77 results on '"Zbigniew Kojs"'
Search Results
2. Metastatic and non-metastatic sentinel inguinofemoral lymph nodes in vulvar cancer show an increased lymphangiogenesis
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Magda Piechowicz, Marcin Mikos, Tomasz Banas, Krzysztof Okon, Milosz Pietrus, Marta Balajewicz-Nowak, Lukasz Szczudlik, Zbigniew Kojs, Aleksandra Czerw, Grzegorz Juszczyk, and Kazimierz Pityński
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anti-d2–40 antibody ,lymphatic vessel density ,immunohistochemistry ,sentinel lymph node ,vulvar cancer ,Agriculture ,Environmental sciences ,GE1-350 - Abstract
Introduction and objective Lymph node involvement is a strong predictor of disease recurrence and patient survival in vulvar cancer. The aim of the study was to evaluate the feasibility of sentinel lymph node (SLN) screening, the incidence of skip metastases, and lymph node lymphangiogenesis. Material and methods Fifty-five patients participated in this prospective, single centre study. A double SLN screening method was employed using radiocolloid (technetium-99 sulfur colloid) and 1.0% Isosulfan Blue. Immunohistochemistry, using a mouse monoclonal antibody against D2–40, was used to evaluate lymphatic vessel density (LVD). All calculations were performed using STATISTICA software v. 10 (StatSoft, USA, 2011); p < 0.05 was considered significant. Results Using both methods of SLN detection, 100% accuracy was achieved, and skip metastases were diagnosed in only one woman (1.82%). Peri-tumour median LVD was significantly increased compared with matched intra-tumour samples (p < 0.001), while median LVD was significantly lower in negative, compared with positive SLN, regardless of whether matched non-SLN were negative (p < 0.001) or positive (p = 0.005). Metastatic SLN exhibited significantly higher median LVD compared with matched negative non-SLN (p = 0.015), while no significant difference in median LVD was detected between positive SLN and matched positive non-SLN. However, negative SLN had a significantly higher median LVD compared with matched negative non-SLN (p = 0.012). Conclusions SLN detection is a safe and feasible procedure in vulvar cancer. In patients without nodular involvement, SLN, compared with non-SLN, exhibited significantly higher median LVD, which may be an indication of its preparation to host metastases, and thus requires further investigation. more...
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- 2020
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3. Cobas 4800 HPV detection in cervical samples of Polish women
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Beata Smolarz, Dariusz Samulak, Krzysztof Szyłło, Marianna Makowska, Hanna Romanowicz, Zbigniew Kojs, and Magdalena M. Michalska
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hpv ,cervical cancer ,genotyping ,Medicine - Published
- 2019
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4. Selected features of breast and peritoneal cancers diagnosed in BRCA1 carriers after risk-reducing salpingo-oophorectomy
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Janusz Menkiszak, Anita Chudecka-Głaz, Aneta Cymbaluk-Płoska, Aleksander Celewicz, Zbigniew Kojs, Mariusz Szajda, Maria Świniarska, Ryszard Bedner, Anna Jurczak, Marta Celewicz, Monika Cieszyńska, Jan Lubiński, and Jacek Gronwald more...
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BRCA1 mutation ,Cancer ,Prophylactic surgery ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 ,Genetics ,QH426-470 - Abstract
Abstract Background Since more than two decades Risk-reducing salpingo-oophorectomy (RRSO) is recommended and widely accepted by BRCA1/2 carriers as a method reducing ovarian cancer risk and improving survival rate. After RRSO, there remains a risk of breast cancer and peritoneal cancer. The characteristics of these neoplasms are not well known. In this study, we determined the selected parameters such as age at cancer diagnosis, time from RRSO to the diagnosis of cancer, and significance of BRCA1 mutation type in patients diagnosed with breast or peritoneal cancer during postoperative follow-up. Methods The material comprised of 195 BRCA1 carriers who performed RRSO between years 1999–2012. In this period, 16 patients developed cancer (6-primary breast cancer, 3-contralateral breast cancer, 5-relapse of breast cancer, 2-peritoneal cancer). They were subject of the further analysis. Results During the follow-up period mean age of patients after RRSO at the time of cancer diagnosis was 53.19. The mean age of patients diagnosed with primary breast cancer was 50, contralateral breast cancer – 58.67, recurrence of breast cancer - 51 and peritoneal cancer 60. The mean time periods from RRSO to the diagnosis of primary, contralateral, recurrence breast cancer were 53, 58.67 and 25,4 months respectively and of peritoneal cancer 46 months. BRCA1 c.5266dupC mutation carriers demonstrated significantly shorter time of cancer development compared to patients carrying c.181T > G and c.4035delA mutations. Peritoneal cancer was only observed in two c.181T > G BRCA1 mutation carriers. Conclusions The mean age of cancer diagnosis and the mean time periods from RRSO to the diagnosis of cancer are similar to those observed by other researchers. The carriers of c.181T > G and c.5266dupC BRCA1 mutation should be the subject further studies in context of breast and peritoneal cancer risk or time of cancer development after RRSO, respectively. more...
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- 2019
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5. Quantitative Assessment of Contrast Enhancement on Contrast Enhancement Spectral Mammography (CESM) and Comparison With Qualitative Assessment
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Tadeusz Popiela, Sylwia Heinze, Zbigniew Kojs, Wojciech Rudnicki, and Elzbieta Luczynska
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Cancer Research ,Contrast enhancement ,medicine.diagnostic_test ,business.industry ,Contrast Media ,General Medicine ,medicine.disease ,Lesion ,Breast cancer ,Oncology ,Biopsy ,Enhancing Lesion ,Quantitative assessment ,Humans ,Medicine ,Breast MRI ,Mammography ,Female ,medicine.symptom ,business ,Nuclear medicine - Abstract
Background/aim Contrast enhanced spectral mammography (CESM) is a novel method of breast cancer diagnosis. Benign lesions are enhanced after contrast injection on both CESM and breast magnetic resonance imaging (MRI). Kinetic curves on breast MRI facilitate differentiation between benign and malignant lesions, while on CESM there is no such possibility and we need to asses lesions based only on their level of enhancement and its patterns. The aim of this study was to compare two subjective assessments of enhancement level on CESM with numerical values measured using the region of interests (ROIs) and to categorize obtained enhancement level values. Patients and methods Patients with suspicious findings on previously performed examinations were qualified for CESM. The qualitative assessment was based on the subjective classification of visible contrast enhancement as weak, medium or strong. The quantitative assessment was obtained by measurements of an average enhancement value and sigma value within the ellipsoidal shape ROI, inserted into the evaluated contrast enhancing lesion. Results The study group included 151 patients with total of 195 lesions diagnosed. It was verified how the classification based on the threshold values of %RS (percentage signal difference between enhancing lesion and background) and SDNR (signal-difference-to-noise Ratio) corresponds to a subjective assessment. Conclusion Quantitative assessment of contrast enhancement on CESM is helpful in making decisions whether a lesion requires a biopsy. This can reduce the number of unnecessary biopsy procedures and reduce the cost of diagnostics. more...
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- 2020
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6. The Impact of Surgical Treatment with Adjuvant Chemotherapy for Ovarian Cancer on Disorders in the Urinary System and Quality of Life in Women
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Marcin Opławski, Beniamin Oskar Grabarek, Agata Średnicka, Justyna Czarniecka, Agata Panfil, Zbigniew Kojs, and Dariusz Boroń
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ovarian cancer ,chemotherapy ,surgical treatment ,urogynecology examination ,quality of life ,sexuality ,General Medicine - Abstract
Ovarian cancer is the fourth-most-common cause of death among all malignant cancers in women in Poland. This study aimed to compare the functioning of the urinary system and quality of life in women in the 12-month period following the completion of surgery or adjuvant treatment for ovarian cancer, with patients who underwent a hysterectomy for non-oncological reasons (control group). The study group consisted of 50 patients diagnosed with stage I–III ovarian cancer. Among 38 patients with type II ovarian cancer (group A), surgery followed by first-line chemotherapy was performed. Within this group of patients, 20 had stage I ovarian cancer, while 18 had stage II ovarian cancer. The study was performed at least 6 months after the final chemotherapy cycle, with no clinical, marker or radiological recurrence determined. On the other hand, in 12 patients with stage I type I ovarian cancer, oncological treatment consisted of only surgery, without the need for adjuvant chemotherapy, due to the low stage of the lesions (group B). In turn, the control group consisted of 50 women who underwent uterine removal for non-oncological reasons (group C). The assessment of quality of life was conducted using the questionnaires: Satisfaction with Life Scale (SWLS); Incontinence Impact Questionnaire, short form (IIQ-7); Urogenital Distress Inventory (UDI-6); and the Sexual Satisfaction Scale for 3, 6, 9, and 12 months after the conclusion of oncological treatment. During the follow-up, a significant reduction in the quality of everyday life and sexual life was noted among patients with ovarian cancer, more pronounced in group B, compared to the control group (p < 0.05). The risk of urinary incontinence is independent of the treatment regimen chosen for ovarian cancer. It is necessary to consider comprehensive psychological care and sexual therapy in patients with ovarian cancer and their families. more...
