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Horváth Z, Paszt A, Simonka Z, Látos M, Kaizer L, Hamar S, Vörös A, Ormándi K, Fejes Z, Oláh J, Lázár G. [New trends in the surgical treatment of axilla in breast cancer]. Magy Seb 2022; 75:169-178. [PMID: 35895538 DOI: 10.1556/1046.2022.20012] [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] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 04/04/2022] [Indexed: 06/15/2023]
Abstract
Oncosurgical treatment of breast tumors involves the removal of metastatic axillary lymph nodes. In the last 30 years, the diagnosis and treatment of axillary lymph nodes have also undergone significant changes. The introduction of sentinel lymph node biopsy in 1993 made axillary block dissection with high morbidity safely omitted in a significant proportion of patients, and similarly, the staging of breast tumors and thus oncology and complex treatment became significantly more accurate. Shortly after the introduction of sentinel lymph node biopsy, intraoperative examination of sentinel lymph nodes (e.g. imprint cytology) also appeared, which significantly reduced the number of surgeries performed in the two sessions, thereby significantly reducing patient burden and surgical costs. The results of our study indicate that axillary block dissection is required in the treatment of axilla in an ever-decreasing group of patients and this proportion will decrease further in the future, with the increasing use of alternative axillary radiotherapy. The imprint cytological examination of sentinel lymph nodes taking into account current guidelines, no longer provides demonstrable benefits and its routine use is not justified. According to the latest international recommendations, intraoperative examination of the sentinel lymph node may be indicated in connection with mastectomy (when postoperative radiotherapy is not planned) and after neoadjuvant treatment. Our results suggest that the detection of suspected lymph nodes during preoperative axillary ultrasound may predict the stage of the disease. Based on our research results confirm that in patients receiving neoadjuvant therapy, in addition to the preoperative size of the tumour (≤20 mm, P = 0.002), the preoperative size of the lymph node (≤15 mm, P = 0.04) may also be used to predict that the stage of the disease is N0-1.
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Affiliation(s)
- Zoltán Horváth
- 1 Szegedi Tudományegyetem Szent-Györgyi Albert Orvostudományi Kar, Sebészeti Klinika, Szeged, Magyarország (tanszékvezető: Prof. Dr. Lázár György)
| | - Attila Paszt
- 1 Szegedi Tudományegyetem Szent-Györgyi Albert Orvostudományi Kar, Sebészeti Klinika, Szeged, Magyarország (tanszékvezető: Prof. Dr. Lázár György)
| | - Zsolt Simonka
- 1 Szegedi Tudományegyetem Szent-Györgyi Albert Orvostudományi Kar, Sebészeti Klinika, Szeged, Magyarország (tanszékvezető: Prof. Dr. Lázár György)
| | - Melinda Látos
- 1 Szegedi Tudományegyetem Szent-Györgyi Albert Orvostudományi Kar, Sebészeti Klinika, Szeged, Magyarország (tanszékvezető: Prof. Dr. Lázár György)
| | - László Kaizer
- 2 Szegedi Tudományegyetem Szent-Györgyi Albert Orvostudományi Kar, Pathológiai Intézet, Szeged, Magyarország (tanszékvezető: Prof. Dr. Tiszlavicz László)
| | - Sándor Hamar
- 2 Szegedi Tudományegyetem Szent-Györgyi Albert Orvostudományi Kar, Pathológiai Intézet, Szeged, Magyarország (tanszékvezető: Prof. Dr. Tiszlavicz László)
| | - András Vörös
- 2 Szegedi Tudományegyetem Szent-Györgyi Albert Orvostudományi Kar, Pathológiai Intézet, Szeged, Magyarország (tanszékvezető: Prof. Dr. Tiszlavicz László)
| | - Katalin Ormándi
- 3 Szegedi Tudományegyetem Szent-Györgyi Albert Orvostudományi Kar, Radiológiai Klinika, Szeged, Magyarország (tanszékvezető: Dr. Kincses Zsigmond Tamás)
| | - Zsuzsanna Fejes
- 3 Szegedi Tudományegyetem Szent-Györgyi Albert Orvostudományi Kar, Radiológiai Klinika, Szeged, Magyarország (tanszékvezető: Dr. Kincses Zsigmond Tamás)
| | - Judit Oláh
- 4 Szegedi Tudományegyetem Szent-Györgyi Albert Orvostudományi Kar, Onkoterápiás Klinika, Szeged, Magyarország (tanszékvezető: Prof. Dr. Oláh Judit)
| | - György Lázár
- 1 Szegedi Tudományegyetem Szent-Györgyi Albert Orvostudományi Kar, Sebészeti Klinika, Szeged, Magyarország (tanszékvezető: Prof. Dr. Lázár György)
