[Show abstract][Hide abstract] ABSTRACT: The achieve pathologic complete response is proven to be the most important parameter of prognosis. Thereports evaluating the impact of obesity on the obtained pathologic response to chemotherapy are unequal. The aim of the study was to evaluate in locally advanced breast cancer patients, treated with AT(doxorubicin plus docetaxel) neoadjuvant chemotherapy: 1. The relationship of obesity with obtaining pathological response. 2. The relationship of obesity and free of disease recurrence survival (DFS) and overall survival (OS) associated with the tumour.
A retrospective study was carried out in a group of 105 patients with locally advanced breast cancer, treated with AT neoadjuvant chemotherapy and then treated with radical surgery. Two variants of pathological response have been adopted: a pCR (T0N0) and pCR1 (TisN0, TxN1, T1N0, T1N1, T0N1). The relationship of obesity with pathological response and survival was investigated.
In univariate analysis the pCR1 was obtained with its arising from the borderline of statistical significance with lower incidence of obesity. In pCR1 multivariate analysis, negative pCR1 relationship with obesity was on the borderline of the statistical significance. The multivariate analysis showed a significant negative association OS with obesity (p=0.047) and positive with the occurrence of menopause (p = 0.029).
In patients with locally advanced breast cancer treated with AT neoadjuvant chemotherapy. 1. Obesity seems to be an independent and unfavourable predictor of the lack of obtaining pCR1 pathological response 2. In the multivariate analysis, the obesity was a significant independent factor related to shorter OS.
Polish Journal of Surgery 05/2015; 87(5):231-7. DOI:10.1515/pjs-2015-0047
[Show abstract][Hide abstract] ABSTRACT: Publication is summarization of existing data being results of literature review and our experience on usefulness of selenium as a diagnostic marker selection for control examinations in surveillance and as a marker of patients with high risk of cancers.
[Show abstract][Hide abstract] ABSTRACT: Xeroderma pigmentosum (XP) is a rare autosomal recessive disease that is associated with a severe deficiency in nucleotide excision repair. Genetic polymorphisms in XP genes may be associated with a change in DNA repair capacity, which could be associated with colorectal cancer development. We assessed the association between 94 single nucleotide polymorphisms (SNPs) within seven XP genes (XPA-XPG) and the colorectal cancer risk in the Polish population. We genotyped 758 unselected patients with colorectal cancer and 1,841 healthy adults. We found that a significantly decreased risk of colorectal cancer was associated with XPC polymorphism rs2228000_CT genotype (OR 0.59; p < 0.0001) and the rs2228000_TT genotype (OR 0.29; p < 0.0001) compared to the reference genotype (CC). And an increased disease risk was associated with the XPD SNP, rs1799793_AG genotype (OR 1.44, p = 0.018) and rs1799793_AA genotype (OR 3.31, p < 0.0001) compared to the reference genotype. Haplotype analysis within XPC, XPD and XPG revealed haplotypes associated with an altered colorectal cancer risk. Stratified analysis by gender showed differences between the association of three SNPs: XPC rs2228000, XPD rs1799793 and XPD rs238406 in females and males. Association analysis between age of disease onset and polymorphisms in XPD (rs1799793) and XPC (rs2228000) revealed differences in the prevalence of these variants in patients under and over 50 years of age. Our results confirmed that polymorphisms in XPC and XPD may be associated with the risk of colorectal cancer.
[Show abstract][Hide abstract] ABSTRACT: The management of peritoneal surface malignancy is a significant clinical problem in oncology. It was demonstrated that the combination of complete cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) may lead to long-term control of the disease or improved survival in selected patients. The aim of this paper was to present the optimal indications and technical guidelines for performing HIPEC in Poland. The application of this method requires experience of a multidisciplinary team of physicians (gynecologic oncologist, surgeon and clinical oncologist), availability of diagnostic and therapeutic resources (intensive care unit) as well as a dedicated perfusion system. A crucial aspect for obtaining optimal treatment outcomes is the selection of patients. Such a selection takes place both at the beginning of treatment and intraoperatively. The initial selection of patients qualified for HIPEC includes ruling out extraperitoneal spread of cancer and metastases to the liver (single resectable liver metastases in patients with colorectal carcinoma are not contraindications) and lungs. According to current international guidelines, the HIPEC procedure is a standard treatment in patients with ovarian carcinoma that metastasizes to the peritoneum, in colorectal cancer, when PCI <20 and in patients with peritoneal mesothelioma or pseudomyxoma peritonei as well as in patients with gastric cancer.
