and chronic forms of anthracycline-induced cardiotoxicity (AIC), which is classified into early-onset (first year) and late-onset cardiotoxicity. 6 Chronic AIC typically presents as irreversible myocardial dysfunction and heart failure (HF). The estimated incidence of HF ranges from 6.6% to 26%. 7,8 An asymptomatic INTRODUCTION Breast cancer (BC) is the most common malignancy in women worldwide. 1,2 The use of potentially cardiotoxic anthracyclines, cytostatic agents introduced many years ago, still remains the cornerstone of BC therapy. 3-5 Most sources distinguish between acute (throughout anthracycline treatment)
IntroductionPostoperative morbidity after colorectal resections for cancer remains a significant problem. Data on the influence of complications on survival after laparoscopic colorectal resection are still limited.AimTo analyze the impact of postoperative complications on long-term survival after radical laparoscopic resection for colorectal cancer.Material and methodsTwo hundred and sixty-five consecutive non-metastatic colorectal cancer patients undergoing laparoscopic colorectal resection for cancer were included in the analysis. The entire study group was divided into two subgroups based on the occurrence of postoperative complications. Group 1 included patients without postoperative morbidity and group 2 included patients with complications. The primary outcome was overall survival.ResultsMedian follow-up was 45 (IQR: 34–55) months. Group 1 consisted of 187 (70.5%) patients and group 2 comprised 78 (29.5%) patients. Studied groups were comparable in terms of sex, age, body mass index, ASA class, cancer staging, localization of the tumor and operative time. Patients in group 1 had significantly better overall 3-year survival compared to those with complications (84.9% vs. 69.8%, p = 0.022). Kaplan-Meier curves showed significantly improved survival rates in patients without complications compared with complicated cases. The Cox proportional multivariate model showed that postoperative complications (HR = 2.83; 95% CI: 1.35–5.92; p = 0.0058) and AJCC III (HR = 3.17; 95% CI: 1.52–6.6; p = 0.0021) were independent predictors of worse survival after laparoscopic colorectal cancer surgery.ConclusionsOur analysis of interim results after 3 years confirms that complications after laparoscopic colorectal cancer surgery have an impact on survival. For this reason, these patients should be carefully monitored after surgery aiming at early detection of recurrence.
Prostate cancer is the most common cancer in men. Strategies relying on androgen deprivation have long been utilized in it's treatment. However, the therapy of castration-resistant disease still remains challenging. Therapeu-tic options have rapidly evolved during the last decade. New molecules with unprecedented activity, provided significant survival benefit in advanced disease. This review presents the key aspects of prostate cancer systemic therapy evolution over the last decades. The first part focuses on therapies active in castration-resistant disease.Part two reviews data on earlier therapy lines and principles relevant to devising optimal treatment sequence.
Background: Breast cancer, with 2.3 million new cases and 0.7 million deaths every year, represents a great medical challenge worldwide. These numbers confirm that approx. 30% of BC patients will develop an incurable disease requiring life-long, palliative systemic treatment. Endocrine treatment and chemotherapy administered in a sequential fashion are the basic treatment options in advanced ER+/HER2- BC, which is the most common BC type. The palliative, long-term treatment of advanced BC should not only be highly active but also minimally toxic to allow long-term survival with the optimal quality of life. A combination of metronomic chemotherapy (MC) with endocrine treatment (ET) in patients who failed earlier lines of ET represents an interesting and promising option. Methods: The methodology includes retrospective data analyses of pretreated, metastatic ER+/HER2- BC (mBC) patients who were treated with the FulVEC regimen combining fulvestrant and MC (cyclophosphamide, vinorelbine, and capecitabine). Results: Thirty-nine previously treated (median 2 lines 1–9) mBC patients received FulVEC. The median PFS and OS were 8.4 and 21.5 months, respectively. Biochemical responses (CA-15.3 serum marker decline ≥50%) were observed in 48.7%, and any increase in CA-15.3 was observed in 23.1% of patients. The activity of FulVEC was independent of previous treatments with fulvestrant of cytotoxic components of the FulVEC regimen. The treatment was safe and well tolerated. Conclusions: Metronomic chemo-endocrine therapy with FulVEC regimen represents an interesting option and compares favorably with other approaches in patients’ refractory to endocrine treatments. A phase II randomized trial is warranted.
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