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Popiţa AR, Rusu A, Muntean V, Cadariu PA, Irimie A, Lisencu C, Pop B, Resiga L, Fekete Z, Badea R. Preoperative MRI accuracy after neoadjuvant chemoradiation for locally advanced rectal cancer. Med Pharm Rep 2023; 96:258-268. [PMID: 37577010 PMCID: PMC10419690 DOI: 10.15386/mpr-2542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/01/2022] [Accepted: 06/27/2022] [Indexed: 08/15/2023] Open
Abstract
Background and aims To evaluate the performance of magnetic resonance imaging (MRI) in restaging locally advanced rectal cancers (LARC) after neoadjuvant chemoradiotherapy (nCRT), with pathologic correlation. Methods 80 patients with LARC treated with neoadjuvant therapy, with restaging MRI and surgery, were enrolled and prospectively reviewed. The diagnostic accuracy of the restaging MRI was assessed for tumor (ymrT), nodal status (ymrN), circumferential resection margin (ymrCRM), extramural vascular invasion (ymrEMVI) and tumoral deposits (ymrN1c) by calculating the sensitivity (Se), specificity (Sp), negative predictive values (NPV) and positive predictive values (PPV). Response to treatment was classified as good response (complete/near complete) vs. poor response (poor/partial response). The agreement between the tumor regression grade at MRI (mrTRG) and pathology (pTRG) was reported, as well the performance of mrTRG to identify good responders. The correlation between restaging MRI and histopathology was assessed by Spearman correlation coefficient. Results The MRI accuracy ranged between 63.8% and 92.5% for T stage and was 81.3% for N stage. All MRI parameters evaluated at restaging were statistically significant correlated with histopathology evaluation, but EMVI. There was moderate correlation for N and N1c and a positive strong correlation for T, CRM and TRG (Spearman correlation coefficient of 0.390 for mrN1c-pN1c, 0.428 for mrN-pN, 0.522 for mrCRM-pCRM, 0.550 for mrT-pT and 0.731 for mrTRG-pTRG). Diagnostic accuracy of anal sphincter invasion was 91.3%, with a negative predictive value (NPV) of 100%. Accuracy rate varied between 70% for partial response to 93.75% for complete response after nCRT. Conclusions MR imaging had good accuracy in restaging LARCs after nCRT. Our results showed high MRI accuracy in detecting anal sphincter involvement for low rectal tumors, with high NPV to exclude tumoral invasion. Restaging MRI predicted well the tumor regression grade, with good diagnostic performance in differentiating good responders from poor/partial responders. The accuracy was high for detecting complete response.
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Affiliation(s)
- Anca-Raluca Popiţa
- “Ion Chiricuţă” Oncology Institute, Cluj-Napoca, Romania
- Medical Imaging Department, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Adriana Rusu
- Diabetes and Nutrition Diseases Department, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Valentin Muntean
- Surgery Department, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Patriciu Achimas Cadariu
- “Ion Chiricuţă” Oncology Institute, Cluj-Napoca, Romania
- Oncology Department, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alexandru Irimie
- “Ion Chiricuţă” Oncology Institute, Cluj-Napoca, Romania
- Oncology Department, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cosmin Lisencu
- “Ion Chiricuţă” Oncology Institute, Cluj-Napoca, Romania
- Oncology Department, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Bogdan Pop
- “Ion Chiricuţă” Oncology Institute, Cluj-Napoca, Romania
- Anatomical Pathology Department, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Liliana Resiga
- “Ion Chiricuţă” Oncology Institute, Cluj-Napoca, Romania
| | - Zsolt Fekete
- “Ion Chiricuţă” Oncology Institute, Cluj-Napoca, Romania
- Oncology Department, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Radu Badea
- Medical Imaging Department, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Lisencu LA, Roman A, Pasca A, Irimie A, Lisencu C, Negrutiu M, Fetica B, Cismaru A, Balacescu O, Tudoran O, Lisencu C. Mammographic assessment of breast density as a tool for predicting the response to neoadjuvant therapy in breast cancer patients. Med Pharm Rep 2023. [DOI: 10.15386/mpr-2554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background and aims. Breast cancer (BC) is the most frequently diagnosed cancer and the leading cause of cancer-related death among women worldwide. For locally advanced diseases and high-risk tumors, neoadjuvant therapy (NAT) is the treatment of choice. Some studies show that mammographic density (MD) tumor margins and the presence of microcalcifications play a prognostic role in BC patients. Hence, the objective of this retrospective study was to assess if MD could predict the response to NAT among different molecular subtypes of BC patients undergoing NAT at The “Prof. Dr I. Chiricuta” Oncology Institute of Cluj-Napoca, Romania (IOCN). Furthermore, the association between MD, tumor margins and the presence of microcalcifications with clinico-pathological data was analyzed.
