1. 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: 115; Prenosov: 34
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2. 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: 130; Prenosov: 102
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3. 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: 112; Prenosov: 30
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4. Surgical treatment and fertility perservation in endometrial cancerNina Kovačević, 2021, pregledni znanstveni članek Povzetek: Endometrial cancer (EC) represents a high health burden in Slovenia and worldwide. The incidence is increasing due to lifestyle and behavioural risk factors such as obesity, smoking, oestrogen exposure and aging of the population. In many cases, endometrial cancer is diagnosed at an early stage due to obvious signs and symptoms. The standard treatment is surgery with or without adjuvant therapy, depending on the stage of the disease and the risk of recurrence. However, treatment modalities have changed in the last decades, considerably in the extent of lymphadenectomy. Conclusions. The gold standard of treatment for is surgery, which may be the only treatment modality in the early stages of low-grade tumours. In recent years, a minimally invasive approach with sentinel node biopsy (SNB) has been proposed. A conservative approach with hormonal treatment is used if fertility preservation is desired. If EC is in advance stage, high-risk histology, or high grade, radiotherapy, chemotherapy, or a combination of both is recommended.
Ključne besede: endometrial cancer, uterus, treatment, minimally invasive surgery
Objavljeno v DiRROS: 22.07.2024; Ogledov: 123; Prenosov: 28
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6. Rak jajčnikov : ponovno nekaj novega2023, zbornik recenziranih znanstvenih prispevkov na domači konferenci Povzetek: Rak jajčnikov je najpogostejši vzrok smrti pri ženskah, ki zbolijo za ginekološkimi raki, saj je bolezen za večino bolnic v napredovalih fazah pogosto usodna. To je posledica težavne prepoznavnosti bolezni v zgodnjih fazah, ko je zdravljenje učinkovito. /// Na žalost preventivni program za zgodnje odkrivanje raka jajčnikov še ne obstaja, zato je pri več kot 75 % bolnic bolezen odkrita v napredovalih stadijih, kar posledično prinaša slabo prognozo. Tako pri zdravnikih kot pri ženskah je pomanjkljivo poznavanje zgodnjih znakov bolezni, kar lahko vodi v napačno diagnostiko in triažiranje bolnic v neprimerno zdravstveno ustanovo. /// Diagnoza se postavi s pomočjo ustreznih diagnostičnih preiskav, potrdi pa se s patohistološko preiskavo. 90 % rakov jajčnikov izvira iz epitelija, medtem ko so drugi tipi redki. Osnovno zdravljenje vključuje kirurški poseg, katerega cilj je popolnoma odstraniti bolezen in doseči stanje brez vidnega ostanka bolezni. Sledi sistemska terapija, medtem ko obsevanje pri zdravljenju raka jajčnikov nima ključnega pomena. /// Ugotovljeno je, da je zdravljenje raka jajčnikov najuspešnejše v specializiranih ustanovah, kjer delujejo strokovnjaki z usmerjenostjo v ginekološko-onkološko področje. V Sloveniji si nenehno prizadevamo za standardizirano in kakovostno obravnavo žensk z rakom jajčnikov.
Ključne besede: ginekološki raki, elektronske knjige
Objavljeno v DiRROS: 22.11.2023; Ogledov: 559; Prenosov: 244
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7. Hodgkinov limfom : vodnik za bolnikeBarbara Jezeršek Novaković, Samo Zver, Metka Zajc, Aleksandra Grbič, Andreja Cirila Škufca Smrdel, Eda Vrtačnik-Bokal, Vesna Šalamun, Nina Kovačević, Lorna Zadravec-Zaletel, Matej Pečovnik, 2022, ni določena Ključne besede: rak (medicina), krvotvorne matične celice, transplantacija, psihološka pomoč, plodnost, hormonsko nadomestno zdravljenje
Objavljeno v DiRROS: 24.07.2023; Ogledov: 587; Prenosov: 154
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8. Kirurško zdravljenje visoko rizičnega raka telesa materniceNina Kovačević, 2023, objavljeni znanstveni prispevek na konferenci Povzetek: Rak materničnega telesa je najpogostejši ginekološki rak in v Sloveniji vsako leto odkrijemo približno 350 novih primerov. Večino rakov materničnega telesa predstavlja rak endometrija, ki ga delimo v dve skupini, in sicer estrogensko odvisni in estrogensko neodvisni rak endometrija. Zdravljenje je v prvi vrsti kirurško, obseg operativnega posega je določen glede verjetnosti ponovitve. Kirurškemu zdravljenju je lahko dodano obsevanje, sistemska terapija ali kombinacija obojega.
Ključne besede: rak maternice, ginekološki raki, ginekološka onkologija
Objavljeno v DiRROS: 30.05.2023; Ogledov: 578; Prenosov: 224
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9. Rak jajčnikov - novosti : ginekološki simpozij2022, zbornik recenziranih znanstvenih prispevkov na domači konferenci Povzetek: Rak jajčnikov je najpogostejši vzrok smrti pri ženskah, ki zbolijo za ginekološkimi raki. Za večino obolelih z napredovalim rakom je bolezen usodna. Razlog za to je slaba prepoznavnost bolezni v zgodnjih stadijih, ko je zdravljenje učinkovito.
Ključne besede: ginekološki raki, klinična slika, laparoskopija, sledenje pacientov, etiologija, imunoterapija, intraperitonealna kemoterapija, COVID-19, zborniki, elektronske knjige
Objavljeno v DiRROS: 04.01.2023; Ogledov: 741; Prenosov: 385
Celotno besedilo (1,18 MB)
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