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The effect of sarcopenia on survival in patients with metastatic colon cancer
No full textIntroduction. Sarcopenia is a common loss of muscle mass in cancer patients. The aim of this study is to investigate the effect of sarcopenia on survival in patients with metastatic colon cancer.
Material and methods. The study was carried out retrospectively in patients diagnosed with metastatic colon cancer between January 2016 and December 2023. Sarcopenic patients were determined by total psoas area index and Hounsfield unit average calculation using computed tomography scan images obtained at the time of diagnosis. Statistical analyses were performed using Windows SPSS 20 package program. The effects of sarcopenia on survival were analyzed using the log-rank test, and univariate Cox regression analysis was applied to evaluate clinicopathological features. A p-value < 0.05 was considered statistically significant.
Results. A total of 70 patients with metastatic colon cancer were evaluated. Sarcopenia was detected in 18 patients (25.7%). The median age of the sarcopenic patients was 72 (53–83) years. A significant correlation was found between age and sarcopenia (p = 0.002). Median survival of sarcopenic patients was 11 months while non-sarcopenic patients had a median survival of 24 months. A difference was found in overall survival between the two groups (p = 0.021). There was no difference in progression free survival between sarcopenic and non-sarcopenic patients (p = 0.615).
Conclusions. In the present study, a significant prognostic effect of sarcopenia on survival was found in patients with metastatic colon cancer. The survival of sarcopenic patients was poorer
A case of primary breast osteosarcoma
No full textPrimary breast osteosarcoma (PBOS) makes up less than 0.125% of all breast neoplasms and 12.5% of breast sarcomas.
Here, the case of a 53-year-old patient is presented who was treated at The Maria Skłodowska-Curie Institute of Oncology in Warsaw. Histopathological examination of core needle biopsy specimen revealed a neoplasm composed of atypic oval and spindle cells with chondroid differentiation as well as osteoid-like bands and myxoid stroma. The patient underwent a simple mastectomy with lymph node dissection. Histopathological evaluation of the surgical specimen confirmed the diagnosis of osteosarcoma G3, any features of metaplastic carcinoma as well as phyllodes tumor were excluded. Patient was given adjuvant radiotherapy after the operation. Seven months subsequent, multiple metastases in the lungs were found in a CT scan. The patient received chemotherapy, which, after three courses, resulted in a significant decrease of the metastases.
Addressed in discussion was the origin of this tumor, which is ambiguous, and a review the prognostic factors, of which, the most reliable is the size of the lesion and treatment methods, where wide excision definitely plays a major role
Three lines of treatment with ALK inhibitors in a patient with adenocarcinoma of the lung with ALK gene rearrangement
No full textLung adenocarcinoma (ADC) with anaplastic lymphoma kinase (ALK) gene rearrangement poses treatment challenges due to its aggressive nature and propensity for central nervous system (CNS) metastasis. This report is the case of a 61-year-old male patient with ALK rearranged ADC who underwent three lines of ALK inhibitor (ALKi) therapy: crizotinib, alectinib, and lorlatinib. The patient's initial treatment with a first-generation ALKi — crizotinib (24 months) — was discontinued due to progression of the primary lesion and CNS metastases, resulting in a switch to alectinib (a second-generation ALKi). However, elevated serum total bilirubin levels during therapy necessitated a reduction in the dose of alectinib. While complete regression of CNS lesions was initially achieved, further disease progression occurred after 11 months of alectinib treatment. Subsequent treatment with lorlatinib, a third-generation ALKi, resulted in stabilization of lung lesions and CNS oligoprogression . The dose was reduced due to the patient's anxiety disorder and elevated total cholesterol and triglyceride levels. Ongoing therapy is showing satisfactory results. This case report highlights the importance of individualized treatment strategies based on toxicity profiles and clinical responses in ALK-positive lung ADC with CNS metastases
Successful immunotherapy with nivolumab in an elderly patient with HBV-associated cirrhotic hepatocellular carcinoma
No full textThrombosis associated with anti-platelet factor 4 antibodies. More than just heparin-induced thrombocytopenia
No full textAntibodies directed against platelet-factor-4 (PF4) were described in the eighties of the XX century in the context of heparin-induced thrombocytopenia. During the last several years similar rare syndromes characterized by the presence of autoantibodies against PF4 and combining thrombocytopenia with a tendency to thrombosis were described. Some were associated with adenoviral vector based COVID-19 vaccination and other more recently described linked with the presence of monoclonal gaamapathy. Presence of anti-PF4 autoantibodies may be responsible for prothrombotic state due to excessive platelet activation
Technologies in minimally invasive treatment of severe mitral regurgitation
No full textMitral valve regurgitation is the second most common valve defect in Europe among adults. Primary mitral regurgitation (MR) results from structural abnormalities of the valve apparatus (e.g., leaflet prolapse, chordae rupture), often due to myxomatous degeneration or congenital defects. Secondary MR arises from left ventricular remodeling (e.g., after myocardial infarction or heart failure), leading to functional valve incompetence despite normal valve structure. The choice of treatment depends on the degree of valve regurgitation and the severity of the patient's clinical symptoms. The focus herein is on discussing the anatomy of the mitral valve, the pathophysiology of regurgitation, and diagnostic methods. The qualification process is then outlined for invasive treatment and various methods of mitral valve repair, including new minimally invasive techniques. Transcatheter mitral valve repair methods are discussed, among other methods, "edge-to-edge" repair and transcatheter mitral valve replacement. Publicly available data confirms that the latter is a widely available and safe treatment method, that represents a promising alternative to surgical treatment
Do we need to use neoadjuvant carboplatin in all patients with triple-negative breast cancer?