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Bor R, Vasas B, Fábián A, Szűcs M, Füredi Á, Czakó L, Rutka M, Farkas K, Molnár T, Milassin Á, Bálint A, Szántó K, Hamar S, Kaizer L, Tiszlavicz L, Szepes Z. Slow-pull technique yields better quality smears: prospective comparison of slow-pull and standard suction techniques of endoscopic ultrasound-guided fine-needle aspiration. Scand J Gastroenterol 2020; 55:1369-1376. [PMID: 33016159 DOI: 10.1080/00365521.2020.1825792] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Diagnostic accuracy and quality of smears obtained by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) are influenced by characteristics of suction and examined organ. AIMS AND METHODS Efficiency of EUS-FNA and quality of smears obtained by slow-pull (SP) and standard suction (SS) techniques was prospectively compared in the sampling of pancreatic (N = 56) and extrapancreatic (N = 145) tumors. RESULTS SS technique resulted in a higher number of smear pairs both in pancreatic (1.74 vs. 3.19; p < 0.001) and extrapancreatic tumors (1.62 vs. 3.28; p < 0.001); however, it decreased the proportion of diagnostic smears (46.69% vs. 36.52%; p = 0.002 and 49.17% vs. 30.67%; p < 0.001) and increased the bloodiness (1.51 vs. 2.07; p < 0.001 and 1.48 vs. 2.05; p < 0.001). In pancreatic cancers, no difference was observed in terms of diagnostic accuracy (81.38% vs. 83.45%) and cellularity (1.44 vs. 1.27; p = 0.067); however, they were substantially higher in extrapancreatic tumors using SP technique (71.41% vs. 60.71% and 1.34 vs. 0.77; p < 0.001). Only SP technique resulted in a significant difference between examiners in terms of technical success rate and quality of smears without any decrease of diagnostic accuracy. CONCLUSIONS SP technique yields better quality smears independently from tumors characteristics; however, it shows significant examiner-dependency. SS technique reduces the diagnostic accuracy of sampling in extrapancreatic tumors.
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Affiliation(s)
- Renáta Bor
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Béla Vasas
- Department of Pathology, University of Szeged, Szeged, Hungary
| | - Anna Fábián
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Mónika Szűcs
- Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary
| | - Árpád Füredi
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - László Czakó
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Mariann Rutka
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Klaudia Farkas
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Tamás Molnár
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Ágnes Milassin
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Anita Bálint
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Kata Szántó
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Sándor Hamar
- Department of Pathology, University of Szeged, Szeged, Hungary
| | - László Kaizer
- Department of Pathology, University of Szeged, Szeged, Hungary
| | | | - Zoltán Szepes
- First Department of Medicine, University of Szeged, Szeged, Hungary
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Horváth Z, Paszt A, Simonka Z, Látos M, Kaizer L, Hamar S, Vörös A, Ormándi K, Fejes Z, Lázár G. Is axillary lymph node dissection necessary for positive preoperative aspiration cytology lymph node results? Eur J Surg Oncol 2019; 46:504-510. [PMID: 31708307 DOI: 10.1016/j.ejso.2019.10.043] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 10/17/2019] [Accepted: 10/31/2019] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Based on international guidelines, axillary lymph node dissection (ALND) is recommended in cases of breast cancer if preoperative examinations confirm axillary metastasis. We examined which set of preoperative parameters might render ALND unnecessary. PATIENTS AND METHODS Preoperative examinations (axillary ultrasound and aspiration cytology) confirmed axillary metastasis in 190 cases out of 2671 patients with breast cancer; primary ALN dissection was performed on these patients with or without prior neoadjuvant therapy. The clinicopathological results were analysed to determine which parameter might predict the presence of no more than 2 or 3 metastatic ALNs. RESULTS The final histological examination confirmed 1-3 metastatic lymph nodes in ALND samples in 116 cases and over 3 metastatic lymph nodes in 74 cases. For patients receiving neoadjuvant therapy (59 out of the 190 cases), if the size of the primary tumour was 2 cm or smaller and/or the metastatic ALN was 15 mm or smaller, then the patient was likely to have no more than 3 positive ALNs (stage N0-1 disease) (p < 0.001). If the patient did not receive neoadjuvant therapy, stage N2 or N3 disease was very likely. No correlation was found between other clinicopathological characteristics of the tumour and involvement of the ALNs. CONCLUSION Axillary lymph node dissection is not necessary for selected breast cancer patients with axillary metastasis receiving neoadjuvant therapy. In these cases, sentinel lymph node biopsy with or without radiation therapy and close follow-up may serve as adequate therapy.
