Publications by authors named "Kocian R"
Background: The aim was to evaluate the performance of the Peritoneal Cancer Index (PCI) using imaging (ultrasound, contrast-enhanced computed tomography (CT), and whole-body diffusion-weighted magnetic resonance imaging (WB-DWI/MRI) in assessing peritoneal carcinomatosis and predicting non-resectability in tubo-ovarian carcinoma patients.
Methods: This was a prospective multicenter observational study. We considered all patients with suspected primary ovarian/tubal/peritoneal cancer who underwent preoperative ultrasound, CT, and WB-DWI/MRI (if available).
Article Synopsis
- People with T1a cervical cancer usually do well, but there's still a chance their cancer might come back, and doctors need better guidance on how to manage this.
- A study looked at over 900 patients from different hospitals to find out more about the chances of cancer returning after surgery.
- The study found that only 4.1% of patients had their cancer return, and it happened more often in certain groups, showing that certain things like lymphovascular space invasion (LVSI) can change the risk.
Introduction: Fertility-sparing treatment (FST) for patients with cervical cancer intends to achieve oncologic outcomes comparable to those after radical treatment while maximizing reproductive outcomes, including the ability to conceive and minimizing the risk of prematurity.
Methodology: International multicentre retrospective FERTISS study focused on patients treated with FST analysed timing of FST relative to pregnancy, conception attempts and methods, abortion rates, prophylactic procedures reducing the risk of severe prematurity, pregnancy duration, and delivery mode.
Results: Of the 733 patients treated at 44 centres in 13 countries, 49.
Purpose: Patients with high-grade serous ovarian carcinoma (HGSOC) are virtually insensitive to immune checkpoint inhibitors (ICI) employed as standalone therapeutics, at least in part reflecting microenvironmental immunosuppression. Thus, conventional chemotherapeutics and targeted anticancer agents that not only mediate cytotoxic effects but also promote the recruitment of immune effector cells to the HGSOC microenvironment stand out as promising combinatorial partners for ICIs in this oncological indication.
Experimental Design: We harnessed a variety of transcriptomic, spatial, and functional assays to characterize the differential impact of neoadjuvant paclitaxel-carboplatin on the immunological configuration of paired primary and metastatic HGSOC biopsies as compared to neoadjuvant chemotherapy (NACT)-naïve HGSOC samples from five independent patient cohorts.
Background: A laparoscopy-based scoring system was developed by Fagotti et al (Fagotti or Predictive Index value (PIV)score) based on the intraoperative presence or absence of carcinomatosis on predefined sites. Later, the authors updated the PIV score calculated only in the absence of one or both absolute criteria of nonresectability (mesenteric retraction and miliary carcinomatosis of the small bowel) (updated PIV model).
Objective: The aim was to demonstrate the noninferiority of ultrasound to other imaging methods (contrast enhanced computed tomography (CT) and whole-body diffusion-weighted magnetic resonance imaging (WB-DWI)/MRI) in predicting nonresectable tumor (defined as residual disease >1 cm) using the updated PIV model in patients with tubo-ovarian cancer.
Article Synopsis
- The study aimed to evaluate the effectiveness of ultrasonography for pre-operative assessment of lymph nodes in cervical cancer patients, specifically comparing pelvic and para-aortic regions and differentiating between macrometastases and micrometastases.
- A total of 390 patients were analyzed, revealing that ultrasonography had good specificity and moderate sensitivity for detecting pelvic macrometastases, but much lower sensitivity for micrometastases, while also showing notable results for para-aortic macrometastases.
- The findings suggest that experienced sonographers can rely on ultrasonography as a valuable diagnostic tool for lymph node assessment in cervical cancer, with performance comparable to other imaging techniques.
Objective: To report the outcome of SLN staging in the SENTIX international prospective trial of SLN biopsy in patients with cervical cancer with an intensive ultrastaging protocol and central quality control and to evaluate how the intensity of pathological assessment correlates with metastatic detection rate in SLNs.
Methods: Eligible were patients with stages T1a1/LVSI+ to T1b2 (<4 cm, ≤2 cm for fertility sparing), common tumor types, no suspicious lymph nodes on imaging, and bilateral SLN detection. SLNs were examined intraoperatively and processed by an intensive protocol for ultrastaging (paraffin blocks sectioned completely in 150-μm intervals/levels).
Background: In addition to the diagnostic accuracy of imaging methods, patient-reported satisfaction with imaging methods is important.