Methods. Eighty-four breast cancer patients diagnosed and treated at IOCN were included in this study. The morphological characteristics of the tumors were framed according to the BIRADS lexicon. The presence or absence of microcalcifications was also assessed. First, the significance of associations between breast density, margins and microcalcifications and clinico-pathological parameters of the patients were tested with Fisher or Fisher-Freeman-Halton Exact Test. Next, using multinomial logistic regression, we modelled the associations between the pathological response measured by Miller Payne and Residual cancer burden (RCB) systems and the BI-RADS. Variables having significant univariate tests were selected as candidates for the multivariable analysis (adjusted model).
Results. Breast densities were significantly associated with the age of the patients (p=0.01), number of positive lymph nodes (p=0.037), margins (p=0.002) and combined categories of Miller-Payne (p=0.034) and RCB pathological response (p=0.021). Margins was significantly associated with ki67 proliferation index (p=0.029), estrogen receptor (ER) (p=0.007), progesterone receptor (PR) (p=0.019), molecular subtype (p<0.001) and the number of clinically observed positive lymph nodes at diagnosis (p=0.019).
Conclusions. In our cohort, BC patients with lower MD had higher odds of achieving pCR following NAT, suggesting the role of MD as a clinical prognostic marker. Larger multicenter studies are warranted to validate the prognostic value of MD, which could aid in patients stratification based on their likelihood to respond to NAT
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Popita AR, Lisencu C, Rusu A, Popita C, Cainap C, Irimie A, Resiga L, Munteanu A, Fekete Z, Badea R. MRI Evaluation of Complete and Near-Complete Response after Neoadjuvant Therapy in Patients with Locally Advanced Rectal Cancer. Diagnostics (Basel) 2022; 12:diagnostics12040921. [PMID: 35453969 PMCID: PMC9027294 DOI: 10.3390/diagnostics12040921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/03/2022] [Accepted: 04/04/2022] [Indexed: 12/04/2022] Open
Abstract
Purpose To evaluate MRI performance in restaging locally advanced rectal cancers (LARC) after neoadjuvant chemoradiotherapy (nCRT) and interobserver agreement in identifying complete response (CR) and near-complete response (nCR). Methods 40 patients with CR and nCR on restaging MRI, surgery and/or endoscopy were enrolled. Two radiologists independently scored the restaging MRI and reported the presence of split scar sign (SSS) and MRI tumor regression grade (mrTRG). Diagnostic accuracy and ROC curves were calculated for single and combined sequences, with inter-reader agreement. Results Diagnostic performance was good for detecting CR and weaker for nCR. T2WI had the highest AUCs among individual sequences. There was a significant positive correlation between SSS and CR, with high Sp (89.5%/73.7%) and PPV (90%/79.2%) for both Readers. Similar accuracy rates were observed for the combination of sequences, with AUCs of 0.828–0.847 for CR and 0.690–0.762 for nCR. Interobserver agreement was strong for SSS, moderate for T2WI, weak for the combination of sequences. Conclusions Restaging MRI had good diagnostic performance in identifying CR and nCR. SSS had high Sp and PPV in diagnosing CR, with a strong level of interobserver agreement. T2WI with DWI was the optimal combination of sequences for selecting good responders.
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Affiliation(s)
- Anca-Raluca Popita
- “Ion Chiricuţă” Oncology Institute, 400015 Cluj-Napoca, Romania; (A.-R.P.); (C.L.); (C.P.); (A.I.); (L.R.); (A.M.); (Z.F.)
- Medical Imaging Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400162 Cluj-Napoca, Romania;
| | - Cosmin Lisencu
- “Ion Chiricuţă” Oncology Institute, 400015 Cluj-Napoca, Romania; (A.-R.P.); (C.L.); (C.P.); (A.I.); (L.R.); (A.M.); (Z.F.)
- Oncology Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania
| | - Adriana Rusu
- Diabetes and Nutrition Diseases Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania;
| | - Cristian Popita
- “Ion Chiricuţă” Oncology Institute, 400015 Cluj-Napoca, Romania; (A.-R.P.); (C.L.); (C.P.); (A.I.); (L.R.); (A.M.); (Z.F.)
| | - Calin Cainap
- “Ion Chiricuţă” Oncology Institute, 400015 Cluj-Napoca, Romania; (A.-R.P.); (C.L.); (C.P.); (A.I.); (L.R.); (A.M.); (Z.F.)
- Oncology Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania
- Correspondence: ; Tel.: +40-026-459-8363
| | - Alexandru Irimie
- “Ion Chiricuţă” Oncology Institute, 400015 Cluj-Napoca, Romania; (A.-R.P.); (C.L.); (C.P.); (A.I.); (L.R.); (A.M.); (Z.F.)
- Oncology Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania
| | - Liliana Resiga
- “Ion Chiricuţă” Oncology Institute, 400015 Cluj-Napoca, Romania; (A.-R.P.); (C.L.); (C.P.); (A.I.); (L.R.); (A.M.); (Z.F.)
| | - Alina Munteanu
- “Ion Chiricuţă” Oncology Institute, 400015 Cluj-Napoca, Romania; (A.-R.P.); (C.L.); (C.P.); (A.I.); (L.R.); (A.M.); (Z.F.)
| | - Zsolt Fekete
- “Ion Chiricuţă” Oncology Institute, 400015 Cluj-Napoca, Romania; (A.-R.P.); (C.L.); (C.P.); (A.I.); (L.R.); (A.M.); (Z.F.)
