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Abstract: The aim of the study was to analyze the overall survival (OS) and progression free survival (PFS) of patients with high grade and advanced stage epithelial ovarian cancer (EOC) with at least 60 months of follow-up treated in a single gynecologic oncology institute. We compared primary debulking surgery (PDS) versus neoadjuvant chemotherapy plus interval debulking surgery (NACT + IDS) stratifying data based on residual disease with the intent to identify the rationale for therapeutic option decision and the role of laparoscopic evaluation of resectability for that intention. Patients and methods. This is observational retrospective study on consecutive patients with diagnosis of high grade and International Federation of Gynecology and Obstetrics (FIGO) stage III/IV EOC referred to our center between January 2008 and May 2012. We selected only patients with a follow-up of at least 60 months. Primary endpoint was to compare PDS versus NACT + IDS in term of progression free survival (PFS) and overall survival (OS). Secondary endpoints were PFS and OS stratifying data according to residual disease after surgery in patients receiving PDS versus NACT + IDS. Finally, through Cox hazards models, we tested the prognostic value of different variables (patient age at diagnosis, residual disease after debulking, American Society of Anesthesiologists (ASA) stage, number of adjuvantchemotherapy cycles) for predicting OS. Results. A total number of 157 patients were included in data analysis. Comparing PDS arm (108 patients) and NACT + IDS arm (49 patients) we found no significant differences in term of OS (41.3 versus 34.5 months, respectively) and PFS (17.3 versus 18.3 months, respectively). According to residual disease we found no significant differences in term of OS between NACT + IDS patients with residual disease = 0 and PDS patients with residual disease = 0 or residual disease = 1, as well as no significant differences in PFS were found comparing NACT + IDS patients with residual disease = 0 and PDS patients with residual disease = 0; contrarily, median PFS resulted significantly lower in PDS patients receiving optimal debulking (residual disease = 1) in comparison to NACT + IDS patients receiving complete debulking (residual disease = 0). PDS arm was affected by a significant higher rate of severe post-operative complications (grade 3 and 4). Diagnostic laparoscopy before surgery was significantly associated with complete debulking. Conclusions. We confirm previous findings concerning the non-superiority of NACT + IDS compared to PDS for the treatment of EOC, even if NACT + IDS treatment was associated with significant lower rate of post-operative complications. On the other hand, selecting patients for NACT + IDS, based on laparoscopic evaluation of resectabilty prolongs the PFS and does not worse the OS compared to the patients not completely debulked with PDS.
Keywords: epithelial ovarian cancer, advanced stage, primary debulking surgery, interval debulking surgery
Published in DiRROS: 11.06.2024; Views: 29; Downloads: 22
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Abstract: Historians have long come to realize the importance of the World War I as the seminal event leading to a short 20th century. If traditional research has often conceptualized the war and post-war years as two distinct historical periods, new studies have emphasized entangle-ments and intertwinements between war- and post-war processes. This turn was influenced by a gradual geographical balance and the inclusion of Eastern and Central Europe in the re-search focus. Wars, collapse of Empires and long-existing State structures, and similar events brought about processes of redefinition of territories and its peoples. The focus on volatile, overlapping and, at times, competing centers of power (States, national, regional and local structures), will allow us to reconsider criteria and concepts of citizenship and belonging that have shaped European politics of governance. Our conference focuses on the Northern Adri-atic transnational borderland from the beginning of World War I in July 1914 to the Treaty of Rome in January 1924, when the Adriatic question was temporarily settled. This decade is of fundamental importance at the global level, while the Northern Adriatic represents a unique laboratory to study the transformations of Europe in the Twentieth Century. The focus is on the question of citizenship beyond nation-state frameworks and monothematic disciplines, in which the question of citizenship is linked to the migratory movement of people. Taking the Northern Adriatic as a case study, this conference aims at rethinking the questions of citizen-ships, national affiliations, territorial belongings and state sovereignty. This will enable us to contribute to a growing dialogue in international academia and to contemporary societal de-bates at a time, when citizenship and the rights linked to it are the subject of intense discus-sions. We aim at reconsidering rigid understandings of center and periphery and restoring a more composite history of twentieth century Europe.
Published in DiRROS: 29.05.2024; Views: 115; Downloads: 121
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Abstract: The authors studied the structure of the coastal fish assemblage in a temperate coral reef within a marine protected area in order to provide a baseline information on the occurrence and temporal distribution of fish and to highlight the importance of the coral reef to ichthyofauna. The coastal fish assemblage was investigated at two sites in Veliko jezero (Mljet National Park) in the southern Adriatic Sea with a non-destructive SCUBA visual technique in the period from 2013 to 2021. Altogether, 38 fish taxa were recorded on the right bank (coral reef) and 36 species on the left bank. The presence of the coral reef at a depth range between 9 m to 12 m is the main factor differentiating the fish fauna in these two areas, which are otherwise governed by the same environmental factors. At the coral reef a decrease in fish diversity was discovered with a steady regression from 2013 to 2021.
Keywords: fish fauna, spatial heterogeneity, Mediterranean coral reef, Cladocora caespitosa, marine protected area, Veliko jezero
Published in DiRROS: 10.05.2024; Views: 126; Downloads: 211
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Abstract: Primary treatment of patients with advanced epithelial ovarian cancer consists of chemotherapy either before (neoadjuvant chemotherapy, NACT) or after primary surgery (adjuvant chemotherapy). The goal of primary treatment is no residual disease after surgery (R0 resection) what is associated with an improvement in survival of patients. There is, however, no evidence of survival benefits in patients with R0 resections after prior NACT. Methods. We retrospectively reviewed the records of patients who were treated with diagnosis of epithelial ovarian cancer at Institute of Oncology Ljubljana in the years 2005%2007. The differences in the rates of R0 resections, progression free survival (PFS), overall survival (OS) and in five-year and eight-year survival rates between patients treated with NACT and patients who had primary surgery were compared. Results. Overall 160 patients had stage IIIC epithelial ovarian cancer. Eighty patients had NACT and eighty patients had primary surgery. Patients in NACT group had higher rates of R0 resection (42% vs. 20%; p = 0.011) than patients after primary surgery. PFS was 14.1 months in NACT group and 17.7 months after primary surgery (p = 0.213). OS was 24.8 months in NACT group and 31.6 months after primary surgery (p = 0.012). In patients with R0 resections five-year and eight-year survival rates were 20.6% and 17.6% in NACT group compared to 62.5% and 62.5% after primary surgery (p < 0.0001), respectively. Conclusions. Despite higher rates of R0 resections achieved by NACT, survival of patients treated with NACT was inferior to survival of patients who underwent primary surgery. NACT should only be offered to patients with advanced epithelial cancer who are not candidates for primary surgery.
Keywords: ovarian cancer, advanced ovarian cancer, neoadjuvant chemotherapy, primary surgery
Published in DiRROS: 30.04.2024; Views: 191; Downloads: 56
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Keywords: morska biologija, biološke lastnosti, skupine vrst, habitatni tipi, morski ekosistemi, morska biodiverziteta, morska biološka raznovrstnost, Občina Koper, poročila
Published in DiRROS: 24.04.2024; Views: 134; Downloads: 0