Objective: To report a secondary outcome of the prospective international multicenter Imaging Study in Advanced ovArian Cancer (ISAAC Study), detailing patients' experience with abdomino-pelvic ultrasound, whole-body contrast-enhanced computed tomography (CT), and whole-body diffusion-weighted magnetic resonance imaging (WB-DWI/MRI) for pre-operative ovarian cancer work-up.
Methods: In total, 144 patients with suspected ovarian cancer at four institutions in two countries (Italy, Czech Republic) underwent ultrasound, CT, and WB-DWI/MRI for pre-operative work-up between January 2020 and November 2022.
Purpose: We found a need for balancing the application of clinical guidelines and tailored approaches to follow-up of cervical cancer (CC) patients in the lymph node micrometastatic (MICs) setting. This review aimed to determine the current knowledge of management of MIC-positive CC cases.
Methodology: We addressed prognostic and risk of recurrence monitoring impacts associated with MIC+ cases.
Intratumoral tertiary lymphoid structures (TLSs) have been associated with improved outcome in various cohorts of patients with cancer, reflecting their contribution to the development of tumor-targeting immunity. Here, we demonstrate that high-grade serous ovarian carcinoma (HGSOC) contains distinct immune aggregates with varying degrees of organization and maturation. Specifically, mature TLSs (mTLS) as forming only in 16% of HGSOCs with relatively elevated tumor mutational burden (TMB) are associated with an increased intratumoral density of CD8 effector T (T) cells and TIM3PD1, hence poorly immune checkpoint inhibitor (ICI)-sensitive, CD8 T cells.
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- The study aimed to create a consensus on the surgical technique for sentinel lymph node dissection in cervical cancer by surveying expert gynecological oncology surgeons.
- A two-step modified Delphi method was employed, involving initial surveys and follow-up interviews, with a 70% agreement threshold for consensus.
- Findings indicated that experts reached consensus on 15 recommended practices, including the use of indocyanine green as a tracer and specific injection techniques, while recommending against certain procedures such as injecting directly into tumors.
Article Synopsis
- - The study focuses on identifying risk factors for anal and oral HPV infections in women with severe cervical lesions (CIN2+) and confirms the link between HPV and cancer in both anogenital and oropharyngeal areas.
- - Strongest risk factors for anal HPV included existing cervical HPV infection, having ten or more sexual partners, and engaging in anal-penetrative intercourse, while for oral HPV, a history of genital warts in the woman or her male partner was significant.
- - The findings suggest that HPV infection in one area (like the cervix) increases the likelihood of infection in another area (like the anus or mouth), highlighting different routes and risk factors for transmission across bodily sites.
Article Synopsis
- The survey aimed to understand the health concerns and characteristics of long-term ovarian cancer survivors (LTS) to improve follow-up care.
- Conducted by NOGGO and shared with ENGOT and GCIG members, the anonymous survey included 68 questions and gathered responses from 1,044 LTS across 14 countries.
- Findings highlighted that LTS who survived 5-10 years reported worse health than those over 10 years, with almost half experiencing persistent symptoms like fatigue and pain, emphasizing the need for specialized long-term care.
Purpose: Platinum-based doublets with concurrent and maintenance bevacizumab are standard therapy for ovarian cancer (OC) relapsing after a platinum-free interval (PFI) >6 months. Immunotherapy may be synergistic with bevacizumab and chemotherapy.
Patients And Methods: ATALANTE/ENGOT-ov29 (ClinicalTrials.
We report a rare case of primary nodal, poorly differentiated endometrioid carcinoma associated with Lynch syndrome. A 29-year-old female patient was referred by her general gynecologist for further imaging with suspected right-sided ovarian endometrioid cyst. Ultrasound examination by an expert gynecological sonographer at tertiary center revealed unremarkable findings in the abdomen and pelvis apart from three iliac lymph nodes showing signs of malignant infiltration in the right obturator fossa and two lesions in the 4b segment of the liver.
View Article and Find Full Text PDFBackground: IMP2 and IMP3 are mRNA binding proteins involved in carcinogenesis. We examined a large cohort of ovarian tumors with the aim to assess the value of IMP2 and IMP3 for differential diagnosis, and to assess their prognostic significance.
Methods: Immunohistochemical analyses with antibodies against IMP2 and IMP3 were performed on 554 primary ovarian tumors including 114 high grade serous carcinomas, 100 low grade serous carcinomas, 124 clear cell carcinomas, 54 endometrioid carcinomas, 34 mucinous carcinomas, 75 mucinous borderline tumors, and 41 serous borderline tumors (micropapillary variant).
Article Synopsis
- The study investigates the effectiveness of adjuvant (chemo)radiation therapy compared to radical surgery alone in patients with intermediate-risk early-stage cervical cancer.