- Oncology Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania
| | - Radu Badea
- Medical Imaging Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400162 Cluj-Napoca, Romania;
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Lisencu LA, Bonci EA, Irimie A, Balacescu O, Lisencu C. The Role of Circulating Tumor Cells in Chemoresistant Metastatic Breast Cancer. J Clin Med 2021; 10:jcm10040684. [PMID: 33578862 PMCID: PMC7916545 DOI: 10.3390/jcm10040684] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/28/2021] [Accepted: 02/08/2021] [Indexed: 12/13/2022] Open
Abstract
Breast cancer is the most frequent form of cancer among women and is one of the leading causes of death. Two routes of the metastatic process have been described: linear and parallel progression. A key factor is represented by circulating tumor cells (CTCs). CTCs detach from the primary tumor or develop from cancer stem cells (CSCs) that undergo epithelial-to-mesenchymal transition (EMT). CTCs migrate to the distant site where the reverse process occurs and a new tumor arises. One of the key problems of metastatic disease is chemoresistance, which leads to treatment failure and, eventually, death. The aim of this review is to present up-to-date data regarding the role of CTCs in chemoresistance in metastatic breast cancer (MBC) patients. A search in Cochrane Library and MEDLINE databases was performed. A total of 125 articles were identified. The results of the final 12 eligible studies revealed that CTCs having stem cell features and those with mesenchymal features are aggressive subtypes of cells that survive chemotherapy, being responsible for chemoresistance and thus for disease progression in MBC patients. The hemodynamic shear stress, alongside dynamic changes among CTCs during the disease, is also an important disease progression factor.
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Affiliation(s)
- Lorena Alexandra Lisencu
- 11th Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (L.A.L.); (A.I.); (C.L.)
| | - Eduard-Alexandru Bonci
- 11th Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (L.A.L.); (A.I.); (C.L.)
- Department of Surgical Oncology, “Prof. Dr. Ion Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania
- Correspondence:
| | - Alexandru Irimie
- 11th Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (L.A.L.); (A.I.); (C.L.)
- Department of Surgical Oncology, “Prof. Dr. Ion Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania
| | - Ovidiu Balacescu
- Department of Functional Genomics, Proteomics and Experimental Pathology, “Prof. Dr. Ion Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania;
- 11th Department of Medical Oncology, “Iuliu Hațieganu”, University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Cosmin Lisencu
- 11th Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (L.A.L.); (A.I.); (C.L.)
- Department of Surgical Oncology, “Prof. Dr. Ion Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania
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Kubelac P, Craciun A, Jalba O, Gheorghe S, Lazar G, Ignat F, Lisencu C, Rancea A, Vlad C, Irimie A, Achimas Cadariu P. Institutional results of OncoOVARIAN Dx - a novel algorithm for the preoperative evaluation of adnexal masses. J BUON 2020; 25:1658-1663. [PMID: 32862619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the predictive performance of OncoOVARIAN Dx algorithm, which takes into account tumor markers (beta HCG, CA 19.9, CEA, AFP, CA 125, HE4), general biochemistry and clinical data (age, menopause, comorbidities) in patients scheduled for surgical removal of a suspicious adnexal tumor in comparison with the Risk of Malignancy Algorithm (ROMA) model. METHODS Consecutive women diagnosed with an adnexal tumor mass and scheduled for surgical intervention at a single tertiary cancer between October 2018 - June 2019 were enrolled. Preoperative values of tumor markers and general biochemistry (ASAT, ALAT, GGT, total bilirubin, creatinine) were determined. Following surgery with adequate surgical staging, a definite pathological diagnosis was made and used as reference. RESULTS A total of 50 patients were selected, including 20 benign, 5 borderline and 25 malignant epithelial ovarian cancer (EOC) cases on final pathology. Borderline tumors comprised 3 serous and 2 mucinous FIGO stage I cases. Malignant tumors included 17 high grade serous, 4 endometrioid and 4 mucinous types, FIGO stage IA-IIIC. The two models demonstrated very good correlation (Phi 0.78, p<0.001). The sensibility (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) of OncoOVARIAN Dx versus ROMA model were 76.66% vs. 60%, 95% vs. 100%, 95.83% vs. 100%, 73.07% vs. 62.5%, respectively. In postmenopausal patients higher Se (85.71%), Sp (100%) and PPV (100%) were observed for OncoOVARIAN Dx. CONCLUSIONS OncoOVARIAN Dx model demonstrated higher Se and NPV compared to ROMA and could be a useful marker in the preoperative management of adnexal masses; however larger studies are warranted to validate and further refine this algorithm.
