355 research outputs found
Lymphadenectomy in hypopharyngeal cancer % correlation of micrometastatic spread with predictive molecular markers of therapeutic response
No full textUvod: Skvamocelularni karcinom hipofarinksa (SKH) predstavlja jednu od najagresivnijih neoplazmi glave i vrata. Petogodišnje preţivljavanje kod ovog oboljenja u većini studija je ispod 30%. Zahvaćenost limfnih ţlezda prepoznata je kao nabitniji prognostiĉki faktor za SKH. Hirurško leĉenje SKH stoga treba orijentisati prema odstranjenju primarnog tumora, ali i adekvatnoj limfonodalnoj disekciji, ĉime bi se postigao potencijalni kurativni efekat, ali i odredio taĉan stadijum i prognoza oboljenja.
Uniformno radikalno operisana grupa bolesnika i veliki broj odstranjenih limfnih nodusa omogućio nam je adekvatno odreĊivanje distribucije limfonodalnih metastaza, procene N stadijuma bolesti, ali i dodatnu imunohistohemijsku analizu na prisustvo mikrometastaza u odstranjenim limfnim nodusima. Dodatnim ispitivanjem pokušali smo da ustanovimo korelaciju ekspresije molekularnih markera p53 i EGFR sa preţivljavanjem, i stadijumom bolesti odraţenim prevashodno kroz N stadijum bolesti.
Metodologija: U studiju je ukljuĉeno ukupno 55 bolesnika kod kojih je naĉinjena faringolaringoezofagektomija sa funkcionalnom disekcijom vrata i rekonstrukcija visceralnim transplantatom. Disekcija obe strane vrata je uĉinjena primenom lateralne selektivne disekcije koja je obuhvatala uklanjanje limfnih nodusa iz nivoa II, III, IV i VI . Prilikom patohistološke obrade preparata posebna paţnja je obraćena na sledeće parametre:1. Primarna lokalizacija tumora (mukozna distribucija i dubina infiltracije, diferencijacija, invazija vaskularnih, limfatiĉnih i neuralnih elemenata), 2. Nodalni status (ukupan broj odstranjenih nodusa, ukupan broj pozitivnih nodusa, prisustvo ektrakapsularnog rasta, veliĉina nodusa). Dodatnom imunohistohemijskom analizom ispitivani su limfni nodusi na prisustvo mikrometastaza i izolovanih tumorskih ćelija, odnosno uĉinjena je semikvantitativna procena ekspresija ispitivanih
6
markera (p53 i EGFR). Statistiĉkim analizama naĉinjena je korelacija gore navedenih parametara sa ukupnim preţivljavanjem i kliniĉkim ishodom pri završetku studije...Introduction: Hypopharyngeal squamocellular carcinoma (HSCC) represents one of the most aggressive neoplastic diseases of head and neck. Most of the studies reports 5 year survival rate to be below 30%. Lymph node involvement in HSCC has been recognized as the most important prognostic factor. Surgical treatment of HSCC therefore should be oriented towards removal of the primary tumor, together with the adequate lymhonodal dissection, by which one accomplishes curative intent, both with the proper definite disease staging and prognosis.
Uniformly radically operated group of patients and a large number of dissected lymph nodes provided us with a possibility of accurate estimation of lymph node distribution, accurate N staging and also allowed us additional immunohistochemical analyzes for presence of micrometastases in lymph nodes. With further investigation we will try to estimate the correlation between molecular expression of p53 and EGFR with the overall survival, and the disease stage.
