Colorectal Cancer Trends of 2018 in Romania—an Important Geographical Variation Between Northern and Southern Lands and High Mortality Versus European Averages

Ionescu, Elena; Tieranu, Cristian; Maftei, Dana; Grivei, Adriana; Olteanu, Andrei Ovidiu; Arbănaş, Tudor; Calu, Valentin; Muşat, Simona; Mihăescu-Pinţia, Constanța; Cucu, Ionut Cristian

doi:10.1007/s12029-020-00382-3

Cited by 18 publications

(15 citation statements)

References 25 publications

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“…Colon cancer is one of the most frequent malignancies, with 14,000 new cases being diagnosed annually in Romania (12). Locally advanced colon cancers invading the duodenum/ pancreas are a less common finding, with an incidence of 11% (13).…”

Section: Discussionmentioning

confidence: 99%

Right‑sided colon cancer with invasion of the duodenum or pancreas: A glimpse into our experience

et al. 2021

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Duodenal or pancreatic invasion in locally advanced right colon cancer (LARCC) is a challenging situation that can pose difficulties in its management. When the duodenum alone is invaded, the surgeon may undertake right hemicolectomy (RH) en bloc with the affected patch of duodenum. The duodenal defect can be reconstructed using several techniques. When invasion of the pancreas is present, RH en bloc with duodenopancreatectomy (DP) is the treatment of choice. We present our experience regarding the treatment and prognostic results of this rare colon cancer form. We retrospectively reviewed the data of patients who underwent surgery for right-sided colon cancer with duodenal and/or pancreatic invasion between January 2004 and March 2020. Among the 110 patients with LARCC, pancreas and/or duodenum invasion was encountered in 22 patients, with a mean age of 49.5 years. From the 22 patients, 5 patients underwent palliative procedures, with a maximal survival of 15 months. Three patients underwent RH alone, with lethal outcome in the first year in 66% of the cases. RH en bloc with antrectomy was performed in 2 patients. Eight patients underwent RH with DP, with a 1-year survival of 75% (6/8) and a 5-year survival of 50% (3/6). Thirty-day mortality post-DP was noted in 25% (2/8) of the cases. Four patients underwent RH with limited duodenal resection, with no recurrence of disease at 11 to 39 months postoperatively. Among the duodenal defect restoration, simple duodenal suture was practiced in 2 patients, duodenojejunostomy in one patient and pedicled ileal flap in 1 case. In conclusion, although postoperative mortality can be significant, en bloc resection for LARCC invading the duodenum and/or pancreas offers prolonged survival in a considerable number of patients.

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Section: Discussionmentioning

confidence: 99%

Right‑sided colon cancer with invasion of the duodenum or pancreas: A glimpse into our experience

et al. 2021

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“…Additionally, there is an annual increase in the number of people diagnosed with cancer, as well as the number of people receiving treatment for cancer [8]. There is no National Cancer Register set in Romania, so there are no updated statistics regarding colorectal cancer available for our country [23]. Data can only be theorized comparing with the neighbouring countries.…”

Section: Direct Costs On Monthsmentioning

confidence: 99%

The Direct Costs Burden of Bevacizumab in South-West Romania

GHIMPĂU¹

2022

FARMACIA

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As costs for cancer treatment increase with the reimbursement of new treatments and increasing of patients' number, prevention and prior detection efforts become even more cost-effective and potentially cost saving. The global economic burden of cancer is mostly unknown. Even though bevacizumab is one of the most prescribed and used angiogenesis inhibitors, it is among the most expensive drugs. This study aimed to generate statistical analyses of the total amounts reimbursed by the Romanian National Health Insurance Fund for treating cancer with Avastin ® in Dolj County, Romania, from January 1 st , 2020 to March 31 st , 2021. We aimed to estimate the real-world incremental costs associated with the use of bevacizumab for metastatic breast cancer, advanced non-small cell lung cancer, metastatic cancer of the colon or rectum, ovarian cancer, advanced renal cell cancer, and cervical cancer. From the total of 351 patients treated with bevacizumab, 114 (31.67%) had colon cancer and 69 (19.17%) had rectum cancer. After we investigated the economic burden of bevacizumab, we observed the highest percentage for the malignant tumour of the colon from all the direct costs. We compared the costs of bevacizumab treatment on diseases and months, observing the highest burden for colon cancer in almost all the months. Molecules such as bevacizumab are adding an appreciable cost burden to the public funded Health Care System and more studies that evaluate their cost-effectiveness are needed. RezumatPe măsură ce costurile tratamentelor pentru cancer cresc, eforturile de prevenție și depistare precoce devin cost-eficiente și pot reduce costurile. Povara economică globală a cancerului este în mare parte necunoscută. Cu toate că bevacizumab este unul dintre cei mai prescriși și utilizați inhibitori ai angiogenezei, el este și printre cele mai scumpe medicamente. Scopul studiului a fost generarea de analize statistice ale sumelor rambursate de Fondul Național de Asigurări de Sănătate pentru tratarea cancerului cu Avastin ® în județul Dolj, România, de la 1 martie 2020 până la 31 martie 2021. Am realizat o analiză economică pentru a estima costurile incrementale asociate administrării de bevacizumab pentru cancer de sân metastatic, de colon sau rect, cancer pulmonar avansat fără celule mici, cancer avansat renal, ovarian și de col uterin. Dintre cei 351 de pacienți tratați cu bevacizumab, 114 (31,67%) au prezentat cancer de colon și 69 (19,17%) cancer de rect. Investigând povara economică prezentată de bevacizumab, am observat că procentul cel mai mare al costurilor directe a fost pentru cancerul de colon. Am comparat costurile tratamentului cu bevacizumab în funcție de categoria de boală și de luna prescrierii, observând că povara economică cea mai ridicată a fost în aproape toate lunile în cazul neoplasmului de colon. Molecule precum bevacizumab adaugă o povară economică însemnată asupra costurilor suportate de către Sistemului Național de Sănătate finanțat din fonduri publice și sunt necesare mai multe studii pentru evaluarea renta...