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Affiliation(s)
- Z Horváth
- Department of Surgery, University of Szeged, Albert Szent-Györgyi Clinical Centre, H-6725, Szeged, Semmelweis u. 8, Hungary.
| | - A Paszt
- Department of Surgery, University of Szeged, Albert Szent-Györgyi Clinical Centre, H-6725, Szeged, Semmelweis u. 8, Hungary.
| | - Z Simonka
- Department of Surgery, University of Szeged, Albert Szent-Györgyi Clinical Centre, H-6725, Szeged, Semmelweis u. 8, Hungary.
| | - M Látos
- Department of Surgery, University of Szeged, Albert Szent-Györgyi Clinical Centre, H-6725, Szeged, Semmelweis u. 8, Hungary.
| | - L Kaizer
- Department of Pathology, University of Szeged, Albert Szent-Györgyi Clinical Centre, H-6725, Szeged, Állomás u. 2, Hungary.
| | - S Hamar
- Department of Pathology, University of Szeged, Albert Szent-Györgyi Clinical Centre, H-6725, Szeged, Állomás u. 2, Hungary.
| | - A Vörös
- Department of Pathology, University of Szeged, Albert Szent-Györgyi Clinical Centre, H-6725, Szeged, Állomás u. 2, Hungary.
| | - K Ormándi
- Affidea Hungary - Szeged, University of Szeged, Albert Szent-Györgyi Clinical Centre, H-6725, Szeged, Semmelweis u. 6/A, Hungary.
| | - Z Fejes
- Affidea Hungary - Szeged, University of Szeged, Albert Szent-Györgyi Clinical Centre, H-6725, Szeged, Semmelweis u. 6/A, Hungary.
| | - G Lázár
- Department of Surgery, University of Szeged, Albert Szent-Györgyi Clinical Centre, H-6725, Szeged, Semmelweis u. 8, Hungary.
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Horvath Z, Paszt A, Simonka Z, Latos M, Nagy J, Szirony D, Frittmann L, Kaizer L, Hamar S, Voros A, Ormandi K, Fejes Z, Lazar G. To do or not to do: axillary blockdissection after preoperative axillary ultrasound and aspiration cytology. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.360] [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: 11/30/2022] Open
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Bor R, Vasas B, Fábián A, Bálint A, Farkas K, Milassin Á, Czakó L, Rutka M, Molnár T, Szűcs M, Tiszlavicz L, Kaizer L, Hamar S, Szepes Z. Prospective comparison of slow-pull and standard suction techniques of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of solid pancreatic cancer. BMC Gastroenterol 2019; 19:6. [PMID: 30626331 PMCID: PMC6327397 DOI: 10.1186/s12876-018-0921-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 12/10/2018] [Indexed: 12/13/2022] Open
Abstract
Background The usage of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for the diagnosis of solid pancreatic cancer is increasing, however mainly retrospective studies are available about the detailed methods of sampling. Methods To compare prospectively the diagnostic yield of EUS-FNA samples obtained with slow-pull (SP) and with standard suction technique (SS). Results EUS-FNA sampling was diagnostic in 72 of 92 cases (78.3%). Diagnostic yield was 67.4% in the SS and 65.2% in the SP group. The number of smear pairs (1.84 vs. 3.56; p < 0.001) and blood contamination (1.50 vs. 2.19; p < 0.001) were significantly higher in the SS group, which resulted in lower rate of diagnostic samples (41.8% vs. 30.0%; p = 0.003). There was no difference in the cellularity (1.58 vs. 1.37; p = 0.2554), or in the sensitivity and specificity in the identification of malignancy between SP and SS subgroups (69.9, 100% vs. 73.5, 100%). Histological samples were obtained in 60 cases (with SP: 49 cases; with SS: 46 cases). There was no difference in the diagnostic yield of histological samples between the groups (63 and 58.7%). Conclusion The diagnostic yield, the cellularity of smears and the rate of acquiring sufficient histological material are similar in the SP and SS group, but due to lower bloodiness and decreased number of slides, the pathological diagnosis is faster and more cost-effective.