Methodology: Overall, in this study we included 55 patients in whom pharyngolaryngoesophagectomy with selective lymph node dissection and reconstruction with the visceral substituent was performed. We performed bilateral selective lymph node dissection, which included levels II, III, IV and VI. During the pathohistologic work up special emphasis was given upon: 1. primary tumor (mucosal distribution and the depth of infiltration, differentiation and invasion of vascular, lymphatic and neural elements), 2. nodal status (overall number of harvested lymh nodes, overall number of positive lymph nodes, size and presence of extracapsular growth). Immunohistochemistry was performed in order to determine presence of micrometastases and isolated tumor cels (ITC) in lymph nodes, and also to determine the expression of p53 and EGFR. Statistical analyzes were performed with the intent to determine the correlation of the aforementioned parameters with the overall survival rate.
Results: In this study there was no intrahospital mortality. Overall survival median was 18.00 months (11,89 - 24,11). 42 (76%) patients died and 13 (24%) was alive when we ended the study. Two year survival was marked in 27 patients (46.5%). N0 stage was present in 17 patients, 8
9
patients had N1 stage while N2 stage was present in 30 patients..
Lymphadenectomy in hypopharyngeal cancer % correlation of micrometastatic spread with predictive molecular markers of therapeutic response
No full textUvod: Skvamocelularni karcinom hipofarinksa (SKH) predstavlja jednu od najagresivnijih neoplazmi glave i vrata. Petogodišnje preţivljavanje kod ovog oboljenja u većini studija je ispod 30%. Zahvaćenost limfnih ţlezda prepoznata je kao nabitniji prognostiĉki faktor za SKH. Hirurško leĉenje SKH stoga treba orijentisati prema odstranjenju primarnog tumora, ali i adekvatnoj limfonodalnoj disekciji, ĉime bi se postigao potencijalni kurativni efekat, ali i odredio taĉan stadijum i prognoza oboljenja.
Uniformno radikalno operisana grupa bolesnika i veliki broj odstranjenih limfnih nodusa omogućio nam je adekvatno odreĊivanje distribucije limfonodalnih metastaza, procene N stadijuma bolesti, ali i dodatnu imunohistohemijsku analizu na prisustvo mikrometastaza u odstranjenim limfnim nodusima. Dodatnim ispitivanjem pokušali smo da ustanovimo korelaciju ekspresije molekularnih markera p53 i EGFR sa preţivljavanjem, i stadijumom bolesti odraţenim prevashodno kroz N stadijum bolesti.
Metodologija: U studiju je ukljuĉeno ukupno 55 bolesnika kod kojih je naĉinjena faringolaringoezofagektomija sa funkcionalnom disekcijom vrata i rekonstrukcija visceralnim transplantatom. Disekcija obe strane vrata je uĉinjena primenom lateralne selektivne disekcije koja je obuhvatala uklanjanje limfnih nodusa iz nivoa II, III, IV i VI . Prilikom patohistološke obrade preparata posebna paţnja je obraćena na sledeće parametre:1. Primarna lokalizacija tumora (mukozna distribucija i dubina infiltracije, diferencijacija, invazija vaskularnih, limfatiĉnih i neuralnih elemenata), 2. Nodalni status (ukupan broj odstranjenih nodusa, ukupan broj pozitivnih nodusa, prisustvo ektrakapsularnog rasta, veliĉina nodusa). Dodatnom imunohistohemijskom analizom ispitivani su limfni nodusi na prisustvo mikrometastaza i izolovanih tumorskih ćelija, odnosno uĉinjena je semikvantitativna procena ekspresija ispitivanih
6
markera (p53 i EGFR). Statistiĉkim analizama naĉinjena je korelacija gore navedenih parametara sa ukupnim preţivljavanjem i kliniĉkim ishodom pri završetku studije...Introduction: Hypopharyngeal squamocellular carcinoma (HSCC) represents one of the most aggressive neoplastic diseases of head and neck. Most of the studies reports 5 year survival rate to be below 30%. Lymph node involvement in HSCC has been recognized as the most important prognostic factor. Surgical treatment of HSCC therefore should be oriented towards removal of the primary tumor, together with the adequate lymhonodal dissection, by which one accomplishes curative intent, both with the proper definite disease staging and prognosis.
