1. Rak jajčnikov : zanositev in nosečnost2024, zbornik recenziranih znanstvenih prispevkov na domači konferenci Povzetek: Predstavljamo vam zbornik znanstvenih prispevkov, ki naslavlja kompleksen odnos med rakom jajčnikov, zanositvijo in nosečnostjo. Gre za tematiko, ki v medicinskih in raziskovalnih krogih postaja vse bolj aktualna, saj tehnološki in terapevtski napredek omogočata razvoj novih pristopov, ki izboljšujejo kakovost življenja bolnic in odpirajo možnosti za ohranjanje plodnosti tudi pri onkoloških bolnicah.
Objavljeno v DiRROS: 24.01.2025; Ogledov: 184; Prenosov: 100
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5. Sodobna dognanja : 8. šola o ginekološkem raku2024, ni določena Povzetek: Raki rodil predstavljajo pomemben zdravstveni izziv za ženske po vsem svetu. So raznovrstna skupina bolezni katere preživetje se močno razlikuje glede na prizadetost organa, razširjenost
bolezni, odgovora na zdravljenje in psihofizičnega stanja bolnice.
V zadnjih letih smo priča izjemnim napredkom na področju medicinske obravnave in zdravstvenih raziskav, ki so privedla do bistvenih izboljšav pri obravnavi bolnic z ginekološkim rakom. Sodobne metode zdravljenja ne le povečujejo možnosti za preživetje, temveč bistveno prispevajo k višji kakovosti življenja onkoloških bolnic. Z vlaganjem v raziskave in izobraževanje lahko dosežemo nove preboje, ki bodo koristili prihodnjim generacijam žensk.
Ključne besede: ginekologija, onkologija, ginekološka onkologija, zdravljenje, ginekološka kirurgija, radioterapija, imunoterapija, laserska terapija, plodnost, parenteralna prehrana, zborniki, elektronske knjige
Objavljeno v DiRROS: 05.09.2024; Ogledov: 460; Prenosov: 221
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6. Modern approach to the management of genitourinary syndrome in women with gynecological malignanciesNina Kovačević, Ines Cilenšek, Sebastjan Merlo, Barbara Šegedin, 2023, pregledni znanstveni članek Povzetek: The term genitourinary syndrome of menopause was first used in 2014 by the North American Menopause Society and the International Society for the Study of Women's Sexual Health to describe conditions previously known as atrophic vaginitis, urogenital atrophy, or vulvovaginal atrophy. It is a complex, chronic, progressive condition characterized by a wide range of signs and symptoms affecting sexual function and the tissues of the urinary and genital tracts. The main cause of genitourinary syndrome of menopause is estrogen deficiency caused by ovarian removal or dysfunction. The most bothersome symptoms are vaginal dryness, decreased vaginal lubrication, and pain during penetration and intercourse. They all have a negative impact on the quality of life. Conclusions: The main goal of treatment is to relieve the symptoms. Treatment modalities are pharmacological or non-pharmacological. The first-line treatment for mild to moderate symptoms is the use of personal lubricants and moisturizers, but the gold standard is estrogen replacement therapy. Hormone therapy may not be an option for women with hormone-dependent cancer.
Ključne besede: genitourinary syndrome, gynecological malignancies, therapy
Objavljeno v DiRROS: 25.07.2024; Ogledov: 468; Prenosov: 151
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7. Treatment of vulvar cancer recurrences with electrochemotherapy : a detailed analysis of possible causes for unsuccessful treatmentGregor Vivod, Tanja Jesenko, Gorana Gašljević, Nina Kovačević, Maša Omerzel, Gregor Serša, Sebastjan Merlo, Maja Čemažar, 2023, izvirni znanstveni članek Povzetek: Background. Electrochemotherapy has good local effectiveness in the treatment of vulvar cancer. Most studies have reported the safety and effectiveness of electrochemotherapy for palliative treatment of gynecological cancers and mostly vulvar squamous cell carcinoma. Some tumors, however, fail to respond to electrochemotherapy. The biological features/determinants for the nonresponsiveness are not determined yet. Patient and methods. A recurrence of vulvar squamous cell carcinoma was treated by electrochemotherapy using intravenous administration of bleomycin. The treatment was performed by hexagonal electrodes according to standard operating procedures. We analyzed the factors that could determine nonresponsiveness to electrochemotherapy. Results. Based on the presented case of nonresponsive vulvar recurrence to electrochemotherapy, we hypothesize that the vasculature of the tumors prior to treatment may predict the response to electrochemotherapy. The histological analysis showed minimal presence of blood vessels in the tumor. Thus, low perfusion may reduce drug delivery and lead to a lower response rate because of the minor antitumor effectiveness of vascular disruption. In this case, no immune response in the tumor was elicited by electrochemotherapy. Conclusions. In this case, of nonresponsive vulvar recurrence treated by electrochemotherapy, we analyzed possible factors that could predict treatment failure. Based on histological analysis, low vascularization of the tumor was observed, which hampered drug delivery and distribution and resulted in no vascular disrupting action of electrochemotherapy. All these factors could contribute to ineffective treatment with electrochemotherapy.