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- 2022
7. Diagnostic imaging in gynecology
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Luczynska, Elzbieta, primary and Zbigniew, Kojs, additional
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- 2022
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8. The association between lymph node metastases and long-term survival in patients with epithelial ovarian cancer
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Wojciech Rokita, Lukasz Wicherek, Grzegorz Panek, Katarzyna Lepinay, Zbigniew Kojs, Agnieszka Lewandowska, Sebastian Szubert, Tomasz Rajs, Krzysztof Koper, and Agnieszka Koper
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Oncology ,medicine.medical_specialty ,medicine.medical_treatment ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,Epithelial ovarian cancer ,In patient ,Lymph node ,positive lymph nodes ,Survival analysis ,Original Paper ,030219 obstetrics & reproductive medicine ,extracapsular involvement ,business.industry ,medicine.disease ,ovarian cancer ,Lymphatic system ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,lymphadenectomy ,Medicine ,Lymphadenectomy ,Lymph ,business ,Ovarian cancer - Abstract
Introduction A key survival prognosis factor for patients treated for ovarian cancer is complete cytoreductive surgery where all macroscopic neoplastic implants, including enlarged metastatic lymph nodes, are removed. We presume that investigating the involvement of the lymphatic system can result in a more individualized approach to the treatment of ovarian cancer patients. The main aim of our study was to analyze the relationship between the presence, number and types of lymph node metastases and ovarian cancer patient prognosis. Material and methods We carried out a retrospective analysis of patients who underwent cytoreduction due to primary ovarian cancer, between 2010 and 2015. We analyzed the number of metastatic lymph nodes, the lymph node ratio defined as the ratio of the number of metastatic lymph nodes to the total number of lymph nodes removed, extracapsular involvement, and the histopathological pattern of metastases. Results The study group included 651 patients. Of these, 377 had lymphadenectomy, 144 presented with lymph node metastases, and 233 had no lymph node metastases. We also included a group of 274 patients who did not have lymphadenectomy. Patients with more than 4 metastatic lymph nodes and a lymph node ratio of ≥ 0.1 had significantly poorer overall survival. Extracapsular involvement had no relation to patient overall survival. Multivariant survival analysis indicated that a lymph node ratio of ≥ 0.1 was an independent predictor of poor survival. Conclusions The analysis of lymph node metastases in ovarian cancer patients can have predictive value for patient overall survival. more...
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- 2020
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9. Vaginal intraepithelial neoplasia – a difficult diagnostic and therapeutic problem
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Radosław Skibko, Anita Chudecka-Głaz, Sebastian Kwiatkowski, Zbigniew Kojs, Hanna Wiśniewska, Aneta Cymbaluk-Płoska, and Paula Gargulińska
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medicine.medical_specialty ,Vaginal intraepithelial neoplasia ,Oncology ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine ,Obstetrics and Gynecology ,medicine.disease ,business ,Dermatology - Published
- 2019
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10. Correlation between quantitative assessment of contrast enhancement in contrast-enhanced spectral mammography (CESM) and histopathology—preliminary results
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Sylwia Heinze, Ed Hendrick, Beata Sas-Korczyńska, Zbigniew Kojs, Wojciech Rudnicki, Joanna Niemiec, and Elzbieta Luczynska
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Adult ,medicine.medical_specialty ,Digital mammography ,Breast Neoplasms ,Malignancy ,Sensitivity and Specificity ,030218 nuclear medicine & medical imaging ,Lesion ,03 medical and health sciences ,Breast cancer ,0302 clinical medicine ,Enhancing Lesion ,Humans ,Medicine ,Mammography ,Radiology, Nuclear Medicine and imaging ,Breast ,Breast ultrasound ,Aged ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Contrast media ,General Medicine ,Middle Aged ,medicine.disease ,030220 oncology & carcinogenesis ,Female ,Histopathology ,Ultrasonography, Mammary ,Radiology ,medicine.symptom ,business - Abstract
Contrast-enhanced spectral mammography (CESM) is a novel method for breast cancer detection. The aim of this study is to check if there is a possibility of quantitative assessment of contrast enhancement in CESM and if there is any correlation between quantitative assessment of contrast enhancement in CESM and histopathology. A total of 167 female patients underwent CESM. All subjects previously had suspicious lesions found on mammography, breast ultrasound, or both. After imaging, the following parameters were evaluated: number of enhancing lesions in each breast and size and degree of enhancement of each lesion. Based on the collected data, the percentage signal difference between enhancing lesion and background (%RS) and signal-difference-to-noise ratio (SDNR) were measured for each lesion. The number of lesions detected in the study population was 195. Among all diagnosed lesions, 120 (62%) were assessed to be infiltrating cancers, 16 (8%) non-infiltrating cancers, and 59 (30%) were benign. Thirteen (7%) lesions did not enhance in CESM; all non-enhancing lesions were confirmed to be benign under histopathological examination. Analysis of enhancement indices showed that signal values within lesions and signal values within background ROIs (regions of interest) were similar in CC (craniocaudal) and MLO (mediolateral) projections. Mean %RS values were correlated with the type of enhancing lesion, infiltrating cancers having the highest values, benign lesions the lowest. This work has demonstrated a significant correlation between the degree of lesion enhancement in CESM and malignancy. Quantitative analysis of enhancement levels in CESM can distinguish between invasive cancers and benign or in situ lesions. • There is a possibility of quantitative assessment of contrast enhancement in CESM. • Correlation between quantitative assessment of contrast enhancement in CESM and histopathology was observed. more...
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- 2019
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11. Role of vitamin D
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Anna, Markowska, Michał, Antoszczak, Zbigniew, Kojs, Wiesława, Bednarek, Janina, Markowska, and Adam, Huczyński
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Male ,Skin Neoplasms ,Calcitriol ,Humans ,Receptors, Calcitriol ,Breast Neoplasms ,Vitamin D ,Melanoma ,Cholecalciferol - Abstract
Vitamin D
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- 2020
12. Cobas 4800 HPV detection in cervical samples of Polish women
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Dariusz Samulak, Hanna Romanowicz, Krzysztof Szyłło, Beata Smolarz, Zbigniew Kojs, Magdalena M. Michalska, and Marianna Makowska
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Oncology ,HPV ,medicine.medical_specialty ,cervical cancer ,lcsh:Medicine ,Hpv detection ,Cervical intraepithelial neoplasia ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Screening programs ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Hpv test ,Genotyping ,Cervical cancer ,Original Paper ,business.industry ,lcsh:R ,HPV infection ,virus diseases ,Cancer ,medicine.disease ,female genital diseases and pregnancy complications ,genotyping ,030220 oncology & carcinogenesis ,business - Abstract
Introduction Long-term infection with human papillomavirus (HPV) is the cause of cervical cancer and its precursor - cervical intraepithelial neoplasia (CIN). The presence of HPV infection can be presumed in more than 99% of cases of cervical cancer worldwide. The introduction of DNA testing for the presence of HPV has increased the effectiveness of screening programs for the detection of this cancer. This study aimed to analyze the prevalence of high risk HPV DNA (HR HPV) in females from Poland. Material and methods The study was performed on 280 cervical smear samples. In this work we used the Roche Cobas 4800 HPV test to detect the HR HPV in cervical smear samples. Results 56 patients (20%) proved to be positive regarding HPV-16 DNA and 40 patients (14.28%) regarding HPV-18 DNA. In overall assessment, in 94 patients (33.57%) we detected oncogenic HPV subtypes, other than the two mentioned above. In 90 patients (32.14%) no high risk HPV was detected. Conclusions The Roche Cobas 4800 HPV test is a viable, effective, easy and quick tool in detecting high risk HPV DNA. more...