Uniformly radically operated group of patients and a large number of dissected lymph nodes provided us with a possibility of accurate estimation of lymph node distribution, accurate N staging and also allowed us additional immunohistochemical analyzes for presence of micrometastases in lymph nodes. With further investigation we will try to estimate the correlation between molecular expression of p53 and EGFR with the overall survival, and the disease stage.
Methodology: Overall, in this study we included 55 patients in whom pharyngolaryngoesophagectomy with selective lymph node dissection and reconstruction with the visceral substituent was performed. We performed bilateral selective lymph node dissection, which included levels II, III, IV and VI. During the pathohistologic work up special emphasis was given upon: 1. primary tumor (mucosal distribution and the depth of infiltration, differentiation and invasion of vascular, lymphatic and neural elements), 2. nodal status (overall number of harvested lymh nodes, overall number of positive lymph nodes, size and presence of extracapsular growth). Immunohistochemistry was performed in order to determine presence of micrometastases and isolated tumor cels (ITC) in lymph nodes, and also to determine the expression of p53 and EGFR. Statistical analyzes were performed with the intent to determine the correlation of the aforementioned parameters with the overall survival rate.
Results: In this study there was no intrahospital mortality. Overall survival median was 18.00 months (11,89 - 24,11). 42 (76%) patients died and 13 (24%) was alive when we ended the study. Two year survival was marked in 27 patients (46.5%). N0 stage was present in 17 patients, 8
9
patients had N1 stage while N2 stage was present in 30 patients..
Animals and philosophers: Preface to my critics
No full textThe author is here seeking to expose his book Philosophical Animal zoographical persuasion to philosophy, to his own remorseless analysis - and that way defend the book from potential criticism by the others. On the other hand, the author believes that this will open up the space for discussion about the book and themes that book provokes. This discussion is not going to be mere neatly registered response and/or appropriate praise but a contribution inspired by the book, resonating back to it
"Author Meets Critics: Predrag Cicovacki, Author of Gandhi's Footprints, Meets Critics Sanjay Lal and Carlo Filice"
No full textTwo critics respond to Predrag Cicovacki’s book, Gandi’s Footprints. Cicovacki opens the discussion by presenting his motivations for exploring a paradox, that Gandhi’s work is widely revered but not widely emulated. Cicovacki explores a resolution to the paradox by suggesting how Gandhi’s promising visions may be followed without being imitated, especially Gandhi’s insight that we must seek spiritual grounding for life in a materialistic world. Critic Sanjay Lal affirms Cicovacki’s insight but suggests that precisely because Gandhi’s aspirations for spiritual life were profoundly transformative we should take care not to dilute them into our conventional wisdoms. Critic Carlo Filice asks how Gandhi’s commitment to unified reality could be more clearly articulated once a distinction is drawn between spirit and matter, also how Gandhi’s nonviolence could manage to embrace important exceptions. In reply to critics, Cicovacki proposes an approach to Gandhi informed by the insights of Tagore
Significance of KIT and PDGFRA gene mutation in evaluation of surgically treated gastric gastrointestinal stromal tumor patients
No full textCilj: Ispitivanje genetskih mutacija na KIT i PDGFRA genima, prikazivanje njihove učestalosti, vrste
mutacija i korelacije ovih specifičnih genskih mutacija sa patohistološkim i imunohistohemijskim
karakteristikama tumora. Korelacija genetskih mutacija na KIT i PDGFRA sa kliničkim tokom operisanih
bolesnika.
Metod: Prospektivna i delimično retrospektivna klinička studija koja je uključila 100 bolesnika operisane
zbog GIST-a želuca u period od 2005 do 2016 godine. Načinjena je molekularna analiza na parafinskim
kalupima tumorskog tkiva, a kod 45 bolesnika kod kojih su identifikovane KIT i PDGFRA mutacije
sprovedena je dalja analiza, sa posebnim osvrtom na patološke karakteristike tumora, recidiv oboljenja i
ukupno preživljavanje, te procena uticaja analiziranih genskih mutacija na navedene promene.
