Methods: Of the 40 patients with cervix cancer whose cells were previously studied in vitro, 32 received radiotherapy. The treated group included two patients with HRS-like positive fibroblasts and four patients with HRS-like positive keratinocytes. In 26 patients both types of cells were HRS-like negative. The in vitro results (MN induction measured in patients' fibroblasts and keratinocytes after in vitrogamma-irradiation with doses ranging from 0.05-4 Gy) were compared with the maximum grade of acute and late reactions.

Results: Five of the six patients whose cells demonstrated low-dose chromosomal hypersensitivity in vitro, did not suffer from any mild or severe side effects after radiotherapy. Although individual variations in the grade scores of normal-tissue reactions were observed in cancer patients, no significant relationship was found between MN induction, either in fibroblasts or keratinocytes, and acute and late effects.

Conclusion: Since the MN assay showed no predictive value, it is rather impossible that the severe late complication observed in one of the six HRS-like positive patients reflects her low-dose chromosomal hypersensitivity in vitro.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/09553000802029910DOI Listing
May 2008

Perivascular epithelioid tumor (PEComa) of the falciform/ broad ligament.

Pol J Pathol 2008 ;59(4):211-5

Department of Tumor Pathology, Cracow Center of Oncology, Kraków.

PEComas localized in the region of falciform ligament and broad ligament are exceedingly rare. Most of them are built of spindle neoplastic cells. We report a case of epithelioid PEComa of the falciform ligament and/or broad ligament. There is only one report of such neoplasm in English-language literature. Histologically, the tumor was composed of nests of epithelioid clear cells stained positively for vimentin, HMB45, and SMA. Because of morphological features of the tumour (4 mitoses /20HPF, focal necrosis, and vascular invasion) we assess the neoplasm as potentially malignant.
View Article and Find Full Text PDF

Download full-text PDF

Source
May 2009

The response of primary keratinocytes and fibroblasts from cancer patients to multiple low-dose irradiations.

Radiat Res 2007 Nov;168(5):631-6

Department of Applied Radiobiology, Centre of Oncology, Garncarska 11, Kraków, Poland.

In our previous study, using the micronucleus (MN) assay, a hyper-radiosensitivity (HRS)-like phenomenon was observed after single low doses for fibroblasts from two and keratinocytes from four of the 40 patients studied. In this paper, we report the response of primary keratinocytes from 23 and fibroblasts from 21 of these cancer patients to multiple low-dose irradiations and answer the question regarding whether the patients with an HRS-like response after single low doses also demonstrate chromosomal hypersensitivity after multiple low doses. The cells were irradiated with three doses of 0.25 Gy separated by 4-h intervals, and MN induction was compared with that after the same total dose given as a single fraction of 0.75 Gy. Similarly, the effect of three doses of 0.5 Gy was compared with that of a single dose of 1.5 Gy. For fibroblasts from two and keratinocytes from four patients who demonstrated a single-dose HRS-like response, a significant inverse effect of fractionation (greater MN induction after three doses of 0.25 Gy than after a single dose of 0.75 Gy) was observed, which suggests a repeated hypersensitive response after each dose of 0.25 Gy. Such an effect was not seen for the cells from 19 patients who were single-dose HRS-like negative. In conclusion, an inverse fractionation effect for MN induction that was observed in fibroblasts from two and keratinocytes from four patients after three doses of 0.25 Gy (but not 3 x 0.5 Gy) reflects the chromosomal hyper-radiosensitivity seen in the same patients in response to single low doses.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1667/RR1001.1DOI Listing
November 2007

Low-dose radiation response of primary keratinocytes and fibroblasts from patients with cervix cancer.

Radiat Res 2007 Mar;167(3):251-9

Department of Applied Radiobiology, Centre of Oncology, Garncarska 11, 31-115 Kraków, Poland.