Ključne besede: electrochemotherapy, bleomycin, vulvar cancer
Objavljeno v DiRROS: 25.07.2024; Ogledov: 524; Prenosov: 237
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8. Preoperative serum CA-125 level as a predictor for the extent of cytoreduction in patients with advanced stage epithelial ovarian cancerSebastjan Merlo, Nikola Bešić, Eva Drmota, Nina Kovačević, 2021, izvirni znanstveni članek Povzetek: 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.
Ključne besede: ovarian cancer, tumour marker, neoadjuvant chemotherapy, CA-125
Objavljeno v DiRROS: 22.07.2024; Ogledov: 510; Prenosov: 166
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9. Modern treatment of vulvar cancerSebastjan Merlo, 2020, pregledni znanstveni članek Povzetek: Vulvar cancer accounts for 3%5% of malignant diseases of the female genital tract. The Slovenian incidence rate is 5.5/100,000, which means 57 new cases per year. The most common histological type (90%) is squamous cell carcinoma. Based on etiology, it can be classified into the first type which correlates with human papillomavirus (HPV) infection and the second type which is not associated with HPV. The most common and long-lasting symptom of vulvar cancer is pruritus. The preferred diagnostic procedure to confirm the diagnosis is a punch or incision biopsy. Surgery in combination with radiotherapy is the standard treatment for vulvar cancer. Sentinel lymph node biopsy with lymphoscintigraphy is now a standard part of surgical treatment. Chemotherapy is a palliative treatment option. Conclusions. Vulvar cancer is a rare disease. Because of the pathogenesis, surgery and radiotherapy are the main treatment modalities. The sentinel node biopsy (SNB) represents a contemporary approach to the vulvar cancer treatment and significantly reduces morbidity. Improvements in treatment of vulvar cancer contributed to the decrease of mortality among Slovenian women.
Ključne besede: vulvar cancer, surgical treatment, sentinel lymph node biopsy, lymphoscintigraphy
Objavljeno v DiRROS: 16.07.2024; Ogledov: 485; Prenosov: 135
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10. The prevalence of occult ovarian cancer in the series of 155 consequently operated high risk asymptomatic patients : Slovenian population based studyAndreja Gornjec, Sebastjan Merlo, Srdjan Novaković, Vida Stegel, Barbara Gazić, Andraž Perhavec, Ana Blatnik, Mateja Krajc, 2020, izvirni znanstveni članek Povzetek: We assessed the prevalence, localization, type and outcome of occult cancer at risk-reducing salpingo-oophorectomy or salpingectomy (RRSO) in asymptomatic carriers of pathogenic or likely pathogenic BRCA1/2 variants and high-risk BRCA1/2 negative women. Patients and methods. A retrospective analysis of all consecutive gynaecologic preventive surgeries from January 2009 to December 2015 was performed. Participants underwent genetic counselling and BRCA1/2 testing before the procedure. Data on clinical parameters, adjuvant treatment and follow-up were collected and analysed. Results. One hundred and fifty-five RRSO were performed in 110 BRCA1, 35 BRCA2 carriers of pathogenic or likely pathogenic variants and 10 high-risk BRCA1/2 negative women, at the mean age of 48.3 years. Nine occult cancers (9/155, 5.8%) were identified; eight in BRCA1 positive women and one in high-risk BRCA1/2 negative woman. We identified four non-invasive serous intraepithelial tubal carcinomas (3 in BRCA1 carriers and 1 in a high-risk BRCA1/2 negative woman) and five invasive tubo-ovarian high grade serous cancers (all detected in BRCA1 carriers). Only one out of nine patients (11.1%) with occult cancer had a slightly elevated CA-125 value preoperatively. Conclusions. A 5.8% prevalence of occult invasive and noninvasive tubo-ovarian serous cancer after RRSO was found in high risk asymptomatic and screen negative women. We conclude that RRSO should be performed in BRCA1/2 carriers and in high-risk BRCA1/2 negative women. Age of preventive gynaecologic surgery should be carefully planned, taking into account the completion of childbearing age and type of mutation. The results favour the tubal hypothesis of tubal origin of high grade serous ovarian and peritoneal cancer. Cytology result of peritoneal cavity washing was important for the decision making process in determining treatment. Cytology examination should be performed in all cases of RRSO. CA-125 assay did not prove to be an effective screening tool for early cancer detection in our patients.
Ključne besede: risk-reducing salpingo-oophorectomy, occult serous cancer, serous tubal intraepithelial cancer, BRCA1/2 pathogenic or likely pathogenic variant
Objavljeno v DiRROS: 12.07.2024; Ogledov: 504; Prenosov: 172
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