1. Safety and efficacy of drug-eluting microspheres chemoembolization under cone beam computed tomography control in patients with early and intermediate stage hepatocellular carcinomaŠpela Koršič, Nastja Levašič, Rok Dežman, Lara Anja Lešnik Zupan, Blaž Trotovšek, Rado Janša, Lojze Šmid, Peter Popović, 2022, original scientific article Abstract: Background. Drug-eluting microsphere transarterial chemoembolization (DEM-TACE) is the standard of care in pa-tients with intermediate-stage hepatocellular carcinoma and ensures targeted and controlled cytotoxic and ischemic effects. Proper patient selection and optimized treatment techniques are associated with longer median survival. The aim of this single-institution retrospective study was to evaluate safety and efficacy of DEM-TACE under cone beam computed tomography (CBCT) control in patients with early and intermediate stagehepatocellular carcinoma.Patients and methods. A total of144 patients (mean age 67.9 ± 8.0 years, 127 males and 17 females) between February 2010 and December 2018 were studied. Microparticles of different dimensions according to two manufac-turers (diameter of 70–150 μm, 100–300 μm or 300–500 μm and 40-μm, 75-μm or 100-μm) were used and loaded with 50–150 mg of doxorubicin. The objective tumour response according to the modified Response Evaluation Criteria in Solid Tumours (mRECIST), the time to progression, adverse events and overall survival were (OS) evaluated.Results. In total, 452 procedures were performed (median, 3 per patient). Four (0.9% of all procedures) major com-plications were noted. Postembolization syndrome occurred after 35% of procedures. At the first imaging follow-up 2–3 months after first treatment, 91% of patients achieved an objective response. The median time to progression was 10.2 months (95% CI: 8.3-12.1 months). OS rates at 1, 2, 3, 4, and 5 years were 85%, 53%, 33%, 20% and 14%, respectively. The median survival time was 25.8 months (95% CI: 22.1–29.5 months). Conclusions. DEM-TACE under CBCT control in patients with early and intermediate stagehepatocellular carcinoma is a safe and effective method of treatment with high objective tumour response and survival rates. Keywords: hepatocellular carcinoma, drug-eluting microspheres, doxorubicin Published in DiRROS: 25.07.2024; Views: 226; Downloads: 67
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2. Percutaneous image guided electrochemotherapy of hepatocellular carcinoma : technological advancementMihajlo Djokić, Rok Dežman, Maja Čemažar, Miha Štabuc, Miha Petrič, Lojze Šmid, Rado Janša, Boštjan Plešnik, Maša Omerzel, Urša Lampreht Tratar, Blaž Trotovšek, Bor Kos, Damijan Miklavčič, Gregor Serša, Peter Popović, 2020, original scientific article Abstract: Background. Electrochemotherapy is an effective treatment of colorectal liver metastases and hepatocellular carcinoma (HCC) during open surgery. The minimally invasive percutaneous approach of electrochemotherapy has already been performed but not on HCC. The aim of this study was to demonstrate the feasibility, safety and effectiveness of electrochemotherapy with percutaneous approach on HCC. Patient and methods. The patient had undergone the transarterial chemoembolization and microwave ablation of multifocal HCC in segments III, V and VI. In follow-up a new lesion was identified in segment III, and recognized by multidisciplinary team to be suitable for minimally invasive percutaneous electrochemotherapy. The treatment was performed with long needle electrodes inserted by the aid of image guidance. Results. The insertion of electrodes was feasible, and the treatment proved safe and effective, as demonstrated by control magnetic resonance imaging. Conclusions. Minimally invasive, image guided percutaneous electrochemotherapy is feasible, safe and effective in treatment of HCC. Keywords: electrochemotherapy, hepatocellular carcinoma, percutaneous, minimally invasive Published in DiRROS: 12.07.2024; Views: 178; Downloads: 103