Rezultati: Od 100 operisanih bolesnika 46% su u grupi visokog rizika od kojih kod 54% nastaju
metastaze ili lokalni recidiv. Od ukupno 100 ispitivanih bolesnika, kod 45 bolesnika je dobijen mutacioni
status, gde su 37 (82%) bolesnika sa KIT mutacijama, 6 (14%) bolesnika sa PDGFRA mutacije i 2 (4%)
bolesnika svrstani u "wild type". Analizom krive preživljavanja kod bolesnika operisanih zbog GIST
želuca utvrđena je značajna razlika u javljanju metastaze i smrtnog ishoda u zavisnosti od tipa
mutacije(p=0.023). Cox-ovim regresionom analizom je pokazano da bolesnici visokog rizika sa
recidivom bolesti koji nisu primali Imatinib imali su 7 puta veću verovatnoću smrtnog ishoda u odnosu na
bolesnike lečene Imatinobom
Zaključak: Analiza mutacije na KIT i PDGFRA genima ima prognostički i prediktivni značaj kod
bolesnika operisanih zbog GIST želuca. Imatinib ima značajnu ulogu u lečenju bolesnika koji su u grupi
viskog rizika.Objective: KIT (KIT proto-oncogene receptor tyrosine kinase) and PDGFRA (Platelet derived growth
factor receptor alpha) gene mutations represent major molecular forces inside the gastrointestinal stromal
tumors (GIST). Aim of this study was to evaluate these mutations in patients who underwent surgical
resection of gastric GIST
Methods: Retrospective clinical study included 100 patients who were operated due to gastric GIST from
2005 till 2016. Molecular analysis of paraffin embedded tumor tissue was performed, and the 45 patients
who had presence of KIT and PDGFRA mutations were further evaluated, with regard to pathological
tumor stage, disease recurrence and overall survival.
Results: Of the 100 patients who were operated 46% are in the high risk group of which at 54% of the
resulting metastasis or local recurrence. From a total of 100 patients, in 45 patients we obtained
mutational status, where 37 (82%) of patients had KIT mutations, 6 (14%) patients had PDGFRA
mutations and 2 (4%) patients were classified into the “ wild-type”. The analysis of survival curves in
patients surgically treated for gastric GIST showed a significant difference in emergence of metastases
and death depending on the type of mutation (p = 0.023). Cox's regression analysis shown that patients
with a high risk of recurrent disease who were not receiving Imatinib had the 7 times greater probability
of fatal outcome compared to patients treated with Imatinib.
Conclusion: Analysis of mutations in the genes KIT and PDGFRA has prognostic and predictive
significance in patients surgically treated for gastric GIST. Imatinib has an important role in the treatment
of patients who are in the group of high risk
Significance of KIT and PDGFRA gene mutation in evaluation of surgically treated gastric gastrointestinal stromal tumor patients
No full textCilj: Ispitivanje genetskih mutacija na KIT i PDGFRA genima, prikazivanje njihove učestalosti, vrste
mutacija i korelacije ovih specifičnih genskih mutacija sa patohistološkim i imunohistohemijskim
karakteristikama tumora. Korelacija genetskih mutacija na KIT i PDGFRA sa kliničkim tokom operisanih
bolesnika.
Metod: Prospektivna i delimično retrospektivna klinička studija koja je uključila 100 bolesnika operisane
zbog GIST-a želuca u period od 2005 do 2016 godine. Načinjena je molekularna analiza na parafinskim
kalupima tumorskog tkiva, a kod 45 bolesnika kod kojih su identifikovane KIT i PDGFRA mutacije
sprovedena je dalja analiza, sa posebnim osvrtom na patološke karakteristike tumora, recidiv oboljenja i
ukupno preživljavanje, te procena uticaja analiziranih genskih mutacija na navedene promene.