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Affiliation(s)
- Paul Kubelac
- Department of Medical Oncology, The Oncology Institute "Prof. Dr. Ion Chiricuta", Cluj-Napoca, Romania
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Sur D, Coza O, Havasi A, Cainap C, Burz C, Vlad C, Balacescu O, Alexandru I, Lisencu C. Exosomal miRNAs in colorectal cancer: the carriers of useful news. J BUON 2020; 25:23-34. [PMID: 32277611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE In this review, we focused on presenting an up-to-date overview of exosomal miRNAs as biomarkers for diagnosis, prognosis, and their therapeutically perspectives in colorectal cancer (CRC). METHODS A comprehensive literature search was conducted using the PUBMED database through February 2019 to identify all studies concerning the role of miRNAs and exosomes in CRC. RESULTS Among the 77 studies identified, 43 articles were relevant for the collaboration of miRNAs and exosomes as therapeutic and diagnostic opportunities in CRC. CONCLUSIONS This review reveals the role of exosomal miRNAs in CRC management and discusses the promises and challenges associated with the introduction of this combination into clinical practice.
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Affiliation(s)
- Daniel Sur
- Department of Medical Oncology, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca 400015, Romania
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Moiș E, Graur F, Lisencu C, Furcea L, Rațiu S, Ciurdorean AM, Elisei R, Al Hajjar N. How I do it: parastomal hernia repair and ventral post-incisional hernia repair using PCS/TAR A case report. Ann Ital Chir 2020; 91:215-219. [PMID: 32503953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We present a medical case of a 61 year-old male patient who reported to the outpatient clinic with a parastomal hernia of 10 cm in diameter and a postincisional midline hernia of 15 cm in diameter. We emphasized that the patient had undergone surgery 4 years before for a rectal adenocarcinoma, in which we performed an abdominal perineal resection of the rectum with end colostomy. At the time of admission, there were no imagistic signs of local or distant relapse. The surgical technique used aimed to repair both of the abdominal defects by placing a large polypropylene mesh (30x30 cm) spanning into the retro-rectus space in a sublay position. On the colostomy side, the mesh is extended up to the median axillary line by performing TAR (transversus abdominis release), according to the technique described by Pauli, thus the colostomy side is not modified. The post-operatory evolution was favourable, with the return of intestinal transit for faeces and gas on the second post-operatory day. The patient was discharged on the 7th postoperatory day, after the suppression of the over-prosthetic drainage. KEY WORDS: Parastomal hernia, PCS/TAR.
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Burz C, Bojan A, Balacescu L, Lisencu C, Puscas E, Pop V, Cainap C. Proinflammatory cytokines as predictive factors for response to chemotherapy or mental disorders present in colorectal cancer patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sas V, Blag C, Zaharie G, Puscas E, Lisencu C, Andronic-Gorcea N, Pasca S, Petrushev B, Chis I, Marian M, Dima D, Teodorescu P, Iluta S, Zdrenghea M, Berindan-Neagoe I, Popa G, Man S, Colita A, Stefan C, Kojima S, Tomuleasa C. Transient leukemia of Down syndrome. Crit Rev Clin Lab Sci 2019; 56:247-259. [PMID: 31043105 DOI: 10.1080/10408363.2019.1613629] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Childhood leukemia is mostly a "developmental accident" during fetal hematopoiesis and may require multiple prenatal and postnatal "hits". The World Health Organization defines transient leukemia of Down syndrome (DS) as increased peripheral blood blasts in neonates with DS and classifies this type of leukemia as a separate entity. Although it was shown that DS predisposes children to myeloid leukemia, neither the nature of the predisposition nor the associated genetic lesions have been defined. Acute myeloid leukemia of DS is a unique disease characterized by a long pre-leukemic, myelodysplastic phase, unusual chromosomal findings and a high cure rate. In the present manuscript, we present a comprehensive review of the literature about clinical and biological findings of transient leukemia of DS (TL-DS) and link them with the genetic discoveries in the field. We address the manuscript to the pediatric generalist and especially to the next generation of pediatric hematologists.
