Faculty of Medicine
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Item type:Publication, Association of prognostic fa ctors with overall survival in myelodysplastic syndromes: a cohort study(SHMSHM - AAMD, 2015); ; ; ; Background: Myelodysplastic syndromes (MDS) are heterogeneous disorders in terms of clinical presentation, laboratory findings and life expectancies. A lot of studies have been conducted to determine factors that can refine the prediction of prognosis in MDS. Aim: Our aim was to evaluate which prognostic factors had an impact on overall survival (OS) in MDS. Methods: we conducted retrospective cohort study of 154 adult patients (81 male, 73 female) with MDS who presented to the University Clinic of Hematology, Ss Cyril and Methodius University, Skopje, Macedonia, from January 2011 to June 2014. Data on demographics, FAB classification, treatment and outcome were collected. Results: Age and gender had no influence on OS (p=.80847 and p=.974895, respectfully). Different FAB subtypes had an impact on OS (p = .00757). Bone marrow (BM) blast percentage correlated significantly with OS (p= .028026). Hemoglobin, platelet count and absolute neutrophil count (ANC) did not influence OS (p=. 179970, p= .386355 and p= .972602, respectfully). Transfusion did not influence OS (p= .445856). Albumins had no impact on OS (p=.559900). Lactate dehydrogenase (LDH) and comorbidities influenced OS (p= .018895 and p= .02278, respectfully). Leukemic transformation was noticed in 7 (4.5%) patients. Mortality was 35.1%. Conclusions: FAB subtypes, BM blast percentage, LDH and comorbidities are independent predictors on OS and should be considered for future revisions of International Prognostic Scoring System in order to refine the prediction of prognosis in MDS. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Impact of age and comorbodity as prognostic factors on overall survival in patients with multiple myeloma(Macedonian Association of Anatomists and Morphologists, 2015); ; ; Background: Multiple myeloma is a heterogeneous disease with variable disease course, a wide range of clinical presentation and many subtypes, variable response to therapy and survival outcome that ranges from less than one year in patients with aggressive disease to more than ten years in patients with indolent disease presentation. It is very important to clearly define the risk profile of each patient during establishing the diagnosis, and to predict the eventual type of therapeutic approach, its depth, quality and length. The age >75 and presence of comorbidities at the start of therapy are risk factors which impact on the quality of life, therapy response and overall survival (OS) in patients with multiple myeloma (MM). Aim: The aim of this study was to assess the influence of the two most important risk factors in myeloma patients, ageism and comorbidities, that complicate the management of MM and at the same time OS. Patients and methods: We retrospectively analyzed a total of 296 myeloma patients (150 male and 146 female) with average age of 62 ±10.3 years. The most affected age group (58.1%) comprised patients at the age ranging between 60 and 88 years, diagnosed at the University Clinic of Hematology, Ss Cyril and Methodius University, Skopje, Macedonia in the period 2005-2015. The follow-up period was 24 months. We evaluated some parameters that could influence OS: age and comorbidity that could influence the overall clinical condition of the patient during his therapy and his eventual future disease behavior. OS was estimated on monthly basis including the period from the date of diagnosis to the time of death / time of last visit. Results: In the study group 26% of patients ≥ 65 years have survived more than 60 months, and 40% younger than 65 years have survived more than 60 months. Survival time in group ≥65 years is 18.3 months, and in group <65 years is 43.4 months. It is evident that age had a significant effect on OS in myeloma patients, and 49% of patients with no registered comorbodity preceding the diagnostic procedures had survived more than 60 months, but only 16% of patients with registered comorbidity survived more than 60 months. Survival time in patients with registered comorbodity preceding the diagnostic procedures was 59.3 months and survival time in patients with registered comorbodity before the diagnostic procedures is 10.7 months. Conclusions: The age-related changes in physiology combined with comorbid conditions, disability or frailty have important implications in the treatment of myeloma patients. Based on these risk factors our recommendation is tailored treatment for each MM patient. Key words: multiple myeloma, prognostic factors, overall survival - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Blood vessel invasion and inflammatory stromal reaction at the invasion front as additional significant prognostic factors in surgically treated patients with cervical carcinoma.