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- 2019
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13. Correlation Between Enhancement Intensity in Contrast Enhancement Spectral Mammography and Types of Kinetic Curves in Magnetic Resonance Imaging
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Tomasz Piegza, Wojciech Rudnicki, Elżbieta Łuczyńska, Zbigniew Kojs, Marta Pawlak, and Sylwia Heinze
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Contrast enhancement ,medicine.diagnostic_test ,business.industry ,Contrast Media ,Magnetic resonance imaging ,Breast Neoplasms ,General Medicine ,Image Enhancement ,Magnetic Resonance Imaging ,Intensity (physics) ,Diagnostic modalities ,Correlation ,ROC Curve ,Clinical Research ,Decreased Sensitivity ,Biopsy ,medicine ,Mammography ,Humans ,Female ,Biopsy, Large-Core Needle ,Breast ,business ,Nuclear medicine - Abstract
strongBACKGROUND/strongDue to the decreased sensitivity of mammography in glandular breasts, new diagnostic modalities, like contrast-enhanced spectral mammography (CESM) and digital breast tomosynthesis (DBT) have been developed. The aim of this study was to compare qualitative enhancement levels on CESM with type of kinetic enhancement curves on MRI examination.strongMATERIAL AND METHODS/strongPatients qualified for the CESM examination presented some diagnostic doubts - suspected multifocality, multicentricity, or having dense glandular breast tissue. The enhancement level on CESM was described as weak, medium, or strong. Enhancement on achieved MR images was assessed on the basis of enhancement kinetic curves. The level of enhancement on CESM was associated with enhancement curves type on MRI. All lesions detected on CESM and MRI were histopathologically verified.strongRESULTS/strongThe study involved 107 lesions diagnosed in 94 patients: 71 lesions (66%) appeared to be infiltrating on histopathological examination, 9 lesions (8%) were non-infiltrating cancers, and 27 lesions (25%) were benign. Data analysis revealed that lesions with wash-out curve on MRI most often presented strong enhancement on CESM, while in lesions with progressive enhancement curve, strong enhancement on CESM was the rarest. The relationship between enhancement level on CESM and curve type on contrast-enhanced MRI depends on the nature of the lesion. The type of MRI curve was found to be associated with enhancement level on CESM.strongCONCLUSIONS/strongWe compared subjective assessments of contrast enhancement on CESM with enhancement kinetic curves on MRI. The results showed that the level of enhancement on CESM and type of kinetic curves on MRI depends on the lesion type. more...
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- 2020
14. Retroperitoneal soft tissue sarcomas
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Wojciech M. Wysocki, Zbigniew Kojs, Jerzy Mituś, Marcin Opławski, and Jakub Kenig
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Pathology ,medicine.medical_specialty ,Oncology ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine ,Obstetrics and Gynecology ,Soft tissue ,business - Published
- 2018
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15. Cancer stem cells in targeted therapy
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Swedish Orphan Biovitrum, Warsaw, Poland, Janina Markowska, Damian Twardawa, and Zbigniew Kojs
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Oncology ,Cancer stem cell ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Cancer research ,Obstetrics and Gynecology ,Medicine ,business ,Targeted therapy - Published
- 2018
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16. Is there aplace for radiotherapy in the treatment of ovarian cancer, e.g. in patients with local recurrence or lymph node disease?
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Małgorzata Klimek and Zbigniew Kojs
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Oncology ,medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Lymph node disease ,Obstetrics and Gynecology ,medicine.disease ,Radiation therapy ,Internal medicine ,Medicine ,In patient ,business ,Ovarian cancer - Published
- 2018
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17. Microbiological monitoring in patients with advanced ovarian cancer before and after cytoreductive surgery – a preliminary report
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Konrad Dziobek, Maria Szymankiewicz, Krzysztof Koper, Lukasz Wicherek, and Zbigniew Kojs
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0301 basic medicine ,medicine.medical_specialty ,microbiological monitoring ,030106 microbiology ,Pharmacology toxicology ,Pharmacy ,Biochemistry ,03 medical and health sciences ,0302 clinical medicine ,Preliminary report ,cytoreductive surgery ,Medicine ,In patient ,030212 general & internal medicine ,Molecular Biology ,multidrug-resistant organisms ,Pharmacology ,Advanced ovarian cancer ,advanced ovarian cancer ,business.industry ,General surgery ,General Medicine ,business ,Cytoreductive surgery - Abstract
Multidrug-resistant organisms (MDROs) are becoming an increasing problem in hospitals. It is believed that screening patients for the incidence of MDROs prior to hospital admission not only allows for the proper management of infection following medical procedures, but can also potentially reduce the transmission of these bacteria to other patients. The aim of this study was to assess the carriers of selected MDROs in the gastrointestinal tract among patients with advanced ovarian cancer admitted to the hospital for cytoreductive surgery and to estimate the possible relationship between rectal colonization with these organisms and nosocomial infections. From December 2013 to May 2014, we evaluated the colonization with VRE (vancomycin-resistant Enterococcus), E. coli KPC+ (class A carbapenemase producing Escherichia coli), E. coli MBL+ (class B carbapenemase, metallo-ß lactamase producing Escherichia coli), and E. coli ESBL+ (extended-spectrum ß-lactamase producing Escherichia coli) in 42 patients. The patients were divided into two subgroups corresponding to the extent of their surgery: the first subgroup consisted of patients with large bowel resection (n=18) and the second subgroup of patients without resection (n=24). A rectal swab was taken within 24 hours of admission. Perioperative infectious complications were analyzed for the first 90 days following surgery with regard to the type of infection and the occurrence of examined MDROs. In our study, 2.4 % of all patients (23.8/1,000 hospitalizations) were colonized with ESBL - producing Escherichia coli: 0.0 % in the first subgroup and 4.2% in the second subgroup, respectively. We did not identify any patients who were colonized with VRE, E. coli MBL+, or E. coli KPC+. Surgical site infections were seen in 8 (19.1%) out of 42 patients. We were, therefore, unable to confirm a relationship between MDROs colonizing the large bowel and the etiological agents of perioperative infections. However, despite the lack of identification of MDROs as etiological agents of postoperative infection, the risk of serious infectious complications, combined with the changing epidemiological situation, means that microbiological monitoring should be performed in patients with ovarian cancer before and after cytoreductive surgery. more...
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- 2017
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18. Trabectedin for the treatment of ovarian cancer
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Jan Kotarski, Zbigniew Kojs, Janina Markowska, and Mariusz Bidziński
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03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,Oncology ,business.industry ,030220 oncology & carcinogenesis ,Endocrinology, Diabetes and Metabolism ,Obstetrics and Gynecology ,Medicine ,030212 general & internal medicine ,business ,Dermatology - Published
- 2017
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19. Recommendations of the Polish Gynecological Oncology Society for the diagnosis andtreatment of endometrial cancer
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Jacek Jan Sznurkowski, Paweł Knapp, Lubomir Bodnar, Mariusz Bidziński, Robert Jach, Marcin Misiek, Andrzej Bieńkiewicz, Paweł Blecharz, Zbigniew Kojs, Jan Kotarski, Janina Markowska, Radosław Mądry, Włodzimierz Sawicki, Łukasz Wicherek, and Antoni Basta more...
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Oncology ,Endocrinology, Diabetes and Metabolism ,Obstetrics and Gynecology - Published
- 2017
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20. Recommendations of the Polish Gynecological Oncology Society for the diagnosis andtreatment of cervical cancer
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Robert Jach, Jacek Jan Sznurkowski, Mariusz Bidziński, Marcin Misiek, Paweł Knapp, Lubomir Bodnar, Andrzej Bieńkiewicz, Paweł Blecharz, Zbigniew Kojs, Jan Kotarski, Janina Markowska, Radosław Mądry, Włodzimierz Sawicki, Łukasz Wicherek, and Antoni Basta more...
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Oncology ,Endocrinology, Diabetes and Metabolism ,Obstetrics and Gynecology - Published
- 2017
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21. Recommendations of the Polish Gynecological Oncology Society for the diagnosis andtreatment of vulvar cancer
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Jacek Jan Sznurkowski, Lubomir Bodnar, Mariusz Bidziński, Andrzej Bieńkiewicz, Paweł Blecharz, Robert Jach, Paweł Knapp, Zbigniew Kojs, Jan Kotarski, Janina Markowska, Radosław Mądry, Marcin Misiek, Włodzimierz Sawicki, Łukasz Wicherek, and Antoni Basta more...
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Oncology ,Endocrinology, Diabetes and Metabolism ,Obstetrics and Gynecology - Published
- 2017
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22. Recommendations of the Polish Gynecological Oncology Society for the diagnosis and treatment of ovarian cancer
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Mariusz Bidziński, Paweł Blecharz, Antoni Basta, Łukasz Wicherek, Robert Jach, Marcin Misiek, Jacek J. Sznurkowski, Paweł Knapp, Włodzimierz Sawicki, Zbigniew Kojs, Andrzej Bieńkiewicz, Jan Bahyrycz, Lubomir Bodnar, Jan Kotarski, Agnieszka Timorek-Lemieszczuk, Janina Markowska, and Radosław Mądry more...
