Faculty of Medicine

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    Association of the CHEK2 c.1100delC variant, radiotherapy, and systemic treatment with contralateral breast cancer risk and breast cancer-specific survival
    (Research Square Platform LLC, 2023-02-13)
    Morra, Anna
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    Schreurs, Maartje A C
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    Andrulis, Irene L
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    Anton-Culver, Hoda
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    Augustinsson, Annelie
    Breast cancer (BC) patients with a germline CHEK2 c.1100delC variant have an increased risk of contralateral BC (CBC) and worse BC-specific survival (BCSS) compared to non-carriers. We aimed to assess the associations of CHEK2 c.1100delC, radiotherapy, and systemic treatment with CBC risk and BCSS. Analyses were based on 82,701 women diagnosed with invasive BC including 963 CHEK2 c.1100delC carriers; median follow-up was 9.1 years. Differential associations of treatment by CHEK2 c.1100delC status were tested by including interaction terms in a multivariable Cox regression model. A multi-state model was used for further insight into the relation between CHEK2 c.1100delC status, treatment, CBC risk and death. There was no evidence for differential associations of therapy with CBC risk by CHEK2 c.1100delC status The strongest association with reduced CBC risk was observed for the combination of chemotherapy and endocrine therapy [HR(95%CI): 0.66 (0.55-0.78)]. No association was observed with radiotherapy. Results from the multi-state model showed shorter BCSS for CHEK2 c.1100delC carriers versus non-carriers also after accounting for CBC occurrence [HR(95%CI) :1.30 (1.09-1.56)]. In conclusion, systemic therapy was associated with reduced CBC risk irrespective of CHEK2 c.1100delC status. Moreover, CHEK2 c.1100delC carriers had shorter BCSS, which appears not to be fully explained by their CBC risk. (Main MS: 3201 words).
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    The Incidence of Lymphovascular and Perineural Invasion and their Impact on Survival in Patients with Rectal Cancer
    (Walter de Gruyter GmbH, 2023-12)
    Misimi, Shqipe
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    Cako, Dajana
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    Demirel, Ali İlbey
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    Ulusoy, Cemal
    Aim: Lymphovascular Invasion (LVI) and Perineural Invasion (PNI) represent undesirable but still realistic pathological features of rectal cancer, associated with poor prognosis and worse survival. The aim of this study is to assess the incidence of LVI and PNI in patients treated for rectal cancer and the impact of LVI and PNI on patient survival. Material and Methods: This retrospective single center observational study, conducted in the period of 2016-2019, includes patients with rectal cancer treated with/without long-course neoadjuvant chemoradiotherapy (nCRT). Data collection encompassed demographics, tumor characteristics, type of surgery (abdominal perineal rectal resection - APR and low anterior rectal resection - LAR), and LVI/PNI presence. Survival during follow-up was estimated and compared for patients with/without LVI and PNI involvement. Results: A total number of 234 patients (77 females and 157 males) with mean age of 61.3 enrolled in the study. Neoadjuvant CRT was conducted in 170 patients. APR procedure was performed in 67 of them and LAR in 167. LVI presence was noted in 55 (24.4%) and PNI in 77 (34.2%) patients. Mean survival during follow-up was 42.07 months. The use of nCRT influenced on survival (p < 0.033). Patients treated with LAR had better survival outcomes (p = 0.001). Presence of LVI and PNI was associated with a worse prognosis (p < 0.001). Conclusion: PNI was more frequent than the LVI in this study. Patients with nCRT conduction had better overall survival. LVI and PNI presence was associated with poor prognosis in terms of overall survival in patients with rectal cancer.
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    DEMOGRAPHYC AND MORPHOLOGIC CHARACTERISTICS OF BONE METASTASES - 11 YEARS SINGLE CENTER EXPERIENCE
    (Macedonian Association of Anatomists, 2021)
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    Pandilov, Stefan
    This is an epidemiological study of bone metastasis (BM) diagnosed and treated in a period of 11 years. Age and sex distribution of BM, localization, origin of primary malignancy, plain radiography appearance, therapeutic options and survival of the patients were evaluated. Of 86 patients, 52 were female and 34 male, ranging in age from 44 to 87 years. The most common site of BM was femur, followed by spine and humerus, and the most common primary malignances were in the breast, lung, kidney and prostate, respectively. Almost one third of patients were with unknown primary malignancy at the time of BM diagnosis.The analysis of patients’ plain radiographies revealed that most BM were osteolytic lesions. Bisphosphonate therapy was applied in only 41.86% of patients, radiotherapy was applied in only 2.33% of patients and combination of bisphosphonates and radiotherapy received 8.14% of patients.The rest of the patients, 47.67%, were treated with symptomatic and/or with systemic therapy according to their primary malignancy.The survival analysis did not show statistically significant influence of any of the analyzed parameters in this study on the survival of the patients. Only 26.74% of patients survived 24 months and the high 73.26% survived 1 to 24 months.