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Affiliation(s)
- Renáta Bor
- First Department of Medicine, University of Szeged, Korányi Fasor 8-10, Szeged, 6720, Hungary
| | - Béla Vasas
- Department of Pathology, University of Szeged, Szeged, Hungary
| | - Anna Fábián
- First Department of Medicine, University of Szeged, Korányi Fasor 8-10, Szeged, 6720, Hungary
| | - Anita Bálint
- First Department of Medicine, University of Szeged, Korányi Fasor 8-10, Szeged, 6720, Hungary
| | - Klaudia Farkas
- First Department of Medicine, University of Szeged, Korányi Fasor 8-10, Szeged, 6720, Hungary
| | - Ágnes Milassin
- First Department of Medicine, University of Szeged, Korányi Fasor 8-10, Szeged, 6720, Hungary
| | - László Czakó
- First Department of Medicine, University of Szeged, Korányi Fasor 8-10, Szeged, 6720, Hungary
| | - Mariann Rutka
- First Department of Medicine, University of Szeged, Korányi Fasor 8-10, Szeged, 6720, Hungary
| | - Tamás Molnár
- First Department of Medicine, University of Szeged, Korányi Fasor 8-10, Szeged, 6720, Hungary
| | - Mónika Szűcs
- Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary
| | | | - László Kaizer
- Department of Pathology, University of Szeged, Szeged, Hungary
| | - Sándor Hamar
- Department of Pathology, University of Szeged, Szeged, Hungary
| | - Zoltán Szepes
- First Department of Medicine, University of Szeged, Korányi Fasor 8-10, Szeged, 6720, Hungary.
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Horváth Z, Paszt A, Simonka Z, Látos M, Oláh V, Nagyszegi D, Kaizer L, Fejes Z, Hamar S, Csörgő E, Ormándi K, Lázár M, Lázár G. Is intraoperative touch imprint cytology indicated in the surgical treatment of early breast cancers? Eur J Surg Oncol 2017; 43:1252-1257. [PMID: 28139361 DOI: 10.1016/j.ejso.2017.01.003] [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: 05/30/2016] [Revised: 11/29/2016] [Accepted: 01/10/2017] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Intraoperative touch imprint cytology (TIC) of the sentinel lymph node(s) (SLN(s)) in the treatment of breast cancer has significantly reduced the number of axillary block dissections (ABD) required during second surgeries. Based on recent studies, ABD was not considered necessary if the presence of tumor cells/micrometastasis was confirmed in the SLN(s) or in the case of macrometastases in a patient group meeting the inclusion criteria for the ACOSOG Z0011 study. Our aim was to determine the sensitivity and usefulness of TIC with regard to these results. METHODS TICs of the SLN(s) were examined in 1168 patients operated on for breast cancer. The method was also analyzed retrospectively based on the guidelines for the Z0011 study. During TIC, new samples were cut every 250 μm; impression smears were evaluated after being stained with hematoxylin eosin. RESULTS TIC confirmed metastasis in 202 cases (202/1168, 17.29%). Metastasis was confirmed in SLN(s) in 149 additional cases during a final histological examination. The sensitivity of TIC was found to be 57.18%, and its specificity was 99.63%. An analysis was then performed except for cases that met the inclusion criteria for the Z0011 study and with metastasis smaller than 2 mm (micrometastasis/isolated tumor cells) considered to be positive during intraoperative cytology. The sensitivity of the method decreased to 34.23%, while its specificity was still high at 99.76%. CONCLUSIONS Based on the new guidelines for ABD, imprint cytology cannot be considered a beneficial and cost-effective intervention in the surgical treatment of early breast cancer.
