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Povzetek: Objective: To develop and validate a prediction model (STOMA score) for 1-year stoma-free survival in patients with rectal cancer (RC) with anastomotic leakage (AL). Background: AL after RC resection often results in a permanent stoma. Methods: This international retrospective cohort study (TENTACLE-Rectum) encompassed 216 participating centres and included patients who developed AL after RC surgery between 2014 and 2018. Clinically relevant predictors for 1-year stoma-free survival were included in uni and multivariable logistic regression models. The STOMA score was developed and internally validated in a cohort of patients operated between 2014 and 2017, with subsequent temporal validation in a 2018 cohort. The discriminative power and calibration of the models' performance were evaluated. Results: This study included 2499 patients with AL, 1954 in the development cohort and 545 in the validation cohort. Baseline characteristics were comparable. One-year stoma-free survival was 45.0% in the development cohort and 43.7% in the validation cohort. The following predictors were included in the STOMA score: sex, age, American Society of Anestesiologist classification, body mass index, clinical M-disease, neoadjuvant therapy, abdominal and transanal approach, primary defunctioning stoma, multivisceral resection, clinical setting in which AL was diagnosed, postoperative day of AL diagnosis, abdominal contamination, anastomotic defect circumference, bowel wall ischemia, anastomotic fistula, retraction, and reactivation leakage. The STOMA score showed good discrimination and calibration (c-index: 0.71, 95% CI: 0.66-0.76). Conclusions: The STOMA score consists of 18 clinically relevant factors and estimates the individual risk for 1-year stoma-free survival in patients with AL after RC surgery, which may improve patient counseling and give guidance when analyzing the efficacy of different treatment strategies in future studies.
Ključne besede: anastomotic leakage, rectal cancer, rectal cancer resection, stoma-free survival permanent
Objavljeno v DiRROS: 03.08.2026; Ogledov: 120; Prenosov: 70
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Povzetek: A total of 16 elasmobranch species (nine shark and seven batoid species) were sampled in the Sea of Marmara (SoM) between 2014 and 2024 for this study. During the same period, an additional nine species (six shark and three batoid species) were recorded from the same area by other researchers. Over the past 100 years, 32 species of demersal elasmobranchs (16 shark and 16 batoid species) have been reported from the SoM, but applying “evidence-based confirmed or unconfirmed presence” criteria reduces the current number to 25 (15 shark species, 10 batoid species). Principal Component Analysis indicates that adaptability to shallower waters is now critical to the spatial distribution of demersal elasmobranchs in the SoM. This shift clearly shows how dramatically the environmental degradation, marine pollution, and deoxygenation have reduced the region’s elasmobranch fauna primarily to demersal species over the last 40 years, underscoring the potentially devastating impact of such degradation on biodiversity.
Ključne besede: Elasmobranchii, survival, conservation, inventory, Sea of Marmara, Turkey
Objavljeno v DiRROS: 26.06.2026; Ogledov: 256; Prenosov: 165
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Povzetek: Background: This study aimed to determine the national incidence, characterize clinical features, and evaluate the treatment outcomes of primary vitreoretinal lymphoma (PVRL) in Slovenia. Methods: We conducted a population-based, retrospective case series of all patients diagnosed with PVRL at the Eye Hospital, University Medical Center Ljubljana, between January 2013 and May 2024. The diagnosis was histopathologically confirmed, and primary central nervous system involvement was excluded. Clinical presentation, diagnostic delay, treatment modality, and adverse events were analyzed. Progression-free survival (PFS), overall survival (OS), and lymphoma-specific survival (LSS) were calculated. Results: Twelve patients were diagnosed with PVRL (four men, eight women; median age of 76 years). The average annual incidence was 0.52 cases per million. The median time from symptom onset to diagnosis was 238 days. The two most common symptoms were decreased visual acuity (75%) and floaters (58%). Vitreous cellular infiltration was the predominant clinical sign and was observed in 92% of patients. Five patients presented with unilateral disease, seven with bilateral disease, and three with unilateral disease that progressed to bilateral involvement. The median follow-up was 31.5 months. Eleven patients received one or more treatment modalities: intravitreal rituximab and/or methotrexate, local radiotherapy, and/or systemic chemotherapy. Local remission was achieved in all treated eyes. Two cases of granulomatous uveitis occurred during intravitreal rituximab therapy. The median PFS was 12 months; the two- and three-year PFS rates were 37.5% and 18.8%, respectively. The median OS was not reached; the two- and three-year OS rates were 70% and 56%, respectively. The LSS was 80% at two years and 64% at three years. Conclusions: This Slovenian population-based study provides real-world insights into PVRL management. In elderly and medically fragile patients, local treatment modalities provided effective ocular disease control with acceptable toxicity.
