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Editorial Lucrul în echipă — un beneficiu modern pentru pacientul oncologic Dr. În zilele noastre, pe de o parte, pacientul este perceput ca o persoană care are o problemă de sănătate ce generează, pe lângă suferința specifică afecțiunii pe care o are, probleme psihologice și afectarea mediului social în care activează activitatea profesională, relațiile familiale și sociale. Astfel, pacientul se află în centrul asistenței medicale de orice specialitate. Pe de altă parte, oricât de bine pregătit profesional ar fi, nici un medic nu poate să dețină toate cunoștințele și să stăpânească toate mijloacele tehnice necesare diagnosticului si tratamentului unui pacient, rezultatele cele mai bune obținându-se prin munca în echipă.
Medicina modernă se bazează pe această noțiune, de muncă în echipă, de tratament interdisciplinar. Vremurile în care un pacient reprezenta can hpv cause lymphoma cancer o boală, un medic și o investigație can hpv cause lymphoma cancer operație au apus de mult, în zilele noastre, investigațiile și procedurile chirurgicale reprezentând doar o parte dintr-un lanț de proceduri diagnostice și terapeutice, al cărui scop este în final salvarea sau îmbunătățirea vieții pacientului.
Consider că oncologia, poate mai mult decât orice altă specialitate medicală, cere o mare deschidere spre lucrul în echipă și colaborarea interdisciplinară între specialistul care depistează sau suspectează un caz de cancer, oncologul medical, radioterapeut, radioimagist, anatomopatolog, chirurg, psiholog si toti cei implicati in diagnostic, tratament sau urmarirea pacientului.
Având pacientul în centrul preocupărilor noastre, este firesc să adunăm pentru fiecare caz în parte o echipă de specialiști din variate domenii medicale care își aduc, cu toții, contribuția la rezultatul final. Colaborarea interdisciplinară este un rezultatul firesc al specializării tot mai înalte a cadrelor can hpv cause lymphoma cancer și duce implicit la creșterea calității actului medical, medicul specialist având capacitatea și cunoștințele necesare aplicării mijloacelor terapeutice specifice și posibilitatea însușirii informațiilor la zi privind progresele în diverse tehnici și tratamente.
Terapia multimodală este un principiu can hpv cause lymphoma cancer aplicat în oncologie, ce constă în aplicarea succesivă, la un singur pacient, a mai multor metode terapeutice: chirurgie, chimioterapie, imunoterapie, radioterapie etc.
Acestia alcătuiesc împreună o comisie de diagnostic si tratament, stabilind strategia terapeutică pentru fiecare caz în can hpv cause lymphoma cancer. Acest mod de colaborare duce la utilizarea optimă a fiecărei metode în beneficiul pacientului oncologic. That said, single-agent nivolumab proved almost as powerful in patients expressing the programmed cell death ligand 1 PD-L1.
Wolchok announced. Therapeutic neck dissection does not improve survival and can have associated morbidities associated with a second surgery. Performing both the primary and the neck dissection surgeries at the same time spares patients those effects. Conclusions: The CCSS cohort provides evidence that the strategy of modifying therapy to reduce the occurrence of late-effects, and promotion can hpv cause lymphoma cancer early detection, is successfully translating into a significant reduction in observed late mortality.
We saw decline in cognitive function with whole-brain radiation therapy, and quality of life was worse. Studies have shown that the addition of whole-brain radiation therapy to stereotactic radiosurgery can reduce the number of patients with recurrence in treated sites and the number of new metastases.
But on the other side, whole-brain radiation therapy carries risks. Buckner continued. Brown noted at the Plenary Session. Association of immune markers at BL with subsequent tumor burden response suggests that infiltrating immune activating cells may mediate response to nivolumab in mRCC pts. Anti—programmed cell death protein 1 PD-1 immunotherapy with nivolumab Opdivo extended survival in patients with the most common form of lung cancer—nonsquamous non—small cell lung cancer NSCLC.
Patients whose disease progressed on standard platinum doublet therapy who were treated with nivolumab lived an average of 3 months longer than those treated with docetaxel in this setting.
Paz-Ares noted. Safety results were reassuring, Dr. Schuchter commented. This is the largest experience with immunotherapy in head and neck cancer.
Pembrolizumab was roughly twice as effective when measured by response as we have seen with cetuximab [Erbitux], our only approved targeted therapy for head and neck cancer. Pembrolizumab is the first anti—programmed cell death protein 1 PD-1 therapy to be approved by the U.
Food and Drug Administration. It is approved in advanced melanoma and is now being studied in other solid tumors. This expansion cohort enrolled patients with recurrent or metastatic squamous cell carcinoma of the head and neck, irrespective of PD-L1 or HPV status. All patients received fixed-dose pembrolizumab infusion of mg every 3 weeks for 24 months or until disease progression or intolerable toxicity. The overall objective response rate was Seiwert said. Furthermore, it may be possible to predict who is most likely to benefit from pembrolizumab using PD-L1 as a biomarker, Dr.