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“…Currently, colorectal cancer (CRC) is a major public health problem worldwide being among the most lethal malignancies both in man and woman. Due to the implementation of CRC screening programs that favour an early diagnosis, the CRC mortality trend is decreasing in Europe, but unfortunately in Romania CRC remains a critical health emerging issue based on the latest high mortality rates reported [1]. Despite the advances in identifying effective chemopreventive agents [2][3][4], primary and adjuvant treatments [5,6] and therapy personalization approaches [7] the poor survival rates observed in CRC patients highlight the need to improve the current therapeutic strategies.…”

Section: Introductionmentioning

confidence: 99%

Silk Fibroin Nanoparticles Reveal Efficient Delivery of 5-Fu in a Ht-29 Colorectal Adenocarcinoma Model in Vitro

Radu¹

2021

FARMACIA

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The aim of the paper was to investigate the efficiency of 5-FU delivery from smart silk fibroin nanoparticles in a HT-29 colorectal adenocarcinoma model in vitro. Therefore, nanoparticles with various amounts of silk fibroin were obtained by nanoprecipitation method and characterized to evaluate the 5-FU encapsulation efficiency and release profile. All nanoparticles showed a good entrapment of the drug and were capable to release 5-FU in a polymer concentration dependent manner. The in vitro biological evaluation revealed an excellent biocompatibility of the pristine silk fibroin nanocarriers, while 5-FU loaded nanoparticles proved to be highly cytotoxic and dramatically decreased the HT-29 cellular viability and proliferation potential. More, the 5-FU silk fibroin nanoparticles induced alterations in the HT-29 cellular morphology and inhibited the formation of compact cellular clusters. Rezumat Scopul lucrării a constat în investigarea eficienței de administrare a 5-FU eliberat din nanoparticule de fibroină de mătase, într-un model de cancer colorectal in vitro. Astfel, au fost obținute nanoparticule cu concentrații variate de polimer prin metoda nanoprecipitării, caracterizate din punct de vedere al eficienței de încapsulare a 5-FU și al profilului de eliberare a substanței active încapsulate. Toate nanoparticulele au prezentat o bună eficiență de încapsulare și au eliberat substanța activă din structura lor într-o manieră dependentă de concentrația de polimer utilizată în procesul de obținere. Evaluarea nanoparticulelelor in vitro a evidențiat o excelentă biocompatibilitate a nanoparticulelor de fibroină de mătase neîncărcate, în timp ce nanoparticulele încărcate cu 5-FU au prezentat citotoxicitate crescută, scăzând semnificativ viabilitatea celulară și potențialul proliferativ al celulelor HT-29. Mai mult, nanoparticulele încărcate cu 5-FU au indus modificări ale morfologiei celulare a celulelor HT-29 și au inhibat formarea grupurilor compacte de celule.

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Colorectal Cancer Trends of 2018 in Romania—an Important Geographical Variation Between Northern and Southern Lands and High Mortality Versus European Averages

Cited by 18 publications

References 25 publications

Right‑sided colon cancer with invasion of the duodenum or pancreas: A glimpse into our experience

Right‑sided colon cancer with invasion of the duodenum or pancreas: A glimpse into our experience

The Direct Costs Burden of Bevacizumab in South-West Romania

Silk Fibroin Nanoparticles Reveal Efficient Delivery of 5-Fu in a Ht-29 Colorectal Adenocarcinoma Model in Vitro

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