(Springer, 2001-09); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Immunohistochemical expression and prognostic significance of DCC (deleted in colon cancer), p53 protein and proliferative marker Ki-67 in colorectal colon cancer.(Springer, 2005-05); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Adjuvant chemotherapy in patients with stage IIIA endometrial carcinoma with solitary adnexal involvement(Macedonian Association of Pathology, 2016-09); ; ; Objective: The optimal adjuvant therapy in endometrial cancer patients with solitary adnexal involvement is still controversial. The purpose of this study was to evaluate, retrospectively, the outcome and efficacy of adjuvant chemotherapy in these patients. Material and Methods: The medical records of the patients with stage IIIA endometrial cancer with solitary adnexal involvement who were treated with surgical resection and adjuvant chemotherapy between 2005 and 2010, were retrospectively analyzed. A total of 40 patients treated with platinum-based adjuvant chemotherapy were included. Following surgery, all patients received 4 cycles of Carboplatin 300 mg/m2 and Paclitaxel 175 mg/m2 by intravenous injection every 3 weeks. The survival and recurrence rates were evaluated. Results: The median follow-up period was 5 years (60 months). Recurrences occurred in 12.5 % (n=5) of the patients. One local recurrence (1/5, 20%) and 4 distant metastases (4/5, 80%) in liver (n=2, 40%), lung (n=1, 20%) and paraaortal lymph nodes (n=1, 20%) were observed. The 3-year disease-free survival (DFS) and overall survival (OS) rates were 87.5% and 92.3%, respectively. Conclusions: In conclusion, platinum-based adjuvant chemotherapy may improve prognosis and survival in stage IIIA endometrial cancer patients with solitary adnexal involvement and could be considered as a potential adjuvant treatment. Although adjuvant chemotherapy has demonstrated improved both disease-fee and overall survival compared to radiotherapy (DFS 87.5% vs 69%; OS 92.3% vs 78%), further studies are needed to define the optimal treatment strategy. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Milestones in Hematology and Oncology: From Fatal to Curable Disease. Progress in the management of patients with Hodgkin’s lymphoma in the Republic of North Macedonia: experience from 40 years of population-based study(Македонска академија на науките и уметностите, Одделение за медицински науки = Macedonian Academy of Sciences and Arts, Section of Medical Sciences, 2022-07-13); Background: The comprehensive management of patients with Hodgkin's lymphoma (HL) is a success story in contemporary oncology. Over the past decades, the survival rate of patients with HL has significantly improved. The objective of this analysis is to evaluate and document the progress in the management of Hodgkin's lymphoma in patients in our country, reflected in their vital statistics, over time periods defined by the respective standard of treatment. Material and methods: The present study is designed as a retrospective-prospective study. We analyzed different modalities of treatment and compared 5 and 10-year overall survival rates in a total of 588 Hodgkin's lymphoma patients treated at the University Clinic for Hematology in Skopje during two consecutive time periods, before 2000 and after 2000. The entire observation period is from 1980 to 2020. All patients are above the age of 14, with a documented histopathological diagnosis of Hodgkin's lymphoma and with evaluable medical documentation, including clinical and laboratory data on their initial condition, the administered therapy, as well as the clinical follow-up of the patients. Results: The basic clinical features of the analyzed population across the two periods correlate with those reported in the relevant medical literature, with only slight deviations. Ten-year overall survival rates improved by 31.7% through the two calendar periods. During the last two decades of the previous century (1980-2000) the initial treatment options were COPP and COPP-like regimens for the vast majority of patients (94.7%), leading to disease remission in 80% of them. After 2000, 95.8% of de novo diagnosed patients have been treated with ABVD chemotherapy as a frontline choice and the complete