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1.
Stomach cancer elective surgery morbidity and mortality at 90-Day (Hold Study) : a prospective, international collaborative cohort study
Claudia Neves-Marques, Mohamed Abulazayem, Geoffrey Yuet Mun Wong, Ricardo David Maldonado, Yirupaiahgari Viswanath, Jan Grosek, Jurij Aleš Košir, 2026, izvirni znanstveni članek

Povzetek: Background: Data on multinational 90-day mortality and morbidity rates after surgery for gastric cancer is limited in the literature. This study aimed to understand the 90-day mortality and morbidity outcomes among patients undergoing elective gastric cancer surgery, as in the GASTRODATA Registry, and to identify associated risk factors. Methods: We conducted an international prospective study on patients aged ≥ 18 years undergoing elective surgery for gastric cancer with curative intent from January 4 to September 30, 2022. Known metastatic disease, concurrent secondary cancers, gastrointestinal stromal tumour (GIST) and Siewert type I/II oesophagogastric junction malignancies were excluded. Univariate and multivariate logistic regression were used to identify variables associated with the 90-day outcome. Results: 380 collaborators from 47 countries submitted data on 1538 patients. Median age was 65 years (IQR: 19–94), and 58.5% were males. 90-day morbidity and mortality rates were 38.2% (n = 587) and 2.9% (n = 45), respectively. Pre-operative higher Charlson Comorbidity Index, higher ASA score, pre-operative weight loss > 10%, positive specimen margin, and post-operative pathological IV staging (p value < 0.05) were significantly associated with clinically relevant complications and mortality. Conclusion: Elective gastric cancer surgery has a 90-day morbidity of 38.2% and a 90-day mortality of 2.9% globally. This study provided the most comprehensive international 90-day prospective data to date regarding gastric cancer surgery. Several factors associated with higher morbidity were identified, highlighting the importance of a unified language on surgical morbidity, prehabilitation, and ongoing audits to enhance patient outcomes.
Ključne besede: gastric cancer, elective surgery, morbidity, mortality, 90-day postoperative outcomes, multinational audit, surgical complications, anastomotic leaks, patient safety
Objavljeno v DiRROS: 16.12.2025; Ogledov: 89; Prenosov: 44
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2.
The role of focal adhesion kinase in bladder cancer : translation from in vitro to ex vivo human urothelial carcinomas
Gaja Markovič, Nataša Resnik, Aleksandar Janev, Daša Zupančič, Gašper Grubelnik, Maruša Debeljak, Maja Čemažar, Tanja Jesenko, Maša Omerzel, Tomaž Smrkolj, Mateja Erdani-Kreft, 2025, izvirni znanstveni članek

Povzetek: Background: Focal adhesion kinase (FAK), a cytoplasmic tyrosine kinase, plays a crucial role in focal adhesion turnover by interfacing between the extracellular space, transmembrane integrins, and actin filaments. Its significance for the progression of several malignancies, including bladder cancer, has been well-documented. However, its precise role and the implications of its inhibition in bladder cancer tissues and urothelial in vitro models has not been fully explored. This study examined FAK expression and function in human bladder cancer biopsies and in vitro bladder cancer models. Materials and methods: Ex vivo analyses were performed using reverse transcription-quantitative PCR (qRT-PCR), western blotting, and immunohistochemistry to compare FAK expression between bladder cancer tissues and adjacent normal tissues. In vitro, FAK expression was assessed in low-grade (LG) human non-invasive papilloma urothelial cell line RT4 for NMIBC (Ta), high-grade (HG) human muscle-invasive cancer urothelial cell line T24 for MIBC (T2) and normal porcine urothelial (NPU) cells using qRT-PCR and western blotting, as well as flow cytometry for the quantification of FAK-positive RT4 and T24 cells. The role of FAK in cancer cell survival was explored in vitro using microRNA (miRNA) to silence FAK expression. Additionally, we used FAK inhibitors PND-1186, PF-573228 and defactinib to investigate the effects of FAK inhibition on normal compared to cancerous bladder urothelial cells. Results: Ex vivo analyses demonstrated significantly higher FAK expression in bladder cancer tissues compared to adjacent normal tissues. Similarly, in vitro analyses showed significantly higher FAK expression in RT4 and T24 cells than NPU cells. Silencing FAK using anti-FAK plasmids led to increased caspase-3-mediated apoptosis of RT4 and T24 cells and growth reduction of stably transfected T24 cells. Importantly, based on cell viability assays, treatment with 100 μM defactinib for 2 hours per day on 3 consecutive days was identified as a clinically relevant regimen. Under this treatment, the viability of differentiated NPU cells remained high at 108.4 ± 17.1%, while the viability of 2-day RT4 and 2-day T24 cells was drastically reduced to 4.1 ± 2.7% and 7.6 ± 2.9%, respectively. Conclusions: To our knowledge, this is the first report demonstrating the role of FAK and its inhibition across both normal and cancerous bladder urothelial models. This study highlights the critical role of FAK in the progression of human bladder cancer and establishes a foundation for exploring FAK inhibition as a potential therapeutic approach in bladder cancer treatment.
Ključne besede: bladder cancer, defactinib, focal adhesion kinase, human urothelial carcinoma, urothelial cell
Objavljeno v DiRROS: 09.12.2025; Ogledov: 105; Prenosov: 52
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3.
Electrochemotherapy (ECT) in treatment of mucosal head and neck tumors : an international network for sharing practices on ECT (InspECT) study group report
Giulia Bertino, Marta Minuti, Aleš Grošelj, Črt Jamšek, Barbara Silvestri, Silvia Carpene, Paolo Matteucci, Giuseppe Riva, Giancarlo Pecorari, Matteo Mascherini, Gregor Serša, 2024, izvirni znanstveni članek