Rezultati: Od 100 operisanih bolesnika 46% su u grupi visokog rizika od kojih kod 54% nastaju
metastaze ili lokalni recidiv. Od ukupno 100 ispitivanih bolesnika, kod 45 bolesnika je dobijen mutacioni
status, gde su 37 (82%) bolesnika sa KIT mutacijama, 6 (14%) bolesnika sa PDGFRA mutacije i 2 (4%)
bolesnika svrstani u "wild type". Analizom krive preživljavanja kod bolesnika operisanih zbog GIST
želuca utvrđena je značajna razlika u javljanju metastaze i smrtnog ishoda u zavisnosti od tipa
mutacije(p=0.023). Cox-ovim regresionom analizom je pokazano da bolesnici visokog rizika sa
recidivom bolesti koji nisu primali Imatinib imali su 7 puta veću verovatnoću smrtnog ishoda u odnosu na
bolesnike lečene Imatinobom
Zaključak: Analiza mutacije na KIT i PDGFRA genima ima prognostički i prediktivni značaj kod
bolesnika operisanih zbog GIST želuca. Imatinib ima značajnu ulogu u lečenju bolesnika koji su u grupi
viskog rizika.Objective: KIT (KIT proto-oncogene receptor tyrosine kinase) and PDGFRA (Platelet derived growth
factor receptor alpha) gene mutations represent major molecular forces inside the gastrointestinal stromal
tumors (GIST). Aim of this study was to evaluate these mutations in patients who underwent surgical
resection of gastric GIST
Methods: Retrospective clinical study included 100 patients who were operated due to gastric GIST from
2005 till 2016. Molecular analysis of paraffin embedded tumor tissue was performed, and the 45 patients
who had presence of KIT and PDGFRA mutations were further evaluated, with regard to pathological
tumor stage, disease recurrence and overall survival.
Results: Of the 100 patients who were operated 46% are in the high risk group of which at 54% of the
resulting metastasis or local recurrence. From a total of 100 patients, in 45 patients we obtained
mutational status, where 37 (82%) of patients had KIT mutations, 6 (14%) patients had PDGFRA
mutations and 2 (4%) patients were classified into the “ wild-type”. The analysis of survival curves in
patients surgically treated for gastric GIST showed a significant difference in emergence of metastases
and death depending on the type of mutation (p = 0.023). Cox's regression analysis shown that patients
with a high risk of recurrent disease who were not receiving Imatinib had the 7 times greater probability
of fatal outcome compared to patients treated with Imatinib.
Conclusion: Analysis of mutations in the genes KIT and PDGFRA has prognostic and predictive
significance in patients surgically treated for gastric GIST. Imatinib has an important role in the treatment
of patients who are in the group of high risk
Impact of surgical approach on treatment outcome in patients with esophageal and esophagogastric junction cancer
No full textHirurgija karcinoma jednjaka i ezofagogastričnog prelaza, kao jedna od najkompleksnijih oblasti digestivne hirurgije, je i dalje povezana sa visokim stopama morbiditeta i mortaliteta, uz relativno nisko ukupno preživljavanje. Uprkos velikom napretku poslednjih decenija, stope mortaliteta se u mnogim centrima širom sveta održavaju na vrednostima od 5-10%, a petogodišnje preživljavanje radikalno operisanih pacijenata retko kada prelazi stopu od 25-30%. Iako je velikim delom ova hirurgija standardizovana, neka pitanja i dalje ostaju otvorena. Definisanjem ciljeva naše studije smo se fokusirali na postojeće kontroverze, i time pokušali da damo skromni doprinos u iznalaženju optimalnih modaliteta lečenja ovih pacijenata. Naša studija je po dizajnu retrospektivna kohortna studija, koja je obuhvatila dvanaestogodišnji period od 01.01.2004.-01.01.2016 godine. U navedenom periodu je u Centru za hirurgiju jednjaka operisano 1129 pacijenata zbog karcinoma jednjaka i želuca. U studiju smo uključili radikalno operisane pacijente sa karcinomom jednjaka i ezofagogastričnog prelaza, kojih je nakon definisanja kriterijuma bilo ukupno 529.
