1191. Prognostic factors of choroidal melanoma in Slovenia, 1986-2008Boris Jančar, Marjan Budihna, Brigita Drnovšek-Olup, Katrina Novak-Andrejčič, Irena-Hedvika Brovet-Zupančič, Dušica Pahor, 2016, original scientific article Abstract: Introduction. Choroidal melanoma is the most common primary malignancy of the eye, which frequently metastasizes. The Cancer Registry of Slovenia reported the incidence of choroid melanoma from 1983 to 2009 as stable, at 7.8 cases/million for men and 7.4/million for women. The aim of the retrospective study was to determinate the prognostic factors of survival for choroidal melanoma patients in Slovenia. Patients and methods. From January 1986 to December 2008 we treated 288 patients with malignant choroidal melanoma; 127 patients were treated by brachytherapy with beta rays emitting ruthenium-106 applicators; 161 patients were treated by enucleation. Results. Patients with tumours thickness < 7.2 mm and base diameter < 16 mm were treated by brachytherapy and had 5- and 10-year overall mortality 13% and 32%, respectively. In enucleated patients, 5- and 10-year mortality was higher, 46% and 69%, respectively, because their tumours were larger. Thirty patients treated by brachytherapy developed local recurrence. Twenty five of 127 patients treated by brachytherapy and 86 of 161 enucleated patients developed distant metastases. Patients of age >/= 60 years had significantly lower survival in both treatment modalities. For patients treated by brachytherapy the diameter of the tumour base and treatment time were independent prognostic factors for overall survival, for patients treated by enucleation age and histological type of tumour were independent prognosticators. In first few years after either of treatments, the melanoma specific annual mortality rate increased, especially in older patients, and then slowly decreased. Conclusions. It seems that particularly younger patients with early tumours can be cured, whereby preference should be given to eyesight preserving brachytherapy over enucleation. Keywords: choroidal melanoma, therapy, brachytherapy, prognostic factors Published in DiRROS: 09.05.2024; Views: 356; Downloads: 183
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1194. A statistical model describing combined irreversible electroporation and electroporation-induced blood-brain barrier disruptionShirley Sharabi, Bor Kos, David Last, David Guez, Dianne Daniels, Sagi Harnof, Yael Mardor, Damijan Miklavčič, 2016, original scientific article Keywords: electroporation, blood brain barrier, Peleg-Fermi Published in DiRROS: 09.05.2024; Views: 309; Downloads: 187
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1195. Electrochemotherapy by pulsed electromagnetic field treatment (PEMF) in mouse melanoma B16F10 in vivoSimona Kranjc Brezar, Matej Kranjc, Janez Ščančar, Jure Jelenc, Gregor Serša, Damijan Miklavčič, 2016, original scientific article Keywords: pulsed electromagnetic field, bipolar pulses, contactless electroporation, CDDP, electrochemotherapy, mouse melanoma Published in DiRROS: 09.05.2024; Views: 296; Downloads: 183
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1196. CA19-9 serum levels predict micrometastases in patients with gastric cancerTomaž Jagrič, Stojan Potrč, Katarina Miš, Mojca Plankl, Tomaž Marš, 2016, original scientific article Abstract: Background. We explored the prognostic value of the up-regulated carbohydrate antigen (CA19-9) in node-negative patients with gastric cancer as a surrogate marker for micrometastases. Patients and methods. Micrometastases were determined using reverse transcription quantitative polymerase chain reaction (RT-qPCR) for a subgroup of 30 node-negative patients. This group was used to determine the cut-off for preoperative CA19-9 serum levels as a surrogate marker for micrometastases. Then 187 node-negative T1 to T4 patients were selected to validate the predictive value of this CA19-9 threshold. Results. Patients with micrometastases had significantly higher preoperative CA19-9 serum levels compared to patients without micrometastases (p = 0.046). CA19-9 serum levels were significantly correlated with tumour site, tumour diameter, and perineural invasion. Although not reaching significance, subgroup analysis showed better five-year survival rates for patients with CA19-9 serum levels below the threshold, compared to patients with CA19-9 serum levels above the cut-off. The cumulative survival for T2 to T4 node-negative patients was significantly better with CA19-9 serum levels below the cut-off (p = 0.04). Conclusions. Preoperative CA19-9 serum levels can be used to predict higher risk for haematogenous spread and micrometastases in node-negative patients. However, CA19-9 serum levels lack the necessary sensitivity and specificity to reliably predict micrometastases. Keywords: gastric cancer, micrometastases, CA19-9, rak (medicina), želodec, metastaze, diagnostika, antigeni, tumorski označevalci Published in DiRROS: 09.05.2024; Views: 258; Downloads: 212