Povzetek: The aim of this multicenter study was to evaluate the effectiveness and safety of electrochemotherapy (ECT) for the treatment of mucosal tumors in the head and neck. A total of 71 patients with 84 nodules of different histologies in the oral cavity, pharynx and larynx treated by ECT were evaluated. The data were collected from the InspECT database from 10 participating centers throughout Europe. Primary and recurrent/secondary tumors of different histologies were treated. The overall response rate was 65 %, with a 33 % complete response rate with limited side effects. The response rates of the primary and secondary tumors were not different. However, smaller tumors responded better than tumors larger than 3 cm in diameter. Furthermore, the tumors that were treated with curative intent responded significantly better than those treated with palliative intent. This study demonstrated the feasibility, safety and effectiveness of ECT in a larger cohort of patients with mucosal lesions in the head and neck region. Based on the available data, ECT can be used for the treatment of recurrent and, in some cases, primary mucosal tumors located in the oral cavity, larynx, and pharynx. A better response was obtained in patients with smaller primary tumors treated with curative intent.
Ključne besede: electrochemotherapy, mucosal cancer, head cancer, neck cancer, ECT
Objavljeno v DiRROS: 05.12.2025; Ogledov: 172; Prenosov: 70
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4.
Patients’ daily reporting of symptoms via mobile application reveals a significant difference between patients’ perceptions and doctors’ interpretations
Cvetka Grašič-Kuhar, Nina Privšek, Marjetka Sraka, Ema Grašič, Timotej Kovač, Matjaž Kukar, 2025, izvirni znanstveni članek

Povzetek: Electronic patient-reported outcomes (ePROs) are gaining importance. The aim of this study was to investigate the difference in the reporting of symptoms between patients via mobile application (m-app) and doctor assessments. Additionally, usability and satisfaction with the use of the m-app were assessed. Methods: In this single-center prospective cohort study, we analyzed ePROs in 46 patients receiving (neo)adjuvant chemotherapy for early breast cancer. Patients recorded the occurrence and intensity of symptoms via the Android-based m-app daily. Three-monthly, patients completed validated quality of life questionnaires (EORTC C30 and BR23). For the 10 most common symptoms reported by patients, we compared the frequencies and grades between patients and doctors. Additionally, we compared daily symptom reports with questionnaire results. Finally, the usefulness of and level of satisfaction with the m-app by patients and doctors were evaluated. Results: During the study, patients recorded almost twice as many different symptoms through the m-app as doctors did in the electronic health records (75 vs 49). Symptoms were described by patients as mild (67%), moderate (30%), or severe (3%). The frequency and intensity of symptoms reported by patients were significantly higher than those reported by doctors (p<0.001). Fatigue, insomnia and dry mouth were the three main symptoms reported in more than 75% of patients, but insomnia and dry mouth were also the symptoms most often underreported by doctors. After three months of chemotherapy, QoL assessments revealed worsening of physical, social, cognitive and role functioning, increased fatigue, systemic therapy side effects, and dyspnea but a reduction in arm and shoulder problems. Patients and doctors rated the m-app with an overall score of 4.5 out of 5 (IQR 1.0). Patients expressed high levels of satisfaction with and usability of the m-app. In contrast, doctors were somewhat reluctant to perceive ePROs as an additional burden with patient management. Conclusion: This study revealed a significant discrepancy between patients’ daily symptom reports via the m-app and doctors’ assessments, indicating that healthcare professionals may not fully capture patients’ experiences. This underscores the importance of integrating PROs to accurately evaluate patients’ conditions. Our m-app serves as a promising tool for reporting and managing side effects during systemic treatment of breast cancer.
Ključne besede: breast cancer, mobile application, patients, doctors
Objavljeno v DiRROS: 05.12.2025; Ogledov: 106; Prenosov: 42
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5.
Complementary detection strategies for circulating tumor cells in breast cancer: clinical implications of combining immunofluorescence and cytopathological staining
Tanja Jesenko, Cvetka Grašič-Kuhar, Živa Pišljar, Simona Miceska, Veronika Kloboves-Prevodnik, Maja Čemažar, 2025, izvirni znanstveni članek