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3. Dendritic cell profiles in the inflamed colonic mucosa predict the responses to tumor necrosis factor alpha inhibitors in inflammatory bowel diseaseNataša Smrekar, David Drobne, Lojze Šmid, Ivan Ferkolj, Borut Štabuc, Alojz Ihan, Andreja Nataša Kopitar, 2018, original scientific article Abstract: Background Dendritic cells play crucial roles in the control of inflammation and immune tolerance in the gut. We aimed to investigate the effects of tumor necrosis factor alpha (TNFa) inhibitors on intestinal dendritic cells in patients with inflammatory bowel disease and the potential role of intestinal dendritic cells in predicting the response to treatment. Patients and methods Intestinal biopsies were obtained from 30 patients with inflammatory bowel disease before and after treatment with TNFa inhibitors. The proportions of lamina propria dendritic cell phenotypes were analysed using flow cytometry. Disease activity was endoscopically assessed at baseline and after the induction treatment. Results At baseline, the proportion of conventional dendritic cells was higher in the inflamed mucosa (7.8%) compared to the uninflamed mucosa (4.5%) (p = 0.003), and the proportion of CD103+ dendritic cells was lower in the inflamed mucosa (47.1%) versus the uninflamed mucosa (57.3%) (p = 0.03). After 12 weeks of treatment, the proportion of conventional dendritic cells in the inflamed mucosa decreased from 7.8% to 4.5% (p = 0.014), whereas the proportion of CD103+ dendritic cells remained unchanged. Eighteen out of 30 (60%) patients responded to their treatment by week 12. Responders had a significantly higher proportion of conventional dendritic cells (9.16% vs 4.4%, p < 0.01) with higher expression of HLA-DR (median fluorescent intensity [MFI] 12152 vs 8837, p = 0.038) in the inflamed mucosa before treatment compared to nonresponders. Conclusions A proportion of conventional dendritic cells above 7% in the inflamed inflammatory bowel disease mucosa before treatment predicts an endoscopic response to TNFa inhibitors. Keywords: inflammatory bowel disease, dendritic cells, colon cancer Published in DiRROS: 02.07.2024; Views: 202; Downloads: 108
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4. Prognostic value of some tumor markers in unresectable stage IV oropharyngeal carcinoma patients treated with concomitant radiochemotherapyErika Šoba, Marjan Budihna, Alojz Šmid, Nina Gale, Hotimir Lešničar, Branko Zakotnik, Primož Strojan, 2015, original scientific article Abstract: The aim of the study was to investigate how the expression of tumor markers p21, p27, p53, cyclin D1, EGFR, Ki-67, and CD31 influenced the outcome of advanced inoperable oropharyngeal carcinoma patients, treated with concomitant radiochemotherapy. Patients and methods. The pretreatment biopsy specimens of 74 consecutive patients with inoperable stage IV oropharyngeal squamous cell carcinoma treated with concomitant radiochemotherapy were in retrospective study processed by immunochemistry for p21, p27, p53, cyclin D1, EGFR, Ki-67, and CD31. Disease-free survival (DFS) was assessed according to the expression of tumor markers. Results. Patients with a high expression of p21 (%10%), p27 (>50%), Ki-67 (>50%), CD31 (>130 vessels/mm2) and low expression of p53 (<10%), cyclin D1 (<10%) and EGFR (<10%) (favorable levels - FL) had better DFS than patients with a low expression of p21 (<10%), p27 (%50%), Ki-67 (%50%), CD31 (<130 vessels/mm2) and high expression of p53 (%10%), cyclin D1 (%10%) and EGFR (%10%) (unfavorable levels - UL). However, statistical significance in survival between FL and UL was achieved only for p27 and cyclin D1. DFS significantly decreased with an increasing number of markers with an unfavorable level per tumor (1%4 vs. 5%7) (78% vs. 32%, respectively; p = 0.004). The number of markers per tumor with UL of expression retained prognostic significance also in multivariate analysis. Conclusions. Statistical significance in survival between FL and UL emerged only for p27 and cyclin D1. The number of markers per tumor with UL of expression was an independent prognostic factor for an adverse outcome . Keywords: oropharynx, radiochemotherapy, tumor markers Published in DiRROS: 22.04.2024; Views: 299; Downloads: 92
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5. Cysteine proteinase inhibitors stefin A and stefin B in operable carcinoma of the head and neck : Inhibitorji cisteinskih proteinaz stefin A in stefin B pri operabilnem karcinomu glave in vratuPrimož Strojan, Marjan Budihna, Alojz Šmid, Branka Svetic, Ivan Vrhovec, Janko Kos, Janez Škrk, 2002, original scientific article Abstract: Purpose. To evaluate the significance of cysteine proteinase inhibitors stefins (Stefs) A and B for a treatment decision and prognosis in operable squamous cell carcinoma of the head and neck (SCCHN). Patients and methods. Stefs A and B concentrations were determined immunobiochemically using ELISAs in cytosols prepared from the tumor and adjacent normal mucosa from 91 patients with operable SCCHN. The median follow-up period of patients alive