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The pandemic spread of the COVID-19 virus significantly affected daily life, but the highest pressure was piled on the health care system. Our aim was to evaluate an impact of COVID-19 pandemic management measures on cancer services at the National Cancer Institute (NCI) of Lithuania. We assessed the time period from 1 February 2020 to 31 December 2020 and compared it to the same period of 2019. Data for our analysis were extracted from the NCI Hospital Information System (HIS) and the National Health Insurance Fund (NHIF). Contingency table analysis and ANOVA were performed. The COVID-19 pandemic negatively affected the cancer services provided by NCI. Reductions in diagnostic radiology (−16%) and endoscopy (−29%) procedures were accompanied by a decreased number of patients with ongoing medical (−30%), radiation (−6%) or surgical (−10%) treatment. The changes in the number of newly diagnosed cancer patients were dependent on tumor type and disease stage, showing a rise in advanced disease at diagnosis already during the early period of the first lockdown. The extent of out-patient consultations (−14%) and disease follow-up visits (−16%) was also affected by the pandemic, and only referrals to psychological/psychiatric counselling were increased. Additionally, the COVID-19 pandemic had an impact on the structure of cancer services by fostering the application of modified systemic anticancer therapy or hypofractionated radiotherapy. The most dramatic drop occurred in the number of patients participating in cancer prevention programs; the loss was 25% for colon cancer and 62% for breast cancer screening. Marked restriction in access to preventive cancer screening and overall reduction of the whole spectrum of cancer services may negatively affect cancer survival measures in the nearest future.

Introduction Recent data suggest that margins ≥2 mm after breast-conserving surgery may improve local control in invasive breast cancer (BC). By allowing large resection volumes, oncoplastic breast-conserving surgery (OBCII; Clough level II/Tübingen 5-6) may achieve better local control than conventional breast conserving surgery (BCS; Tübingen 1-2) or oncoplastic breast conservation with low resection volumes (OBCI; Clough level I/Tübingen 3-4). Methods Data from consecutive high-risk BC patients treated in 15 centers from the Oncoplastic Breast Consortium (OPBC) network, between January 2010 and December 2013, were retrospectively reviewed. Results A total of 3,177 women were included, 30% of whom were treated with OBC (OBCI n = 663; OBCII n = 297). The BCS/OBCI group had significantly smaller tumors and smaller resection margins compared with OBCII (pT1: 50% vs. 37%, p = 0.002; proportion with margin <1 mm: 17% vs. 6%, p < 0.001). There were significantly more re-excisions due to R1 (“ink on tumor”) in the BCS/OBCI compared with the OBCII group (11% vs. 7%, p = 0.049). Univariate and multivariable regression analysis adjusted for tumor biology, tumor size, radiotherapy, and systemic treatment demonstrated no differences in local, regional, or distant recurrence-free or overall survival between the two groups. Conclusions Large resection volumes in oncoplastic surgery increases the distance from cancer cells to the margin of the specimen and reduces reexcision rates significantly. With OBCII larger tumors are resected with similar local, regional and distant recurrence-free as well as overall survival rates as BCS/OBCI.

In this study, dosing with ADPREM at intervals of 24 hours was therapeutically equivalent to CRM dosed at intervals of 12 hours.

According to the guidelines on cancer treatment up to 52% of newly diagnosed cancer patients should be treated with external beam radiotherapy. Ionizing radiation (IR)-induced skin injury (radiation dermatitis) occurs in up to 95% of radiotherapy patients and can manifest from mild erythema till necrosis and ulceration. Individual radiosensitivity was proposed to be an important factor for the development of adverse reactions to IR. Therefore, assessment of radiosensitivity could be useful in predicting and dealing with radiation injuries caused by both radiotherapy and accidental overexposure. Here, we present a case of early diagnosis of IR-induced skin lesions performed by reflectance confocal microscopy in comparison to clinical evaluation in a highly radiosensitive patient.

Background. The outcomes after different low rectal resection types applied for rectal cancer treatment are still uncertain. The aim of the investigation was to evaluate longterm functional results, the rate of complications and post-operative lethality after rectum low resection operations (connection with J-pouch group: coloplasty-group 2 and "straight" anastomosis-group 3). Patients and methods. In 2003, a randomized study was started and completed on December 2007. The study included 82 patients (38 females and 44 males). The patients were randomized into three groups. They were suffering from cancer stage I-III. Results. There were no postoperative deaths after 82 resections with total mesorectal excision (TME) and low connection. The overall rate of postoperative complications was 28%, and the rate of anastomosis suture leakage was 11%. The rate of postoperative complications was 20.7% (6 patients) in group 1, 28.6% (6 patients) in group 2, 34.3% (11 patients) in group 3. The rate of complications was substantially higher in groups 2 and 3; however, this difference was statistically not significant (p = 0.2636). The functional results after 3, 6, 9, 12 and 24 months showed no statistical difference among the groups; moreover functional results after 24 months in all groups were similar (p = 0.046). Anastomosis with or without pouch does not influence postoperative lethality. The incidence of complications and suture leakage is higher in cases of straight anastomosis; however, this finding is not statistically significant. Necrosis was observed only in patients for whom anastomosis with pouches was performed. Conclusion. Comparison of functional results after 3, 6, 9, 12 and 24 months showed no statistically significant differences among the groups.The necrosis of pulleddown bowel was observed only in the pouch groups.

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Background: During radiotherapy (RT), most breast cancer patients experience ionizing radiation (IR)-induced skin injury—acute radiation dermatitis (ARD). The severity of ARD is determined by a physician according to CTCAE or RTOG scales, which are subjective. Reflectance confocal microscopy (RCM) is a noninvasive skin imaging technique offering cellular resolution. Digital dermoscopy (DD) performed in conjugation with RCM can provide more information regarding skin toxicity. The purpose of this study is to create an RCM and DD features-based ARD assessment scale, to assess the association with CTCAE scale and possible predictive value. Methods: One hundred and three breast cancer patients during RT were recruited; every week, clinical symptoms of ARD (CTCAE scale) were evaluated and RCM, together with digital dermoscopy (DD), was performed. Results: According to RCM; after 2 RT weeks, exocytosis and/or spongiosis were present in 94% of patients; after 3 weeks, mild contrast cells (MMCs) were detected in 45%; disarrayed epidermis (DE) was present in 66% of patients after 4 weeks and in 93% after 5 weeks; abnormal dermal papillae (ADP) were present in 68% of patients after 5 weeks. The coefficients of RCM features (RCMcoef) alone and together with dermoscopically determined erythema (RCM-ERYcoef) were significantly associated with ARD severity grade. RCMcoef is a significant predictive factor for the clinical manifestation of ARD. Conclusions: RCM features of irradiated skin appear earlier than clinical symptoms, have a characteristic course, and allow the severity of ARD to be predicted.