Novinky v onkogynekologii

doc. MUDr. Igor Sirák, Ph.D.

Onkologie. 2024:18(1):3  

Surgical treatment of malignant neoplasms cervix

Ivan Práznovec, Munachiso Ndukwe, Petr Halada, Dominik Karásek, Denisa Pohanková, Jiří Špaček

Onkologie. 2024:18(1):7-9 | DOI: 10.36290/xon.2024.001  

Surgical treatment of cervical cancer has undergone many changes over the last decades. Through simple operations and subsequent surgical radicality to the gradual transformation to personalized medicine. In this article, we try to retrospectively evaluate the development of surgical treatment of malignant neoplasms of the cervix from the beginnings of surgery to the present.

Surgical management of ovarian cancer

Munachiso Ndukwe, Ivan Práznovec, Martin Štěpán, Klára Kolářová, Denisa Pohanková, Jiří Špaček

Onkologie. 2024:18(1):10-12 | DOI: 10.36290/xon.2024.002  

Ovarian cancer is a heterogeneous group of diseases with an overall poor prognosis, whose treatment is necessary to manage well keeping in mind the quality of life and overall survival of the patient. Preoperative diagnosis and treatment in a multidisciplinary setting play an important role in setting the optimal treatment strategy. Surgical treatment in the early stages of ovarian cancer has a curative and staging purpose while in advanced stages it has primarily a goal of optimal resection of macroscopic tumors. Surgical treatment of ovarian cancer should be performed by experienced gynecological oncologists in centers with expertise. The discussion...

Non-surgical treatment of cervical cancer

Igor Sirák, Denisa Pohanková, Miroslav Hodek, Munachiso Ndukwe, Ivan Práznovec

Onkologie. 2024:18(1):13-17 | DOI: 10.36290/xon.2024.003  

Cervical cancer remains a significant social and medical problem in the Czech Republic despite a decrease in incidence and effective prevention measures. Every year, over 700 cases of malignant cervix disease are diagnosed in the country, and about 300 patients die from the disease. However, interdisciplinary cooperation, the expertise of individual healthcare professionals (such as doctors, nurses, medical physicists, and assistants), modern equipment, and the availability of innovative drugs have contributed to an improving prognosis for patients. This review article highlights the current procedures and recommendations for non-surgical treatment...

News in the systemic treatment of endometrial cancer

Denisa Pohanková, Veronika Novotná, Munachiso Ndukwe

Onkologie. 2024:18(1):18-21 | DOI: 10.36290/xon.2024.004  

Endometrial tumours (EC) are a disease with an increasing incidence. Currently they are the sixth most common cancer in women worldwide. EC include several histological subtypes with different prognoses. Currently, the molecular classification of the tumour is gaining importance, which can significantly influence the planned treatment procedure and leads to the possibility of using precisely targeted individualized treatment for each patient.

Treatment of metastatic endometrial carcinoma

Veronika Novotná, Denisa Pohanková

Onkologie. 2024:18(1):22-24 | DOI: 10.36290/xon.2024.005  

Malignant tumors of the uterine body are the most common gynecological malignancy in developed countries. In advanced stages, approximately 10-15 % of patients are dia­gnosed. The treatment of metastatic endometrial carcinoma has advanced in recent years, thanks in part to the diverse molecular profile of the disease. In addition to surgical and radiotherapeutic approaches, not only cytotoxic chemotherapy but also immunotherapy, hormonal therapy, and targeted treatment are available. This article provides an overview of the currently used treatments for this condition in the Czech Republic.

Systemic treatment of ovarian cancer

Mária Hanišová, Munachiso Ndukwe

Onkologie. 2024:18(1):25-31 | DOI: 10.36290/xon.2024.006  

The most common subtype of ovarian cancer is high grade epithelial serous carcinoma. For several decades, the standard of care has been optimal cytoreductive surgery in combination with platinum-based chemotherapy. Due to the fact that roughly 70% of patients relapse in the first 3 years after induction chemotherapy, strategies are being sought to extend the time until further progression of the disease. Maintenance therapy with targeted drugs (PARP inhibitors and antiangiogenesis inhibitors) is an effective option that makes it possible to extend the time until the disease progresses, it also improves the overall survival and helps to delay the toxicity...