Ključne besede: methotrexate, population-based study, primary vitreoretinal lymphoma, radiotherapy, survival analysis
Objavljeno v DiRROS: 24.04.2026; Ogledov: 317; Prenosov: 210
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Povzetek: Background: The aim of this nation-wide 2009-2021 cohort study was to analyze postoperative survival of patients with resected appendicular skeletal metastases and endoprosthetic reconstruction in comparison to sarcoma patients and non-oncological reconstructions. Patients and methods: A single institution nation-wide cohort of 144 consecutive patients with tumor endoprosthetic reconstructions (32 resected metastases, 73 resected sarcomas, 39 non-oncological) were stratified into histopathological groups according to the 2013-SPRING prediction model. Their survival was analyzed with the Kaplan-Meier method and Cox regression. Results: The observed patient survival rates after wide resection of fast/moderate/slow growing metastases were 25/55/88% at 2 years and 10/30/83% at 5 years, while in sarcomas the observed survival rates were 80% at 2 years and 69% at 5 years. Estimated mean postoperative survival after resection of skeletal metastases was significantly shorter in comparison to sarcomas (4.6 years vs. 9.1 years, log-rank p < 0.001). Predictors of worse patient survival included higher age, pathologic fracture or >1 metastasis, diagnostic group fast-growing metastases and higher preoperative C-reactive protein (CRP). Conclusions: Wide resection and endoprosthetic reconstruction offer a reliable solution in selected patients with skeletal metastases. Higher age, fast-growing metastases (from bladder cancer, colorectal, hepatocellular, lung cancer, malignant melanoma, unknown origin), pathologic fracture or >1 metastasis and elevated CRP predict shorter patient survival and may represent a relative contraindication in this regard.
Ključne besede: skeletal metastases, wide resection, endoprosthetic reconstruction, patient survival
Objavljeno v DiRROS: 29.01.2026; Ogledov: 454; Prenosov: 324
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Povzetek: Background: Short-term gastric cancer surgery outcomes depend greatly on hospital surgical volume, whereas long-term survival studies show conflicting results. This study evaluated the effect of surgical volume on the long-term survival of patients who underwent surgery for gastric cancer in Slovenia. Methods: A retrospective cohort analysis was performed using the Slovenian Cancer Registry data. Patients diagnosed between 2016 and 2020 who underwent gastric cancer surgery were categorized into high- and low-volume centers. High-volume centers were defined, as the two University Medical Centers (Ljubljana and Maribor), which together treated 76.4 % of all patients during the study period. Survival analysis was conducted using Kaplan-Meier overall survival and Pohar-Perme net survival estimators, with predefined subgroup analysis. Cox proportional hazards models assessed the independent association between center volume and overall survival. Results: Among the 652 patients, 498 (76.4 %) underwent surgery at high-volume centers (44,2-55,4 mean surgeries/year), which demonstrated higher median overall survival (4.9 vs. 3.2 years) and improved overall and net 1-, 3-, and 5-year survival rates compared with low-volume centers (0,2-6,2 mean surgeries/year). This differences persisted in stratified analyses by stage and neoadjuvant therapy but not by age. In multivariable Cox analysis the hazard ratio remained directionally favorable for high-volume centers but was not statistically significant. Conclusions: Overall, high-volume centers were consistently associated with better long-term survival after gastric cancer surgery in Slovenia, supporting further evaluation of centralization strategies. Future policies should aim to balance the benefits of centralization while maintaining equitable access to timely and high-quality surgical treatment, regardless of location or socioeconomic status.
Ključne besede: gastric cancer, survival, survival analysis, surgical oncology, centralized hospital services
Objavljeno v DiRROS: 07.01.2026; Ogledov: 554; Prenosov: 431
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