We present results of retrospective real-life data of nonsquamous lung cancer patients treated in first-line (platinum-based chemotherapy with gemcitabine without bevacizumab). 56 patients with satisfactory performance status for cytotoxic chemotherapy were treated in 2010-2014. Median progression-free survival was 6.48 months (95% CI: 4.44-9.48), time to progression was 10.19 months (95% CI: 7.59-12.19). Median overall survival was 10.8 months (95% CI: 6.72-14.52). Although our group of patients had higher proportion of elderly patients with somewhat limited performance status, progression-free survival rate was comparable to large registration studies. Overall survival, despite intervening comorbidities and subsequent limited use of second-line treatment was analogous to large gemcitabine/platinum Phase III studies in nonsquamous population. We believe our data represent real-life survival rates of unselected patients with advanced NSCLC of nonsquamous type from mostly rural catchment area.
Východiská: Paraneoplastické syndrómy často predchádzajú dia gnózu malignity. Ich včasná dia gnostika môže viesť ku skorému rozpoznaniu okultného karcinómu ešte v kuratívnon štádiu. Diferenciálna dia gnostika zriedkavej paraneoplastickej vaskulitídy vyžaduje multidisciplinárnu spoluprácu medzi internistami-reumatológmi, rádiodia gnostikmi a onkológmi. Prípad: 41-ročná pacientka s karcinómom cervixu uteru IVB štádium (paraaortálna lymfadenopatia) s klinickými i rádiologickými známkami akútnej vaskulitídy bola prijatá na naše oddelenie k onkologickej liečbe. Začalo sa s chemorádioterapiou, súčasne bola podávaná kortikoterapia. Počas liečby sme pozorovali zmiernenie príznakov vaskulitídy. Pri ďalších dispenzárnych kontrolách sa stav pacientky viac nezlepšoval, čo nás viedlo k podozreniu relapsu malígneho ochorenia, ktoré sa potvrdilo CT vyšetrením. Zahájená paliatívna chemoterapia však nepriniesla očakávaný efekt a kvôli zhoršujúcemu sa výkonnostnému stavu bola ukončená. Záver: Aktivita vaskulitídy bola u našej pacientky pomerne úzko spojená s aktivitou malígneho ochorenia. Rozpoznanie paraneoplastického syndrómu má význam nielen v dia gnostike malignity, ale aj počas dispenzárnych kontrol. Kľúčová slová karcinóm krčka maternice-paraneoplastický syndróm-vaskulitída-angiografi a Summary Background: Paraneoplastic syndromes precede the dia gnosis of malignancy. Early detection of paraneoplastic syndrome may lead to detection of malignancy in its early and potencially curable stage. Diff erential dia gnostic process of rare paraneoplastic vasculitis requires multidisciplinar cooperation between rheumatologists, radiologists and oncologists. Case: 41-year-old female patient with cervical cancer in stage IVB (paraaortic lymphadenopathy) and clinical symptoms of acute vasculitis was admitted to our ward for oncological treatment. Chemoradiotheraphy was initiated concurently with corticotherapy. During the treatment we observed alleviation of vasculitis-related symptoms. Ongoing follow-up, however, brought no further improvement in vasculitis-related symptoms. This lead us to suspiction of recurrence, confi rmed on CT scan. Paliative chemotherapy was without any eff ect and due to worsening performance status was terminated. Conclusion: The activity of vasculitis was closely associated with the activity of primary malignant disease. Early recognition of paraneoplastic syndrome may contribute not only to dia gnosis of malignancy, but is helpfull during follow-up of these patients.
Abstract. Due to its rarity, male breast cancer remains a poorly characterized disease. The present study obtained retrospective clinicopathological data, treatment patterns and outcomes for all male patients diagnosed with breast cancer in the Oncology Department, Faculty Hospital Trenčín (Trenčín, Slovakia) over the last 21 years from January 1995 to December 2015. A total of 21 patients with male breast cancer were analyzed, with a median patient age of 65.6 years. Two patients were diagnosed with lobular invasive cancer; all others were diagnosed with cancer of a ductal origin. One patient presented with metastatic disease in the pleural cavity. The primary tumors in 8 patients were staged as pT1, whilst 6 patients were staged as pT2 and 7 as pT4. Axillary lymph node involvement was present in 11 patients (52%) and 15 patients were hormone receptor-positive (83%). All but 1 patient underwent mastectomy and surgical staging of the axilla. Adjuvant chemotherapy, radiotherapy and hormone treatment was administered in the same manner as breast cancer treatment in female patients. The median follow-up time was 4.5 years. The 5-and 10-year overall survival rates were 87 and 74%, respectively, and the estimated median disease-free survival for the same population was 9.5 years (95% confidence interval, 6.2-14.6). The survival rates reported in the present retrospective study are comparable with previously published studies. In addition, the current study reported predominant hormone-positive characteristics and rare expression of human epidermal growth factor receptor 2. However, further multi-institutional trials are required to allow for informed treatment decisions in this uncommon disease. IntroductionMale breast cancer is a rare disease accounting for <1% of all diagnosed breast cases (1). The only ethnic group with a higher than average incidence of male breast cancer is Jewish men, regardless of their residence (2). A previous study determined a strong family predisposition for the disease, with an odds ratio of 3.3 (3). It is recognized that breast cancer (BRCA) mutations may be detected in a significant portion of male breast cancer cases (primarily BRCA2) and the National Comprehensive Cancer Network guidelines recommend genetic testing for such patients (4). It has been suggested that male breast cancer is associated with a poorer prognosis compared with females, largely due to delays in diagnosis, lack of clinical care pathways and associated comorbidities due to the advanced age of patients (5). A recent comparative analysis of menopausal status in female patients with breast cancer concluded poorer outcomes for male patients with breast cancer compared with postmenopausal females and similar outcomes to premenopausal female patients with breast cancer (6). Recommendations for treatment in males are extrapolated from extensive evidence in women. Due to lack of breast tissue, simple mastectomy is commonly the preferred surgical procedure. Sentinel lymph node biopsy is feasible and is being performed mor...
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