Current Gynecologic Oncology 08/2014; 12(2):86-97. DOI:10.15557/CGO.2014.0009
[Show abstract][Hide abstract] ABSTRACT: A protective stoma performed in patients after the anterior resection of the rectum is an important and current problem. In relation to the presented conclusions from the literature, the group of experts from the Polish Coloproctology Club has indicated a number of areas which should be the subject of future organisational activities and which should become the basis for future scientific research. They include: 1. The creation of a register of patients operated using the TME technique, in which a protective stoma was performed, and the strict clinical supervision of this group. 2. The initiation of studies with the view to further analysis of risk factors of intestinal anastomotic leakage after the anterior resection of the rectum and the discussion on the importance of specific indications of protective stoma. 3. The need to conduct the debates in this area and to analyse current global literature. Since the experts of the Polish Coloproctology Club are aware that the definition of precise and unequivocal recommendationsin this scope is very difficult and often disputable, they are of an opinion that this document, albeit imperfect, can serve as a guideline and can help surgeons who decide about the matters discussed herein, which is often quite difficult. The experts consider that this consensus statement is a substantial support, but the final decision should be made by an operating surgeon on the basis of his own experience and a specific clinical situation.
Polish Journal of Surgery 08/2014; 86(8):391-404. DOI:10.2478/pjs-2014-0071
[Show abstract][Hide abstract] ABSTRACT: The E318K mutation in the MITF gene has been associated with a high risk of melanoma, renal cell carcinoma, and pancreatic cancer; the risk of other cancers has not been evaluated so far. Herein, we examined the possible association of E318K and a novel variant of the MITF gene, V320I, with the risk of cancers of different sites of origin in a Polish population. We assayed for the presence of the E318K and V320I missense mutations in 4,226 patients with one of six various cancers (melanoma or cancer of the kidney, lung, prostate, colon, or breast) and 2,114 controls from Poland. The E318K mutation was detected in 4 of 2,114 participants (0.19%) in the Polish control population, the V320I in 3 of 2,114 participants (0.14%) in the control group. We found no statistically significant differences in the prevalence of the E318K and V320I variants among cases and controls. We found two carriers of the E318K variant among melanoma patients (P = 0.95), one carrier among breast cancer patients (P = 0.77), one carrier among colorectal cancer patients (P = 0.82), and one carrier among kidney cancer patients (P = 0.64). Our study demonstrates a lack of strong association of E318K and V320I with increased risk of melanoma or cancers of the kidney, breast, prostate, lung, or colon.
Cancer Genetics 03/2014; 207(4). DOI:10.1016/j.cancergen.2014.03.003 · 2.98 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Parasitic protozoans of the Cryptosporidium genus are intracellular intestinal parasites of mammals, causing cryptosporidiosis. Clinically, cryptosporidiosis manifests as chronic diarrhoea. Individuals with immune disorders, including those with neoplasms, are at risk of symptomatic invasion.
Was the evaluation of Cryptosporidium sp. prevalence in patients with diagnosed colorectal cancer.
The studied group encompassed 87 patients with diagnosed colorectal cancer, undergoing surgery at the Department of General and Oncological Surgery, Pomeranian Medical University, in the years 2009-2010. Immunoenzymatic tests for Cryptosporidium sp. on faeces samples were performed with the use of commercial test kit, ProSpecT(®)Cryptosporidium Microplate Assay (Remel Inc).
The presence of Cryptosporidium sp. was found in 12.6% of studied patients with colorectal cancer. The performed statistical analysis did not reveal any correlation between Cryptosporidium sp. infection and gender, age, neoplasm advancement stage as per Astler-Coller scale, neoplasm differentiation grade, or neoplastic tumour localisation in relation to the splenic flexure.
There was found high prevalence of Cryptosporidium sp. in patients with colorectal cancer. It was comparable to the prevalence reported for patients with immune deficiency.