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1197. Pancreaticoduodenectomy for ductal adenocarcinoma of the pancreatic head with venous resectionVojko Flis, Stojan Potrč, Nina Kobilica, Arpad Ivanecz, 2016, original scientific article Abstract: Background. Recent reports have shown that patients with vascular tumour invasion who undergo concurrent vascular resection can achieve long-term survival rates equivalent to those without vascular involvement requiring pancreaticoduodenectomy alone. There is no consensus about which patients benefit from the portal-superior mesenteric vein resection and there is no consensus about the best surgical technique of vessel reconstruction (resection with or without graft reconstruction). As published series are small the aim of this study was to evaluate our experience in pancreatectomies with en bloc vascular resection and reconstruction of vessels. Methods. Review of database at University Clinical Centre Maribor identified 133 patients (average age 65.4 +/- 8.6 years, 69 female patients) who underwent pancreatoduodenectomy between January 2006 and August 2014. Clinical data, operative results, pathological findings and postoperative outcomes were collected prospectively and analyzed. Current literature and our experience in pancreatectomies with en bloc vascular resection and reconstruction of portal vein are reviewed. Results. Twenty-two patients out of 133 (16.5 %) had portal vein-superior mesenteric vein resection and portal vein reconstruction (PVR) during pancreaticoduodenectomy. In fourteen patients portal vein was reconstructed without the use of synthetic vascular graft. In these series two types of venous reconstruction were performed. When tumour involvement was limited to the superior mesenteric vein (SPV) or portal vein (PV) such that the splenic vein could be preserved, and vessels could be approximated without tension a primary end-to-end anastomosis was performed. When tumour involved the SMV-splenic vein confluence, splenic vein ligation was necessary. In the remaining eight procedures interposition graft was needed. Dacron grafts with 10 mm diameter were used. There was no infection after dacron grafting. One patient had portal vein thrombosis after surgery: it was thrombosis after primary reconstruction. There were no thromboses in patients with synthetic graft interposition. There were no significant differences in postoperative morbidity, mortality or grades of complication between groups of patients with or without a PVR. Median survival time in months was in a group with vein resection 16.13 months and in a group without vein resection 15.17 months. Five year survival in the group without vein resection was 19.5%. Comparison of survival curves showed equal hazard rates with log-rank p = 0.090. Conclusions. Survival of patients with pancreatic cancer who undergo an R0 resection with reconstruction was comparable to those who have a standard pancreaticoduodenectomy with no added mortality or morbidity. Synthetic graft appeared to be an effective and safe option as an interposition graft for portomesenteric venous reconstruction after pancreaticoduodenectomy. Published in DiRROS: 09.05.2024; Views: 225; Downloads: 146
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1198. Imaging of human glioblastoma cells and their interactions with mesenchymal stem cells in the zebrafish (Danio rerio) embryonic brainMiloš Vittori, Barbara Breznik, Tajda Gredar, Katja Hrovat, Lilijana Bizjak-Mali, Tamara Lah Turnšek, 2016, original scientific article Keywords: brain tumors, tumor microenvironment, animal models, xenotransplantation Published in DiRROS: 09.05.2024; Views: 263; Downloads: 491