atthe close-out date was 5.8 years (range, 5-9.3 years). Results. Stef A concentrations were significantly higher in tumor compared to normal mucosa (FM.05). When a subgroup with clinically palpable nodes) at presentation was taken into consideration (n=57), a significant difference in Stef A (P=0.03) and Stef B (P=0.02) concentrations between those with negative and positive necks, as determined on histopathological examination, was observed. On the univariate survival analysis, higher Stefsć concentrations turned to be prognostically advantageous. Stef A proved its independent prognostic significance also on multivariate setting. Conclusions. With the capability todifferentiate between the pN0- and pN+-stages of the disease in the patientsoriginally presented as node-positive, Stefs A and B could be useful markers when deciding on the extent of neck surgery. In addition, both Stefs proved to be reliable prognosticators for survival in patients with operable SCCHN. Published in DiRROS: 31.01.2024; Views: 308; Downloads: 69
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6. Factors influencing rehabilitation in patients with head and neck cancerIrena Hočevar-Boltežar, Alojz Šmid, Miha Žargi, Avgust Župevc, Igor Fajdiga, Janez Fischinger, Ana Jarc, 2000, original scientific article Abstract: Purpose. The purpose of the prospective study was to identify the factors adversely influencing the post-treatment rehabilitation in patients with head and neck cancer. Patients and methods. One hundred and ten patients with oral cavity, pharyngeal and laryngeal cancer were examined before surgical treatment in order to find unfavorable factors: hearing loss, defective teeth,impaired pulmonary function, and speech disorders. The patients evaluated the success of their rehabilitation 12 months after the treatment. The influence of possible unfavorable factors, tumor site, and type of surgeryon speech, swallowing and reintegration competence was determinated. Results. The site of the tumor and the type of surgery did not influence the quality of rehabilitation in general. Defective teeth influenced the ability of swallowing but not the speech. Hearing loss impaired the patient's reintegration in their home environment. Impaired pulmonary function did not affect patient's speech. Speech was the poorest in laryngectomized patients. However, about two thirds of the patients were satisfied with their capabilityof speech, swallowing and their rehabilitation in general. Conclusions. Early identification of unfavorable factors, and individually planned rehabilitation can ensure a suitable quality of life for patients thathave undergone surgery for head and neck cancer. Published in DiRROS: 25.01.2024; Views: 328; Downloads: 98
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7. Ultrasound-guided aspiration biopsy of subclinical regional metastases of head and neck carcinomaAlenka Višnar-Perovič, Aleksandar Aničin, Živa Zupančič, Bojana Černelč, Alojz Šmid, Dubravka Vidmar, Milan Gorenc, 2000, original scientific article Abstract: Background. Studies concerned with the estimation of ultrasound (US) combined with ultrasound-guided aspiration biopsy (USGAB) in the detection of subclinical regional metastases from the planocellular carcinoma of head and neck are promising, but in few cases. Recently, the authors have pointed out the role of lymph node size parameters in order to decide about the use of USGAB. The aim of this study was to test the reliability of US-USGAB for the detection of subclinical regional metastases in patients with planocellular head and neck carcinomas, including the evaluation of lymph node size parameters. Patients and methods. 121 neck sides with no palpable metastases were examined by US in 77 patients with planocellular carcinomas of head and neck. Depending on the results obtained, USGAB was performed on 64 neck sides.After surgery, the results of US-USGAB were compared with histological findings of the dissected lymph nodes. Results. The study showed 77% overall sensitivity of US and USGAB, and 100% specificity, while the versal / longiyudinal diameter was the best predictor of metastatic lymph node involvement. Conclusion. The results of this study established that USGAB is an appropriate method for detection the subclinical regional metastases on neck, and should be included into routine diagnostic work up in the evaluationof the extent of head and necks carcinomas. Published in DiRROS: 24.01.2024; Views: 325; Downloads: 87
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