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Stupar D, Jungić S, Gojković Z, Berendika J, Janičić Ž. Risk-factors for locally advanced rectal cancer relapse after neoadjuvant chemoradiotherapy: A single center experience. Medicine (Baltimore) 2023; 102:e35519. [PMID: 37933003 PMCID: PMC10627596 DOI: 10.1097/md.0000000000035519] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/14/2023] [Indexed: 11/08/2023] Open
Abstract
The overall prognosis of locally advanced rectal cancer (LARC) remains unsatisfactory due to a high incidence of disease relapse. The present understanding of the factors that determine the likelihood of recurrence is limited or ineffective. We aimed to identify the main risk factors influencing tumor relapse in LARC patients after neoadjuvant chemoradiotherapy (nCRT) and surgical treatment in a single center in Republika Srpska. Patients with stage II or stage III who received nCRT before surgery for primary rectal cancer at the Oncology Clinic, University Clinical Center of Republika Srpska from January 2017 and December 2022 were included in the study. We collected patient demographics, clinical stage and characteristics, neoadjuvant therapy, and surgical methods, along with the pathological response after treatment completion, and analyzed them to identify the risk factors for tumor relapse. Out of 109 patients diagnosed with LARC, 34 (31,2%) had tumor relapse. The median time to relapse was 54 months. Participants with clinical T4 stage had a significantly shorter relapse time compared to the patients with clinical T2/3 stage. Subjects with positive lymph nodes removed, perivascular and perineural invasion, intraoperative perforation and patients without ypN stage improvement had significantly shorter time to relapse. Subjects with T4 stage had more than 4 times higher risk of relapse than patients with clinical T2/3 stage. Higher clinical T stage was an essential risk factor for tumor relapse in LARC patients after nCRT and surgical treatment. Comprehensive understanding and identification of the risk factors for tumor relapse in LARC patients are crucial for improving their long-term outcomes.
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Affiliation(s)
- Dragana Stupar
- Faculty of Medicine, University of Banja Luka, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
- University Clinical Center of the Republic of Srpska, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
- General Hospital Prijedor, Prijedor, The Republic of Srpska, Bosnia and Herzegovina
| | - Saša Jungić
- Faculty of Medicine, University of Banja Luka, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
- University Clinical Center of the Republic of Srpska, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
| | - Zdenka Gojković
- Faculty of Medicine, University of Banja Luka, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
- University Clinical Center of the Republic of Srpska, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
| | - Jelena Berendika
- Faculty of Medicine, University of Banja Luka, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
- University Clinical Center of the Republic of Srpska, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
| | - Živojin Janičić
- Faculty of Medicine, University of Banja Luka, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
- University Clinical Center of the Republic of Srpska, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
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Joshi J, Rotti C, Bandyopadhyay M, Chakraborty A, Eckardt C, Pfaff E, Schäfer J, Metz A, Stupar D, Wischet Y, Bush M. Manufacturing technology development for an ‘angled’ accelerator grid segment for DNB Beam Source. Fusion Engineering and Design 2017. [DOI: 10.1016/j.fusengdes.2017.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Stupar D, Popovic B, Romanov R, Jankovic M, Jezdimirovic T, Medjedovic B. The Effects of Specific Exercise Program on Anthropometric Characteristics and Motor Abilities of Preschool Children. INT J MORPHOL 2017. [DOI: 10.4067/s0717-95022017000300038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Parojcic D, Stupar D. Portable medicine chests in Serbia during the 19th and the first half of the 20th century. Pharmazie 2004; 59:312-8. [PMID: 15125581] [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: 04/29/2023]
Abstract
Portable medicine chests could be considered as the oldest type of pharmacy in the 19th century Serbia. Historically their emergence could be associated with the appearance of the first physicians who kept post in Serbia. They were foreigners engaged on a contract to work during the reign of Prince Milos Obrenovic. According to the data preserved at the State Archive of Serbia (Chancellery of the principality, State Council, Home Office - Medical Department), medicine chests existed as late as the middle of the last century. They were an important source for health protection of the Serbian people as well as for distribution of drugs during the course of the 19th century. This article aims to analyse the content of these chests, based on the archive data records referring to the regular supervision of the medicine chests conducted every fourth year by the district physician. The legal aspect of keeping the portable medicine chest will be discussed as well.
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Affiliation(s)
- D Parojcic
- School of Pharmacy, University of Belgrade, Serbia and Montenegro.
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Stupar D, Mićic M. [Not Available]. Acta Hist Med Pharm Vet (Beograd) 2001; 30:33-41. [PMID: 11638394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Denović Z, Stupar D, Duknić M, Jovanović Z, Macić I, Topalov V, Pesić M. [New possibilities for medical and pharmaceutic activities in field conditions]. VOJNOSANIT PREGL 1991; 48:424-8. [PMID: 1788970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Z Denović
- Sanitetska uprava, Vojnomedicinska akademija, SSNO
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Stupar D, Hranilović A. [Outfitting pharmacies for catastrophes and natural disasters]. VOJNOSANIT PREGL 1989; 46:268-72. [PMID: 2800421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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Keca G, Stupar D, Pavlica D, Arandelović S, Novaković S. [Supplying the mobile units of the military health services]. VOJNOSANIT PREGL 1989; 46:200-3. [PMID: 2815636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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Pavlica D, Novaković S, Arandelović S, Keca G, Stupar D. [Organization of mobile units in the military health service]. VOJNOSANIT PREGL 1989; 46:195-9. [PMID: 2815635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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Katan E, Stupar D. [Procurement of medical supplies from occupied regions as a specific source of medical provisions during the National War of Liberation]. VOJNOSANIT PREGL 1988; 45:454-8. [PMID: 3066012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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Hranilović A, Stupar D. [The formation, organization and work of the Main Medical Storage Facility of the National Liberation Army of Yugoslavia during the closing operations of the National War of Liberation]. VOJNOSANIT PREGL 1988; 45:53-9. [PMID: 3284196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Hranilović A, Stupar D. [Medical equipment and improvisation in hospitals in temporarily occupied territories]. VOJNOSANIT PREGL 1980; 37:426-8. [PMID: 7210580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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Kostić D, Stupar D. [The use of computers in the medical-material supply service]. VOJNOSANIT PREGL 1978; 35:17-21. [PMID: 644918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Stupar D, Tartalja H. [Pharmaceutical problems in the National Liberation War as based on materials presented at the conference of pharmacist in Vis at the beginning of 1944]. VOJNOSANIT PREGL 1978; 35:64-7. [PMID: 347703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Stupar D. [From the Pharmacy of the Belgrade Military Hospital to the Pharmacy of the Military Medical Academy (1836-1950)]. VOJNOSANIT PREGL 1975; 32:605-7. [PMID: 1108426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Stupar D. [Knowledge of health conditions and deontological standards in Belgrade in the year 1850]. SRP ARK CELOK LEK 1975; 103:205-14. [PMID: 1096319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Stupar D. [Physician and English consul accused of poisoning Prince Milos (1838)]. SRP ARK CELOK LEK 1975; 103:101-6. [PMID: 1096316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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