Journal of B.U.ON.: official journal of the Balkan Union of Oncology (J BUON)

Publisher: Balkan Union of Oncology

Journal description

Current impact factor: 0.71

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 0.706
2012 Impact Factor 0.761
2011 Impact Factor 0.607
2010 Impact Factor 0.482
2009 Impact Factor 0.6

Impact factor over time

Impact factor

Additional details

5-year impact 0.65
Cited half-life 3.30
Immediacy index 0.09
Eigenfactor 0.00
Article influence 0.13
Other titles Journal of BUON, Journal of Balkan Union of Oncology
ISSN 1107-0625
OCLC 42889499
Material type Periodical
Document type Journal / Magazine / Newspaper

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Surgeons learn over time when it is appropriate to recommend an operation. This is particularly true in the management of pelvic carcinomatous disease, which often gives rise to symptoms that are debilitating and difficult to manage by non-surgical means. Radical pelvic cytoreduction, complete resection of all visible tumor, remains the established operation for the treatment of carefully selected patients with biologically favorable tumors. Complexities in pelvic surgery and pelvic cytoreduction cover the strategic evaluation, specific approaches, and management techniques. The essential principle to removal of a very advanced pelvic disease lies in the retroperitoneal surgery. The retroperitoneal approach allows for dissection of the pan-pelvic tumoral mass and deposits using the peritoneum as a pseudo-capsule while identifying vital retroperitoneal structures such as the iliac vessels and ureter. Despite the fact that there are several considerations in favor of cytoreductive surgery, overall morbidity due to its application depends not only on the extent of the surgical procedure but also on the patient's medical fitness, the experience and expertise of the operating surgeon, as well as the quality of the supportive care, particularly anesthesia and critical care. The major source of trouble is the hostile pelvis itself. The reasons are fairly clear: most patients have had incomplete 'in-line' resective attempts, irradiation, and inflammation due to prior overhealing. Many of the complications of the procedure can be ameliorated or eliminated by careful attention to patient preparation, intraoperative meticulous technique, and post-cytoreductive intensive care. Achieving success and safety with these cytoreductive techniques requires extensive knowledge of pelvic anatomy, the use of special techniques of exposure and methods of dissection, a clear understanding of the objectives of the operation, and a flexibility of mind.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 05/2015; 20(1(Supp. 1)):S29-S39.
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    ABSTRACT: Bleomycin, etoposide and cisplatinum (BEP) comprise the most common regimen in the treatment of advanced testicular tumors, including seminoma. Common side effects are of hematologic, renal, and cardiovascular origin. One of the most prominent side effects is pulmonary toxicity attributed to bleomycin. We describe three patients who developed bleomycin-induced pneumonitis (BIP) with full recovery. Pre-and post-treatment clinical, biochemical (including specific tumor markers) and radiological response assessment of 26 patients with primary advanced seminoma (AS) who were referred to our hospital for platinum-based chemotherapy between 1989-2010 are described. All patients were assessable for evaluation and all achieved long-term complete remission. Side effects were mild and manageable. Three patients developed bleomycin pulmonary toxicity after reaching cumulative doses of 180-240 units. All three patients presented with classical symptoms of non-productive cough, exertional dyspnea, and low-grade fever. Radiologically, the patients presented in the first months following completion of chemotherapy with initial bilateral interstitial and alveolar infiltrates, which worsened and progressed into consolidation and then regressed until total disappearance. All patients were treated with high-dose steroids and broad-spectrum antibiotics. AS is a very chemotherapy-responsive and sensitive disease, and approximately 90% of the patients enjoy complete regression of tumor masses and durable and sustained long-term survival with no evidence of disease. BIP may be a dangerous acute and chronic side effect, even in doses lower than 360 units. Considering the favorable clinical outcome of our patients, prompt diagnosis should be made and rapid medical intervention should be implemented.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 05/2015; 20(3):928-932.