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Gynecology ,medicine.medical_specialty ,Gynecological oncology ,business.industry ,Endocrinology, Diabetes and Metabolism ,General surgery ,Endometrial cancer ,Obstetrics and Gynecology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,030220 oncology & carcinogenesis ,medicine ,030212 general & internal medicine ,business - Published
- 2017
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23. Metastatic and non-metastatic sentinel inguinofemoral lymph nodes in vulvar cancer show an increased lymphangiogenesis
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Marta Bałajewicz-Nowak, Marcin Mikos, Grzegorz Juszczyk, Milosz Pietrus, Lukasz Szczudlik, Krzysztof Okoń, Aleksandra Czerw, Zbigniew Kojs, Magda Piechowicz, Kazimierz Pityński, and Tomasz Banas
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medicine.medical_specialty ,Sentinel lymph node ,Urology ,Isosulfan Blue ,Groin ,lcsh:Agriculture ,Antibodies, Monoclonal, Murine-Derived ,Mice ,Rosaniline Dyes ,medicine ,Lymphatic vessel ,Animals ,Humans ,Prospective Studies ,Lymphangiogenesis ,Waste Management and Disposal ,Lymph node ,lcsh:Environmental sciences ,Ecology, Evolution, Behavior and Systematics ,Aged ,Neoplasm Staging ,lcsh:GE1-350 ,vulvar cancer ,Vulvar Neoplasms ,business.industry ,anti-d2–40 antibody ,Incidence (epidemiology) ,lymphatic vessel density ,lcsh:S ,Public Health, Environmental and Occupational Health ,Vulvar cancer ,medicine.disease ,Immunohistochemistry ,medicine.anatomical_structure ,Lymphatic Metastasis ,Technetium Tc 99m Sulfur Colloid ,Carcinoma, Squamous Cell ,Female ,Sentinel Lymph Node ,business - Abstract
Introduction and objective Lymph node involvement is a strong predictor of disease recurrence and patient survival in vulvar cancer. The aim of the study was to evaluate the feasibility of sentinel lymph node (SLN) screening, the incidence of skip metastases, and lymph node lymphangiogenesis. Material and methods Fifty-five patients participated in this prospective, single centre study. A double SLN screening method was employed using radiocolloid (technetium-99 sulfur colloid) and 1.0% Isosulfan Blue. Immunohistochemistry, using a mouse monoclonal antibody against D2–40, was used to evaluate lymphatic vessel density (LVD). All calculations were performed using STATISTICA software v. 10 (StatSoft, USA, 2011); p < 0.05 was considered significant. Results Using both methods of SLN detection, 100% accuracy was achieved, and skip metastases were diagnosed in only one woman (1.82%). Peri-tumour median LVD was significantly increased compared with matched intra-tumour samples (p < 0.001), while median LVD was significantly lower in negative, compared with positive SLN, regardless of whether matched non-SLN were negative (p < 0.001) or positive (p = 0.005). Metastatic SLN exhibited significantly higher median LVD compared with matched negative non-SLN (p = 0.015), while no significant difference in median LVD was detected between positive SLN and matched positive non-SLN. However, negative SLN had a significantly higher median LVD compared with matched negative non-SLN (p = 0.012). Conclusions SLN detection is a safe and feasible procedure in vulvar cancer. In patients without nodular involvement, SLN, compared with non-SLN, exhibited significantly higher median LVD, which may be an indication of its preparation to host metastases, and thus requires further investigation. more...
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- 2020
24. Therapeutic options in radiation-induced rectovaginal fi stula
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Marcin Opławski, Tomasz Cegielny, Roman M. Herman, Zbigniew Kojs, and Patrycja Wreczycka-Cegielny
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medicine.medical_specialty ,urogenital system ,business.industry ,Endocrinology, Diabetes and Metabolism ,General surgery ,fungi ,food and beverages ,Obstetrics and Gynecology ,Rectum ,medicine.disease ,digestive system ,digestive system diseases ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Oncology ,Rectovaginal fistula ,030220 oncology & carcinogenesis ,medicine ,Vagina ,030211 gastroenterology & hepatology ,business - Abstract
A pathological communication between the rectum and the vagina, referred to as rectovaginal fistula, can develop as a result of...
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- 2016
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25. Role of vitamin D3 in selected malignant neoplasms
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Zbigniew Kojs, Anna Markowska, Adam Huczyński, Wiesława Bednarek, Janina Markowska, and Michał Antoszczak
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Vitamin ,Nutrition and Dietetics ,Calcitriol ,business.industry ,Endocrinology, Diabetes and Metabolism ,Melanoma ,medicine.disease ,Review article ,chemistry.chemical_compound ,medicine.anatomical_structure ,Vitamin D3 Receptor ,chemistry ,Cancer stem cell ,Prostate ,Cancer cell ,Cancer research ,Medicine ,business ,medicine.drug - Abstract
Vitamin D3 is a fat-soluble essential nutrient that affects multiple biologic functions in the organism through calcitriol and the vitamin D3 receptor. This review article focuses on the results of studies on the relationship between the level of vitamin D3 and cancer incidence or mortality, but also on the anticancer properties of vitamin D3 that support its significant role in the prevention, clinical course, and overall survival rates of selected cancers (colorectal, prostate, breast, ovarian, endometrial, bladder, and malignant melanoma). The mechanisms of vitamin D3 action involve, among others, polymorphism of vitamin D3 receptor, cell cycle, caspases, and cancer stem cells. The level of vitamin D3 has been also demonstrated to serve as a biomarker in some cancers, and high levels of vitamin D3 can be conducive to successful cancer therapy. more...
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- 2020
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26. The potential predictive value of serum srCaS1 levels for overall survival in endometrial cancer
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Sebastian Szubert, Krzysztof Koper, Zbigniew Kojs, and Magdalena Dutsch-Wicherek
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Oncology ,Adult ,medicine.medical_specialty ,Multivariate analysis ,medicine.medical_treatment ,Disease ,03 medical and health sciences ,0302 clinical medicine ,Antigens, Neoplasm ,Predictive Value of Tests ,Internal medicine ,medicine ,Overall survival ,Humans ,Stage (cooking) ,Cancer immunology ,Aged ,Aged, 80 and over ,Univariate analysis ,030219 obstetrics & reproductive medicine ,business.industry ,Endometrial cancer ,Obstetrics and Gynecology ,Middle Aged ,medicine.disease ,Survival Analysis ,Endometrial Neoplasms ,Radiation therapy ,Female ,business - Abstract
Objectives: The main aim of the study was to evaluate the impact of levels of serum soluble receptor-binding cancer antigen expressed on SiSo cells (sRCAS1) on the overall survival (OS) rates in patients with endometrial cancer. Furthermore, we analyzed sRCAS1 levels according to the clinicopathological characteristics of the disease. Material and methods: The study group comprised 43 patients who were being treated for endometrial cancer. We included 10 low-risk, 20 intermediate-risk and 13 high-risk endometrial cancers using the criteria of the European Society for Medical Oncology (ESMO), the European Society for Radiotherapy & Oncology (ESTRO) and the European Society of Gynaecological Oncology (ESGO). Serum sRCAS1 levels were obtained before and after surgery. Serum sRCAS1 levels were assessed using the ELISA method. Results: In our univariate analysis, both the pre- and post-surgery high sRCAS1 groups of patients with endometrial cancer indicated a shortened OS. However, in our multivariate analysis, when patients’ age and disease-related risk was taken into consideration, only the post-surgery sRCAS1 levels remained as independent prognostic factors of a poor OS. Pre-treatment serum sRCAS1 levels were statistically significantly higher than post-surgery sRCAS1 levels; however, the difference between pre- and post-surgery sRCAS1 levels did not influence the patients’ OS rate. Pre- and post-surgery sRCAS1 levels did not differ according to tumor grade, stage of the disease or the disease-related risk group. Conclusions: High post-surgery serum sRCAS1 levels seem to be an independent indicator of shortened overall survival in patients with endometrial cancer. more...
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- 2019
27. The Role of Human Papillomavirus in Cervical Cancer
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Beata, Smolarz, primary, Dariusz, Samulak, additional, Marianna, Makowska, additional, Hanna, Romanowicz, additional, Zbigniew, Kojs, additional, Luiza, Wójcik, additional, and Magdalena M, Michalska, additional more...
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- 2019
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28. The impact of combination therapy for ovarian carcinoma on the urinary tract
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Zbigniew Kojs, Magdalena Smoczyńska, Ewelina Kojs-Pasińska, Marcin Opławski, Michał Kwiatkowski, and Janusz Jaszczyński
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Oncology ,medicine.medical_specialty ,endocrine system diseases ,Combination therapy ,business.industry ,Endocrinology, Diabetes and Metabolism ,Urinary system ,Incidence (epidemiology) ,Obstetrics and Gynecology ,Cancer ,medicine.disease ,Ovarian carcinoma ,Internal medicine ,Genital tract ,otorhinolaryngologic diseases ,medicine ,Medicine ,business - Abstract
The incidence of ovarian carcinoma in Poland is 11.2/100,000. It is the second most common cancer of the genital tract....
