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Abstract: Background: Gastric cancer (GC) is the fourth most common cancer and the third leading cancer-related cause of death worldwide since most patients are diagnosed at an advanced stage. The majority of GCs are adenocarcinomas (ACs), and the poorly characterized clear cell AC represents a unique subgroup of GCs and is an independent marker of poor prognosis. Even though the prognosis for patients with advanced GC is poor we present a report of a patient with long-term survival despite having liver metastases from clear cell gastric AC. Case presentation: A 45-year-old male with clear cell gastric AC underwent subtotal gastrectomy and postoperative chemoradiation. Only a year and a half after his initial treatment the disease spread to his liver. He received two lines of chemotherapy treatment within the next two years before a right hepatectomy was suggested. Due to an initially insufficient future liver remnant (FLR), transarterial chemoembolization (TACE) and portal vein embolization (PVE) were performed, which made the surgical procedure possible. Shortly after a disease progression in the remaining liver was detected. In the following three years the patient was treated with a carefully planned combination of systemic therapy and different interventional oncology techniques including selective internal radiation therapy (SIRT) and TACE. And as illustrated, an attentive, patient-tailored, multimodality treatment approach can sometimes greatly benefit our patients as he had an overall survival of 88 months despite the poor prognosis of his disease. Conclusion: To the best of our knowledge, this report is the first to describe a patient with liver metastases from clear cell gastric AC treated with interventional oncology techniques (PVE, TACE, and SIRT) in combination with other locoregional and systemic therapies thereby presenting that these interventional oncology techniques can be successfully integrated into long-term management of non-conventional liver tumors.
Keywords: gastric adenocarcinoma, survival, multimodality treatment
Published in DiRROS: 15.09.2022; Views: 143; Downloads: 78
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Keywords: adenokarcinom želodca, priporočila, prebavni trakt, multidisciplinarno zdravljenje
Published in DiRROS: 16.12.2021; Views: 709; Downloads: 303
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Abstract: V Sloveniji vsako leto zboli zaradi raka želodca okrog 450 bolnikov, od tega ima tri četrtine bolnikov ob postavitvi diagnoze razširjeno ali razsejano bolezen. Zato je pomembno, da imamo razvito sodobno multidisciplinarno zdravljenje. Onkološki inštitut je na poti pridobitve evropske onkološke akreditacije, ki jo podeljuje priznana Evropska organizacija onkoloških inštitutov (OECI), katere član je tudi Onkološki inštitut Ljubljana. Namen tega projekta je razvoj kliničnih poti, ki bodo omogočile celostno obravnavo bolnikov z rakom. Slovenskih priporočil za zdravljenje adenokarcinoma želodca trenutno nimamo, zato smo bili primorani sprejeti te, ki jim bomo sledili na Onkološkem inštitutu. V teh priporočilih, zaradi drugačne narave bolezni, ni zajeto zdravljenje raka ezofagogastričnega stika.
Keywords: rak želodca, adenokarcinom, onkološko zdravljenje, priporočila
Published in DiRROS: 14.09.2021; Views: 926; Downloads: 252
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Abstract: Paliativna oskrba je v slovenskem prostoru mlada stroka. Z njenim razvojem so se začeli uporabljati številni izrazi, ki so včasih nejasno in nenatančno opredeljeni. Posledica tega je, tako med strokovnjaki kot na splošno v družbi, njeno neustrezno razumevanje. občasno zato prihaja do nesporazumov in posledično tudi do strokovnih napak. Namen izvajanja paliativne oskrbe je zagotoviti čim boljšo kakovost življenja bolnikom z napredujočimi neozdravljivimi boleznimi ter nuditi podporo njihovim bližnjim, v času bolnikove bolezni in po smrti. V paliativni oskrbi zdravstveno osebje veliko bolj kot sicer posveča pozornost celostni obravnavi posameznega človeka, kot osebo z individualnimi telesnimi, psihološkimi, socialnimi in duhovnimi potrebami. To je dinamičen proces, saj se moramo ves čas prilagajati trenutnim potrebam bolnika in njegovih bližnjih ter z aktivnim načrtovanjem učinkovito preprečevati nove in nepotrebne zaplete. Zgodnja paliativna oskrba se v začetku obravnave bolnika z neozdravljivo boleznijo prepleta s specifičnim zdravljenjem. Kasneje, z napredovanjem bolezni, obravnava prehaja v obdobje pozne paliativne oskrbe in obdobje oskrbe umirajočega. Po sodobnih smernicah se paliativna oskrba izvaja celostno, neprekinjeno in integrirano v ostale zdravstvene stroke. Cilj paliativne oskrbe je sledenje vrednotam posameznika in ohranjanje dostojanstva življenja. V prispevku smo zbrali najpogosteje uporabljene izraze s področja paliativne oskrbe. Na podlagi mednarodnih priporočil, lokalnih značilnosti in nacionalnih izkušenj smo jih skušali čim bolj jasno opredeliti za naš prostor. Natančno opredeljeni pojmi paliativne oskrbe in njihova dosledna uporaba bodo vodili k boljšemu medsebojnemu razumevanju strokovnjakov in uporabnikov paliativne oskrbe ter k njenemu kakovostnejšemu izvajanju.
Keywords: paliativna oskrba, zdravljenje, mesebojno sporazumevanje
Published in DiRROS: 04.01.2021; Views: 1273; Downloads: 346
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Published in DiRROS: 11.08.2020; Views: 1180; Downloads: 517
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