Objective The purpose of the study was to compare the long‐term outcomes of patients with localized adrenocortical carcinoma (ACC) subjected to open vs laparoscopic surgery. Design Retrospective study. Patients This retrospective study included 46 patients with the ACC ENSAT stage I‐stage III of whom 23 underwent open surgery (OA group), whereas 23 were subjected to laparoscopic adrenalectomy (LA group). The main outcomes analysed in the study were differences between the OA and LA groups in recurrence‐free survival (RFS) and overall survival (OS). Results Patients in OA group had larger tumours (120 [70‐250] mm vs 75 [26‐110] mm; P < .001), higher Ki‐67 index (16 [1‐65] % vs 10 [1‐25] %; P = .04) and higher disease stage (P = .01) compared with the patients in the LA group. The median duration of follow‐up for patients underwent OA and LA was 51 (12‐174) and 53 (5‐127) months, respectively. Eight patients (5 OA and 3 LA) experienced recurrent disease, whereas six patients (3 OA and 3 LA) died during follow‐up. No differences in RFS and OS were found between patients who underwent open or laparoscopic surgery. Conclusion The study demonstrated that in patients with localized ACC and without invasion of extra‐adrenal tissues, LA is a plausible treatment option in terms of RFS and OS. However, our results are limited to referral centres with large experience in the management of patients with ACC and may not necessarily apply to nonspecialized centres.
germ cell testicular cancer (gCTC) is a malignant neoplasm derived from the primordial germ cell. Although it accounts for approximately 1% of all malignancies in men, it is the most common cancer of younger male population, with the highest incidence between ages 15 and 35. Testicular cancer incidence rate has risen globally over the past several decades, with the average increase in the incidence of testicular cancer in Croatia of 7% per annum from the year 1983 to 2007. Two main groups are seminomas and non-seminomas, each accounting for 50% of cases, and they differ in treatment modalities and response to therapy. Despite increase in the incidence rate, a promising circumstance is that gCTC has become a model of curable cancer. Because of advances in diagnostic procedures, sophisticated radiation techniques and especially the introduction of cisplatin based chemotherapy protocols together with advanced postchemotherapy surgical techniques, curability is expected in about 95% of all patients diagnosed with testicular cancer and over 70% of patients with advanced disease. in this review, we will focus on treatment strategies of primary gCTC.
forty two to 57% of patients with metastatic renal cell carcinoma (mrCC) receive the second-line therapy according to available data. in our analysis we wanted to determine the percentage of patients within intermediate/poor prognostic group mRCC who continued the treatment with the second line following progression on the first line and the percentage of patients who were not able to receive the second line treatment. Patients received sunitinib (first started on 12 August 2018) or pazopanib (first started on May 2014) at University Hospital Center Zagreb. The latest treatment started in December 2018. our results show that 39.4% of patients who received sunitinib and 37.9% of patients who received pazopanib, did not receive the second line treatment, which is consistent with available data. The question arises whether we could have helped those patients if we had access to newer therapeutic options. KeY WorDs: Metastatic kidney cancer, treatment sunitinib, pazopanib ANALIZA BOLESNIKA S METASTATSKIM RAKOM BUBREGA SREDNJE I LOŠE PROGNOSTIČKE SKUPINE LIJEČNIH U KLINIČKOM BOLNIČKOM CENTRU ZAGREB SAŽETAK prema literaturnim podacima oko 42% do 57% bolesnika s metastatskim karcinomom bubrega primi drugu liniju liječenja. Retrospektivnom analizom naših podataka htjeli smo prikazati postotak bolesnika s metastatskim karcinomom bubrega koji pripadaju srednjoj/lošoj prognostičkoj skupini a koji su nastavili liječenje drugom linijom nakon progresije na prvolinijsko liječenje. Također smo htjeli prikazati postotak bolesnika koji nisu bili u mogućnosti nastaviti drugolinijsko liječenje. Bolesnici su primali sunitinib (prvi bolesnik je započeo liječenje u svibnju 2014.) i pazopanib (prvi bolesnik je započeo liječenje 12. kolovoza 2018) u Kliničkom bolničkom centru Zagreb. Uključeni su bili bolesnici koji su liječenje započeli do kraja prosinca 2018. godine. 39.4% bolesnika koji su primali sunitinib i 37.9% bolesnika koji su primali pazopanib, nije primilo drugu liniju liječenja, što se podudara s literaturnim podacima. Nameće se pitanje, jesmo li navedenim bolesnicima mogli pomoći da smo imali dostupne novije terapijske opcije. KLJUČNE RIJEČI: metastatski karcinom bubrega, liječenje, sunitinib, pazopanib
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