Karcinom pankreatu – změna k lepšímu?

MUDr. Marián Liberko

Onkologie. 2023:17(2):79  

Surgical treatment of resectable and borderline resectable pancreatic cancer

Martin Oliverius

Onkologie. 2023:17(2):82-85 | DOI: 10.36290/xon.2023.018  

Surgical treatment remains the only treatment method that gives patients hope of cure, or of a significant prolongation of the asymptomatic period. In combination with multimodal oncological treatment, survival of patients has improved in recent years, although from the point of view of other cancers of the gastrointestinal tract it continues to be one of the worst. The mortality rate of patients operated in large centers ranges between 3-5%, although the morbidity due to the complexity of the procedure and the predominantly higher age composition of patients remains around 40%. A single examination is sufficient for the indication and the right decision...

Is surgical treatment of liver metastases from pancreatic adenocarcinoma currently indicated?

Robert Gürlich

Onkologie. 2023:17(2):86-89  

At the time of primary diagnosis, metastatic pancreatic ductal adenocarcinoma (mPDAC) occurs in up to 60%. In approximately half of these patients, synchronous distant metastases are present, with around 37-42% of them being liver metastases. The existing recommendations do not indicate a primary surgical procedure in stage IV of the disease. Recently, particularly with the advancement of systemic treatment, initial results have been published demonstrating the benefit of the primary surgical approach. The results of ongoing randomized trials have been unavailable so far; therefore, there is not strong enough evidence to recommend a change in the strategy...

The role of radiotherapy in the treatment of pancreatic cancer

Renata Soumarová, Marián Liberko

Onkologie. 2023:17(2):90-94 | DOI: 10.36290/xon.2023.019  

Surgery remains the most important modality in the treatment of resectable pancreatic cancer, but only 10-15% of patients are suitable candidates. Despite the still high rate of local recurrence after radical surgery, adjuvant radiotherapy has now been replaced by chemotherapy, which has been shown to have better outcomes in randomized trials. Systemic therapy is also preferred in the neoadjuvant indication, but further studies investigating the position of radiotherapy in this group of patients are needed. Radiotherapy has a place in unresectable disease, where in combination with systemic therapy it affects local disease control and overall survival....

Personalized therapy in pancreatic cancer

Marián Liberko, Renata Soumarová

Onkologie. 2023:17(2):95-100 | DOI: 10.36290/xon.2023.020  

Pancreatic cancer is a disease with increasing incidence and mortality worldwide. Current standard of treatment is chemotherapy regardless of clinical stage. Despite improvements in survival thanks to multi-agent regimens in adjuvant, neoadjuvant and paliative setting, pancreatic cancer still has the worst prognosis across all malignancies. Oncology nowadays is more or less personalized/precise. With help of NGS we are able to identify specific subtypes of patients with pancreatic cancer, which have both, different prognosis and require specific approach to treatment. The aim of this review is to provide information about pancreatic cancer as a molecularly...

Metastatic pancreatic cancer and personalized therapy: a case report

Marián Liberko, Renata Soumarová

Onkologie. 2023:17(2):101-107 | DOI: 10.36290/xon.2023.021  

We present a case report of a patient with pancreatic cancer who developed metastatic disease early after surgery and adjuvant therapy. Palliative systemic treatment resulted in long-term control of the disease, followed by pulmonary metastasectomy of residual lesions. Early relapse of the disease after metastasectomy was treated with platinum derivatives, based on the results of NGS testing. Personalized treatment has led to a rapid response and stabilization of the disease. Maintenance therapy with PARP inhibitors will follow in the future.

Effect of target therapy with BRAF and MEK inhibitors on the immune system in metastatic melanoma

Linda Řandová, Ondřej Kodet

Onkologie. 2023:17(2):108-112 | DOI: 10.36290/xon.2023.022  

Target therapy with BRAF and MEK inhibitors is one of the main pillars of treating patients with BRAF-mutated melanoma. Despite a good therapeutic response, this treatment is burdened by early development resistance. A particular possibility to overcome this resistance is the combination of target therapy and immunotherapy. BRAF-mutated melanomas themselves have immunosuppressive properties that stimulate the tumour microenvironment. Target therapy with BRAF and MEK inhibitors significantly affects the immune tumour microenvironment, which could support the use of combination therapy with checkpoint inhibitors. However, these findings have not...

Breast reconstruction and radiotherapy

Igor Sirák, Aleš Fibír, Igor Slaninka, Adam Paulík, Iveta Kolářová, Petr Motyčka, Jakub Grepl, Petr Paluska, Milan Vošmik

Onkologie. 2023:17(2):113-118 | DOI: 10.36290/xon.2023.023  

Breast-conserving surgical treatment combined with perioperative systemic therapy and postoperative radiotherapy is the standard treatment for early-stage breast carcinoma. Mastectomy continues to be performed in patients in whom breast-conserving surgery cannot be recommended for therapeutic or cosmetic reasons. They often have locally or regionally advanced disease in which mastectomy is virtually always followed by adjuvant radiotherapy. Breast reconstruction following mastectomy is increasingly encountered, and this trend will continue to grow in the future. With advances in medicine, there has been progress in both the surgical procedures used...

Types and characteristics of renal lesions - diagnosis, treatment and prognosis

Vít Paldus, Vladimír Šámal, Marie Pechová, Igor Richter

Onkologie. 2023:17(2):119-122 | DOI: 10.36290/xon.2023.024  

Characteristics of renal lesions may predict further development of the disease, its prognosis and thus becomes part of the decision-making process, as to which treatment strategy to choose, right from the beginning. Unfortunately, a simple TMN classification of the disease stage may not always be sufficient. Some of the centrally localized renal cell carcinomas (RCC) may be re-evaluated from the primary stage cT1 to the final pathological stage pT3a. Cystic renal lesions represent another specific group in the evaluation of RCC. Their diagnostic work up and treatment strategy is guided by the Bosniak classification based on the CT. The clinical approach...

Long­‑term survival of a patient with disseminated adenocarcinoma of the ampulla of Vater: a complex therapeutic approach in metastases recurrence

Martin Gryc, Michal Eid

Onkologie. 2023:17(2):123-126 | DOI: 10.36290/xon.2023.025  

Adenocarcinoma of the ampulla of Vater is a rare but aggressive disease with a poor prognosis. While radical surgical resection is the standard treatment of choice, recurrence and metastatic dissemination remain common clinical challenges. Furthermore, there is no clear guideline consensus regarding adjuvant treatment. Precise histopathological characterization is paramount in terms of disease prognosis. We report a case of a patient who underwent a multimodal treatment for recurrent lung metastasis with a good clinical outcome.

Hidradenocarcinoma arising in the axilla - a report of a rare case

Vladimír Bartoš, Zuzana Murárová

Onkologie. 2023:17(2):127-130 | DOI: 10.36290/xon.2023.026  

Introduction: Hidradenocarcinoma is a rare malignant adnexal tumor which arises from the intradermal ducts of sweat glands. It often clinically mimics a benign (non-neoplastic) skin disease, which contributes to delayed diagnosis. Case report: A 51-year old man had noticed an "inflamed lump" in his right armpit for the last year. The lesion clinically appeared as a suppurative hidradenitis. After its surgical incision, it was seen a progression of cutaneous tumorous resistance at a given location. The mass was completely excised. Histopathology revealed a solid high-grade carcinoma with a histomorphology and immunophenotype favoring the diagnosis of...