- It aims to determine whether the addition of adjuvant treatment offers any survival benefit or if radical surgery alone is sufficient for disease-free survival.
- In this phase III trial, 514 patients will be randomly assigned to either receive no additional treatment or undergo adjuvant therapy after surgery, with patient data tracked for three to six years to assess outcomes.
Objective: Case report of a gynecologically polymorbid patient with enhanced myometrial vascularity, and review of current scientific literature on incidence, dia-gnostic method, and management of this phenomenon.
Case Report: A 38-year-old patient that has been treated long-term for secondary sterility with a medical history of laparotomic cytoreduction surgery for adenomyosis and subsequent development and treatment of postoperative intrauterine adhesions. Currently presenting with enhanced myometrial vascularity after spontaneous abortion.
Background: The aim of the study was to compare health-related quality of life (QoL) and oncological outcome between gynaecological cancer patients undergoing pelvic exenteration (PE) and extended pelvic exenteration (EPE). EPEs were defined as extensive procedures including, in addition to standard PE extent, the resection of internal, external, or common iliac vessels; pelvic side-wall muscles; large pelvic nerves (sciatic or femoral); and/or pelvic bones.
Methods: Data from 74 patients who underwent PE (42) or EPE (32) between 2004 and 2019 at a single tertiary gynae-oncology centre in Prague were analysed.
This is a case report of a rare finding of an extragonadal yolk sac tumor in a 37-year-old patient who presented with shortness of breath and abdominal bloating. During imaging and staging surgery, the findings were strongly suggestive of an extragonadal advanced tumor presenting with peritoneal dissemination, predominantly affecting omentum, with no clear primary origin. Histology revealed an extragonadal yolk sac tumor in a pure form outside the ovaries.
View Article and Find Full Text PDFObjective: In order to define the clinical significance of low-volume metastasis, a comprehensive meta-analysis of published data and individual data obtained from articles mentioning micrometastases (MIC) and isolated tumor cells (ITC) in cervical cancer was performed, with a follow up of at least 3 years.
Methods: We performed a systematic literature review and meta-analysis, following Cochrane's review methods guide and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The primary outcome was the disease-free survival (DFS), and the secondary outcome was the overall survival (OS).
Article Synopsis
- Lower limb lymphoedema (LLL) is a common and severe complication after pelvic lymph node surgery, but there is currently no standardized way to measure it.
- In the SENTIX trial, 150 cervical cancer patients were monitored for changes in limb volume over 24 months, revealing that LLL fluctuates significantly over time, with a notable percentage developing swelling months after surgery.
- The study suggests that LLL should only be diagnosed when there is more than a 15% increase in limb volume, and it emphasizes the need for prolonged follow-up to accurately differentiate between transient and persistent swelling.
Article Synopsis
- Minimally invasive radical trachelectomy offers a fertility-preserving option for early-stage cervical cancer but has raised concerns about poorer oncologic outcomes compared to open radical hysterectomy.
- A study comparing 4.5-year disease-free survival rates involved 646 patients treated from 2005-2017 across multiple international centers, focusing on those with tumor sizes of ≤2 cm.
- The analysis used Kaplan-Meier methods to evaluate the outcomes, revealing differences in recurrence rates between open and minimally invasive surgical approaches.
Background: To prospectively assess LLL incidence among cervical cancer patients treated by uterine surgery complemented by SLN biopsy, without PLND.
Methods: A prospective study in 150 patients with stage IA1-IB2 cervical cancer treated by uterine surgery with bilateral SLN biopsy. Objective LLL assessments, based on limb volume increase (LVI) between pre- and postoperative measurements, and subjective patient-perceived swelling were conducted in six-month periods over 24-months post-surgery.
Preoperative staging of ovarian cancer: comparison between ultrasound, CT and whole-body diffusion-weighted MRI (ISAAC study).
Ultrasound Obstet Gynecol
February 2022
Objectives: To compare the performance of transvaginal and transabdominal ultrasound with that of the first-line staging method (contrast-enhanced computed tomography (CT)) and a novel technique, whole-body magnetic resonance imaging with diffusion-weighted sequence (WB-DWI/MRI), in the assessment of peritoneal involvement (carcinomatosis), lymph-node staging and prediction of non-resectability in patients with suspected ovarian cancer.
Methods: Between March 2016 and October 2017, all consecutive patients with suspicion of ovarian cancer and surgery planned at a gynecological oncology center underwent preoperative staging and prediction of non-resectability with ultrasound, CT and WB-DWI/MRI. The evaluation followed a single, predefined protocol, assessing peritoneal spread at 19 sites and lymph-node metastasis at eight sites.