Povzetek: Background: Circulating Tumor Cells (CTCs) serve as important biomarkers for disease monitoring and treatment response in patients with metastatic breast cancer. Their detection remains challenging because of their low abundance, phenotypic diversity and non-standardized mode of detection. Cytopathological Giemsa and Immunofluorescence (IF) staining can offer complementary approaches for CTC characterization. Giemsa staining enables assessment of cellular morphology, while IF allows for marker-specific identification, together providing a more comprehensive and accurate evaluation of CTCs. Methods: We developed an IF staining protocol with antibodies against Cytokeratin (CK), vimentin (VIM), and Cluster of Differentiation 45 (CD45) to distinguish epithelial, mesenchymal, hybrid and hematopoietic cells for CTC detection and characterization and compared it with cytopathologic method of detection via Giemsa staining with regard to CTC detection rates and morphological detail. Results: Study was performed on the samples of 29 heavily pretreated patients with metastatic breast cancer (median duration of metastatic disease 19.4 months). Giemsa staining enabled the detection of a higher number of CTCs compared to our IF protocol. Lower detection rate was potentially due to the loss of fragile or loosely adherent cells during methanol fixation and IF staining. Additionally, in IF-stained samples, some CTCs presented faint nuclear signals, potentially impairing their recognition. The IF staining supported the identity of CTCs detected on Giemsa-stained slides by employing a three-color antibody panel-based approach and allowed detailed phenotypic discrimination and structural analysis of CTCs, including the identification of a distinctive CK polarization pattern suggestive of a transitional state during intravasation. Conclusion: Giemsa and IF may thus be complementary rather than mutually exclusive and relying on a single detection approach could underestimate the true CTC burden. An integrative strategy combining both techniques may offer a more comprehensive view of CTC populations in metastatic breast cancer, thereby enhancing diagnostic precision.
Ključne besede: biomarkers, breast cancer, circulating tumor cells, cytopathological detection
Objavljeno v DiRROS: 05.12.2025; Ogledov: 200; Prenosov: 32
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6.
Assessing the impact of waste co-incineration at the Anhovo cement plant (Slovenia) on the regional cancer burden*
Vesna Zadnik, Mojca Birk, Teja Oblak, Maja Jurtela, Sonja Tomšič, Katarina Lokar, Ana Mihor, Nika Bric, Miran Mlakar, Amela Duratović Konjević, Tina Žagar, 2025, izvirni znanstveni članek

Povzetek: This epidemiological study aims to assess the cancer risk potentially associated with environmental exposure resulting from cement production and waste co-incineration at the Anhovo cement plant in Western Slovenia and to develop a strong and reliable methodological framework for the long-term surveillance of environmentally related cancer risks in small geographical areas. Materials and methods We integrated all the available data sources: cancer cases from the population-based Slovenian Cancer Registry; background population; and available measurements on exposure to air PM10 particles and chromium (Cr) in the soil in the municipality of Kanal and the wider Goriška region. Relative risks of cancer in small geographical areas were estimated using Bayesian hierarchical spatial models and the population attributable fractions of the modelled risk factors were calculated. The point source analysis compared the cancer risk near the cement plant to that in more distant areas. Results The analysis did not reveal any excess cancer incidence in the area of the Anhovo cement plant or an association with the PM10 particles and Cr in the soil. The incidence of mesothelioma remains high in the region, but stable in the last two decades. Conclusions In view of the environmental pollution caused by either historical cement production or the potential impact of current waste co-incineration activities in Kanal, we strongly recommend that a follow-up epidemiological study be carried out in the next 10 to 20 years. The methodological framework established in the present study provides a foundation for the ongoing surveillance of the cancer burden in the region.
Ključne besede: cancer incidence, environmental exposure, cancer data
Objavljeno v DiRROS: 05.12.2025; Ogledov: 81; Prenosov: 0

