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Abstract: Background. The aim of the study was to identify the value of extensive resection and reconstruction with flaps in the treatment of locoregionally advanced lateral skull-base cancer.Patients and methods. The retrospective case review of patients with lateral skull-base cancer treated surgically with curative intent between 2011 and 2019 at a tertiary otorhinolaryngology referral centre was made. Results. Twelve patients with locoregionally advanced cancer were analysed. Lateral temporal bone resection was performed in nine (75.0%), partial parotidectomy in six (50.0%), total parotidectomy in one (8.3%), ipsilateral selective neck dissection in eight (66.7%) and ipsilateral modified radical neck dissection in one patient (8.3%). The defect was reconstructed with anterolateral thigh free flap, radial forearm free flap or pectoralis major myocutaneous flap in two patients (17.0%) each. Mean overall survival was 3.1 years (SD = 2.5) and cancer-free survival rate 100%. At the data collection cut-off, 83% of analysed patients and 100% of patients with flap reconstruction were alive. Conclusions. Favourable local control in lateral skull-base cancer, which mainly involves temporal bone is achieved with an extensive locoregional resection followed by free or regional flap reconstruction. Universal cancer registry should be considered in centres treating this rare disease to alleviate analysis and multicentric research.
Keywords: temporal bone, microsurgery, parotid region, free tissue flaps, neoplasm staging, ear
Published in DiRROS: 22.07.2024; Views: 370; Downloads: 190
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Keywords: cancer burden, cancer survival, time trend, cancer registry
Published in DiRROS: 22.07.2024; Views: 313; Downloads: 191
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Abstract: Radiotherapy-associated angiosarcoma (RAA) of the breast is a rare complication of radiotherapy, which is often difficult to identify and has poor prognosis. It usually presents as violaceous skin, erythema or rapidly growing palpable firm mass that can be confused with other benign skin lesions. Patients and methods After reviewing the literature, we found only four cases with RAA after mastectomy and autologous breast reconstruction. The presented case is the first that was treated by electrochemotherapy. The patient presented with secondary angiosarcoma of the breast five years after mastectomy, immediate breast reconstruction with deep inferior epigastric artery perforator free flap and adjuvant radiotherapy. Results Electrochemotherapy was feasible, safe and effective in treatment of radiation induced sarcoma. Most of the treated lesions in several consecutive electrochemotherapy sessions responded with complete response, but multiple recurrences occurred in non-treated areas. Conclusions Patients with breast cancer after skin-sparing mastectomy and immediate breast reconstruction, who receive radiotherapy, need regular long-term follow up and low threshold for biopsy of any suspicious lesions is mandatory. Electrochemotherapy proved as one of feasible modalities of treatment for RAA.
Keywords: angiosarcoma, breast reconstruction, breast cancer, electrochemotherapy
Published in DiRROS: 22.07.2024; Views: 448; Downloads: 138
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Abstract: Background. Ovarian cancer is the seventh most common cancer in women worldwide and the eighth most common cause of cancer death. Due to the lack of effective early detection strategies and the unspecific onset of symptoms, it is diagnosed at an advanced stage in 75% of cases. The cancer antigen (CA) 125 is used as a prognostic marker and its level is elevated in more than 85% of women with advanced stages of epithelial ovarian cancer (EOC). The standard treatment is primary debulking surgery (PDS) followed by adjuvant chemotherapy (ACT), but the later approach is neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS). Several studies have been conducted to find out whether preoperative CA-125 serum levels influence treatment choice, surgical resection and survival outcome. The aim of our study was to analyse experience of single institution as Cancer comprehensive center with preoperative usefulness of CA-125. Patients and methods. At the Institute of Oncology Ljubljana a retrospective analysis of 253 women with stage FIGO IIIC and IV ovarian cancer was conducted. Women were divided into two groups based on their primary treatment. The first group was the NACT group (215 women) and the second the PDS group (38 women). The differences in patient characteristics were compared using the Chi-square test and ANOVA and the Kaplan-Meier method was used for calculating progression-free survival (PFS) and overall survival (OS). Results. The median serum CA-125 level was higher in the NACT group than in the PDS group, 972 IU/ml and 499 IU/ ml, respectively. The PFS in the NACT group was 8 months (95% CI 6.4%9.5) and 18 months (95% CI 12.5%23.4) in the PDS group. The median OS was lower in the NACT group than in the PDS group, 25 months (95% CI 20.6%29.5) and 46 months (95% CI 32.9%62.1), respectively. Conclusions. Preoperative CA-125 cut off value of 500 IU/ml is a promising threshold to predict a successful PDS.
Keywords: ovarian cancer, tumour marker, neoadjuvant chemotherapy, CA-125
Published in DiRROS: 22.07.2024; Views: 313; Downloads: 114
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Abstract: For mitigation of the effects of pollution, the media, policy makers and, in turn, the scientific community and industry each provide contributions through development of a sense of urgency, and with guidelines and solutions. For non-indigenous species (NIS) that can frequently have negative impacts on the native biota, this is often conveyed in an emotive way to the general public, who are typically keen to help and to get personally involved. This might be through organization of cleaning campaigns, influence on the media, or collaboration with scientists, to inform them of the local presence and abundance of NIS. Alternatively, they might proactively develop technological solutions themselves. To assess the current state of affairs, we reviewed the presence and effects of NIS in the Mediterranean Sea. As so often, any well-planned and successful activity is directly linked to financing, or a lack thereof, and this leads to sometimes untargeted and sporadic measures that are developed within a project or over a limited timeframe, without any sustainability measures. Therefore, we also assessed the activities and strategies that have been financed in this area of NIS mitigation. Based on this review of the presence and impact of NIS, and previous and ongoing activities, we propose a new paradigm to mitigate such pollution: the 8Rs model (i.e., Recognize, Reduce, Replace, Reuse, Recycle, Recover/Restore, Remove, and Regulate). This model extends from the more traditional 3Rs model (i.e., Reduce, Reuse, and Recycle) that is often used and promoted for innovative waste management strategies. Importantly, the 8Rs model can be applied sequentially, for either prevention of NIS introduction, or preparation of mitigation measures. The 8Rs model was constructed based on Mediterranean NIS, although we believe it can be applied to other sources of pollution and other geographic areas. Importantly, the 8Rs model represents a general framework to organize and categorize future pollution mitigation strategies. This approach is essential for development of any action plan to influence the administrative and financial decision makers who essentially enable these activities, and therefore who have important roles in the guarantee of sustainability of these actions, and the creation of innovative societies.
Keywords: non-indigenous species, pollution mitigation, pollution mitigation, 8Rs model, quadruple helix, Mediterranean Sea, citizen science, communication, sustainability
Published in DiRROS: 22.07.2024; Views: 375; Downloads: 256
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