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Affiliation(s)
- Valentina Sas
- a Department of Hematology , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania.,b Department of Pediatrics , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Cristina Blag
- b Department of Pediatrics , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Gabriela Zaharie
- c Department of Neonatology , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Emil Puscas
- d Department of Surgery , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Cosmin Lisencu
- d Department of Surgery , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Nicolae Andronic-Gorcea
- a Department of Hematology , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Sergiu Pasca
- a Department of Hematology , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Bobe Petrushev
- a Department of Hematology , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Irina Chis
- e Department of Physiology , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Mirela Marian
- f Department of Hematology , Ion Chiricuta Clinical Cancer Center , Cluj Napoca , Romania
| | - Delia Dima
- f Department of Hematology , Ion Chiricuta Clinical Cancer Center , Cluj Napoca , Romania
| | - Patric Teodorescu
- a Department of Hematology , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Sabina Iluta
- a Department of Hematology , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Mihnea Zdrenghea
- f Department of Hematology , Ion Chiricuta Clinical Cancer Center , Cluj Napoca , Romania
| | - Ioana Berindan-Neagoe
- g MedFuture Research Center for Advanced Medicine , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Gheorghe Popa
- b Department of Pediatrics , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Sorin Man
- b Department of Pediatrics , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Anca Colita
- h Department of Pediatrics , Carol Davila University of Medicine and Pharmacy , Bucharest , Romania.,i Department of Pediatrics , Fundeni Clinical Institute , Bucharest , Romania
| | - Cristina Stefan
- j African Organization for Research and Training in Cancer , Cape Town , South Africa
| | - Seiji Kojima
- k Department of Pediatrics , Nagoya University Graduate School of Medicine , Nagoya , Japan.,l Center for Advanced Medicine and Clinical Research , Nagoya University Hospital , Nagoya , Japan
| | - Ciprian Tomuleasa
- a Department of Hematology , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania.,f Department of Hematology , Ion Chiricuta Clinical Cancer Center , Cluj Napoca , Romania.,m Research Center for Functional Genomics and Translational Medicine , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
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Bonci E, Petrusan A, Bobes V, Titu S, Puscas E, Lisencu C, Irimie A, Achimas-Cadariu P, Piciu D, Fetica B. Corrigendum to “A retrospective study on parasitic thyroid nodules: A Romanian single-center 20-years experience” [45 (2) (February 2019) e124]. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2019.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Bonci E, Petrusan A, Bobes V, Titu S, Puscas E, Lisencu C, Irimie A, Achimas-Cadariu P, Piciu D, Fetica B. A retrospective study on parasitic thyroid nodules: a Romanian single-center 20-years experience. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Rusu RA, Sîrbu D, Curşeu D, Năsui B, Sava M, Vesa ŞC, Bojan A, Lisencu C, Popa M. Chemotherapy-related infectious complications in patients with Hematologic malignancies. J Res Med Sci 2018; 23:68. [PMID: 30181750 PMCID: PMC6091125 DOI: 10.4103/jrms.jrms_960_17] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 03/10/2018] [Accepted: 04/29/2018] [Indexed: 12/11/2022]
Abstract
Background: The objective of the present study was to determine the association between chemotherapy and infectious complications in patients diagnosed with Hematologic malignancies (HMs). Materials and Methods: The study included 463 patients diagnosed with HMs multiple myeloma (MM), Hodgkin's lymphoma (HL), non-HL (NHL), acute myeloid leukemia (AML), acute lymphocytic leukemia, chronic lymphocytic leukemia, and chronic myeloid leukemia, between January 2014 and June 2015. The patients were followed for 1 year after inclusion, to record the infectious complications. The collected data included age, sex, type of chemotherapy regimen, and several blood tests at admission. All patients received prophylactic treatment with antibiotics and antifungal agents. For each infection, we recorded the microbiological diagnosis and the day of occurrence since HMs diagnosis. Results: In patients with MM, we found that the treatment with growth factors (hazard ratio [HR] 2.2; confidence interval [CI] 95%: 1–4.6; P = 0.03) was associated with a higher chance of infectious complications. In patients with non-Hodgkin lymhoma (LNH), the following drugs were associated with a higher infectious incidence: cytarabine (HR: 2.3; CI 95%: 1–5; P = 0.03), methotrexate (HR: 2.1; CI 95%: 1.8–4; P = 0.01), dexamethasone (HR: 1.7; CI 95%: 0.9–3; P = 0.06), growth factors (HR: 1.7; CI 95%: 0.9–3.2; P = 0.001), and etoposide (HR: 2.5; CI 95%: 1.5–4.2; P = 0.002). Cytarabine (induction) (HR: 2; CI 95%: 1.1–3.7; P = 0.01), cytarabine (consolidation) (HR: 2.1; CI 95%: 1.3–3.5; P = 0.01), and growth factors (HR: 2.1; CI 95%: 1.3–3.5; P = 0.002) were often on the therapeutic plan of patients with AML, which developed infections. Conclusion: Regarding the chemotherapy regimen, the highest incidences of infectious complications were observed for growth factors and cytarabine.
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Affiliation(s)
- Raluca-Ana Rusu
- Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dana Sîrbu
- Department of Hygiene, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Daniela Curşeu
- Department of Hygiene, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Bogdana Năsui
- Department of Hygiene, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mădălina Sava
- Department of Dermatology, University of Oradea, Oradea, Romania
| | - Ştefan Cristian Vesa
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Anca Bojan
- Department of Hematology, Iuliu Ha-ieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cosmin Lisencu
- Department of Oncologic Surgery and Oncologic Gynecology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Monica Popa
- Department of Hygiene, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Frinc I, Ilies P, Zaharie F, Dima D, Tanase A, Petrov L, Irimie A, Berce C, Lisencu C, Berindan-Neagoe I, Tomuleasa C, Bojan A. Transthoracic ultrasonography for the immunocompromised patient. A pilot project that introduces transthoracic ultrasonography for the follow-up of hematological patients in Romania. ACTA ACUST UNITED AC 2017; 55:103-116. [PMID: 28103204 DOI: 10.1515/rjim-2017-0006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Indexed: 11/15/2022]
Abstract
In the past decade, there has been significant progress in clinical hematology with the discovery of targeted molecules and thus the achievement of both hematologic and molecular responses. Nevertheless, chemotherapy remains the treatment of choice for many types of hematological malignancies. Aggressive chemotherapy leads to immunosuppression, accompanied by a high rate of infections and an increased rate of treatment-related mortality. Invasive fungal infections as well as more common bacterial and viral infections are frequent in immunocompromised patients as they are difficult to diagnose and treat. Pleuropulmonary infections in immunocompromised patients are diagnosed using clinical examination, imaging and laboratory tests. Many laboratory tests are run for several days before a final result is given and are expensive. Computer tomography is a reliable technique, but it is encumbered by high irradiation and high cost, and can assess lesions larger than 1 cm. Transthoracic ultrasound is a modern method, used in the diagnostic algorithm of pleuropulmonary pathology. It allows the diagnosis of small lesions, can be performed at the patients' bedside, with acceptable costs and no irradiation. A fast, informed and accurate medical decision is essential for a favorable outcome in immunosuppressed patients with an adjacent infection. In the current case series we present the implementation of a new protocol for the follow-up of immunocompromised patients using transthoracic ultrasonography, of great potential use in the clinic.
