1. Age, gender, and BMI in presentation of primary hyperparathyroidismchallenges : a single-center experienceKatarina Mlekuš, Gaj Vidmar, Mojca Jensterle Sever, Luka Ležaič, Marko Hočevar, Sončka Jazbinšek, Katarina Remec, Andrej Janež, Tomaž Kocjan, 2025, original scientific article Abstract: Background: Primary hyperparathyroidism (PHPT) is a relatively common disease with considerable heterogeneity. We aimed to assess the impact of age, gender, and body mass index (BMI) on the presentation of PHPT. Material and methods: We retrospectively analyzed the baseline biochemical status, symptoms, renal manifestations, and bone mineral density (BMD) of patients diagnosed with PHPT at the national tertiary endocrine referral clinic from January 2004 to December 2016. Results: We included 415 patients [333 women (41 premenopausal, 292 postmenopausal) and 82 men] with PHPT, aged 64 years on average [standard deviation (SD) 13, range 19–89 years], with an average BMI of 28.4 (SD 6.0, range 11.2–51.1 kg/m2). Older age was statistically significantly associated with milder biochemical presentation — lower total and corrected calcium (standardized regression coefficient β = –0.17, p < 0.001 and β = –0.12, p = 0.018). In comparison with premenopausal women, postmenopausal women [estimated odds ratio (OR) = 8.6, 95% confidence interval (CI): 3.9–20.8; p < 0.001] and men (OR = 5.9, 95% CI: 2.5–15.6; p < 0.001) were more likely to suffer from skeletal manifestations of PHPT. Renal manifestations were less likely among postmenopausal than premenopausal women (OR = 0.4, 95% CI: 0.2–0.8; p = 0.014). BMI was negatively associated with skeletal and renal manifestations (OR = 0.94 per unit change, p = 0.002) and symptomatic presentation (OR = 0.96 per unit change, p = 0.012). Conclusion: Older patients with PHPT presented with a biochemically less florid disease. Postmenopausal women and men with PHPT were more likely to suffer from skeletal manifestations of PHPT than premenopausal women. Patients with higher BMI had fewer skeletal and renal manifestations of PHPT and were less likely to be symptomatic.
Keywords: primary hyperparathyroidism, hypercalcemia, osteoporosis
Published in DiRROS: 23.02.2026; Views: 163; Downloads: 60
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2. Melanom : informacije o bolezni in zdravljenjuJanja Ocvirk, Marko Hočevar, Primož Strojan, Borut Žgavec, 2008, dictionary, encyclopaedia, lexicon, manual, atlas, map Published in DiRROS: 02.09.2025; Views: 397; Downloads: 132
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5. Priporočila za obravnavo bolnikov z melanomom kožeMartina Reberšek, Janja Ocvirk, Primož Strojan, Barbara Perić, Marko Hočevar, Katarina Šmuc Berger, Vesna Zadnik, Olga Blatnik, Katarina Zevnik, Nina Boc, Nežka Hribernik, Tanja Mesti, Karla Berlec, Nada Rotovnik-Kozjek, Maja Ebert Moltara, Jernej Benedik, Boštjan Luzar, Jože Pižem, Marko Boc, Marija Ignjatović, Katarina Barbara Karner, Gaber Plavc, Marko Kokalj, Marko Snoj, Katarina Trčko, 2024, professional article Keywords: koža, rak (medicina), zaščitni ukrepi, dejavniki tveganja, klinična diagnostika, stadij, prognoza, histopatologija, kirurško zdravljenje, radioterapija, sistemsko zdravljenje, sledenje pacientov, prehranska podpora, paliativna oskrba, elektronske knjige
Published in DiRROS: 21.05.2025; Views: 659; Downloads: 316
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6. Detection and localization of hyperfunctioning parathyroid glands on [18F]fluorocholine PET/CT using deep learning – model performance and comparison to human expertsLeon Jarabek, Jan Jamšek, Anka Cuderman, Sebastijan Rep, Marko Hočevar, Tomaž Kocjan, Mojca Jensterle Sever, Žiga Špiclin, Žiga Maček Ležaić, Filip Cvetko, Luka Ležaič, 2022, original scientific article Abstract: In the setting of primary hyperparathyroidism (PHPT), [18F]fluorocholine PET/CT (FCH-PET) has excellent diagnostic performance, with experienced practitioners achieving 97.7% accuracy in localising hyperfunctioning parathyroid tissue (HPTT). Due to the relative triviality of the task for human readers, we explored the performance of deep learning (DL) methods for HPTT detection and localisation on FCH-PET images in the setting of PHPT. Patients and methods. We used a dataset of 93 subjects with PHPT imaged using FCH-PET, of which 74 subjects had visible HPTT while 