The aim of the present study was to examine, using the micronucleus (MN) assay, the low-dose radiation response of normal skin cells from cancer patients and to determine whether the hyper-radiosensitivity (HRS)-like phenomenon occurs in cells of these patients. Primary skin fibroblasts and keratinocytes derived from 40 patients with cervix cancer were studied. After in vitro gamma irradiation with single doses ranging from 0.05 to 4 Gy, MN induction was assessed. For each patient, the linear-quadratic (LQ) model and the induced repair (IR) model were fitted over the whole data set. In fits of the IR model, an HRS-like response after low doses (seen as the deviation over the LQ curve) was demonstrated for the fibroblasts of two patients and for the keratinocytes of four other patients. The alpha(s)/alpha(r) ratio for the six patients ranged from 2.7 to 15.4, whereas the values of the parameter d(c) ranged from 0.13 to 0.36 Gy. No relationship was observed between chromosomal radiosensitivity of fibroblasts and keratinocytes derived from the same donor in the low-dose (0.1-0.25 Gy) region. In conclusion, the fact that low-dose chromosomal hypersensitivity was observed for cells of only six of the patients studied suggests that it is not a common finding in human normal cells and can represent an individual characteristic.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1667/rr0649DOI Listing
March 2007

[Prognostic factors in patients with cervical--confined endometrial carcinoma treated with surgery and postoperative radiotherapy].

Przegl Lek 2005 ;62(12):1444-6

Klinika Ginekologii Onkologicznej, Krakowskiego Oddziału Centrum Onkologii, Instytutu im. M. Skłodowskiej-Curie.

Objective: The aim of the study was to determine prognostic factors in the group of the patients with uterine--confined endometrial carcinoma treated with surgery and postoperative radiotherapy.

Material And Methods: The authors analyzed 102 patients (mean age 58 years) with stage 1 (74 patients) and stage 11 (28 patients) endometrial carcinoma. All patients were treated with surgery (abdominal hysterectomy and bilateral adnexectomy) and postoperative radiotherapy: external beam pelvic irradiation (20 patients), vaginal cuff irradiation (33 patients) and combination (49 patients). Analysed were prognostic factors as follows: age, stage, tumor grade, depth of myometrial invasion, hormone receptors, expression of the tumor suppressor gene p53, Her 2/neu and MIB-1 (ki-67 paraffin).

Results: In our group of patients, multivariate analysis has identified tumor grade, progesterone receptors status and MIB-1 as independent significant prognostic factors.
View Article and Find Full Text PDF

Download full-text PDF

Source
November 2006

[Analysis of treatment outcome in patients with endometrial cancer limited to the uterus].

Ginekol Pol 2005 Feb;76(2):100-7

Klinika Ginekologii Onkologicznej Centrum Onkologii Oddział Kraków.

Objectives: The aim of study was to analyse results of treatment patients with uterine-confined endometrial cancer which underwent surgery and postoperative radiotherapy in Center of Oncology in Kraków between 1985 and 1997.

Material And Methods: The research included a group of 650 women. All patients undergo total abdominal hysterectomy with bilateral salpingo-oophorectomy and postoperative radiotherapy. 155 patients with intermediate-risk of recurrence (IA-G3, IB-G1, G2) received postoperative whole pelvic irradiation only. In the group of 495 patients with high-risk of recurrence (IB-G3, IC, II) 210 patients received brachytherapy vaginal cuff only and 285 patients whole pelvic and vaginal cuff irradiation.

Results: In the group of patients with intermediate-risk of recurrence five NED survival was 93.5%. In the group of patients with high-risk of recurrence five NED survival was statistically lower in patients treated with brachytherapy vaginal cuff only (83.2% vs. 71.9%).

Conclusion: In uterine-confined endometrial cancer patients, with intermediate-risk of recurrence treated with surgery and postoperative whole pelvis irradiation, 5-year NED survival is above of 90%. In the group of patients with high-risk of recurrence the adjuvant treatment of choice is whole pelvic and vaginal cuff irradiation.
View Article and Find Full Text PDF

Download full-text PDF

Source
February 2005

[Effectiveness of surgical treatment of patients with stage IA endometrial cancer].

Ginekol Pol 2004 Dec;75(12):937-40

Klinika Ginekologii Onkologicznej krakowskiego Oddziału Centrum Onkologii-Instytutu im. M. Sklodowskiej-Curie.

Objectives: The aim of the study was to analyse results of surgical treatment patients with stage IA-G1, G2 endometrial cancer treated in Center of Oncology in Kraków between 1985 and 1997.

Materials And Methods: The research included a group of 44 women. All patients underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH and BSO) without complementary treatment.

Results: Five NED survival was 95.5%. During the 5-year follow-up period 2 patients died, I of myocardial infarction and 1 of cerebral hemorrhage.