No full textNeoadjuvant systemic therapy represents a standard approach for locally advanced breast cancer, with triple-negative breast cancer (TNBC) showing the most recent progress through combined chemoimmunotherapy. The role of platinum agents in TNBC has long been debated, initially reserved for BRCA1/2-mutated cases. Evolving over the last decade, consensus, along with the newest robust evidence, confirmed that adding carboplatin to paclitaxel significantly improves pCR, event-free survival (EFS), and overall survival (OS) in TNBC patients undergoing neoadjuvant treatment. However, the utilization of carboplatin in the neoadjuvant setting does not seem to be universally beneficial for TNBC patients, especially in the case of older, postmenopausal patients. This article aims to review the available data on the actual benefit of carboplatin in the neoadjuvant setting in TNBC
Physical activity and quality of life in breast cancer patients receiving chemotherapy after surgery — results from a cross-sectional study
No full textIntroduction. Breast cancer is the most common malignancy among women worldwide, and systemic chemotherapy, though effective, often compromises quality of life (QoL). Physical activity may mitigate treatment-related side effects and support psychosocial well-being. This study aimed to assess the associations between physical activity, body composition, and QoL in women undergoing chemotherapy after breast surgery.
Material and methods. A prospective observational study was conducted among 60 women aged 40–80 years with histopathologically confirmed breast cancer. Assessments were performed before the first chemotherapy cycle and six weeks later, prior to the third cycle. Physical activity was evaluated using the International Physical Activity Questionnaire — long form (IPAQ-L), and QoL was measured with the World Health Organization Quality of Life — BREF (short form; WHOQOL-BREF). Anthropometric data and clinical characteristics, including tumor size, human epidermal growth factor receptor 2 (HER2) status, and lymph node involvement, were collected. Statistical analyses included paired tests, chi-square, and Spearman correlations, with significance at p < 0.05.
Results. Participants increased total physical activity during chemotherapy (3738.3 to 5300.7 MET-min/week; p = 0.002), mainly through moderate-intensity activity, while sedentary time decreased (p = 0.020). QoL remained stable across most domains, with significant improvement in the environmental dimension (p = 0.028). Walking and moderate activity correlated positively with physical and psychological QoL, whereas sedentary behavior showed negative associations. Younger age, smaller tumor size, HER2-negative status, and absence of nodal involvement were linked with higher QoL scores.
Conclusions. Despite chemotherapy, women maintained or improved physical activity, preserving QoL. Walking and moderate-intensity activity supported better well-being, while sedentary time predicted lower outcomes. Promoting regular activity during treatment may enhance supportive care in breast cancer
Out-of-pocket (OOP) costs incurred by breast cancer patients in Poland
No full textIntroduction. Breast cancer is the most frequently diagnosed malignant tumor in women worldwide, the treatment of which, despite being financed by public systems, generates significant costs borne directly by patients. Aim: The study aimed to analyze out-of-pocket (OOP) costs incurred by breast cancer patients in Poland, identify the main categories of expenses, and assess their impact on patients’ financial situation.
Material and methods. A survey was conducted on a group of 106 women with breast cancer, using a questionnaire containing questions about the demographic situation and treatment costs. Statistical analysis was performed using IBM SPSS Statistics 26.
Results. As many as 90.6% of respondents declared incurring additional treatment costs, mainly related to travel, dietary supplements, private consultations, and diagnostics. The average annual expenditure on private consultations amounted to PLN 1,137.36 (EUR 264.50), and the monthly costs of prescription drugs were PLN 193.25 (EUR 44.94). More than half of the patients also incurred costs related to rehabilitation, a specialist diet, and medical equipment.
Conclusions. Breast cancer treatment in Poland is associated with a significant financial burden for patients. This indicates the need to develop systemic support mechanisms and expand the scope of reimbursement, which can improve the quality of life of patients and access to comprehensive oncological care
Zastosowanie albutrepenonakogu alfa w terapii hemofilii B
No full textHemophilia B is an inherited coagulation disorder caused by a deficiency or dysfunction of factor IX, for which prophylactic replacement therapy remains the standard of care. The introduction of extended half-life (EHL) FIX concentrates, such as Idelvion® (albutrepenonacog alfa, rIX-FP), has enabled a substantial reduction in dosing frequency and improved pharmacokinetic stability, resulting in enhanced hemostatic control and improved quality of life for patients. Evidence from clinical trials and real-world data consistently demonstrates the effectiveness of rIX-FP in maintaining low annual bleeding rates. It supports individualizing prophylactic regimens based on bleeding phenotype and patient lifestyle. This article presents clinical experience with Idelvion in the preventive management of severe hemophilia B in routine practice.Hemofilia B to wrodzona koagulopatia wynikająca z niedoboru lub dysfunkcji czynnika krzepnięcia IX (FIX, factor IX), w której standardem postępowania pozostaje profilaktyczne leczenie substytucyjne. Wprowadzenie koncentratów FIX o przedłużonym działaniu, takich jak Idelvion® [albutrepenonakog alfa (rekombinowany czynnik IX-FP {rFIX-FP, recombinantfactor IX-FC})], umożliwiło znaczną redukcję częstości przyjmowania leku przez chorych oraz poprawę stabilności farmakokinetycznej, co przełożyło się na lepszą kontrolę hemostazy i wyższą jakość życia pacjentów. Dostępne dane z badań klinicznych oraz analiz real-world evidence (RWE) potwierdzają skuteczność rFIX-FP w utrzymywaniu niskich wskaźników krwawień oraz pozwalają na indywidualizację terapii w zależności od fenotypu krwawienia i stylu życia chorego. W niniejszej pracy przedstawiono doświadczenia kliniczne związane z zastosowaniem Idelvionu® w profilaktyce ciężkiej hemofilii B w warunkach rutynowej praktyki