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- 2015
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29. The extent of lymphadenectomy in endometrial cancer and its effect on blood loss and procedure duration
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Tomasz Bieda, Marcin Zarawski, Marcin Opławski, and Zbigniew Kojs
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medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Endometrial cancer ,General surgery ,medicine.medical_treatment ,Obstetrics and Gynecology ,medicine.disease ,Pelvic lymph nodes ,Dissection ,medicine.anatomical_structure ,Oncology ,Blood loss ,medicine ,Medicine ,Procedure Duration ,Lymphadenectomy ,Radiology ,business ,Surgical treatment ,Lymph node - Abstract
The clinical staging of endometrial cancer is performed based on surgical-pathological criteria. The extent of lymph node dissection represents a...
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- 2015
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30. Rhabdomyosarcoma alveolare in the urogenital region – a case report and literature review
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Janusz Jaszczyński, Zbigniew Kojs, Ewelina Kojs-Pasińska, and Michał Jankiewicz
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Pathology ,medicine.medical_specialty ,Adult patients ,business.industry ,Endocrinology, Diabetes and Metabolism ,Soft tissue sarcoma ,Obstetrics and Gynecology ,medicine.disease ,Oncology ,Urogenital region ,otorhinolaryngologic diseases ,medicine ,Alveolar rhabdomyosarcoma ,Medicine ,Rhabdomyosarcoma ,business - Abstract
Introduction: Soft tissue sarcoma accounts for 1% of malignant neoplasms detected in adult patients in Poland. Their primary localization in...
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- 2015
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31. The possible use of the blood serum concentration measurements of sHLA-G in women with endometrial and cervical cancers during radiotherapy as an indicator of the status of the tumour microenvironment
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Konrad Dziobek, Łukasz Wicherek, Magdalena Dutsch-Wicherek, Sebastian Szubert, Zbigniew Kojs, Maria Szymankiewicz, and Sławomir Wileński
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Cervical cancer ,medicine.medical_specialty ,Tumor microenvironment ,business.industry ,Endometrial cancer ,medicine.medical_treatment ,Cancer ,Malignancy ,medicine.disease ,Gastroenterology ,Radiation therapy ,Blood serum ,Immune system ,Internal medicine ,Medicine ,business - Abstract
Background: The selective suppression of cytotoxic immune cells constitutes a crucial event in the development of malignancy. This phenomenon increases in accordance with the growth of a tumor and is just one result of the increased expression in the cancer milieu of those proteins, such as human leukocyte antigen G (HLA-G) and its soluble form (sHLA-G). Given that radiotherapy may influence immune system activity, we aimed to measure (sHLA-G) serum levels both before and after the radiotherapy due to endometrial or cervical cancer. Methods: We assessed the sHLA-G blood serum concentration levels in a group of 43 patients (28 and 15 diagnosed with cervical cancer and endometrial cacer respectively), who received primary or adjuvant radiotherapy. We assessed the blood serum concentrations of the sHLA-G through a series of measurements taken before and four days after the latest radiation dosage using an ELISA kit. Results: Median serum sHLA-G levels significantly decreased after radiotherapy (5.63 U/ml; range 0.00 – 344.55; vs 5.57 U/ml; 0.00 –94.02; P = 0.045). The changes of sHLA-G levels didn’t influence patients’ survival. Pretreatment and post-treatment sHLA-G levels were negatively correlated with patients’ age (R Spearman = -0.45, P = 0.041; R Spearman = -0.46. P = 0.038). Conclusions: The detected levels of sHLA-G blood serum concentrations may supply clinically applicable information regarding the status of the tumor microenvironment — that is, the size and the degree of suppression of the tumor environment — where the tumor-immune cell interaction is realized. Finally, this information may also prove helpful in the treatment of cancer. more...
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- 2018
32. Current treatment options for advanced choriocarcinoma on the basis of own case and review of the literature
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Marcin Opławski, Patrycja Wreczycka-Cegielny, Tomasz Cegielny, Włodzimierz Sawicki, and Zbigniew Kojs
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Adult ,medicine.medical_specialty ,Disease ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Antineoplastic Combined Chemotherapy Protocols ,Epidemiology ,medicine ,Humans ,Choriocarcinoma ,Intensive care medicine ,Neoplasm Staging ,030219 obstetrics & reproductive medicine ,Medical treatment ,Gestational trophoblastic disease ,business.industry ,Obstetrics and Gynecology ,Treatment options ,medicine.disease ,Treatment Outcome ,030220 oncology & carcinogenesis ,Female ,business ,Pregnancy Complications, Neoplastic ,Rare disease - Abstract
Choriocarcinoma is one of rare neoplasms of female reproductive organs. In the last decade only a few cases of this disease have been registered in Poland. The paper presents the current principles of diagnosis and treatment options for this rare disease based on the authors' clinical experience (description of the case) and literature review. This paper provides basic information on epidemiology, FIGO classification, and also discusses the chemotherapy regimens used in the medical treatment of choriocarcinoma. Surgical options were also considered. A thematic review of the most important papers published in international journals in recent years has also been made. more...
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- 2018
33. Zasady stosowania dootrzewnowej chemioterapii w hipertermii (HIPEC) w leczeniu nowotworów złośliwych powierzchni otrzewnej w połączeniu z zabiegami cytoredukcyjnymi: zalecenia krajowe
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Beata Śpiewankiewicz, Piotr Rutkowski, Lucjan Wyrwicz, Wojciech Zegarski, Marcin Zdzienicki, Tomasz Jastrzębski, Zbigniew Kojs, Maciej Krzakowski, Wojciech Polkowski, Krzysztof Herman, Piotr J. Wysocki, and Józef Kładny more...
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Clinical Practice ,Peritoneal malignancy ,Cancer Research ,medicine.medical_specialty ,Oncology ,business.industry ,medicine ,Hyperthermic intraperitoneal chemotherapy ,business ,Surgery - Abstract
Leczenie nowotworow powierzchni otrzewnej stanowi istotny problem w onkologii. Wykazano, ze skojarzenie maksymalnej cytoredukcji chirurgicznej z dootrzewnową chemioterapią w hipertermii (HIPEC; hyperthermic intraoperative peritoneal chemotherapy ) moze prowadzic do dlugotrwalej kontroli choroby lub wydluzenia przezyc u odpowiednio wybranych chorych. Celem niniejszego opracowania są zalecenia dla optymalnego zakresu wskazan i sposobu prowadzenia HIPEC w Polsce. more...
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- 2015
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34. Surgical therapy and exenteration for advanced cervical cancer – literature review
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Zbigniew Kojs, Andrzej Stelmach, Łukasz Wicherek, Kinga Krokowska, Jerzy Siekiera, Krzysztof Koper, Beata Śpiewankiewicz, Maria Szymankiewicz, and Pawel Mach
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Cervical cancer ,Surgical therapy ,medicine.medical_specialty ,Oncology ,business.industry ,Endocrinology, Diabetes and Metabolism ,General surgery ,medicine ,Obstetrics and Gynecology ,medicine.disease ,business - Published
- 2014
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35. Polish clinical practice guideline on hyperthermic intraperitoneal chemotherapy (HIPEC) with cytoreductive surgery in peritoneal malignancy treatment
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Tomasz Jastrzębski, Maciej Krzakowski, Marcin Zdzienicki, Piotr Rutkowski, Beata Śpiewankiewicz, Piotr J. Wysocki, Zbigniew Kojs, Wojciech Polkowski, Krzysztof Herman, Lucjan Wyrwicz, Wojciech Zegarski, and Józef Kładny more...
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Oncology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Obstetrics and Gynecology ,Medicine ,business ,Nuclear medicine - Abstract
Leczenie nowotworow powierzchni otrzewnej stanowi istotny problem w onkologii. Wykazano, ze skojarzenie maksymalnej cytoredukcji chirurgicznej z dootrzewnową chemioterapią w hipertermii (HIPEC; hyperthermic intraoperative peritoneal chemotherapy) moze prowadzic do dlugotrwalej kontroli choroby lub wydluzenia przezyc u odpowiednio wybranych chorych. Celem niniejszego opracowania są zalecenia dla optymalnego zakresu wskazan i sposobu prowadzenia HIPEC w Polsce2. more...