HER-2 low breast cancer

Adam Paulík

Onkologie. 2024:18(1):32-38 | DOI: 10.36290/xon.2024.007  

HER-2 low breast cancer is newly established term of completely heterogeneous subgroup of breast cancer sharing one common phenotype which is low to moderate expression of HER-2 protein and not meeting criteria for HER-2 positivity. The specific attribute of this subgroup is high responsiveness to antibody-drug conjugates (ADC´s) that can cause bystander killing effect (ADC´s of the 3^rd generation - especially T-DXd) in comparison to older ADC´s lacking this disposition (T-DM1) and to monoclonal antibodies (trastuzumab, pertuzumab, margetuximab) with almost zero efficacy due to the absence of oncogenic HER-2 signalling in HER-2 low tumours....

Changes in approach to locoregional treatment of early breast cancer

Iveta Kolářová, Jaroslav Vaňásek, Igor Sirák, Kateřina Horáčková, Denisa Pohanková

Onkologie. 2024:18(1):39-42 | DOI: 10.36290/xon.2024.008  

Choosing the optimal therapeutic strategy in patients with breast cancer is a challen­ging task. The disease comprises a number of subtypes having distinct biological charac­teristics and variable prognosis, and can occur in elderly women in whom standard therapeutic approaches may result in significant deterioration in their quali­ty of life with no survival benefit. Numerous studies have shown various options for reducing the burden of surgery and radiotherapy not only for the group of patients at early stages of breast cancer. De-escalation of radiotherapy involves omitting radiation in selected patients, shortening the duration of treatment by...

Surgical treatment of endometrial cancer

Dominik Karásek, Munachiso Ndukwe, Ivan Práznovec, Jiří Špaček, Denisa Pohanková, Igor Sirák

Onkologie. 2024:18(1):43-47 | DOI: 10.36290/xon.2024.009  

Endometrial cancer is the most common gynecological malignancy in resource-abundant countries. Prevalence grows with age and it is more frequent among obese women. It tends to have relatively low mortality, because of its early presentation and diagnosis in early stages of disease, when it is confined to the uterus. In the last decade, we can observe a decline in the open abdominal surgical approach and a rise and dominance of minimally invasive approaches to surgical staging, those combined with lymph nodes evaluation provide an alternative to previous surgical management with no compromise to the onco-gynecological outcomes. Recently, a new surgical...

Cholangiocellular carcinoma - treatment options

Marián Liberko, Renata Soumarová

Onkologie. 2024:18(1):48-52 | DOI: 10.36290/xon.2024.010  

Cholangiocellular carcinoma represents major medical issue owing to its high mortality rate, despite not being frequent malignancy. Patients diagnosed at early stages are treated with postoperative treatment after surgery with the aim to decrease rate of locoregionanal or distant relapse. Nevertheless, majority of patients are diagnosed in locoregionaly advanced and/or metastatic stage. These patients are treated with systemic treatment. After years of stagnation there is proven survival benefit with the use of immunotherapy. Moreover, due to our better understanding of molecular biology of disease, we are able to better tailor treatment based on presence...

Definitive proton chemoradiotherapy in cervical esophageal tumors - a preliminary analysis results

Pavel Vítek, Jiří Kubeš, Kateřina Jiránková, Vladimír Vondráček

Onkologie. 2024:18(1):53-58 | DOI: 10.36290/xon.2024.011  

Cancer of cervical esophagus belongs to rare diseases. Its standard treatment includes definitive chemoradiotherapy without subsequent surgery. There are several controversies concerning chemoradiotherapy, the most substantial of them being uncertain effective dose and uncertain benefit of dose escalation. The doses exceeding 60 Gy in 30 fractions are frequently administered. A benefit of proton radiotherapy (PRT) is predicted by favorable dose distribution. The results of PRT administered in PTC Prague have been assessed in 29 patients who have been irradiated up to 70 Gy (equivalent) in 35 fractions using pencil beam scanning technique with concomitant...