Polish Journal of Surgery 07/2012; 84(7):348-51. DOI:10.2478/v10035-012-0058-4
[Show abstract][Hide abstract] ABSTRACT: Effective treatment is the primary objective of surgeon in the treatment of advanced gastric cancer. Poor prognosis and significant advancement of gastric cancer at the time of diagnosis are decisive factors for the only possible surgical management method being palliative procedures.
was the evaluation of the value of palliative resection procedures in patients with advanced gastric cancer.
The subject in the study was a group of 105 patients with gastric adenocarcinoma at stage 4 of advancement, in whom curative treatment was not possible. The group constituted 44.5% of patients operated on due to gastric cancer at the Department of General and Oncological Surgery, PUM, in the years 1998-2009. The patients were divided into two groups: the first one comprised 44 patients post palliative resections, the second - 61 patients post non-resection procedures. The subject of analysis were early and late treatment results post palliative resections, and they were compared with the treatment results post non-resection procedures.
Palliative resections were performed in 44 patients (19 females and 25 males), while in 61 patients (38 males and 23 females) non-resection procedures were performed. Postoperative complications were observed in 25% of patients in the group post palliative resections and in 11.5% in the group of patients without the resection of primary focus. In-hospital mortality stood at 4.5% in the group post palliative resections and 4.8% in the group post non-resection procedures. The percentage of 1-year and 4-year survival post palliative resections stood at 43% and 8.8%, respectively. In the group without the resection of primary focus, 16% survived 1 year and nobody survived 2 years.
Palliative resections improve the survival of patients with incurable gastric cancer and should be considered if only the loco-regional conditions are favourable.
Polish Journal of Surgery 08/2011; 83(8):449-56. DOI:10.2478/v10035-011-0070-0
[Show abstract][Hide abstract] ABSTRACT: Optimal management of asymptomatic generalized rectal cancer is still the matter of debate. The aim of the study was to review stage IV rectal cancer patients who were treated in our clinic since 2000 till 2008 in order to evaluate the effectiveness of surgery.
Fifty-two generalized rectal cancer patients treated with elective resection of primary tumor were identified. Patients' age, sex, duration of hospital stay, modality of surgery, complications, postoperative mortality rate and survival rate were assessed.
Median survival was 16.3 months. Postoperative complications occurred in 29% patients. Postoperative mortality rate was 1.9%.
In properly selected group of patients elective resection of primary tumor may cause low mortality rate and acceptable morbidity rate. This surgical modality allows to avoid potential complications of tumor local growth.
Polish Journal of Surgery 07/2011; 83(7):372-6. DOI:10.2478/v10035-011-0059-8
[Show abstract][Hide abstract] ABSTRACT: Evidence to date that germline mutations in the tumor suppressor gene BRCA1 increase the incidence of colorectal cancer is mixed, and both positive and negative results have been reported. To establish whether or not inherited variation in BRCA1 influences the risk of colorectal cancer, we genotyped 2,398 unselected patients with colorectal cancer and 4,570 controls from Poland for three BRCA1 founder mutations (C61G, 4153delA and 5382insC). A BRCA1 mutation was present in 0.42% of unselected cases of colorectal cancer and in 0.48% of controls (OR = 0.8; P = 0.8). The mutation frequency was slightly higher (0.93%) in 321 cases who reported a family history of colon cancer in a first- or second-degree relative (OR = 1.9; P = 0.5). A BRCA1 mutation was also seen in excess (0.82%) in 851 cases who were diagnosed with colorectal cancer at age 60 or earlier (OR = 1.7; P = 0.3). The mean age at onset in carriers was 7 years younger than in non-carriers (57.0 years vs. 64.0) and the difference was significant (P = 0.05). This study suggests that BRCA1 mutations may be associated with early-onset of colorectal cancer.
Familial Cancer 12/2010; 9(4):541-4. DOI:10.1007/s10689-010-9378-x · 1.98 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: CYP1B1 is a P450 enzyme which is involved in the activation of pro-carcinogens to carcinogens as well as sex hormone metabolism. Because differences in the activity of the enzyme have been correlated with variant alleles of single nucleotide polymorphisms (SNPs), it represents an attractive candidate gene for studies into colorectal cancer susceptibility.
