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Query: "author" (Uroš Smrdel) .

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Long-term survival in glioblastoma : methyl guanine methyl transferase (MGMT) promoter methylation as independent favourable prognostic factor
Uroš Smrdel, Mara Popović, Matjaž Zwitter, Emanuela Boštjančič, Andrej Zupan, Viljem Kovač, Damjan Glavač, Drago Bokal, Janja Jerebic, 2016, original scientific article

Abstract: In spite of significant improvement after multi-modality treatment, prognosis of most patients with glioblastoma remains poor. Standard clinical prognostic factors (age, gender, extent of surgery and performance status) do not clearly predict long-term survival. The aim of this case-control study was to evaluate immuno-histochemical and genetic characteristics of the tumour as additional prognostic factors in glioblastoma. Long-term survivor group were 40 patients with glioblastoma with survival longer than 30 months. Control group were 40 patients with shorter survival and matched to the long-term survivor group according to the clinical prognostic factors. All patients underwent multimodality treatment with surgery, postoperative conformal radiotherapy and temozolomide during and after radiotherapy. Biopsy samples were tested for the methylation of MGMT promoter (with methylation specific polymerase chain reaction), IDH1 (with immunohistochemistry), IDH2, CDKN2A and CDKN2B (with multiplex ligation-dependent probe amplification), and 1p and 19q mutations (with fluorescent in situ hybridization). Methylation of MGMT promoter was found in 95% and in 36% in the long-term survivor and control groups, respectively (p < 0.001). IDH1 R132H mutated patients had a non-significant lower risk of dying from glioblastoma (p= 0.437), in comparison to patients without this mutation. Other mutations were rare, with no significant difference between the two groups. Molecular and genetic testing offers additional prognostic and predictive information for patients with glioblastoma. The most important finding of our analysis is that in the absence of MGMT promoter methylation, longterm survival is very rare. For patients without this mutation, alternative treatments should be explored.
Keywords: glioblastoma, long-term survival, methyl guanine methyl transferase, MGMT, prognostic factor
Published in DiRROS: 30.04.2024; Views: 117; Downloads: 105
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Glioblastoma patients in Slovenia from 1997 to 2008
Uroš Smrdel, Viljem Kovač, Mara Popović, Matjaž Zwitter, 2014, original scientific article

Abstract: Glioblastoma is the most common primary brain tumour. It has a poor prognosis despite some advances in treatment that have been achieved over the last ten years. In Slovenia, 50 to 60 glioblastoma patients are diagnosed each year. In order to establish whether the current treatment options have any influence on the survival of the Slovenian glioblastoma patients, their data in the period from the beginning of the year 1997 to the end of the year 2008 have been analysed. Patients and methods. All patients treated at the Institute of Oncology Ljubljana from 1997 to 2008 were included in the retrospective study. Demographics, treatment details, and survival time after the diagnosis were collected and statistically analysed for the group as a whole and for subgroups. Results. From 1997 to 2008, 527 adult patients were diagnosed with glioblastoma and referred to the Institute of Oncology for further treatment. Their median age was 59 years (from 20 to 85) and all but one had the diagnosis confirmed by a pathologist. Gross total resection was reported by surgeons in 261 (49.5%) patients; good functional status (WHO 0 or 1) after surgery was observed in 336 (63.7%) patients, radiotherapy was performed in 422 (80.1%) patients, in 317 (75.1%) of them with radical intent, and 198 (62.5 %) of those received some form of systemic treatment (usually temozolomide). The median survival of all patients amounted to 9.7 months. There was no difference in median survival of all patients or of all treated patients before or after the chemo-radiotherapy era. However, the overall survival of patients treated with radical intent was significantly better (11.4 months; p < 0.05). A better survival was also noticed in radically treated patients who received additional temozolomide therapy (11.4 vs. 13.1 months; p = 0.014). The longer survival was associated with a younger age and a good performance status as well as with a more extensive tumour resection. In patients treated with radical intent, having a good performance status, and receiving radiotherapy and additional temozolomide therapy, the survival was significantly longer, based on multivariate analysis.
Keywords: glioblastoma, treatment, survival, surgery, radiotherapy, termozolomide
Published in DiRROS: 11.04.2024; Views: 332; Downloads: 379
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Genetic markers in oligodendroglial tumours
Tomaž Velnar, Uroš Smrdel, Mara Popović, Gorazd Bunc, 2010, review article

