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982. Association of OPRM1, MIR23B, and MIR107 genetic variability with acute pain, chronic pain and adverse effects after postoperative tramadol and paracetamol treatment in breast cancerZala Vidic, Katja Goričar, Branka Stražišar, Nikola Bešić, Vita Dolžan, 2023, original scientific article Abstract: Background. Tramadol is an opioid analgesic often used for pain management after breast cancer surgery. Its anal-gesic activity is due to the activation of the μ-opioid receptor, encoded by the OPRM1 gene. This study investigated the association of genetic variability in OPRM1 and its regulatory miRNA genes with outcomes of tramadol/paraceta-mol treatment after breast cancer surgery with axillary lymphadenectomy.Patients and methods. The study included 113 breast cancer patients after breast cancer surgery with axillary lymphadenectomy treated with either 75/650 mg or 37.5/325 mg of tramadol with paracetamol for pain relief within the randomized clinical trial KCT 04/2015-DORETAonko/si at the Institute of Oncology Ljubljana. All patients were geno-typed for OPRM1 rs1799971 and rs677830, MIR23B rs1011784, and MIR107 rs2296616 using competitive allele-specific PCR. The association of genetic factors with acute and chronic pain as well as adverse effects of tramadol treatment was evaluated using logistic regression, Fisher’s exact test, and Mann-Whitney test.Results.The investigated OPRM1 related polymorphisms were not associated with acute pain assessed with the VAS scale within four weeks after surgery (all P > 0.05). Carriers of at least one polymorphic OPRM1 rs1799971 allele had a higher risk of constipation in the first four weeks after surgery compared to non-carriers (OR = 4.5, 95% CI = 1.6–12.64, P = 0.004). Carriers of at least one polymorphic OPRM1 rs677830 allele had a higher risk of constipation after third week of tramadol treatment (OR = 3.11, 95% CI = 1.08–8.89, P = 0.035). Furthermore, carriers of two polymorphic MIR23Brs1011784 alleles had a higher risk of nausea after 28 days of tramadol treatment (OR = 7.35, 95% CI = 1.27–42.6, P = 0.026), while heterozygotes for MIR107 rs2296616 allele had a lower risk of nausea after 21 days of tramadol treatment (OR = 0.21, 95% CI = 0.05–0.87, P = 0.031). In carriers of two polymorphic MIR107 rs2296616 alleles, chronic pain was significantly more common than in carriers of two wild-type alleles (P = 0.004). Carriers of at least one polymorphic MIR23B rs1011784 allele experienced more neuropathic pain after adjustment for tramadol dose (OR = 2.85, 95% CI = 1.07–7.59, P = 0.036), while carriers of at least one polymorphic OPRM1 rs677830 allele experienced less neuropathic pain compared to carriers of two wild-type alleles (OR = 0.38, 95% CI = 0.15–0.99, P = 0.047).Conclusions.Genetic variability of OPRM1 and genes coding for miRNAs that could affect OPRM1 expression may be associated with adverse effects of tramadol/paracetamol treatment as well as with chronic and neuropathic pain after breast cancer surgery with axillary lymphadenectomy.
Keywords: operacija raka na dojki, zdravljenje bolečine, tramadol
Published in DiRROS: 25.07.2024; Views: 825; Downloads: 218
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983. Does concurrent gynaecological surgery affect infectious complications rate after mastectomy with implant-based reconstruction?Nina Pišlar, Barbara Perić, Uroš Ahčan, Romi Cencelj-Arnež, Janez Žgajnar, Andraž Perhavec, 2023, original scientific article Abstract: Background. Women who undergo breast cancer surgery often have an indication for gynaecological procedure. The aim of our study was to compare infectious complications rate after mastectomy with implant-based reconstruc-tion in patients with and without concurrent gynaecological procedure.Patients and methods. We retrospectively reviewed clinical records of 159 consecutively operated patients after mastectomy with implant-based reconstruction. The patients were divided in 2 groups: 102 patients without (Group 1) and 57 with (Group 2) concurrent gynaecological procedure. Infectious complications rates between the groups were compared using χ2-test. Logistic regression was performed to test for association of different variables with infec-tious complications.Results. There were240 breast reconstructions performed. Median follow-up time was 297 days (10–1061 days). Mean patient age was 47.2 years (95% CI 32.8–65.9); 48.2 years (95% CI 46.1–50.3) in Group 1 and 45.8 years (95% CI 43.2–48.3) in Group 2; p = 0.002). Infectious complications rate was 17.6% (17.6% vs. 17.5%, p = 0.987), implant loss occurred in 5.7% (4.9% vs. 7.0%, p = 0.58). Obesity (body mass index[BMI] > 30 kg/m2), age, previous breast conserv-ing treatment (BCT) with radiotherapy (RT) were identified as risk factors for infectious complications in univariate analysis. Obesity (adjusted odds ratio [aOR] 3.319, 95% CI 1.085–10.157, p = 0.036) and BCT with RT (aOR 7.481, 95% CI 2.230–25.101, p = 0.001) were independently associated with infectious complications in multivariate model.Conclusions. Concurrent gynaecological procedure for patients undergoing mastectomy with implant-based re-construction did not carry an increased risk for infectious complications.