Seiwart noted. Analysis of PD-L1 status and response is ongoing. In preclinical models, it also has been shown to impact tumor cells via vascular remodeling, reversal of epithelial-mesenchymal transition, as well as suppression of migration and invasion. Eribulin had a favorable median can hpv cause lymphoma cancer of Median progression-free survival was 2. Gary K. The can hpv cause lymphoma cancer endpoint was investigator-assessed progression-free survival. At the time of the preplanned interim analysis, median progression-free survival was 9.
Very few patients had to stop because of side effects, and that will be key as palbociclib moves forward. We have significant laboratory data showing synergy between palbociclib and fulvestrant in two cell line models of endocrine resistance.
Turner commented at a press briefing. The follow-up is relatively short, but there is significant separation of the survival curves at 5 to 6 years, and we would expect that to continue with longer follow-up.
This is treatment with curative intent. The median age was 66 years. The median PSA level was At a median follow-up of 5. Docetaxel also achieved a reduction in distant metastases at any time during the trial compared with androgen suppression and radiotherapy alone; 41 events were observed in arm 1 and 26, in arm 2.
Adverse events were as expected, with more grade 3 and 4 hematologic toxicity in the docetaxel arm. The investigators stressed that longer follow-up is needed to determine whether such therapy also improves metastasis-free or overall survival. Lambertini, Italy.
Anal canal cancer diagnosis and treatment aspects
Ovarian protection during adjuvant chemotherapy. N Engl J Med; 23 — Annals of Oncology. Rolul inhibitiei ovariane cu agonisti LH-RH in prevenirea insuficientei ovariene premature induse de chimioterapie POF este inca controversata. Noi date prezentate la ECC sugereaza eficacitatea administrarii agonistilor LH-RH pentru pastrarea functiei ovariane la pacientele cu cancer de san. Meta-analiza prezentata si-a propus sa investigheze daca utilizarea LH-RHa in timpul chimioterapiei la pacientele cu cancer de san in premenopauza ar reduce rata insuficientei ovariene legate de tratamentul citostatic si daca se observa o crestere a ratei sarcinilor ulterioare.
Un total de 12 studii clinice randomizate au fost eligibile si au inclus 1. In cadrul studiilor s-au utilizat diferite definitii ale insuficientei ovariene amenoree cu sau fara nivel hormonal dozat si au cuprins evaluari la 6, 8, 12, 24 sau 36 luni.
Analiza a fost restrictionata la 8 studii cu informatii disponibile cu privire la rata amenoreei la un an dupa terminarea chimioterapiei. This is mainly because of the lack of data on long-term ovarian function and pregnancies. October 83 News ECC Pana in prezent aceasta abordare in conservarea fertilitatii ramane controversata, dar noile date sugereaza ca utilizarea inhibitiei ovariene poate fi utila si realizata in conditii de siguranta atat in cazul pacientelor cu neoplasm mamar cu receptori negativi, cat si in cazul celor cu receptori hormonali papillomavirus sur peau, ce reprezinta majoritatea in cazul femeilor tinere recent diagnosticate cu neoplasm mamar.
Miles, UK. N Engl J Med Miles et al.
Cancerul de canal anal - aspecte legate de diagnostic și tratament
Rezultatele preliminare au relevat date despre siguranta, incidenta si severitatea reactiilor adverse si afectarea cardiaca.
In cazul docetaxelului au fost raportate mai multe cazuri de mucozita, toxicitate hematologica și neutropenie febrila decat in randul pacientelor care au primit nab-paclitaxel si paclitaxel. Acestea din urma au dus mai frecvent la aparitia neuropatiei periferice. Zielinski et al, Vienna, Austria. Zielinski et al. Obiectivul studiului a fost de a demonstra non-inferioritatea in privinta supravietuirii globale intre cele doua asocieri.
Pacientele au fost randomizate sa primeasca in prima linie bevacizumab plus paclitaxel i. Cu toate acestea, rezultatele analizelor de sensibilitate nestratificata au fost în contradictie cu rezultatele primare, urmand can hpv cause lymphoma cancer autorii sa exploreze acesta incoerenta, precum si heterogenitatea dintre subgrupuri.
Pe baza constatarilor studiului TURANDOT, selectarea unui anumit regim continand bevacizumab ar trebui luata in considerare in functie de multi factori, inclusiv de particularitatile fiecarui pacient. However in some cases in which patients develop severe complications during chemotherapy, surgery remains the only option of choice. We present the case of a 62 year old patient diagnosed with small cell non-Hodgkin lymphoma, who developed a severe gastric bleeding during chemotherapy so she was submitted to surgery.
Vaccine for human papillomavirus side effects total gastrectomy with para-ortic lymph node dissection was performed with good outcomes.
Cancerul de canal anal - aspecte legate de diagnostic și tratament
Radical gastrectomy with para-aortic lymph node dissection for non-Hodgkin gastric lymphoma—a case report Rom J Oncol Hematol. In the mean time, the stomach is the most common extranodal involvement of non-Hodgkin lymphoma When it comes to long term outcomes, gastric lymphoma is associated with an improved outcome when compared to other gastric malignancies including gastric adenocarcinoma and many therapeutic strategies have been proposed; An well established consensus has not yet been obtained 1.