Abstract: Background. Oliogodendrogliomas are brain tumours composed of the cells resembling oligodendrocytes. They represent the third most common glial tumour, comprising 2.5% of all primary brain tumours and 5-20% of all gliomas. Conclusions. Oligodendroglial tumours with 1p and 19q loss demonstrate a better overall prognosis due to more indolent clinical behaviour and higher sensitivity to treatment. Additionally, 1p and 19q loss is a marker of clinical utility, helping to assess tumour sensitivity to chemotherapy and harbouring the potential for improving the diagnosis and survival of oligodendroglioma patients as well as future clinical practice.
Published in DiRROS: 15.03.2024; Views: 133; Downloads: 34
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Erlotinib in previously treated non-small-cell lung cancer
Uroš Smrdel, Viljem Kovač, 2006, professional article

Published in DiRROS: 15.02.2024; Views: 154; Downloads: 37
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Brain metastases in lung cancer : impact of prognostic factors on patient survival
Uroš Smrdel, Matjaž Zwitter, Viljem Kovač, 2003, original scientific article

Abstract: Background. Brain metastases are common patterns of dissemination in lung cancer patients. In this paper we would like to assess the pattern of brain metastases in lung cancer patients and the impact of prognostic factors on thesurvival of lung cancer patients with brain metastases. Patients and methods. In the year 1998 there were 974 registered patients with lung cancer in Slovenia, six hundred and fifteen of them were treated at the Institute of Oncology Ljubljana and we analyzed them. Among 615 patients 137 (22.3%) of them have had brain metastases during a natural course of disease. Results. For 12 patients presenting with solitary brain metastases (most of them were undertaken metastaseetomy) median survival was 7.6 months, while in patients with multiple brain metastases the median survival was 2.8 months (p = 0.0018). Of the 137 patients 45 (32.8%) were small cell lung cancer patients, 43 (31.4%) were adenocarcinoma patients and 19 (13.9%) were squamous cell carcinoma patients. Patients with performance status (WHO scale) less than 2 had the median survival time 3.7 months while patients with performance status2 or more had median survival time 2.7 moths (p=0.0448). Conclusions. Patients with solitary brain metastases had better survival comparing with those who had multiple metastases. It is surprisingly that the portion of brain metastases patients with adenocarcinoma is almost equal to those with small-call lung cancer therefore, the prophylactic cranial radiation becomes actual for both groups of patients. The performance status of patients with brain metastases remains very important prognostic factor.
Published in DiRROS: 06.02.2024; Views: 171; Downloads: 46
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Radiokirurgija možganskih zasevkov pri melanomu
Uroš Smrdel, 2023, published scientific conference contribution

Abstract: Melanom spada med tumorje, ki najpogosteje dajejo možganske zasevke. Sicer ne v absolutnem številu temveč relativno. Poleg simtomatskega zdravljenja, operacije, obsevanja celih možganov in sistemske terapije je ena od možnosti zdravljenja možganskih zasevkov tudi radiokirurgija. Radiokirurgija ni nova tehnika, jo je pa napredek tehnologije popeljal na nov nivo. Gre pri radiokirurgiji za neinvaziven poseg in so komplikacije zapleti zdravljenja bistvpomembnoeno nižjie kot pri operativnem zdravljenju. Pri zdravljenju z radiokirurgijo je pomembno to, da je zdravljenje zelo lokalno. Zaradi tega lahko bolnike zdravimo z radiokirurgijo tudi večkrat. Vsekakor je radiokirurgija možganskih zasevkov melanoma še en majhen delec v sestavljanki kako kontrolirati bolezen in je prav zaradi tega posvet strokovnjakov več strok pomembnih pri onkološkem zdravljenju na multidisciplinarnem konziliju bistvenega pomena.
Keywords: rak kože, melanom, radiokirurgija
Published in DiRROS: 18.05.2023; Views: 315; Downloads: 125
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Vloga radioterapije v zdravljenju ekstraaksialnih možganskih tumorjev
Uroš Smrdel, 2022, published scientific conference contribution

Keywords: možganski tumorji, centralno živčevje, radioterapija
Published in DiRROS: 16.12.2022; Views: 504; Downloads: 102
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Stereotaktična reiradiacija
Uroš Smrdel, 2020, published professional conference contribution

Keywords: stereotaktično obsevanje, radioterapija, reiradiacija
Published in DiRROS: 14.04.2022; Views: 683; Downloads: 199
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