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Affiliation(s)
- Z Horváth
- Department of Surgery, University of Szeged, Albert Szent-Györgyi Clinical Center, Semmelweis u. 8., Szeged, H-6720, Hungary.
| | - A Paszt
- Department of Surgery, University of Szeged, Albert Szent-Györgyi Clinical Center, Semmelweis u. 8., Szeged, H-6720, Hungary.
| | - Z Simonka
- Department of Surgery, University of Szeged, Albert Szent-Györgyi Clinical Center, Semmelweis u. 8., Szeged, H-6720, Hungary.
| | - M Látos
- Department of Surgery, University of Szeged, Albert Szent-Györgyi Clinical Center, Semmelweis u. 8., Szeged, H-6720, Hungary.
| | - V Oláh
- Department of Surgery, University of Szeged, Albert Szent-Györgyi Clinical Center, Semmelweis u. 8., Szeged, H-6720, Hungary.
| | - D Nagyszegi
- Department of Surgery, University of Szeged, Albert Szent-Györgyi Clinical Center, Semmelweis u. 8., Szeged, H-6720, Hungary.
| | - L Kaizer
- Department of Pathology, University of Szeged, Albert Szent-Györgyi Clinical Center, Allomás u. 2., Szeged, H-6720, Hungary.
| | - Z Fejes
- Department of Pathology, University of Szeged, Albert Szent-Györgyi Clinical Center, Allomás u. 2., Szeged, H-6720, Hungary.
| | - S Hamar
- Department of Pathology, University of Szeged, Albert Szent-Györgyi Clinical Center, Allomás u. 2., Szeged, H-6720, Hungary.
| | - E Csörgő
- Department of Pathology, University of Szeged, Albert Szent-Györgyi Clinical Center, Allomás u. 2., Szeged, H-6720, Hungary.
| | - K Ormándi
- Diagnoscan Hungary - Szeged, Semmelweis u. 6., Szeged, H-6725, Hungary.
| | - M Lázár
- Diagnoscan Hungary - Szeged, Semmelweis u. 6., Szeged, H-6725, Hungary.
| | - G Lázár
- Department of Surgery, University of Szeged, Albert Szent-Györgyi Clinical Center, Semmelweis u. 8., Szeged, H-6720, Hungary.
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Horvath Z, Paszt A, Simonka Z, Nagyszegi D, Kaizer L, Hamar S, Csorgo E, Lazar G. 45. Is intraoperative imprint cytology indicated in the surgical treatment of early breast cancers? Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.06.051] [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: 11/26/2022] Open
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Bor R, Farkas K, Bálint A, Molnár T, Nagy F, Valkusz Z, Sepp K, Tiszlavicz L, Hamar S, Szepes Z. [Endoscopic ultrasound-guided ethanol ablation: an alternative option for the treatment of pancreatic insulinoma]. Orv Hetil 2015; 155:1647-51. [PMID: 25282110 DOI: 10.1556/oh.2014.30012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 12/22/2022]
Abstract
Endoscopic ultrasound is the most accurate imaging modality for the diagnosis of pancreatic cancer, and endoscopic ultrasound-guided fine needle injection has already been used for palliative interventions. Surgical resection is currently the standard treatment for pancreatic insulinoma. Medical treatment may be necessary for symptomatic patients with unresectable disease. Case reports have been published about the success of endoscopic ultrasound-guided alcoholic ablation, but it has not been reported previously in Hungarian literature. The authors present the history of an 83-year-old woman who was evaluated because of repeated hypoglycemic coma occurring during the night. Endosonographic image and laboratory findings (elevated serum insulin and chromogranin A) revealed pancreatic insulinoma. Because of severe comorbidities and high risk of surgical resection, the decision was made to ablate the insulinoma by endoscopic ultrasound-guided alcohol injection. A total of 3 mL 95% ethanol was injected into the tumor. Despite the discontinuation of the diazoxide therapy the hypoglycemic episodes disappeared. This case history confirms that endoscopic ultrasound-guided alcoholic ablation is a novel, minimal invasive alternative treatment for patients with pancreatic neuroendocrine tumors in whom surgery is not feasible.