Conclusion: Total abdominal hysterectomy and bilateral salpingo-oophorectomy are the treatment of choice for stage IA-G1, G2 endometrial cancer.
View Article and Find Full Text PDF

Download full-text PDF

Source
December 2004

[The efficacy of adjuvant thoracic radiation therapy in NSCLC patients with ipsilateral mediastinal/hilar lymph nodes involvement (clinical trial)].

Pneumonol Alergol Pol 2003 ;71(11-12):496-503

Zaklad Teleradioterapii, Centrum Onkologii, Oddział Kraków.

Between 1992 and 1999 at the Oncology Centre in Cracow 138 NSCLC patients after complete resection of the tumour with mediastinal/hilar node involvement were included in the prospective clinical trial. The analysis of the results did not show any improvement of survival in the postoperatively irradiated group. Three-year survival rates with no symptoms of disease in postoperative radiotherapy patients compared to surgery alone group were 30% and 29% respectively. In this study adjuvant radiotherapy significantly improved local recurrence rate from 28% in surgery only group to 9% in postoperatively treated patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
September 2004

[The effectiveness of postoperative external beam radiotherapy for incompletely resected non-small cell lung cancer].

Pneumonol Alergol Pol 2003 ;71(11-12):488-95

Zakład Teleradioterapii, Centrum Onkologii, Oddział Kraków.

In a retrospective analysis of 150 incompletely resected NSCLC patients treated with adjuvant external beam radiotherapy 32 (21.3%) survived 3 years with no symptoms of disease. Ipsilateral mediastinal/hilar lymph node involvement and macroscopic incomplete surgery were the prognostic factors that unfavourably influenced survival in Cox's proportional hazards model. Postoperative external beam radiotherapy was the efficient adjuvant treatment method in microscopically incompletely resected NSCLC, predominantly with no nodes involvement, but had no benefit in those with macroscopic incomplete surgery.
View Article and Find Full Text PDF

Download full-text PDF

Source
September 2004

[Patients with advanced ovarian cancer after negative second-look laparoscopy--follow up study].

Ginekol Pol 2004 Feb;75(2):85-90

Kliniki Ginekologii Onkologicznej Krakowskiego Oddziału Centrum Onkologii.

Objectives: Follow-up in 65 patients with stage III-IV ovarian cancer after negative second-look laparotomy. Prognostic factors and causes of failure were also discussed.

Material And Methods: 65 patients with ovarian cancer stage III-IV were treated with surgery and at least six courses of chemotherapy (cisplatin, adriamycin, cyclophosphamide) and second-look laparotomy. Results of the treatment are presented in a form of 5-year NED (no evidence of disease) survival. Dependence between analyzed factors and survival was assessment based on proportional hazard Cox model.

Results: In 30 patients (46.1%) recurrence during 5 year follow-up was observed. In 28 patients out of them (93.3%) it was loco-regional failure and in 2 patients distant metastases were the sole reason of unsuccessful results of the treatment. Adverse prognostic factors found in statistical analysis were: advanced primary stage, residual infiltrations after first laparotomy exceeding 2 cm and low grade of differentiation.

Conclusions: 1. In about 50% of patient with advanced ovarian cancer loco-regional recurrence was observed, 2. Adverse prognostic factors were: advanced primary stage, residual masses after first laparotomy above 2 cm and low grade of differentiation.
View Article and Find Full Text PDF

Download full-text PDF

Source
February 2004

[A case of multiple malignancies].

Ginekol Pol 2002 Jun;73(6):543-5

Kliniki Ginekologii Onkologicznej Centrum Onkologii Instytutu im. Marii Skłodowskiej-Curie, Oddział w Krakowie.

A case of fourfold cancer: of the vulva and larynx diagnosed synchronously and the breast and lung diagnosed metachronously is presented.
View Article and Find Full Text PDF

Download full-text PDF

Source
June 2002

[Prognostic factors in the primary invasive vaginal carcinoma].

Ginekol Pol 2002 Mar;73(3):163-6

In the period 1965-1988, 125 women with primary invasive vaginal carcinoma were treated with radiotherapy. 53 (42.4%) survived 5-year without evidence of disease. In the Cox multivariate analysis three variables were independently related to survival: age of the patients, grade of differentiation of tumor and the clinical stage of illness.
View Article and Find Full Text PDF

Download full-text PDF

Source
March 2002