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1199. Non-contrast computed tomography in the diagnosis of cerebral venous sinus thrombosisJernej Avsenik, Janja Pretnar-Oblak, Katarina Šurlan Popović, 2016, original scientific article Abstract: Due to the diversity of underlying factors and the absence of a uniform treatment approach, diagnosis and management of patients with cerebral venous sinus thrombosis (CVST) remain a challenging task.1 CVST represents 0.5% to 1% of all strokes and affects approximately 5 patients per million every year, but has a higher frequency among younger patients. Typical acquired risk factors include recent surgery, trauma, pregnancy, postpartum state, antiphospholipid syndrome, cancer and use of oral contraceptives. Cases of inherited thrombophilia include Antithrombin III, Protein C and Protein S deficiency, factor V Leiden positivity, prothrombin gene mutation and hyperhomocisteinemia. Infection of parameningeal spaces (ears, paranasal sinuses, oral cavity, face and neck) is common cause of CVST in pediatric population but rare in adults. The symptoms of CVST are not specific. The most common complaint is headache which occurs in up to 90% of patients. Additionally, abnormal vision, any of the symptoms of stroke and seizures have been described. In the past D-dimer levels appeared to be of value as an initial screening test. A study in 2004 evaluated the sensitivity of D-dimer to be 97.1% and specificity 99.1%.8 However, later studies showed that up to 10% of patients with CVST have a normal D-dimer. As it is fast, affordable and widely available, non-contrast computed tomography (NCCT) is the most frequently performed imaging study for evaluation of patients with new headache, focal neurological abnormalities, seizure, or change in mental status. A typical imaging finding in patients with CVST is direct visualization of a hyperattenuating thrombus in the occluded sinus (dense sinus sign). Occasionally, NCCT may only show indirect signs of thrombosis, including diffuse brain edema and parenchymal hemorrhage. Sensitivity of NCCT in the diagnosis of CVST was previously considered rather poor. However, using modern multidetector row CT scanners, recent studies report higher sensitivity and specificity values. In addition, Buyck et al. suggest measurement of the venous sinus attenuation to increase the diagnostic yield of the examination. Therefore, the goal of the present study was to evaluate the diagnostic accuracy of NCCT in the diagnosis of CVST in the emergency setting Keywords: cerebral venous sinus thrombosis, computed tomography, stroke, radiologija, računalniška tomografija, diagnostika, možganski venski sinusi Published in DiRROS: 09.05.2024; Views: 233; Downloads: 197
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1200. Virtual modelling of novel applicator prototypes for cervical cancer brachytherapyPrimož Petrič, Robert Hudej, Noora Al-Hammadi, Barbara Šegedin, 2016, original scientific article Abstract: Standard applicators for cervical cancer Brachytherapy (BT) do not always achieve acceptable balance between target volume and normal tissue irradiation. We aimed to develop an innovative method of Targetvolume Density Mapping (TDM) for modelling of novel applicator prototypes with optimal coverage characteristics. Patients and methods. Development of Contour-Analysis Tool 2 (CAT-2) software for TDM generation was the core priority of our task group. Main requests regarding software functionalities were formulated and guided the coding process. Software validation and accuracy check was performed using phantom objects. Concepts and terms for standardized workflow of TDM post-processing and applicator development were introduced. Results. CAT-2 enables applicator-based co-registration of Digital Imaging and Communications in Medicine (DICOM) structures from a sample of cases, generating a TDM with pooled contours in applicator-eye-view. Each TDM voxel is assigned a value, corresponding to the number of target contours encompassing that voxel. Values are converted to grey levels and transformed to DICOM image, which is transported to the treatment planning system. Iso-density contours (IDC) are generated as lines, connecting voxels with same grey levels. Residual Volume at Risk (RVR) is created for each IDC as potential volume that could contain organs at risk. Finally, standard and prototype applicators are applied on the TDM and virtual dose planning is performed. Dose volume histogram (DVH) parameters are recorded for individual IDC and RVR delineations and characteristic curves generated. Optimal applicator configuration is determined in an iterative manner based on comparison of characteristic curves, virtual implant complexities and isodose distributions. Conclusions. Using the TDM approach, virtual applicator prototypes capable of conformal coverage of any target volume, can be modelled. Further systematic assessment, including studies on clinical feasibility, safety and effectiveness are needed before routine use of novel prototypes can be considered. Keywords: cervical cancer, brachytherapy, applicators, virtual modelling Published in DiRROS: 09.05.2024; Views: 264; Downloads: 138
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