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Affiliation(s)
- Renáta Bor
- Szegedi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Szeged Korányi fasor 8-10. 6720
| | - Klaudia Farkas
- Szegedi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Szeged Korányi fasor 8-10. 6720
| | - Anita Bálint
- Szegedi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Szeged Korányi fasor 8-10. 6720
| | - Tamás Molnár
- Szegedi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Szeged Korányi fasor 8-10. 6720
| | - Ferenc Nagy
- Szegedi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Szeged Korányi fasor 8-10. 6720
| | - Zsuzsanna Valkusz
- Szegedi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Szeged Korányi fasor 8-10. 6720
| | - Krisztián Sepp
- Szegedi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Szeged Korányi fasor 8-10. 6720
| | - László Tiszlavicz
- Szegedi Tudományegyetem, Általános Orvostudományi Kar Patológiai Intézet Szeged
| | - Sándor Hamar
- Szegedi Tudományegyetem, Általános Orvostudományi Kar Patológiai Intézet Szeged
| | - Zoltán Szepes
- Szegedi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Szeged Korányi fasor 8-10. 6720
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Cserni G, Bori R, Sejben I, Vörös A, Kaiser L, Hamar S, Csörgő E, Kulka J. Unifocal, multifocal and diffuse carcinomas: A reproducibility study of breast cancer distribution. Breast 2013; 22:34-8. [DOI: 10.1016/j.breast.2012.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2012] [Revised: 05/06/2012] [Accepted: 05/14/2012] [Indexed: 11/26/2022] Open
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Nikolényi A, Uhercsák G, Csenki M, Hamar S, Csörgo E, Tánczos E, Thurzó L, Brodowicz T, Wagnerova M, Kahán Z. Tumour topoisomerase II alpha protein expression and outcome after adjuvant dose-dense anthracycline-based chemotherapy. Pathol Oncol Res 2011; 18:61-8. [PMID: 21681601 DOI: 10.1007/s12253-011-9417-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Accepted: 05/12/2011] [Indexed: 10/18/2022]
Abstract
There is a need for the selection of those breast cancers where benefit may be attained from the addition of an anthracycline to the adjuvant chemotherapy. The expression of topoisomerase II alpha (TOP2A) protein in 3 cohorts of breast cancers treated with adjuvant dose-dense anthracycline-based chemotherapy was determined retrospectively. The TOP2A status was analysed in relation with the other standard tumour features and the outcome. TOP2A IHC results were assessable in 106 patients: with a cut-off value of 15%, 48% of the tumours were classified as TOP2A-positive. The expression of TOP2A correlated with that of Ki67 (R = 0.532, p < 0.001) and a high grade (p = 0.04), but did not correlate with the proportion of ER- or PR-positive cells in the tumour. More tumors were TOP2A-negative among the ER- or PR-positive cancers than among the ER/PR-negative cancers (p = 0.021 and p = 0.002, respectively). After a median follow-up time of 64.5 months, 31 relapses (23.5%) and 23 deaths (17.4%) had occurred in 131 patients. The overall survival was longer in the TOP2A-positive cases than in the TOP2A-negative cases. The recurrence-free survival and the overall survival were significantly more favourable in the ER/PR-negative and TOP2A-positive tumours than in other subgroups. In a Cox proportional hazards model, the grade and TOP2A remained significant determinants in the ER/PR-negative subgroup. TOP2A positivity and grade 3 indicated a decrease in the risk of death with HR = 0.211 (95% CI: 0.042-1.05, p = 0.056) and HR = 0.216 (95% CI: 0.047-0.990, p = 0.048), respectively. A higher sensitivity to anthracycline-containing regimens is suggested in ER/PR-negative and TOP2A-positive cancers.
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Affiliation(s)
- Alíz Nikolényi
- Department of Oncotherapy, University of Szeged, Hungary
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Novák P, Németh I, Hamar S, Tiszlavicz L, Szalai L, Sonkodi I, Nagy K. [Clear cell adenocarcinoma of the tongue. Coincidence or distant metastasis?]. Fogorv Sz 2009; 102:183-186. [PMID: 20000197] [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: 05/28/2023]
Abstract
Malignant tumors of the salivary glands are rare, they account for less than 0.5% of all malignancies and for 5% of cancers of maxillofacial regions. Clear cell adenocarcinoma represents 1% of malignant tumors of the salivary glands. The present case involved a 63-years-old Hungarian woman with a painless, non-ulcerated, nodular mass on the right side of the middle part of the tongue. Her past medical history included right nephrectomy of renal cell carcinoma, seven years before the tongue tumor. The initial orofacial clinical examination suspected lipoma, neurinoma or distant metastasis of the renal cell carcinoma. The histomorphological analysis of the resected tongue tumor showed similar clear cell adenocarcinoma mimicking the phenotype of renal cell carcinoma but detailed immunohistochemical analysis proved the primary origin of tongue indicating second primary metachronous malignant tumor.
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Affiliation(s)
- Péter Novák
- Szegedi Tudományegyetem, Fogorvostudományi Kar, Szájsebészeti Tanszék, Orális Medicina Részleg
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Nádasdy T, Hamar S, Remák G. [Pericardial mesothelioma]. Morphol Igazsagugyi Orv Sz 1986; 26:264-71. [PMID: 3785245] [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: 01/07/2023]
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