Osnovni ciljevi naše studije bili su: 1. utvđivanje kliničko-patološki karakteristika i perioperativnih rezultata lečenja (morbiditet i mortalitet), kao i analiza preživljavanja ove homogene populacije pacijenata; 2. Ispitivanje značaja Lymph Node Ratio (LNR) i njegovo poređenje sa N stadijumom prema 7. izdanju TNM klasifikacije; 3. Ispitivanje značaja hirurškog pristupa za ishod lečenja pacijenata sa karcinomomima ezofagogastričnog prelaza tipa II po Siewert-ovoj klasifikaciji; 4. Uticaj statusa cirkumferentne resekcione margine, definisane prema dva postojeća kriterijuma klasifikacije (Kraljevsko udruženje patologa i Američko udruženje patologa) na ukupno preživljavanje, pojavu recidiva i pojavu lokalnih recidiva bolesti; 5. Uticaj transfuzije alogene krvi na ishod lečenja operisanih pacijenata.
Karcinom jednjaka i ezofagogastričnog prelaza se najčešće javljao u sedmoj deceniji života (60±10.3), a dominirao je muški pol (4:1). Mediana dužine hospitalizacije je iznosila 15 dana (raspon:14.0-19.0 dana), a intrahospitalni mortalitet 2.8%...complex field in digestive surgery, is still burdened with high morbidity and mortality rates and relatively poor overall survival. Despite the great progress in the recent decades, a mortality rate remains high worldwide (5-10%), with 5-year survival rates that rarely exceeds 25-30% in the population of patients operated with radical intent. Althought mostly standardized, there are some dilemmas that remain unanswered. Aims of our study were focused on the existing controversies, trying to give a modest contribution in defining optimal treatment modalities for this patient population. Our study was designed as restrospective cohort study, with all limitations by the study design, which enrolled consecutive patients operated on esophageal and esophagogastric junction cancer in the period between January 2004 and January 2016. There were 1129 surgically treated patients due to esophageal and gastric cancer in the observed period. Finally, 529 patiens have met our criteria and were included in the analysis.
Aims of our study were: 1. To determine basic clinical and pathological characteristics, perioperative (morbidity and mortality) and long term outcome of the study population; 2. To investigate significance of LNR; 3. To compare two surgical approaches (esophagectomy versus extended total gastrectomy), and their impact on outcome of patients with Siewert type II esophagogastric junction cancer; 4. To compare two different classifications of CRM and their impact on surgical outcome; 5. To investigate impact of allogeneic blood transfusion following surgical treatment of esophageal and esophagogastric junction cancer.
Most of the patients in our study were in seventh decade of life (60±10.3), with male predominance (4:1). Median in-hospital stay was 15 days (range: 14.0-19.0), in-hospital mortality of 2.8%..
Impact of surgical approach on treatment outcome in patients with esophageal and esophagogastric junction cancer
No full textHirurgija karcinoma jednjaka i ezofagogastričnog prelaza, kao jedna od najkompleksnijih oblasti digestivne hirurgije, je i dalje povezana sa visokim stopama morbiditeta i mortaliteta, uz relativno nisko ukupno preživljavanje. Uprkos velikom napretku poslednjih decenija, stope mortaliteta se u mnogim centrima širom sveta održavaju na vrednostima od 5-10%, a petogodišnje preživljavanje radikalno operisanih pacijenata retko kada prelazi stopu od 25-30%. Iako je velikim delom ova hirurgija standardizovana, neka pitanja i dalje ostaju otvorena. Definisanjem ciljeva naše studije smo se fokusirali na postojeće kontroverze, i time pokušali da damo skromni doprinos u iznalaženju optimalnih modaliteta lečenja ovih pacijenata. Naša studija je po dizajnu retrospektivna kohortna studija, koja je obuhvatila dvanaestogodišnji period od 01.01.2004.-01.01.2016 godine. U navedenom periodu je u Centru za hirurgiju jednjaka operisano 1129 pacijenata zbog karcinoma jednjaka i želuca. U studiju smo uključili radikalno operisane pacijente sa karcinomom jednjaka i ezofagogastričnog prelaza, kojih je nakon definisanja kriterijuma bilo ukupno 529.