We genotyped 597 cancer patients and 597controls for three CYP1B1 SNPs, which have previously been shown to be associated with altered enzymatic activity. Using the three SNPs, eight different haplotypes were constructed. The haplotype frequencies were estimated in cases and controls and then compared. The odds ratio for each tumour type, associated with each haplotype was estimated, with reference to the most common haplotype observed in the controls.
The three SNPs rs10012, rs1056827 and rs1056836 alone did not provide any significant evidence of association with colorectal cancer risk. Haplotypes of rs1056827 and rs10012 or rs1056827 and rs1056836 revealed an association with colorectal cancer which was significantly stronger in the homozygous carriers. One haplotype was under represented in the colorectal cancer patient group compared to the control population suggesting a protective effect.
Genetic variants within the CYP1B1 that are associated with altered function appear to influence susceptibility to a colorectal cancer in Poland. Three haplotypes were associated with altered cancer risk; one conferred protection and two were associated with an increased risk of disease. These observations should be confirmed in other populations.
BMC Cancer 08/2010; 10(1):420. DOI:10.1186/1471-2407-10-420 · 3.36 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Mutations of genes associated with the mismatch repair mechanism and mutations of the APC gene are the most frequent causes of hereditary colorectal cancer. An iPLEX test combined with TaqMan genotyping assays was therefore developed to identify common recurrent mutations of those genes in the Polish population. We analyzed 349 DNA samples from 95 positive controls previously identified by sequencing and 254 unexamined individuals. The iPLEX test included two plexes, which comprised seven mutations of the APC gene and 29 mutations of three of the mismatch repair genes. TaqMan assays were designed for nine mutations not covered by the iPLEX assays: one mutation in the APC gene and eight mutations in the mismatch repair genes. Results were then verified independently by sequencing. Our combination method allowed detection of all recurrent mutations occurring in group of patients, followed by full analysis by DNA sequencing. With the exception of one false positive in the iPLEX test in the positive control group that could be assigned to contamination from neighboring wells rather than a detection error, given sufficient DNA concentration and quality, the designed iPLEX/TaqMan test had an accuracy of 100% for the designed assays. These results suggest that the combined iPLEX/TaqMan test is an outstanding tool for identification of recurrent mutations among hereditary colorectal cancer patients.
The Journal of molecular diagnostics: JMD 12/2009; 12(1):82-90. DOI:10.2353/jmoldx.2010.090063 · 4.85 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Recently, the 1100delC variant of cell cycle checkpoint kinase 2 (CHEK2) has been reported to confer a colorectal cancer risk in hereditary non-polyposis-colorectal cancer (HNPCC) and HNPCC-related families in the Netherlands. To investigate whether CHEK2 mutations confer increased cancer risk in HNPCC and HNPCC-related families in Poland, we genotyped 463 probands from HNPCC and HNPCC-related families, and 5,496 controls for 4 CHEK2 alleles (1100delC, IVS2+1G>A, del5395, I157T). All 463 probands were screened for mutations in the HNPCC-related genes MSH2, MLH1 and MSH6. A positive association was observed for HNPCC-related cancer and the I157T missense CHEK2 mutation (OR = 1.7; p = 0.007), but not for the truncating alleles (OR = 1.0; p = 1.0). The association with the I157T was seen both for the 117 cases who fulfill Amsterdam criteria (OR = 1.9; p = 0.1) and for the 346 cases who do not fulfill the criteria (OR = 1.6; p = 0.03). One hundred forty-five of the 463 families had a mutation in MSH2, MLH1 or MSH6 (MMR-positive families). A positive association between the CHEK2 I157T mutation and HNPCC-related cancer was observed only for MMR-negative cases (OR = 2.1; p = 0.0004), but not for MMR-positive cases (OR = 0.8; p = 0.9). The association with I157T was particularly strong for MMR-negative cases with familial colorectal cancer (2 or more first-degree relatives affected) (OR = 2.5; p < 0.0001). We conclude that the I157T variant of CHEK2 increases the risk of colorectal cancer among MMR-negative, HNPCC/HNPCC-related families in Poland.
International Journal of Cancer 10/2009; 126(12):3005-9. DOI:10.1002/ijc.25003 · 5.09 Impact Factor