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- 2014
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36. Limitations in the treatment of ovarian carcinoma
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Zbigniew Kojs, Krzysztof Koper, Tomasz Bieda, Michał Makarewicz, Andrzej Budzyński, Łukasz Wicherek, Beata Śpiewankiewicz, and Tomasz Rajs
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medicine.medical_specialty ,Oncology ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Ovarian carcinoma ,Splenectomy ,Urology ,medicine ,Obstetrics and Gynecology ,Para aortic lymphadenectomy ,business - Published
- 2014
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37. Primary diffuse large B-cell lymphoma of the uterine cervix – case report
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Ewelina Kojs-Pasińska, Włodzimierz Sawicki, Maciej Niemiec, Zbigniew Kojs, and Barbara Papuga-Fujak
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Oncology ,medicine.medical_specialty ,medicine.medical_treatment ,Uterine Cervical Neoplasms ,CHOP ,immune system diseases ,hemic and lymphatic diseases ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Stage (cooking) ,CD20 ,Chemotherapy ,biology ,business.industry ,Obstetrics and Gynecology ,Middle Aged ,medicine.disease ,Chemotherapy regimen ,Lymphoma ,Treatment Outcome ,biology.protein ,Female ,Rituximab ,Lymphoma, Large B-Cell, Diffuse ,Radiology ,business ,Diffuse large B-cell lymphoma ,medicine.drug - Abstract
We present a case of a 54-year-old woman treated for stage IIAE primary diffuse large B-cell lymphoma (DLBCL) of the uterine cervix. The CHOP chemotherapy regimen was started. After the diagnosis of lymphoma of DLBCL CD20+ type was confirmed, rituximab was added to the therapy. Within systemic therapy, the patient received two cycles of CHOP and six cycles of R-CHOP altogether. After treatment completion, total remission of the lesions was observed on computed tomography. Twenty-four months after therapy completion, the patient is disease-free with no signs of recurrence. more...
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- 2016
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38. Role of splenectomy in surgical treatment of ovarian cancer
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Zbigniew Kojs, Marcin Opławski, and Tomasz Bieda
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medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,General surgery ,medicine.medical_treatment ,Splenectomy ,Obstetrics and Gynecology ,medicine.disease ,Surgery ,Oncology ,Medicine ,business ,Surgical treatment ,Ovarian cancer - Published
- 2013
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39. Psychoneurocybernetic etiopathogenesis of cancers
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Beata Śpiewankiewicz, Wiesław Szymański, Zbigniew Kojs, Krzysztof Czajkowski, and Rudolf Klimek
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Oncology ,medicine.medical_specialty ,Pathology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Internal medicine ,medicine ,Cancer therapy ,Obstetrics and Gynecology ,Cancer ,business ,medicine.disease - Published
- 2013
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40. Pelvic and periaortic lymphadenectomy in the treatment of endometrial cancer
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Radosław Kosobucki, Marcin Opławski, Zbigniew Kojs, and Magdalena Smoczyńska
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Oncology ,medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Endometrial cancer ,Obstetrics and Gynecology ,medicine.disease ,Radiation therapy ,Internal medicine ,medicine ,Lymphadenectomy ,Radiology ,business - Published
- 2013
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41. Hormone replacement therapy in gynecologic oncology
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Zbigniew Kojs, Kamila Witczak, and Stefan Sajdak
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Oncology ,Cervical cancer ,medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Endometrial cancer ,Obstetrics and Gynecology ,Gynecologic oncology ,Vulvar cancer ,medicine.disease ,Breast cancer ,Internal medicine ,medicine ,Hormone replacement therapy ,Ovarian cancer ,business - Published
- 2013
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42. Inguinal lymphadenectomy in case of vulvar carcinoma – point of view of a surgeon and a pathologist
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Zbigniew Kojs, Joanna Wysocka, Wojciech M. Wysocki, Jakub Kenig, Odział Kliniczny Onkologii, Szpital Uniwersytecki w Krakowie, Kraków, Polska, Jerzy Mituś, Andrzej L. Komorowski, and Ewelina Kojs-Pasińska more...
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spływ chłonki ,medicine.medical_specialty ,inguinal lymphadenectomy ,Endocrinology, Diabetes and Metabolism ,limfadenektomia pachwinowa ,przerzuty ,pathologic examination ,Inguinal lymphadenectomy ,паховая лимфаденэктомия ,рак вульвы ,Lymph drainage ,Medicine ,badania patomorfologiczne ,lymph drainage ,metastases ,лимфоток ,патологическое исследование ,integumentary system ,urogenital system ,business.industry ,General surgery ,Obstetrics and Gynecology ,Cancer ,метастазирование ,medicine.disease ,vulvar carcinoma ,female genital diseases and pregnancy complications ,stomatognathic diseases ,Oncology ,rak sromu ,Vulvar Carcinoma ,business - Abstract
Rak sromu plasuje się na czwartym miejscu wśród najczęstszych nowotworów narządów płciowych u kobiet (stanowi około 5% zachorowań na nowotwory z tej grupy). Histologicznie wyróżnia się zmiany pochodzenia nabłonkowego - w 90% jest to rak płaskonabłonkowy rogowaciejący - i nienabłonkowego. Większość raków sromu występuje w wieku pomenopauzalnym i ma związek z przewlekłą infekcją bakteryjną bądź wirusową (wirus brodawczaka ludzkiego). Chłonka ze sromu drenowana jest do trzech grup węzłów chłonnych pachwinowych i do węzłów biodrowych. W zależności od lokalizacji zmiany nowotworowej rak sromu przerzutuje jednostronnie lub obustronnie. Podstawowymi metodami leczenia pozostają chirurgiczne wycięcie oraz limfadenektomia pachwinowa powierzchowna i głęboka. W artykule zaprezentowano szczegółową budowę anatomiczną układu chłonnego pachwinowo-biodrowego, a także najpowszechniej wykorzystywane techniki operacyjne i najczęstsze powikłania zabiegu. Kluczowa dla przedstawienia wartościowego raportu patomorfologicznego jest współpraca z klinicystą. W szpitalach dysponujących własnym zakładem patomorfologii chirurg powinien przesłać materiał nieutrwalony, optymalnie - w sposób jałowy. W szpitalach bez zakładu patomorfologii preparat należy utrwalić. Aby patomorfolog mógł dokonać wiarygodnej oceny cechy pN - zgodnie z klasyfikacją TNM z 2010 roku - preparat operacyjny obejmujący pachwinowy układ chłonny powinien zawierać co najmniej sześć węzłów chłonnych. Podstawowe znaczenie dla osiągnięcia dobrych wyników leczenia mają poznanie budowy anatomicznej tego regionu i technik operacyjnych oraz prawidłowe przygotowanie preparatu do badania patomorfologicznego. Vulvar carcinoma is the fourth most prevalent cancer of genitals in women (accounting for 5% of all neoplasms from this group). Histologically, we differentiate epithelial neoplasms - in 90% of cases we are dealing keratotic squamous cell carcinoma - and non-epithelial ones. The majority of vulvar carcinomas occur at a postmenopausal age and are related to chronic bacterial or viral infection (human papilloma virus). Lymph from the vulva is drained to three groups of inguinal lymph nodes and to iliac lymph nodes. Depending on the location of a neoplastic lesion, vulvar carcinoma metastasizes unilaterally or bilaterally. The basic methods of treatment are surgical removal or inguinal lymphadenectomy - both superficial and deep. This article presents a detailed anatomy of the inguinal-iliac lymphatic system as well as the most widely used surgical techniques and the most common postoperative complications. Cooperation with the clinician is crucial to present a valuable pathology report. In hospitals with an anatomic pathology unit on-site, the surgeon should send a non-fixed material, and optimally - in sterile conditions. In hospitals without an anatomic pathology unit, the specimen must be fixed. For the pathologist’s assessment of pN stage - in accordance with the TNM classification of 2010 - to be reliable, the operative specimen comprising the inguinal lymphatic system must include at least six lymph nodes. Obtaining satisfactory management results requires a good knowledge of anatomy of this area and surgical techniques as well as a proper preparation of the specimen for pathologic examination. Рак вульвы занимает четвертое место среди наиболее распространенных раковых заболеваний половых органов у женщин (примерно 5% случаев рака в этой группе). Гистологически выделяют изменения эпителиального происхождения - в 90% это плоскоклеточный, роговеющий рак - и неэпителиального происхождения. Большинство случаев рака вульвы встречается у женщин после менопаузы и связано с хронической бактериальной или вирусной инфекцией (папилломавирус человека). Лимфа из вульвы отводится в три группы паховых лимфатических узлов и подвздошных узлов. В зависимости от локализации опухоли метастазы рака переходят на одну или обе стороны. Основными методами лечения остаются хирургическое удаление и паховая, поверхностная и глубокая лимфаденэктомия. В статье представлена подробная анатомическая лимфатическая пахово-бедренная система, а также наиболее часто используемые хирургические методы и наиболее распространенные осложнения процедуры. Ключевым для представления стоящего патологического доклада является сотрудничество с врачом. В больницах с собственной лабораторией патоморфологии хирург должен отправить нефиксированный материал, оптимально - в стерильных условиях. В больницах без патоморфологической лаборатории препарат необходимо фиксировать. Чтобы патоморфолог мог провести достоверную оценку pN - в соответствии с классификацией TNM с 2010 года - операционный препарат, охватывающий паховую лимфатическую систему, должен содержать как минимум шесть лимфоузлов. Существенное значение для достижения хороших результатов лечения имеет понимание анатомической структуры этой области и хирургических методов, а также правильная подготовка препарата к патологическому исследованию. more...