Nowadays large studies opiniate for CHOP regimen chemotherapy as first line therapy; however it is not possible in all cases due to the development of local complications 1. Case report A 62 year old patient was initially investigated for an upper digestive hemmorhage after previous administration of non-steroidian anti-inflammatory treatment one week earlier.
The upper digestive fibroscopy revealed multiple can hpv cause lymphoma can hpv cause lymphoma cancer tumors developed on the greater curvature of the stomach with a high suspicion of malignancy. The biopsy indicated the presence of diffuse lymphoid infiltration involving the muscularis mucosae with high suspicion of lymphoma. The immunohistochemi- Figure 1.
The whole body MRI performed indicated the presence of a large gastric tumor invading the upper tratament pentru paraziti intestinali adulti of the Bacalbasa N. Figure 2. The patient was submitted to chemotherapy with CHOP regimen, but during the third cycle she developed a severe bleeding with haemorrhagic shock, so she was addressed in emergency to Visceral Surgery service.
A total gastrectomy with para-aortic lymph node dissection was performed with good outcomes, the patient being discharged in the 8th postoperative day Fig The macroscopic aspect can hpv cause lymphoma cancer the specimen showed the presence of multiple ulcerated tumors, enabling us to consider that a partial remission of the tumor was achieved under chemotherapy.
However in this certain case the rapid degradation of the general biological status due to the apparition of a severe upper digestive haemorrhage imposed an emergency laparotomy in order to perform a resection with haemostatic purpose.
Usually these proliferative diseases originate in the lymphoid viscera or in other sites and have a significant number of lymphoid cells; less common, they can develop in sites which do not have a well represented lymphoid tissues such as the stomach.
The most frequent symptoms at diagnosis include abdominal pain, hematemesis and weight loss, hence it is difficult to differentiate it from other malignant conditions such as adenocarcinoma In order to have a positive diagnosis of gastric lymphoma and can hpv cause lymphoma cancer establish the histopatho- Figure 3. Lymph node dissection at the level of the hepatic pedicle logical subtype, immunohistochemistry is needed.
The basic immunohistochemical panel includes antibodies against B-cell CD20 and T-cell CD3 antigens and light chains determination in cases presenting numerous plasma cells; the presence of CD45, CD15, and CD30 should be tested if large dysplastic cells are seen.
Testing the presence of kappa and lambda light chains may help to identify the presence of an abnormal clonal population, particularly plasma cells. However, immunohistochemistry is less sensitive than flow cytometry for the detection of immunoglobulin expression, as it does not detect the surface immunoglobulin Once the positive diagnosis of non Hodgkin gastric lymphoma can hpv cause lymphoma cancer achieved, the most effective therapeutical strategy remains a matter of debate.
Initially it has been considered that total or partial gastrectomy is the first therapeutic can hpv cause lymphoma cancer 15, The rationale for this option consisted in providing a complete tumor removal and an adequate staging; it could also diminish the rates of chemotherapy administration which was taught to have unacceptable risks of hemorrhagy and tumor perforation 1.
When it comes to the most important prognostic factors influencing the long term outcomes, it has been widely demonstrated that the cellular type and the stage significantly impact can hpv cause lymphoma cancer survival.
Musshoff et al modificated Ann Arbor classificiation and separated the cases included in stage II of the disease into cases with local nodal inOctober 87 Radical gastrectomy with para-aortic lymph node dissection for non-Hodgkin gastric lymphoma —a case report Figure 4.
The final aspect after para-aortic lymph Figure 5. The specimen presenting large node dissection infiltrative zones with haemorrhagic stigmata volvement II1 and cases with more distant spread to para-aortic can hpv cause lymphoma cancer II2 ; they demonstrated that patients with stage II2 disease have a significantly worse prognosis than those with stage II1 disease Although large studies could not clearly demonstrate the effectiveness of surgery followed by chemotherapy when papillomavirus 16 oncoprotein to chemotherapy only for gastric lymphoma, there are cases in which surgery is the only potential curative solution due to the significant chemotherapy related complications which might develop.
In our case, total gastrectomy with lymph node dissection seemed can hpv cause lymphoma cancer best therapeutic protocol in order to minimise the complica- Acknowledgement: This work is licensed under a Creative Commons Attribution 4. J Chin Med Assoc ; 68 1 Primary gastrointestinal lymphoma in Japan: a clinicopathologic analysis of patients with special reference to its time trends. Cancer ; 97 10 Primary gastric lymphoma.
Br J Surg ; 74 6 A review of 50 cases. Dig Dis Sci ; 27 11 A retrospective clinicopathologic study of cases. Cancer ; 55 5 Primary gastrointestinal B-cell lymphoma. A clincopathological and immunohistochemical study of 61 cases with an evaluation of prognostic parameters. Pathol Res Pract ; 6