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Dima D, Tomuleasa C, Frinc I, Pasca S, Magdo L, Berindan-Neagoe I, Muresan M, Lisencu C, Irimie A, Zdrenghea M. The use of rotation to fentanyl in cancer-related pain. J Pain Res 2017; 10:341-348. [PMID: 28223843 PMCID: PMC5310636 DOI: 10.2147/jpr.s121920] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Pain is commonly diagnosed with respect to cancer and heart diseases, being a major symptom in most neoplastic diseases. Uncontrolled pain leads to a decrease in the quality of life and an increase in the morbidity of the patient. Opioids represent the best analgetic supportive therapy and are frequently used in patients suffering from cancer and experiencing a high level of pain. Opioid treatment starts with a gradual titration of the dose until the minimum effective dose and the maximum tolerated dose are determined. Opioid rotation refers to the switch from one opioid to another in order to get a better response to analgetic therapy and reduce side effects. Fentanyl therapy is recommended to be continued during chemotherapy, radiotherapy, or in the case of surgical intervention. Rotation to fentanyl patches is an efficient and elegant solution for cancer patients, with reduced side effects. Opioid rotation, especially to fentanyl, was shown to increase the quality of life in patients with malignant disease. Finally, rotation to fentanyl is also advantageous from an economic point of view.
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Affiliation(s)
- Delia Dima
- Department of Hematology, Ion Chiricuta Oncology Institute
| | | | - Ioana Frinc
- Department of Hematology, Ion Chiricuta Oncology Institute
| | - Sergiu Pasca
- Faculty of Medicine, Research Center for Functional Genomics and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Iuliu Hatieganu
| | - Lorand Magdo
- Faculty of Medicine, Research Center for Functional Genomics and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Iuliu Hatieganu
| | - Ioana Berindan-Neagoe
- Faculty of Medicine, Research Center for Functional Genomics and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Iuliu Hatieganu; Department of Functional Genomics, The Oncology Institute Ion Chiricuta; Medfuture Research Center for Advanced Medicine, University of Medicine and Pharmacy, Iuliu Hatieganu
| | - Mihai Muresan
- Department of Surgery, Ion Chiricuta Oncology Institute
| | | | - Alexandru Irimie
- Department of Surgery, Ion Chiricuta Oncology Institute; Department of Oncology, University of Medicine and Pharmacy, Iuliu Hatieganu
| | - Mihnea Zdrenghea
- Department of Hematology, Ion Chiricuta Oncology Institute; Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
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Gavrilas LI, Ionescu C, Tudoran O, Lisencu C, Balacescu O, Miere D. The Role of Bioactive Dietary Components in Modulating miRNA Expression in Colorectal Cancer. Nutrients 2016; 8:nu8100590. [PMID: 27681738 PMCID: PMC5083978 DOI: 10.3390/nu8100590] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 08/31/2016] [Accepted: 09/18/2016] [Indexed: 02/07/2023] Open
Abstract
Colorectal cancer is the third most common cancer in the world and considered to be one of the most diet-related types of cancer. Extensive research has been conducted but still the link between diet and colorectal cancer is complex. Recent studies have highlight microRNAs (miRNAs) as key players in cancer-related pathways in the context of dietary modulation. MicroRNAs are involved in most biological processes related to tumor development and progression; therefore, it is of great interest to understand the underlying mechanisms by which dietary patterns and components influence the expression of these powerful molecules in colorectal cancer. In this review, we discuss relevant dietary patterns in terms of miRNAs modulation in colorectal cancer, as well as bioactive dietary components able to modify gene expression through changes in miRNA expression. Furthermore, we emphasize on protective components such as resveratrol, curcumin, quercetin, α-mangostin, omega-3 fatty acids, vitamin D and dietary fiber, with a focus on the molecular mechanisms in the context of prevention and even treatment. In addition, several bioactive dietary components that have the ability to re-sensitize treatment resistant cells are described.