- Published
- 2016
43. Analysis of RCAS1 Immunoreactivity within Hydatidiform Mole Cells and Decidual Cells according to the Applied Therapeutic Strategy: Surgery or Surgery Followed by Chemotherapy
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Galazka Krystyna, Lukasz Wicherek, Milosz Pietrus, Zbigniew Kojs, Paweł Basta, Marek Grabiec, Bogdan Małkowski, and Iwona Wertel
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medicine.medical_treatment ,chemical and pharmacologic phenomena ,Biology ,Endometrium ,Immune system ,Antigens, Neoplasm ,Pregnancy ,Mole ,Decidua ,medicine ,Humans ,Decidual cells ,reproductive and urinary physiology ,Therapeutic strategy ,Chemotherapy ,Obstetrics and Gynecology ,Trophoblast ,Hydatidiform Mole ,biochemical phenomena, metabolism, and nutrition ,Immunohistochemistry ,female genital diseases and pregnancy complications ,medicine.anatomical_structure ,Reproductive Medicine ,Chemotherapy, Adjuvant ,Uterine Neoplasms ,Immunology ,Cancer research ,bacteria ,Female ,Pregnancy Complications, Neoplastic - Abstract
Introduction: Trophoblast cells cooperate with both maternal immune cells and decidual cells to help develop the suppressive microenvironment of the endometrium. The maternal immune response against hydatidiform mole depends on this suppressive endometrial profile. Since RCAS1 is one of the molecular factors participating in the development of the suppressive profile of the endometrium we decided to examine the immunoreactivity of the RCAS1 within both the trophoblast and decidual cells during the development of hydatidiform mole. Methods: We analyzed the immunoreactivity of RCAS1 on both trophoblast and decidual cells derived from patients who underwent curettage because of hydatidiform mole. These patients were then divided into two subgroups according to whether or not they required chemotherapy after the surgical procedure. Result: We observed significantly lower immunoreactivity levels of both RCAS1 within the complete molar lesions of the patients on whom surgery alone was performed when compared to the levels found in those for whom surgery was followed by chemotherapy. Conclusion: RCAS1 staining may provide information regarding the intensity of the immunosuppressive microenvironment of both the molar lesion and the endometrium. This information can prove significant in determining the clinical course of hydatidiform mole. more...
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- 2012
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44. ORIGINAL ARTICLE: Differences in the Soluble HLA-G Blood Serum Concentration Levels in Patients with Ovarian Cancer and Ovarian and Deep Endometriosis
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Marek Grabiec, Paweł Basta, Paweł Blecharz, Joanna Skręt-Magierło, Piotr Marianowski, Zbigniew Kojs, Lukasz Wicherek, and Pawel Mach
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medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,Immunology ,Endometriosis ,Obstetrics and Gynecology ,Cancer ,medicine.disease ,Gastroenterology ,Endocrinology ,Blood serum ,Reproductive Medicine ,Internal medicine ,Cancer cell ,Follicular phase ,medicine ,Ovarian Endometriosis ,Immunology and Allergy ,Ovarian cancer ,business ,Menstrual cycle ,media_common - Abstract
Citation Mach P, Blecharz P, Basta P, Marianowski P, Skret-Magierlo J, Kojs Z, Grabiec M, Wicherek L. Differences in the soluble HLA-G blood serum concentration levels in patients with ovarian cancer and ovarian and deep endometriosis. Am J Reprod Immunol 2010 Problem The relationship between endometriosis and cancer has been widely discussed in the literature but is still not well clarified. Perhaps significantly, soluble human leukocyte antigen-G (sHLA-G) has been identified in the microenvironment of both ovarian cancer and endometrioma. The aim of this study has been to evaluate the sHLA-G levels in the blood sera of women with deep endometriosis and ovarian endometrioma over the course of the menstrual cycle and to compare to the levels of sHLA-G in the blood sera of women with ovarian cancer. Method of study In our study, we examined the blood sera obtained from 123 patients operated on because of ovarian cancer (65 cases), ovarian endometrioma (30 cases), and deep endometriosis (28 cases). We decided to compare the levels of sHLA-G in patients with endometriosis to those found in patients with ovarian cancer with respect to the menstrual cycle phases. The sHLA-G concentration level was measured by enzyme-linked immunosorbent assay kit. Results The level of sHLA-G concentration in the blood serum of patients with deep endometriosis fluctuates over the course of the menstrual cycle, and during the proliferative and secretory phases, it remains at a high level comparable to that found in patients with ovarian cancer. By contrast, the level of sHLA-G concentration in the blood serum of patients with ovarian endometrioma fluctuates minimally over the course of the different menstrual cycle phases and, as in patients with ovarian cancer, it remains at high level during the proliferative phase. Conclusion sHLA-G blood serum concentration levels would seem to provide important information regarding the degree of immune system regulation disturbance in both ectopic endometrial cells and the cancer cell suppressive microenvironment. more...
- Published
- 2010
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45. Comparison of chromosomal radiosensitivity of normal cells with and without HRS-like response and normal tissue reactions in patients with cervix cancer
- Author
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Beata Biesaga, Krzysztof Urbański, Zbigniew Kojs, and Dorota Słonina
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Keratinocytes ,Pathology ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Uterine Cervical Neoplasms ,Cervix Uteri ,Radiation Tolerance ,Chromosomes ,Cell Line ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Radiosensitivity ,Cervix ,Chromosome Aberrations ,Micronucleus Tests ,Models, Statistical ,Radiological and Ultrasound Technology ,business.industry ,Smoking ,Cancer ,Fibroblasts ,medicine.disease ,In vitro ,Radiation therapy ,medicine.anatomical_structure ,Micronucleus test ,Female ,Dose Fractionation, Radiation ,Micronucleus ,business - Abstract
In our previous study, using the micronucleus (MN) assay, the low- and high-dose radiation response of fibroblasts and keratinocytes from cancer patients was assessed. We reported that a hyper-radiosensitivity (HRS)-like phenomenon was observed for fibroblasts of two and keratinocytes of four of the 40 patients studied. In this paper, we report the comparison of these in vitro results and normal tissue reactions in patients with cervix cancer and answer the question of the predictive value of the MN assay.Of the 40 patients with cervix cancer whose cells were previously studied in vitro, 32 received radiotherapy. The treated group included two patients with HRS-like positive fibroblasts and four patients with HRS-like positive keratinocytes. In 26 patients both types of cells were HRS-like negative. The in vitro results (MN induction measured in patients' fibroblasts and keratinocytes after in vitrogamma-irradiation with doses ranging from 0.05-4 Gy) were compared with the maximum grade of acute and late reactions.Five of the six patients whose cells demonstrated low-dose chromosomal hypersensitivity in vitro, did not suffer from any mild or severe side effects after radiotherapy. Although individual variations in the grade scores of normal-tissue reactions were observed in cancer patients, no significant relationship was found between MN induction, either in fibroblasts or keratinocytes, and acute and late effects.Since the MN assay showed no predictive value, it is rather impossible that the severe late complication observed in one of the six HRS-like positive patients reflects her low-dose chromosomal hypersensitivity in vitro. more...