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    ABSTRACT: To evaluate the rates of locoregional failure (LRF) vs distant metastasis (DM), and find risk factors for recurrence in patients with completely resected N1 non-small cell lung cancer (NSCLC). By searching Pubmed, Embase and the Cochrane Controlled Trials Register from 1995 through 2014, eligible randomized clinical trials (RCTs) were identified. In addition, the reference lists of articles and conference abstracts were searched. The logarithm of the risk ratio (RR) and its standard error (SE) were calculated, and a fixed-effect model was used to combine the estimates. 3 RCTs and 9 retrospective studies, which included 889 patients, were identified and selected. All studies dealt with resected N1 NSCLC, LRF vs DM, and risk factors such as visceral pleural invasion (VPI) and lymphovascular invasion (LVI). There was statistically significant benefit on 5-year overall survival (OS) for LRF (RR=0.68,95% CI=0.60-0.78, p<0.00001). Further analysis for patients with LRF also showed that VPI (RR=1.25, 95% confidence interval/CI=1.09-1.42, p=0.0009), LVI (RR=1.16, 95% CI=1.04-1.30, p=0.009), were the main risk factors for recurrence. The present study indicates that in patients with resected N1 NSCLC, the incidence of LRF is lower than DM. Advanced T stage classification, VPI, and LVI were predictors of poor survival. These patients represent a subgroup with N1 disease who might benefit from additional therapy, including adjuvant radiotherapy (RT). However, large, well-designed prospective studies should be conducted to confirm this conclusion.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 05/2015; 20(3):791-799.
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    ABSTRACT: We analyzed the significance of age together with other classic prognostic parameters on the course of breast cancer in postmenopausal patients. Our study included 151 postmenopausal patients with primary breast cancer, of which 55% received adjuvant tamoxifen therapy and 45% did not receive any kind of therapy. Probabilities of disease-free interval (DFI) were estimated using the Kaplan-Meier method and were compared by the log-rank test. A p value < 0.05 was considered as statistically significant. In the tamoxifen-treated subgroup, patients with estrogen receptor (ER) or progesterone receptor (PR) concentration ≥5 fmol/mg had favorable course of disease (p<0.01, p<0.04), respectively. Patients ≥66 years of age had a worse disease course compared to those <66 years. Also, patients ≥66 years with pT1 tumors had a worse disease course compared to those <66 years and pT1 tumors. This result was repeated in other groups as well. In pT2 )≥2 cm), ER-positive, PR-positive and invasive ductal carcinoma (IDC) subgroups, patients ≥66 years always had a worse disease course compared to patients <66 years. In the untreated subgroup, patients with ER ≥52 fmol/mg (p<0.01), tumors ≥2 cm (p<0.01), IDC (p<0.01) type or ≥56 years (p<0.04) had statistically more recurrences. Among patients ≥56 years, those with ER-positive or pT2 tumors had shorter DFI compared to ER-negative or pT1. Positive correlation between ER, PR and age of patients was also shown in this subgroup (p<0.03, p<0.02). Age of patients, ER and PR are significant prognostic factors in the tamoxifen-treated subgroup. In the untreated subgroup relevant prognostic parameters are age, tumor size, histological type and ER. The above prognostic factors retained their value in the long-term follow up in both the investigated subgroups of patients.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 05/2015; 20(3):723-729.
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    ABSTRACT: To examine the prognostic value of lymph node ratio (LNR) in pathological nodal (pN) stage breast cancer patients. Also, to analyse additional clinical and pathologic prognostic factors and the impact of LNR among molecular subtypes. Among a total of 3088 patients, 1004 women with non-metastatic lymph node-positive breast cancer were analysed. The patients were classified into low (≤0.20), intermediate (0.20 to 0.65) and high-risk (>0.65) LNR groups. Univariate and multivariate Cox proportional hazards regression model for disease-free survival (DFS), and overall survival (OS) were performed to evaluate the prognostic value of LNR. The median LNR was 0.17 (range 0.02-1.00). Of the patients, 55.7% were in low, 32.1% in intermediate, and 12.3% in high risk group. When compared with low risk group, high risk group had more often large tumor size and high grade tumor with lymphovascular invasion. The median follow-up period was 46.8 months. The 5-year breast cancer-specific OS and DFS rates for patients with low, intermediate, and high were 88%-67%, 65%-48% and 53%-24%, respectively (both plog-rank < 0.0001). On multivariate analysis, pN stage and LNR were both independent predictors of survival, however, an overlapping between N1 (250 months, 95% confidence interval [CI] 88.15-413.21 ) and N2 (176 months, 95% CI 129.51-222.93) curves in pN staging was determined. We also observed clear prognostic separation for triple negative breast cancer with LNR survival over pN staging. The LNR predicts survival more accurately than pN staging in node-positive breast cancer patients. The use of LNR may standardize the staging and guide decisions for adjuvant treatments.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 05/2015; 20(3):737-745.