response rate is 88.4%. We confirmed the superiority of ABVD in terms of efficacy, improved tumor and disease control, as well as its long-term clinical outcome. While in the past we had very limited options for relapsed/refractory HL patients, the analysis of the results of HL patients treated with various therapeutic approaches in the latter period, defines BEACOPP as the preferred choice. High-dose chemotherapy, followed by autologous hematopoietic stem cell graft, as a strategy for our R/R patients in the timeframe after 2000, ensures a 5-year overall survival for 51% of them, whereas 45% of the patients survive more than 10 years. Conclusion: This analysis from our Hodgkin's lymphoma database illustrates that there has been tremendous improvement in the long-term survival rates since the turn of this century. At our institution we strive to implement positive trends in practice, as suggested by relevant guidelines, regarding the evolution and progress in the diagnostic workup, treatment, and the overall management of patients with Hodgkin's disease. The objective would be to secure favorable vital statistics for our patient population, now reaching 83.5% at 10 years, which closely correlates with the data of more developed countries and centers. In future clinical trials we will also evaluate the efficacy of brentuximab-vedotin and new PD-1 blocking antibodies. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, IMPACT OF INITIAL RENAL INVOLVEMENT AND BENCE JONES PROTEINS IN THE URINE ON OVERALL SURVIVAL OF PATIENTS WITH MULTIPLE MYELOMA(Macedonian Association of Anatomists, 2022-03); ; ; ; Ridova, NevenkaMultiple myeloma (MM) is a cancer of plasma cells with a frequency of around 50 cases per million population (pmp)/year. This retrospective study was conducted at the University Clinic for Hematology in Skopje, North Macedonia, in the period between January 2009 and December 2019. The cohort group was consisted of 296 recently diagnosed patients with MM. According to the results of our study, in 47% of patients who did not have renal involvement (RI), the survival rate was more than 60 months. On the other side, the survival percentage in those patients who had ARI (acute renal impairment) was 9% and in those who had CRI (chronic renal impairment) only 10%. Forty percent of patients with a negative Bence Jones proteinuria survived more than 60 months. Besides, only 20% of patients with a positive Bence Jones proteinuria survived more than 60 months. Nowadays, bortezomib is generally used as a first-line drug in the treatment of MM in patients with serious RI. In conclusion, there are various research questions that can differentiate the treatment of patients with MM and RI in the near future. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Association of prognostic factors with overall survival in Myelodisplastic syndromes: a cohort study(SHMSHM/AAMD, 2015-07-01); ; Background: Myelodysplastic syndromes (MDS) are heterogeneous disorders in terms of clinical presentation, laboratory findings and life expectancies. A lot of studies have been conducted to determine factors that can refine the prediction of prognosis in MDS. Aim: Our aim was to evaluate which prognostic factors had an impact on overall survival (OS) in MDS. Methods: we conducted retrospective cohort study of 154 adult patients (81 male, 73 female) with MDS who presented to the University Clinic of Hematology, Ss Cyril and Methodius University, Skopje, Macedonia, from January 2011 to June 2014. Data on demographics, FAB classification, treatment and outcome were collected. Results: Age and gender had no influence on OS (p=.80847 and p=.974895, respectfully). Different FAB subtypes had an impact on OS (p = .00757). Bone marrow (BM) blast percentage correlated significantly with OS (p= .028026). Hemoglobin, platelet count and absolute neutrophil count (ANC) did not influence OS (p=. 179970, p= .386355 and p= .972602, respectfully). Transfusion did not influence OS (p= .445856). Albumins had no impact on OS (p=.559900). Lactate dehydrogenase (LDH) and comorbidities influenced OS (p= .018895 and p= .02278, respectfully). Leukemic transformation was noticed in 7 (4.5%) patients. Mortality was 35.1%. Conclusions: FAB subtypes, BM blast percentage, LDH and comorbidities are independent predictors on OS and should be considered for future revisions of International Prognostic Scoring System in order to refine the prediction of prognosis in MDS. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Overall survival in myelodysplastic syndromes: a cohort study(Quest Journals, 2014-12-25); ; ;