19 controls had no visible HPTT on FCH-PET. A conventional Resnet10 as well as a novel mPETResnet10 DL model were trained and tested to detect (present, not present) and localise (upper left, lower left, upper right or lower right) HPTT. Our mPETResnet10 architecture also contained a region-of-interest masking algorithm that we evaluated qualitatively in order to try to explain the model’s decision process. Results. The models detected the presence of HPTT with an accuracy of 83% and determined the quadrant of HPTT with an accuracy of 74%. The DL methods performed statistically worse (p < 0.001) in both tasks compared to human readers, who localise HPTT with the accuracy of 97.7%. The produced region-of-interest mask, while not showing a consistent added value in the qualitative evaluation of model’s decision process, had correctly identified the foreground PET signal. Conclusions. Our experiment is the first reported use of DL analysis of FCH-PET in PHPT. We have shown that it is possible to utilize DL methods with FCH-PET to detect and localize HPTT. Given our small dataset of 93 subjects, results are nevertheless promising for further research
Keywords: primary hyperparathyroidism, deep learning, nuclear medicine
Published in DiRROS: 25.07.2024; Views: 1246; Downloads: 554
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7. Completely resected stage III melanoma controversy : 15 years of national tertiary centre experienceBarbara Perić, Sara Milićević, Andraž Perhavec, Marko Hočevar, Janez Žgajnar, 2021, original scientific article Abstract: Background Two prospective randomized studies analysing cutaneous melanoma (CM) patients with sentinel lymph node (SLN) metastases and rapid development of systemic adjuvant therapy have changed our approach to stage III CM treatment. The aim of this study was to compare results of retrospective survival analysis of stage III CM patients% treatment from Slovenian national CM register to leading international clinical guidelines. Patients and methods Since 2000, all Slovenian CM patients with primary tumour % TIb are treated at the Institute of Oncology Ljubljana and data are prospectively collected into a national CM registry. A retrospective analysis of 2426 sentinel lymph node (SLN) biopsies and 789 lymphadenectomies performed until 2015 was conducted using Kaplan-Meier survival curves and log-rank tests. Results Positive SLN was found in 519/2426 (21.4%) of patients and completion dissection (CLND) was performed in 455 patients. The 5-year overall survival (OS) of CLND group was 58% vs. 47% of metachronous metastases group (MLNM) (p = 0.003). The 5-year OS of patients with lymph node (LN) metastases and unknown primary site (UPM) was 45% vs. 21% of patients with synchronous LN metastasis. Patients with SLN tumour burden < 0.3 mm had 5-year OS similar to SLN negative patients (86% vs. 85%; p = 0.926). The 5-year OS of patients with burden > 1.0 mm was similar to the MLNM group (49% vs. 47%; p = 0.280). Conclusions Stage III melanoma patients is a heterogeneous group with significant OS differences. CLND after positive SLNB might still remain a method of treatment for selected patients with stage III.
Keywords: cutaneous melanoma, surgery treatment, sentinel node biopsy
Published in DiRROS: 17.07.2024; Views: 1054; Downloads: 630
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8. Surgical options in treating patients with primary hyperparathyroidismMaša Majcen, Marko Hočevar, 2020, review article Abstract: Background. Primary hyperparathyroidism is the third most common endocrine disorder for which surgical procedure called parathyroidectomy is the most effective treatment. Since the early 20th century, parathyroid surgery has improved extensively. With the advances in preoperative imaging and with understanding the causes of disease, new and minimally invasive surgical approaches overrode the standard bilateral exploratory operations. Directed parathyroidectomy is currently the standard technique for treatment of primary hyperparathyroidism worldwide. Conclusions. Surgery is the only definitive treatment of primary hyperparathyroidism. The most appropriate type of surgical procedure depends on the number and localization of the hyperactive parathyroid glands, availability of modern imaging techniques, limitation of each type of procedure and expertise.