  • Journal of B.U.ON.: official journal of the Balkan Union of Oncology 05/2015; 20(3):933-935.
  • Journal of B.U.ON.: official journal of the Balkan Union of Oncology 05/2015; 20(3):934.
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    ABSTRACT: Several clinical trials have suggested that adjuvant chemotherapy improves the survival of patients with resected gastric cancer, but the optimal time at which to initiate post-operative adjuvant chemotherapy has not been studied. This study investigated the association between time to adjuvant chemotherapy and survival in gastric cancer. We retrospectively identified 266 patients with stage IB-IIIC gastric cancer who received fluorouracil-based adjuvant chemotherapy after radical gastrectomy. Overall survival (OS) was compared between patients grouped according to time from surgery to adjuvant chemotherapy (<45 and ≥45 days). The Cox proportional hazards model was used to analyze the effects of time to initiation of chemotherapy and other clinical covariates on survival. Of 266 patients, 141 (53%) started adjuvant chemotherapy within 45 days after surgery and 125 (47%) started adjuvant chemotherapy more than 45 days after surgery. The 3-year OS rates were 81.2 and 65.8% for patients starting chemotherapy within 45 days and after 45 days, respectively (p=0.006). Multivariate analysis identified early initiation of adjuvant chemotherapy, completion of the planned chemotherapy, and early-stage disease as favorable prognostic factors in terms of OS (p<0.05). Subgroup analysis suggested that starting chemotherapy within 45 days after surgery was associated with significant OS benefit compared with initiation of chemotherapy after 45 days from surgery in most subgroups. This retrospective analysis suggests that delaying adjuvant chemotherapy for longer than 45 days after surgery may be associated with poorer survival in patients with resected gastric cancer.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 05/2015; 20(3):800-807.
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    ABSTRACT: The discovery of prognostic factors for patients who undergo hepatectomy for colorectal liver metastases (CRLM) in the era of neoadjuvant chemotherapy is imperative. This study aimed to establish a simple, cheap and easily available prognostic score for these patients. Preoperative carcinoembryonic antigen (CEA), serum alkaline phosphatase (ALP), and lymphocyte count (LC) were used for the establishment of a prognostic score (CALy PS). The cut-off levels of these variables were determined by applying receiver operating curve (ROC) analysis. The final prognostic score assigned one risk point for each variable (CEA>4 μg/L, ALP>93 U/L, and LC≥1.6x109/L). One hundred and thirty-five patients were included. Two risk categories were established with 0-1 and 2-3 points, respectively. CALy 0-1 vs CALy 2-3, and CALy 2-3 were associated with decreased disease free survival (DFS) and overall survival (OS) both in univariate and multivariate analysis (DFS: HR 1.84; 95% CI 1.18-2.86; p=0.007; OS: HR 2.25; 95% CI 1.23-4.11; p=0.008). When four risk categories were established with 0,1,2,and 3 points,CALy was again associated with decreased DFS and OS both in univariate and in multivariate analysis (DFS: HR 1.37; 95% CI 1.083-1.74; p=0.009; OS:HR 1.84; 95% CI 1.31-2.59; p<0.001). Three-year DFS rates for these categories (CALy 0, CALy 1, CALy 2, and CALy 3) were 45, 38, 15 and 7%, respectively, and the 5-year OS rates were 78, 68, 32, and 24%, respectively. This simple, cheap, and easily available risk score provides good prognostic accuracy for both DFS and OS for patients undergoing liver resection for liver-only colorectal metastases after neoadjuvant chemotherapy.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 05/2015; 20(3):746-755.
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    ABSTRACT: Total or subtotal gastrectomy are performed as curative or palliative treatment in patients with gastric cancer. Anemia is a frequent complication of gastrectomy. Patients undergoing total or subtotal gastrectomy should be carefully monitored for the development of anemia and be given appropriate treatment when indicated. This survey-based study aimed to determine the level of knowledge about post-gastrectomy anemia in Turkish medical oncologists. The study included 110 Turkish medical oncologists that agreed voluntarily to participate in the survey and answer an 8-item questionnaire. The survey was distributed as a questionnaire during the 5th Turkish Medical Oncology Congress in March 2014. All participants completed the questionnaire. Most of the participants would not recommend oral iron or cobalamin replacement after gastrectomy. The results of the survey indicate that Turkish medical oncologists have some knowledge about post-gastrectomy anemia, but need to learn more about appropriate follow-up and replacement therapies for post-gastrectomy anemia.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 05/2015; 20(3):808-811.