Dostarlimab in the 1^st line treatment of metastatic and recurrent endometrial cancer

Igor Sirák

Onkologie. 2024:18(1):59-62 | DOI: 10.36290/xon.2024.012  

Metastatic endometrial cancer still represents a major medical and social problem, and patients and their doctors have so far faced a very unfavorable prognosis of the disease and little chance of inducing long-term remission. For many decades, palliative treatment was based mainly on chemotherapy or hormone therapy, and research into targeted therapy or modern cytostatic therapy did not yield satisfactory results. Thanks to better molecular-genetic knowledge, we can better categorize endometrial tumors and better predict the treatment response to chemotherapy and especially to the increasingly rapidly developing immunotherapy targeting the PD-1 receptor...

Androgen deprivation therapy and antagonist relugolix in practice

Samuel Vokurka

Onkologie. 2024:18(1):63-67 | DOI: 10.36290/xon.2024.013  

Androgen deprivation therapy with gonadoliberin analogues are an essential element of treatment in indicated cases of prostate cancer. Agonists are more often used, but in the beginning, antiandrogen therapy is necessary to suppress the flare phenomenon, and the decrease in testosterone levels is later. The antagonists have a rapid onset of testosterone level decrease, there appears to be a reduced risk of cardiovascular complications, and p.o. relugolix is not burdened with pain and reactions at the site of s.c. injection like is in degarelix. Attention should be paid to risky drug interactions.

Long-term good-quality survival in a young man with metastatic pancreatic cancer pretreated with gemcitabine + nab-paclitaxel regimen achieved with nal-IRI + 5-FU/LV combination therapy

Petra Klimčíková

Onkologie. 2024:18(1):68-73 | DOI: 10.36290/xon.2024.014  

Pancreatic cancer is a disease with high mortality rates, often detected at late stage. Surgical resection is the only curative treatment, and the outcomes are improved by adjuvant chemotherapy. In patients with an advanced finding, the FOLFIRINOX regimen or the doublet gemcitabine + nab-paclitaxel are recommended in the first-line of palliative treatment; in the second-line, following the gemcitabine-based treatment, nal-IRI (pegylated liposomal irinotecan) + 5-fluorouracil (5-FU) + leucovorin (LV), or the regimen with 5-FU are recommended; and following the therapy with 5-FU, gemcitabine in monotherapy or in combination. New results presented at...

Clear cell atypical fibroxanthoma in a patient with multiple keratinocytic carcinomas of the skin

Vladimír Bartoš

Onkologie. 2024:18(1):74-77 | DOI: 10.36290/xon.2024.015  

Introduction: Atypical fibroxanthoma (AFX) is a rare mesenchymal skin tumor of unknown histogenesis and unclear biological behaviour. It is characterized by marked structural variability, which causes great diagnostic embarrassment during biopsy examination. Establishing a correct diagnosis can not be done without using a wide spectrum of immunohistochemical markers. Case report: A 79-year-old man with a history of multiple keratinocytic skin carcinomas noticed another lesion arising in the left cheek. It looked like basal cell carcinoma and was completely removed by surgical excision. The tumor consisted of a relatively circumscribed intradermal nodule...

Limberg flap reconstruction after basal cell carcinoma excision

Júlia Bartková, Dominika Miklišová, Miroslava Verbat, Ema Šutaková, Jana Bartošková, Iva Tresnerová, Břetislav Lipový

Onkologie. 2024:18(1):78-82 | DOI: 10.36290/xon.2024.016  

Basal cell carcinoma (BCC) is the most common skin tumor in fair-skinned people with a constantly increasing worldwide incidence. Patients with BCC represent a great burden on the health care system, because of their high incidence, which constantly increases the costs of the provided health care. It is therefore very important to work on the continuous improvement of preventive programs dedicated to the issue and solving the growing problem of skin cancer.