7.
Gene therapy of rare diseases as a milestone in medicine : overview of the field and report on initial experiences in Slovenia
Urh Grošelj, Marko Kavčič, Ana Drole Torkar, Jan Kafol, Duško Lainšček, Roman Jerala, Matjaž Sever, Samo Zver, Gregor Serša, Maja Čemažar, Primož Strojan, Aleš Grošelj, Mojca Žerjav-Tanšek, Špela Miroševič, Simona Ivančan, Tomaž Prelog, David Gosar, Jasna Oražem, Matej Mlinarič, Sara Bertok, Jernej Kovač, Jana Kodrič, Saba Battelino, Marko Pokorn, Alojz Ihan, Janez Jazbec, Tadej Battelino, Damjan Osredkar, 2025, pregledni znanstveni članek

Povzetek: Gene therapy has transitioned from a long-awaited promise to a clinical reality, offering transformative treatments for rare congenital diseases and certain cancers, which have a significant impact on patients’ lives. Current approaches focus on gene replacement therapy, either in vivo or ex vivo, mostly utilizing viral vectors to deliver therapeutic genes into target cells. However, refining these techniques is essential to overcome challenges and complications associated with gene therapy to ensure long-term safety and efficacy. Slovenia has witnessed significant advancements in this field since 2018, marked by successful gene therapy trials and treatments for various rare diseases. Significant strides have been made in the field of gene therapy in Slovenia, treating patients with spinal muscular atrophy and rare metabolic disorders, including the pioneering work on CTNNB1 syndrome. Additionally, immune gene therapy, exemplified by IL-12 adjuvant therapy for cancer, has been a focus of research in Slovenia. Through patient-centred initiatives and international collaborations, researchers in Slovenia are advancing preclinical research and clinical trials, paving the way for accessible gene therapies. Establishing clinical infrastructure and genomic diagnostics for rare diseases is crucial for gene therapy implementation. Efforts in this regard in Slovenia, including the establishment of a Centre for Rare Diseases, Centre for the Technologies of Gene and Cell Therapy, and rapid genomic diagnostics, demonstrate a commitment to comprehensive patient care. Despite the promises of gene therapy, challenges remain, including cost, distribution, efficacy, and long-term safety. Collaborative efforts are essential to address these challenges and ensure equitable access to innovative therapies for patients with rare diseases.
Ključne besede: gene therapy, rare genetic diseases, Slovenia, CAR-T cells, cancer, immune gene therapy
Objavljeno v DiRROS: 04.12.2025; Ogledov: 160; Prenosov: 124
.pdf Celotno besedilo (2,18 MB)
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8.
Bisphenol A in the urine : association with urinary creatinine, impaired kidney function, use of plastic food and beverage storage products but not with serum anti-müllerian hormone in ovarian malignancies
Mateja Sladič, Špela Smrkolj, Gorazd Kavšek, Senka Imamović-Kumalić, Ivan Verdenik, Irma Virant-Klun, 2025, izvirni znanstveni članek

Povzetek: Bisphenol A (BPA) is a high-production-volume industrial chemical and component of commonly used plastic products. However, it is also an endocrine-disrupting chemical that can negatively affect human health. It is not yet known whether it is associated with the development of epithelial ovarian cancer (EOC), a severe and highly fatal human disease. Therefore, the purpose of this study was to determine the concentrations of BPA in the urine of women with EOC or epithelial borderline ovarian tumors (EBOTs) using gas chromatography tandem mass spectrometry (GC-MS/MS) and find their possible associations with kidney function at the molecular level, urine and blood biochemical parameters related to metabolism, anti-Müllerian hormone (AMH) (a marker of ovarian reserve/fertility), and lifestyle habits determined via a questionnaire in comparison to healthy controls. The results suggest that the unadjusted or urine-specific-gravity-adjusted BPA levels were significantly increased in women with EOC/EBOT. The unadjusted BPA was significantly positively associated with urinary creatinine (p = 0.007) in all women with EOC/EBOT after adjustment for age, body mass index, and pregnancy using multiple linear regression analysis. This may be related to kidney injury. However, no association was found between urinary BPA and serum AMH levels in women. Women with ovarian malignancies were more exposed to plastic products for storing foods and drinks. Some lifestyle habits, including refilling plastic bottles, correlate with higher urinary BPA levels across the entire cohort of women. When considering EOC or EBOT, it is necessary to consider the potential higher exposure of women to BPA, as reflected in their urine and lifestyle habits.
Ključne besede: anti-Müllerian hormone, kidney function, lifestyle habits, ovarian cancer, thrombocytes, urine, female exposure
Objavljeno v DiRROS: 03.12.2025; Ogledov: 177; Prenosov: 77
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9.
Nontargeted urinary profiling strategy for endocrine-disrupting chemicals in women with ovarian malignancies
Helena Plešnik, Žan Rekar, Stefanela Stevanović, Irma Virant-Klun, Senka Imamović-Kumalić, Mateja Sladič, Darja Mazej, Janja Snoj Tratnik, Milena Horvat, Tina Kosjek, 2025, izvirni znanstveni članek