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    ABSTRACT: To investigate the effect of quercetin on the reversal of tamoxifen resistance in breast cancer cells, and explore the underlying mechanism. We established a tamoxifen-resistant breast cancer cell line (MCF-7Ca/TAM-R), and exposed it to different concentrations of quercetin (experimental group 1: 10μM, group 2: 25μM, and group 3: 50μM). Each group was further subdivided into 2 subgroups: 1) simultaneous administration of quercetin and 4-hydroxytamoxifen (OHT); 2) sequential administration of quercetin (12-h induction) followed by OHT. No drug exposure and OHT alone were used as controls. We determined cell survival, apoptosis, and expression of ERα (estrogen receptor α) and Her-2 (human epidermal growth factor receptor 2). With increasing dosage of quercetin, significant decrease in proliferation and increase in apoptosis was observed. Low concentrations of quercetin (10μM) had no effects. We found no significant difference between simultaneous and sequential mode of drug administration. Further, with increasing dosage of quercetin, we observed a gradual reduction in Her-2 expression and upregulation of ERα. Again, no difference in Her-2 and ERα protein levels between simultaneous and sequential drug administration was noticed. Proliferation inhibition and apoptosis in MCF-7Ca/TAM-R cells increase with increasing dosage of quercetin. This suggests that quercetin can reverse tamoxifen resistance in breast cancer cells. The underlying mechanism likely involves upregulation of ERα combined with downregulation of Her-2. However, this effect is independent of whether quercetin and tamoxifen are administered simultaneously or sequentially.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 05/2015; 20(3):707-713.
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    ABSTRACT: Combined modality therapy is standard of care for patients with unresectable locally advanced non-small cell lung cancer (NSCLC), however, insufficient data exist regarding prognostic factors in this disease setting. To evaluate the treatment results and prognostic variables, 85 NSCLC patients treated from October 2005 to April 2008 were randomly assigned to one of the two treatment arms. In the first arm (sequential arm), 45 patients received sequential chemotherapy with 4 cycles of carboplatin and etoposide followed by conformal 3-dimensional (3D) radiotherapy (RT). In the second arm (concurrent arm), 40 patients received concomitant chemotherapy with cisplatin and etoposide and conformal RT, followed by two cycles of consolidation chemotherapy with carboplatin and etoposide. The median survival was 13 months for the patients in the sequential arm and 19 months for those in the concurrent treatment arm (p=0.0039). The disease-free survival (DFS) was 9 months in the sequential arm and 16 months in the concurrent treatment arm (p=0.0023). The following prognostic factors significantly influenced the survival of the patients treated with combination of RT and chemotherapy: age (p<0.05), performance status (PS) (p<0.001), weight loss (p<0.001), tumor size (p<0.05), nodal involvement (p<0.05). Given the higher toxicity in the second arm, this should be reserved for younger patients (<70 years), having good PS and minimal weight loss. We highly recommend precise stage and prognostic factors definitions in such patients so that they receive the most beneficial treatment.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 05/2015; 20(3):775-781.
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    ABSTRACT: To evaluate the reliability of ultrasound scan (US) findings in the preoperative assessment of the nature of adnexal masses in females. After detailed history, a preoperative US examination was performed in all women. Tumor diameter, localization, the presence of solid, cystic and multilocular components, excrescences, metastasis and free fluid were assessed. Doppler scan was done and pulsatility (PI) and resistance indices (RI) were determined. These data were compared with postoperatively obtained histopathological findings and statistically analyzed. The study included 609 women out of which 20.7% had malignant, 73.7% benign, and 5.6% border-line tumors. Patients with malignant tumors were oldest (p<0.001). There were significantly more positive US parameters in malignant than in benign tumors (p<0.001). Also, there were significant differences (p<0.001) between malignant, benign and borderline tumors regarding all examined US and Doppler parameters except tumor multilocularity. RI had sensitivity 75%, specificity 61.2%, positive predictive value (PPV) 42.70% and negative predictive value (NPV) 96.16%. PI had sensitivity 50%, specificity 35.3%, PPV 8.37% and NPV 25.93%. Sensitivity of US characteristics was 94.34%, specificity 30.62%, PPV 22.27% and NPV 96.25%. US pattern characteristics and Doppler parameters were found to be moderately reliable in discriminating malignant, benign and borderline adnexal tumors. Tumor of solid or mixed consistency, presence of ascites and excrescences were the best predictors of malignancy.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 05/2015; 20(3):862-869.