Keywords: primary hyperparathyroidism, minimally invasive parathyroidectomy, directed parathyroidectomy
Published in DiRROS: 16.07.2024; Views: 981; Downloads: 562
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9. Significance of nuclear factor - kappa beta activation on prostate needle biopsy samples in the evaluation of Gleason score 6 prostatic carcinoma indolenceMarko Zupančič, Boris Pospihalj, Snežana Cerović, Barbara Gazić, Primož Drev, Marko Hočevar, Andraž Perhavec, 2020, original scientific article Abstract: The goal of our study was to find out whether the immunohistochemical expression of nuclear factor-kappa beta (NF-%B) p65 in biopsy samples with Gleason score 3 + 3 = 6 (GS 6) can be a negative predictive factor for Prostate cancer (PCa) indolence. Patients and methods Study was conducted on a retrospective cohort of 123 PCa patients with initial total PSA % 10 ng/ml, number of needle biopsy specimens % 8, GS 6 on biopsy and T1/T2 estimated clinical stage who underwent laparoscopic radical prostatectomy and whose archived formalin-fixed and paraffin-embedded (FFPE) prostate needle biopsy specimens were used for additional immunohistochemistry staining for detection of NF-%B p65. Both cytoplasmic and nuclear NF-%B p65 expression in biopsy cores with PCa were correlated with postoperative pathological stage, positive surgical margins, GS and biochemical progression of disease. Results After follow-up of 66 months, biochemical progression (PSA % 0.2 ng/ml) occurred in 6 (5.1%) patients, 3 (50%) with GS 6 and 3 (50%) with GS 7 after radical prostatectomy. Both cytoplasmic and nuclear NF-%B p65 expressions were not significantly associated with pathological stage, positive surgical margin and postoperative GS. Patients with positive cytoplasmic NF-kB reaction had significantly more frequent biochemical progression than those with negative cytoplasmic NF-kB reaction with PSA 0.2 ng/ml as cutoff point (p = 0.015) and a trend towards more biochemical progression with PSA % 0.05 ng/ml as cutoff point (p = 0.068). Conclusions Cytoplasmic expression of NF-%B is associated with more biochemical progression and might be an independent prognostic factor for recurrence-free survival (RFS), but further studies including larger patient cohorts are needed to confirm these initial results.
Keywords: prostate cancer, needle biopsy, nuclear factor-kappa beta, Gleason
Published in DiRROS: 12.07.2024; Views: 1161; Downloads: 683
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10. Spremljanje bolnikov z rakom po zaključenem zdravljenjuMarko Hočevar, 2024, published professional conference contribution Abstract: V razvitem zahodnem svetu s staranjem populacije strmo narašča breme raka. Prevalenca raka je v zadnjih 50 letih naraščala praktično eksponentno. Bolniki po končanem primarnem zdravljenju s kurativnim namenom so bili tradicionalno spremljani v ustanovah, kjer so bili zdravljeni, in sicer pet let ali več, glavni namen spremljanja pa je bil zgodnje odkrivanje morebitne ponovitve bolezni. Po tem obdobju so bolnike prevzeli v oskrbo družinski zdravniki. Takšen tradicionalen način spremljanja bolnikov po končanem zdravljenju (angl. follow-up) zanemari vse ostale težave in potrebe preživelih z rakom. V zadnjem obdobju se zato pojavlja nov, širši pojem spremljanja bolnikov v onkologiji (angl. survivorship), ki naslavlja različne fizične, psihosocialne, materialne in informacijske težave in potrebe, ki jih imajo ti bolniki. Idealno je, da dobi vsak bolnik z rakom ob koncu zdravljenja t. i. načrt oskrbe preživelih, ki jasno povzame opravljeno zdravljenje in hkrati natančno opiše načrt spremljanja. Težave in potrebe preživelih se močno razlikujejo med različnimi vrstami raka in med različnimi načini zdravljenja, prav tako pa po posamičnih obdobjih preživetja. V prispevku so opisani različni modeli, ki so nam na voljo pri organizaciji spremljanja bolnikov v onkologiji in predlagan način stratificiranja bolnikov v različne skupine glede na verjetnost pojava poznih posledic zdravljenja in ponovitve bolezni. Najprimernejši modeli za posamezne vrste raka bodo opisani v posebnih prispevkih in bodo upoštevali specifiko posameznih rakov (npr. ginekologi na primarnem nivoju pri ginekoloških rakih). V prispevku bo dodatno poudarjen pomen umestitve poglavja o spremljanju bolnikov v onkologiji v priporočila in klinične poti za posamične vrste raka ter njihovo sprotno posodabljanje ob novih spoznanjih.
Keywords: bolniki, onkologija, spremljanje bolnikov
Published in DiRROS: 06.06.2024; Views: 1174; Downloads: 338
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