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Affiliation(s)
- Laura I Gavrilas
- Department of Bromatology, Hygiene, Nutrition, University of Medicine and Pharmacy "Iuliu Hatieganu", Marinescu Street 23, Cluj-Napoca 400337, Romania.
| | - Corina Ionescu
- Department of Pharmaceutical Biochemistry and Clinical Laboratory, University of Medicine and Pharmacy "Iuliu Hatieganu", Louis Pasteur Street 6, Cluj-Napoca 400349, Romania.
| | - Oana Tudoran
- Department of Functional Genomics, Proteomics and Experimental Pathology, The Oncology Institute "Prof. Dr. Ion Chiricuta", Republicii Street 34-36, Cluj-Napoca 400015, Romania.
| | - Cosmin Lisencu
- Department of Surgical and Gynecological Oncology, University of Medicine and Pharmacy "Iuliu Hatieganu", Republicii Street 34-36, Cluj-Napoca 400015, Romania.
- Department of Surgery, The Oncology Institute "Prof. Dr. Ion Chiricuta", Republicii Street 34-36, Cluj-Napoca 400015, Romania.
| | - Ovidiu Balacescu
- Department of Functional Genomics, Proteomics and Experimental Pathology, The Oncology Institute "Prof. Dr. Ion Chiricuta", Republicii Street 34-36, Cluj-Napoca 400015, Romania.
| | - Doina Miere
- Department of Bromatology, Hygiene, Nutrition, University of Medicine and Pharmacy "Iuliu Hatieganu", Marinescu Street 23, Cluj-Napoca 400337, Romania.
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Burz C, Aziz BYM, Bălăcescu L, Leluţiu L, Buiga R, Samasca G, Irimie A, Lisencu C. Tumor markers used in monitoring the tumor recurrence in patients with colorectal cancer. ACTA ACUST UNITED AC 2016; 89:378-83. [PMID: 27547057 PMCID: PMC4990433 DOI: 10.15386/cjmed-635] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 02/19/2016] [Indexed: 12/22/2022]
Abstract
Background and aims The aim of this study was to investigate the value of serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA 19-9) correlated with some tissue molecules as predictive markers for recurrence in colon cancer. Methods A total of 30 patients diagnosed with colon cancer stage II or III who underwent optimal surgery were enrolled in study. Tumor markers CEA and CA 19-9 were determined before surgery. Tumor samples were prepared using tissue microarray kit (TMA) then stained for different cellular markers (Ki 67, HER2, BCL2, CD56, CD4, CD8) and analyzed using Inforatio programme for quantitative determination. All patients received standard adjuvant treatment, which consisted of eight cycles chemotherapy type XELOX. The patients were followed up for 3 years. Results Upon 3 years follow-up, 67% of patients developed tumor relapse, the most common site of metastasis being the liver. No correlations were observed between either serum or tissue tumor markers and the risk of tumor relapse. Conclusion Over 50% of patients with colon cancer who had optimal treatment developed metastasis. No statistically significant predictive value for investigated molecules was found. Future studies are needed to confirm the use of molecular markers in monitoring patients with colorectal cancer
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Affiliation(s)
- Claudia Burz
- Prof. Dr. Ion Chiricuţă Cancer Institute, Cluj-Napoca, Romania; Department of Immunology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | | | | | - Rareş Buiga
- Prof. Dr. Ion Chiricuţă Cancer Institute, Cluj-Napoca, Romania
| | - Gabriel Samasca
- Department of Immunology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alexandru Irimie
- Prof. Dr. Ion Chiricuţă Cancer Institute, Cluj-Napoca, Romania; Department of Surgical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cosmin Lisencu
- Prof. Dr. Ion Chiricuţă Cancer Institute, Cluj-Napoca, Romania; Department of Surgical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Cainap C, Nagy V, Seicean A, Gherman A, Laszlo I, Lisencu C, Nadim AH, Constantin AM, Cainap S. Results of third-generation epirubicin/cisplatin/xeloda adjuvant chemotherapy in patients with radically resected gastric cancer. J BUON 2016; 21:349-359. [PMID: 27273944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the efficacy and toxicity of a third-generation chemotherapy regimen in the adjuvant setting to radically operated patients with gastric cancer. This proposed new adjuvant regimen was also compared with a consecutive retrospective cohort of patients treated with the classic McDonald regimen. METHODS Starting in 2006, a non-randomized prospective phase II study was conducted at the Institute of Oncology of Cluj-Napoca on 40 patients with stage IB-IV radically resected gastric adenocarcinoma. These patients were administered a chemotherapy regimen already considered to be standard treatment in the metastatic setting: ECX (epirubicin, cisplatin, xeloda) and were compared to a retrospective control group consisting of 54 patients, treated between 2001 and 2006 according to McDonald's trial. RESULTS In a previous paper, we reported toxicities and the possible predictive factors for these toxicities; in the present article, we report on the results concerning predictive factors on overall survival (OS) and disease free survival (DFS). The proposed ECX treatment was not less effective than the standard suggested by McDonald's trial. Age was an independent prognostic factor in multivariate analysis. N3 stage was an independent prognostic factor for OS and DFS. N ratio >70% was an independent predictive factor for OS and locoregional disease control. The resection margins were independent prognostic factors for OS and DFS. CONCLUSION The proposed treatment is not less effective compared with the McDonald's trial. Age was an independent prognostic factor in multivariate analysis. N3 stage represented an independent prognostic factor and N ratio >70% was a predictive factor for OS and DFS. The resection margins were proven to be independent prognostic factors for OS and DFS.