Keywords: rak na dojki, infekcijski zapleti, rekonstrukcija z vsadki
Published in DiRROS: 25.07.2024; Views: 266; Downloads: 142
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984. Ultrasonography of peripheral nerve tumours : a case seriesSimon Podnar, 2023, original scientific article Abstract: Background. Peripheral nerve tumours (PNTs) are rare, but important cause of peripheral nerve dysfunction. The aim of the study was to present a series of consecutive patients with PNTs evaluated in authors’ ultrasonography (US) practice.Patients and methods. The electronic medical records of patients with PNTs examined at our US laboratory from February 2013 to May 2020 were retrospectively reviewed. Data on gender, age, clinical features, PNT location, elec-trodiagnostic (EDx) features and US findings were collected.Results. In the analyzed period 2845 patients were examined in our US laboratory. From these 15 patients (0.5%) with PNTs were identified. Four of them (3 with confirmed neurofibromatosis) had multiple PNTs. Half of patients (53%) presented with features of peripheral nerve damage, and others with palpable mass or pain. The most often involved nerve was ulnar (36%). PNT cross sectional areas varied from 24 mm2 to 1250 mm2 (median, 61 mm2). Based in 5 pa-tients on histological and in remaining patients on US features, schwannoma was diagnosed in 40%, neurofibroma in 27%, and perineurioma in 27% of patients.Conclusions. As in previous reports,PNTs in our series presented with neurological symptoms, palpable mass or pain. In contrast to other focal neuropathies, particularly nerves with schwannomas, in spite of their large thickening, often demonstrated well preserved function. Adding US to our clinical practice, enabled us to diagnose these rare periph-eral nerve lesions that we missed before.
Keywords: elektrodiagnostika, površina preseka živca, periferni živci
Published in DiRROS: 25.07.2024; Views: 267; Downloads: 173
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985. Oral verrucous carcinoma : a diagnostic and therapeutic challengeNejc Krištofelc, Nina Zidar, Primož Strojan, 2023, review article Abstract: Background. Verrucous carcinoma is a low-grade variant of squamous cell carcinoma with specific morphologic, cytokinetic and clinical features. Despite low mitotic activity and slow growth, it can infiltrate adjacent tissues in advanced stages but does not metastasize. The most frequently affected site is the oral cavity. The following article provides latest updates in the etiology, clinical presentation, diagnostics and treatment options in oral verrucous car-cinoma and discusses the existing dilemmas linked to this unique malignancy.Conclusions. Oral verrucous carcinoma must be differentiated from conventional squamous cell carcinoma due to its less aggressive behaviour with a more favourable prognosis. Close communication between clinician and patholo-gist is mandatory for making a correct diagnosis. Primary surgery with negative surgical margins seems to be the most successful treatment. However, management recommendations are not uniform since they are mostly based on case reports and small retrospective case series. Prospective and pooled multi-institutional studies are therefore needed.
Keywords: verrucous carcinoma, oral verrucous carcinoma, squamous cell carcinoma
Published in DiRROS: 25.07.2024; Views: 267; Downloads: 203
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986. The five-year KRAS, NRAS and BRAF analysis results and treatment patterns in daily clinical practice in Slovenia in 1st line treatment of metastatic colorectal (mCRC) patients with RASwild-type tumour (wtRAS) : a real- life data report 2013–2018Tanja Mesti, Martina Reberšek, Janja Ocvirk, 2023, original scientific article Abstract: Background. We preformed a Phase IV non-interventional study to assess KRAS, NRAS and BRAF status in metastatic colorectal cancer (mCRC) patients suitable for 1st line treatment and to evaluate the decisions for 1st line treatment considering the treatment goals in the RAS wild type (wt) patients. The aim of our study was also to evaluate the influ-ence of a waiting period for biomarkers analysis on the start of first-line treatment.Patients and methods. Patients with histologically confirmed mCRC adenocarcinoma suitable for first-line treat-ment fulfilling all inclusion criteria were included in the study. The KRAS, NRAS and BRAF analysis was performed from tissue samples of primary tumor site or metastatic site. All included patients have given consent to participate in the study by signing the informed consent form. Results. From April 2013 to March 2018 at the Institute of Oncology Ljubljana 650 patients were included, 637 of them were treated with first- line systemic treatment according to RAS and BRAF status. Remaining 13 patients with mCRC did not receive systemic first-line treatment. The distribution of patients with KRAS mutated and wild-type tumors, was almost equal, 48.8% and 47.9% respectively, 89 % of the patients had wt NRAS tumours and 86.1% had wt BRAF tu-mours. The most frequently prescribed treatment was bevacizumab-based therapy (53.1%), either in combination with doublet chemotherapy or with mono-chemotherapy. EGFR inhibitors cetuximab and panitumumab were prescribed in wt RAS mCRC patients (30.9%). The waiting period for biomarkers analysis was two weeks.Conclusions. Our real-world data, single centre 5-year analysis showed that the distribution between wild type and mutated type tumors of the patients with mCRC was approximately the same, as worldwide, so the Slovenian popula-tion with mCRC has the same ratio distribution of KRAS, NRAS and BRAF wild and mutated genes. We concluded that a two-week waiting period for biomarkers analysis did not influence the first line treatment decision, so it was in the accordance with the worldwide treatment guidelines based on evidence-based medicine.
Keywords: metastatic colorectal cancer, RAS and BRAF biomarkers, systemic treatment
Published in DiRROS: 25.07.2024; Views: 248; Downloads: 115
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987. 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, original scientific article Abstract: 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.
Keywords: electrochemotherapy, bleomycin, vulvar cancer
Published in DiRROS: 25.07.2024; Views: 262; Downloads: 159
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988. Estimating exposure to extremely low frequency magnetic fields near high-voltage power lines and assessment of possible increased cancer risk among Slovenian children and adolescentsTina Žagar, Blaž Valič, Tadej Kotnik, Sara Korat, Sonja Tomšič, Vesna Zadnik, Peter Gajšek, 2023, original scientific article Keywords: exposure assessment, childhood cancer, extremely low frequency magnetic fields, modelling, high voltage power lines
Published in DiRROS: 25.07.2024; Views: 281; Downloads: 643
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