Povzetek: Endocrine-disrupting chemicals (EDCs), includingknown and unknown parent compounds, their metabolites, andtransformation products, are pervasive in daily life, posingincreasing risks to human health and the environment. Thisstudy employed a high-resolution mass spectrometry-basednontargeted screening approach, integrating polar (HILIC) andreversed-phase separations to expand the chemical space coverageand, supported by open-science tools and resources, evaluatedurinary chemical profiles to assess internal EDC exposure. Among106 annotated biomarkers of exposure, six exhibited significantlyhigher normalized intensities in patients with ovarian malignanciescompared to healthy controls (p < 0.05). This suggests theirgreater exposure to phthalates (diethylhexyl phthalate and diethylphthalate), pesticides (metolachlor metabolite and 4-nitrophenol), a UV filter (benzophenone-1), and an industrial byproduct (4-methyl-2-nitrophenol). These compounds may interfere with hormonal regulation, potentially contributing to cancer development.While these findings highlight potential differences in internal EDC exposure, the study primarily demonstrates the applicability ofnontargeted urinary profiling for chemical exposure assessment. By providing new insights into EDCs burden and its pathologicalimplications, this work contributes to advancing next-generation chemical risk assessment within the European Partnership for theAssessment of Risks from Chemicals initiative and supports the development of preventive strategies to mitigate environmentalcancer risks
Ključne besede: ovarian cancer, biomarkers, exposure, nontargeted screening, high-resolution mass spectrometry, analytical coverage, reversed-phase, HILIC
Objavljeno v DiRROS: 02.12.2025; Ogledov: 157; Prenosov: 88
.pdf Celotno besedilo (4,13 MB)
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10.
In vitro evaluation of electrochemotherapy combined with sotorasib in pancreatic carcinoma cell lines harboring distinct kras mutations
Tanja Jesenko, Maša Omerzel, Tina Živič, Gregor Serša, Maja Čemažar, 2025, izvirni znanstveni članek

Povzetek: Pancreatic cancer is among the deadliest malignancies, with limited treatment options and poor prognosis. Novel strategies are therefore urgently needed. Sotorasib, a KRAS G12C-specific inhibitor, offers targeted treatment for a small subset of patients with this mutation. Electrochemotherapy (ECT), which enhances the cytotoxicity of chemotherapeutic agents through electroporation-induced membrane permeabilization, has shown promise in various tumor types, including deep-seated malignancies such as pancreatic cancer. Combining ECT with sotorasib may potentiate antitumor effects in KRAS G12C-mutated pancreatic cancer; however, preclinical data on such combinations are lacking. This proof-of-concept study evaluated the cytotoxic effects of ECT using bleomycin (BLM) or cisplatin (CDDP) in combination with sotorasib in KRAS G12C-mutated MIA PaCa-2 and KRAS G12D-mutated PANC-1 pancreatic cancer cell lines. ECT alone significantly reduced cell viability, particularly in MIA PaCa-2 cells, where electric pulses induced approximately 75% cell death. Combining ECT with sotorasib resulted in an additive effect on KRAS G12C-mutated MIA PaCa-2 cells, though no synergy was observed, likely due to the high intrinsic sensitivity to electric pulses. These results support the potential of combining physical and molecular therapies in a subset of pancreatic cancer patients and lay the groundwork for further in vivo studies to optimize treatment parameters and explore clinical translatability.
Ključne besede: bleomycin, cisplatin, electrochemotherapy, pancreatic cancer
Objavljeno v DiRROS: 26.11.2025; Ogledov: 113; Prenosov: 51
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