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Affiliation(s)
- Calin Cainap
- Prof. Dr. Ion Chiricuta" Institute of Oncology, Department of Medical Oncology, Cluj-Napoca, Romania
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Zgaia AO, Irimie A, Sandesc D, Vlad C, Lisencu C, Rogobete A, Achimas-Cadariu P. The role of ketamine in the treatment of chronic cancer pain. ACTA ACUST UNITED AC 2015; 88:457-61. [PMID: 26733743 PMCID: PMC4689236 DOI: 10.15386/cjmed-500] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 09/11/2015] [Accepted: 09/24/2015] [Indexed: 12/14/2022]
Abstract
Background and aim Ketamine is a drug used for the induction and maintenance of general anesthesia, for the treatment of postoperative and posttraumatic acute pain, and more recently, for the reduction of postoperative opioid requirements. The main mechanism of action of ketamine is the antagonization of N-methyl-D-aspartate (NMDA) receptors that are associated with central sensitization. In the pathogenesis of chronic pain and particularly in neuropathic pain, an important role is played by the activation of NMDA receptors. Although ketamine is indicated and used for the treatment of chronic cancer pain as an adjuvant to opioids, there are few clinical studies that clearly demonstrate the effectiveness of ketamine in this type of pain. The aim of this study is to analyze evidence-based clinical data on the effectiveness and safety of ketamine administration in the treatment of chronic neoplastic pain, and to summarize the evidence-based recommendations for the use of ketamine in the treatment of chronic cancer pain. Method We reviewed the literature from the electronic databases of MEDLINE, COCHRANE, PUBMED, MEDSCAPE (1998–2014), as well as chapters of specialized books (palliative care, pain management, anesthesia). Results A number of studies support the effectiveness of ketamine in the treatment of chronic cancer pain, one study does not evidence clear clinical benefits for the use of ketamine, and some studies included too few patients to be conclusive. Conclusions Ketamine represents an option for neoplasic pain that no longer responds to conventional opioid treatment, but this drug should be used with caution, and the development of potential side effects should be carefully monitored.
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Affiliation(s)
- Armeana Olimpia Zgaia
- Department of Oncological Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alexandru Irimie
- Department of Oncological Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dorel Sandesc
- Department of Anesthesia and Critical Care, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Catalin Vlad
- Department of Oncological Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cosmin Lisencu
- Department of Oncological Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alexandru Rogobete
- Department of Anesthesia and Critical Care, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Patriciu Achimas-Cadariu
- Department of Oncological Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Fetica B, Pop B, Lisencu C, Rancea AC, Coman A, Cucuianu A, Petrov L. Castleman Disease. A Report of Six Cases. ACTA ACUST UNITED AC 2014; 87:192-7. [PMID: 26528023 PMCID: PMC4508595 DOI: 10.15386/cjmed-302] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 09/01/2014] [Accepted: 09/02/2014] [Indexed: 12/16/2022]
Abstract
Background and aims: Castleman’s disease is a rare disorder situated at the boundary between reactive and neoplastic conditions. The pathogenesis is a subject of debate and the limited number of cases renders the study of the disease difficult. In our paper we present a series of six cases of Castleman disease with emphasis on the clinical presentation, pathology examination and the use of immunohistochemistry in the final diagnosis of the cases. Patients and method: The classification of the disease was based on clinical, imaging and pathological assessment. Specimens were obtained by surgical excision and were routinely processed for the pathology examination. Results: All cases were unicentric disease. Two cases were locally extensive. The clinical symptoms were related mostly to compression effects. Five case were of the hyaline-vascular type and one was included in the plasma cell variant. One case showed angiomyoid differentiation. Conclusions: We strongly believe that by understanding the pathogenesis of the precursor lesions we will gain better understanding of the pathways that lead to neoplasia and that Castleman disesase is a very interesting ”natural experiment” illustrating the progression from chronic antigen stimulation to reactive lymphoid hyperplasia and finally to overt lymphoid neoplasia.
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Affiliation(s)
- Bogdan Fetica
- Department of Pathology, "Prof. Dr. I. Chiricuta" Oncology Institute, Cluj-Napoca, Romania
| | - Bogdan Pop
- Department of Pathology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cosmin Lisencu
- Department of Surgery, "Prof. Dr. I. Chiricuta" Oncology Institute, Cluj-Napoca, Romania ; Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alin Cristian Rancea
- Department of Surgery, "Prof. Dr. I. Chiricuta" Oncology Institute, Cluj-Napoca, Romania ; Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Aurel Coman
- Department of Surgery Polisano Clinic Sibiu, Romania
| | - Andrei Cucuianu
- Department of Hematology, "Prof. Dr. I. Chiricuta" Oncology Institute, Cluj-Napoca, Romania ; Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ljubomir Petrov
- Department of Hematology, "Prof. Dr. I. Chiricuta" Oncology Institute, Cluj-Napoca, Romania ; Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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