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    ABSTRACT: Recent progress in cancer treatment has increased the use of oral antineoplastic agents. It is now estimated that at least 25% of the existing antineoplastic agents are planned to be used as oral agents and this mode of administration is likely to increase in the coming years. The use of oral anti- neoplastic agents affects many aspects of cancer treatment, and despite advantages, it also poses challenges to health care professionals and patients, many of which refer to the adherence and safety. Low patient adherence demonstrates the need for better management and monitoring of patients on oral antineoplastic agents. Patient education is essential to maintain adherence to oral antineoplastic therapy, promoting a better understanding of the patient treatment regimen, treatment goals and potential side-effects, patient safety and implementation of self-care measurement. This article discusses the above-mentioned challenges, as well as the possibilities of patient and family education to improve adherence, outcomes of treatment and quality of life, and offers recommendations for practice and further research.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 05/2015; 20(3):690-698.
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    ABSTRACT: Colorectal cancer (CRC) is the third most common cancer worldwide and despite the abundance of molecular pathways and markers continually being reported, the mortality rates remain high. Hypoxia inducible factor 1alpha (HIF-1α) plays a major role in the response of tumors to hypoxia, and contributes to tumor aggressiveness, invasiveness and resistance to radiotherapy and chemotherapy. Targeting HIF-1α is an attractive strategy, with the potential for disrupting multiple pathways crucial for tumor growth. In the current study, HIF-1α immunohistochemical expression in CRC is reviewed along with the relation to clinical outcome and prognosis. In addition, the significant correlation of HIF-1α to vascular endothelial growth factor (VEGF) expression is reported, as well as the possible role of HIF-1α in predicting the therapeutic response to anti-EGFR therapies. Herein, an overview of the HIF-1α expression in CRC is presented. This review delineates the crucial role that HIF-1α plays in carcinogenesis, tumor angiogenesis and cancer progression. The evaluation of HIF-1α in patient biopsies could be useful as a prognostic and/or predictive biomarker in personalized cancer treatment.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 05/2015; 20(3):680-689.
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    ABSTRACT: The purpose of this study was to evaluate the oncological and functional results of patients affected by laryngeal squamous cell carcinoma (SCC) and surgically treated by supracricoid partial laryngectomy (SCPL) at the ENT Department of the University Hospital of Ferrara. In this retrospective study a total of 155 patients (149 males/l96.1% and 6 females/3.9%), have been included. All patients were treated between January 1st 1998 and December 31st 2010, by SCPL, including 126 cricohyoidopexies (CHP) and 29 cricohyoidoepiglottopexies (CHEP). The overall survival (OS) at 3 and 5 years was 88.77 and 83.24%, respectively and the disease-free survival (DFS) at 3 and 5 years was 84.4 and 81.55%, respectively.The recurrence rate was 17.5%,with local recurrences in 12.1% of the cases, regional in 4.7% and distant metastasis in 0.7% of the cases. Synchronous second primary tumors were 0.7% and metachronous second primary cancers (MSPCs) 5.4%. Removal of nasogastric feeding tube (NGT) or percutaneous endoscopic gastrostomy (PEG) was performed in 98.7% of the patients and lasted 22 days on average after SCPL (range 9-60), while decannulation was performed in all of patients at the 27th day on average after surgery. Oncological outcomes of this series are consistent with those of the literature, showing that SCPL is an effective and safe procedure in terms of survival rate and disease control. Functional outcomes confirmed that SCPL allows a good organ preservation and recovery of laryngeal functions.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 05/2015; 20(3):879-885.