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- 2008
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46. Post-irradiation bladder syndrome after radiotherapy of malignant neoplasm of small pelvis organs: an observational, non-interventional clinical study assessing VESIcare®/solifenacin treatment results
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Piotr Chlosta, Jerzy Jakubowicz, Janusz Jaszczyński, Łukasz Wohadlo, Sylwia Heinze, Elżbieta Łuczyńska, Zbigniew Kojs, Janusz Rys, and Andrzej Stelmach
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Adult ,Male ,Solifenacin Succinate ,Detrusor muscle ,medicine.medical_specialty ,medicine.medical_treatment ,Urinary Bladder ,030232 urology & nephrology ,Urology ,Muscarinic Antagonists ,urologic and male genital diseases ,Pelvis ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Clinical Research ,medicine ,Humans ,Nocturia ,Radiation Injuries ,Pelvic Neoplasms ,Solifenacin ,Urinary bladder ,business.industry ,Urinary Bladder Diseases ,Syndrome ,General Medicine ,Middle Aged ,medicine.disease ,Radiation therapy ,Urodynamics ,Treatment Outcome ,medicine.anatomical_structure ,Urinary Bladder Neoplasms ,030220 oncology & carcinogenesis ,Quality of Life ,Female ,medicine.symptom ,business ,Urinary bladder disease ,medicine.drug - Abstract
BACKGROUND Radiotherapy is explicitly indicated as one of the excluding factors in diagnosing overactive bladder syndrome (OAB). Nevertheless, symptoms of OAB such as urgent episodes, incontinence, pollakiuria, and nocturia, which are consequences of irradiation, led us to test the effectiveness of VESIcare®/Solifenacin in patients demonstrating these symptoms after radiation therapy of small pelvis organs due to malignant neoplasm. MATERIAL AND METHODS We conducted an observatory clinical study including 300 consecutive patients with symptoms of post-irradiation bladder; 271 of those patients completed the study. The observation time was 6 months and consisted of 3 consecutive visits taking place at 12-week intervals. We used VESIcare® at a dose of 5 mg a day. Every sixth patient was examined urodynamically at the beginning and at the end of the observation period, with an inflow speed of 50 ml/s. RESULTS We noticed improvement and decline in the average number of episodes a day in the following parameters: number of micturitions a day (-36%, P more...
- Published
- 2016
47. The Response of Primary Keratinocytes and Fibroblasts from Cancer Patients to Multiple Low-Dose Irradiations
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Beata Biesaga, Krzysztof Urbański, Zbigniew Kojs, and Dorota Słonina
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Adult ,Keratinocytes ,Multiple low dose ,Biophysics ,Uterine Cervical Neoplasms ,Pharmacology ,Radiation Dosage ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Cells, Cultured ,Chromosome Aberrations ,Radiation ,business.industry ,Low dose ,Dose fractionation ,Cancer ,Dose-Response Relationship, Radiation ,Fibroblasts ,Middle Aged ,medicine.disease ,Single fraction ,Total dose ,Female ,Dose Fractionation, Radiation ,Nuclear medicine ,business ,Micronucleus - Abstract
In our previous study, using the micronucleus (MN) assay, a hyper-radiosensitivity (HRS)-like phenomenon was observed after single low doses for fibroblasts from two and keratinocytes from four of the 40 patients studied. In this paper, we report the response of primary keratinocytes from 23 and fibroblasts from 21 of these cancer patients to multiple low-dose irradiations and answer the question regarding whether the patients with an HRS-like response after single low doses also demonstrate chromosomal hypersensitivity after multiple low doses. The cells were irradiated with three doses of 0.25 Gy separated by 4-h intervals, and MN induction was compared with that after the same total dose given as a single fraction of 0.75 Gy. Similarly, the effect of three doses of 0.5 Gy was compared with that of a single dose of 1.5 Gy. For fibroblasts from two and keratinocytes from four patients who demonstrated a single-dose HRS-like response, a significant inverse effect of fractionation (greater MN induction after three doses of 0.25 Gy than after a single dose of 0.75 Gy) was observed, which suggests a repeated hypersensitive response after each dose of 0.25 Gy. Such an effect was not seen for the cells from 19 patients who were single-dose HRS-like negative. In conclusion, an inverse fractionation effect for MN induction that was observed in fibroblasts from two and keratinocytes from four patients after three doses of 0.25 Gy (but not 3 x 0.5 Gy) reflects the chromosomal hyper-radiosensitivity seen in the same patients in response to single low doses. more...
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- 2007
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48. The biological role of Treg cells in ectopic endometrium homeostasis
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Pawel, Basta, Krzysztof, Koper, Wojciech, Kazmierczak, Michal, Wisniewski, Adrianna, Makarewicz, Magdalena, Dutsch-Wicherek, Zbigniew, Kojs, Tadeusz J, Popiela, Robert, Slusarz, Mariusz, Dubiel, and Lukasz, Wicherek more...
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Endometrium ,Endometriosis ,Animals ,Homeostasis ,Humans ,Female ,T-Lymphocytes, Regulatory - Abstract
Although retrograde menstruation is observed in up to 90% of women, endometriosis actually develops in only 15% of women. There is considerable evidence in the literature that ectopic endometrial cells are able to evade immune surveillance and that the immune response in the microenvironment of ectopic lesions is limited. Endometriosis develops when a deficiency in the local immune response has been generated, and progression of the disease is related to the intensity of this process. Over the last couple of decades it has been well known that T regulatory lymphocytes (Tregs) play a crucial role in controlling a variety of physiological and pathological immune responses. In this review we have focused on the physiological alteration of Treg cell infiltration into the endometrium during the reproductive processes of women. We discuss how a disturbance in Treg cell expansion is involved in generating such pathological processes as miscarriage and ectopic pregnancy development. We hypothesize about the role Treg cells might play in the survival of endometriosis foci in ectopic localization and in the evasion of such lesions from host immune surveillance. more...
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- 2014
49. Prognostic Significance of Pretherapeutic and Therapeutic Factors in Patients with Advanced Cancer of the Uterine Cervix Treated with Radical Radiotherapy Alone
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Stanisław Korzeniowski, Andrzej Sokołowski, Krzysztof Urbański, Kazimierz Karolewski, and Zbigniew Kojs
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Adult ,medicine.medical_specialty ,Multivariate analysis ,medicine.medical_treatment ,Uterine Cervical Neoplasms ,Abortion ,Gastroenterology ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Stage (cooking) ,Aged ,Neoplasm Staging ,Retrospective Studies ,Cervical cancer ,Univariate analysis ,business.industry ,Dose-Response Relationship, Radiation ,Radical radiotherapy ,Hematology ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,Surgery ,Survival Rate ,Radiation therapy ,Uterine cervix ,Oncology ,Linear Models ,Female ,business - Abstract
The prognostic importance of various pretherapeutic and therapeutic factors was analysed in a group of 413 cervical cancer patients with stage IIB (183 pts) and IIIB (230 pts) treated with radical radiotherapy, which consisted of external irradiation and intracavitary brachytherapy. Univariate analysis of pretherapeutic factors revealed the prognostic significance of patient age, history of abortion, stage, haemoglobin and hematocrit levels. Five-year overall survival rate in stage IIB patients was 51%, in stage IIIB 40% and the respective rates for local control at each stage were 61%, and 46%. Univariate analysis of therapeutic factors showed that survival and local control rates increased with the dose, but a significant difference was found only in the case of a paracentral (point A) dose. In a multivariate analysis only patient age, abortions, and clinical stage appeared to have a significant and independent impact on survival. Linear regression analysis results indicated that prolongation of treatment time between 33 and 108 days caused a loss of local control of 0.36% per day. more...
- Published
- 1999
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50. Primary Invasive Vaginal Carcinoma Treated with Radiotherapy: Analysis of Prognostic Factors
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Krzysztof Urbański, Marian Reinfuss, Zbigniew Kojs, and Wiesław Fabisiak
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Adult ,medicine.medical_specialty ,Vaginal Neoplasms ,medicine.medical_treatment ,VAGINAL CARCINOMA ,Vaginal disease ,medicine ,Carcinoma ,Humans ,Neoplasm Invasiveness ,Stage (cooking) ,Aged ,Salvage Therapy ,Vaginal cancer ,Radiotherapy ,business.industry ,Intracavitary brachytherapy ,Obstetrics and Gynecology ,Middle Aged ,Prognosis ,medicine.disease ,Surgery ,Radiation therapy ,medicine.anatomical_structure ,Oncology ,Multivariate Analysis ,Vagina ,Female ,business - Abstract
Between 1965 and 1988, 125 patients with primary invasive vaginal carcinoma were treated with radiation therapy at the Center of Oncology in Krakow. Twenty-two superficial stage I patients received radium or cesium intracavitary radiation alone. The remaining 11 patients with stage I disease whose lesions were either large or thick and 77 patients with stages II and III were treated with a combination of external irradiation followed by intracavitary brachytherapy. Fifteen patients with stage IVA received external irradiation only. Five-year NED survival was achieved in 42.4% of patients. In the Cox multivariate analysis three variables were independently related to beneficial survival: grade G1 + G2, stage I + II, and age below 60 years. Of 66 patients who died of vaginal cancer, locoregional failure was found in 51 (77.3%), locoregional and distant in 5 (7.6%), and distant only in 10 (15.1%) patients. Late radiation morbidity occurred in 16 (12.8%) patients. more...
- Published
- 1996
- Full Text
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