Osnovni ciljevi naše studije bili su: 1. utvđivanje kliničko-patološki karakteristika i perioperativnih rezultata lečenja (morbiditet i mortalitet), kao i analiza preživljavanja ove homogene populacije pacijenata; 2. Ispitivanje značaja Lymph Node Ratio (LNR) i njegovo poređenje sa N stadijumom prema 7. izdanju TNM klasifikacije; 3. Ispitivanje značaja hirurškog pristupa za ishod lečenja pacijenata sa karcinomomima ezofagogastričnog prelaza tipa II po Siewert-ovoj klasifikaciji; 4. Uticaj statusa cirkumferentne resekcione margine, definisane prema dva postojeća kriterijuma klasifikacije (Kraljevsko udruženje patologa i Američko udruženje patologa) na ukupno preživljavanje, pojavu recidiva i pojavu lokalnih recidiva bolesti; 5. Uticaj transfuzije alogene krvi na ishod lečenja operisanih pacijenata.
Karcinom jednjaka i ezofagogastričnog prelaza se najčešće javljao u sedmoj deceniji života (60±10.3), a dominirao je muški pol (4:1). Mediana dužine hospitalizacije je iznosila 15 dana (raspon:14.0-19.0 dana), a intrahospitalni mortalitet 2.8%...complex field in digestive surgery, is still burdened with high morbidity and mortality rates and relatively poor overall survival. Despite the great progress in the recent decades, a mortality rate remains high worldwide (5-10%), with 5-year survival rates that rarely exceeds 25-30% in the population of patients operated with radical intent. Althought mostly standardized, there are some dilemmas that remain unanswered. Aims of our study were focused on the existing controversies, trying to give a modest contribution in defining optimal treatment modalities for this patient population. Our study was designed as restrospective cohort study, with all limitations by the study design, which enrolled consecutive patients operated on esophageal and esophagogastric junction cancer in the period between January 2004 and January 2016. There were 1129 surgically treated patients due to esophageal and gastric cancer in the observed period. Finally, 529 patiens have met our criteria and were included in the analysis.
Aims of our study were: 1. To determine basic clinical and pathological characteristics, perioperative (morbidity and mortality) and long term outcome of the study population; 2. To investigate significance of LNR; 3. To compare two surgical approaches (esophagectomy versus extended total gastrectomy), and their impact on outcome of patients with Siewert type II esophagogastric junction cancer; 4. To compare two different classifications of CRM and their impact on surgical outcome; 5. To investigate impact of allogeneic blood transfusion following surgical treatment of esophageal and esophagogastric junction cancer.
Most of the patients in our study were in seventh decade of life (60±10.3), with male predominance (4:1). Median in-hospital stay was 15 days (range: 14.0-19.0), in-hospital mortality of 2.8%..
(In)Visible Hand(s)
No full textIn this paper, the author discusses the regulatory role of the state and legal norms, in market economy, especially in so-called transition countries. Legal policy, and other questions of the state and free market economy are here closely connected, because the state must ensure with legal norms that economic processes are not interrupted: only the state can establish the legal basis for a market economy. The free market’s invisible hand is acting in questions such as: what is to be produced, how much is to be produced, for whom it is to be produced, how it is to be produced. During the transition period but also in the establishnig EU, the role of legal norms is much more important then it (is) would be expected: problems of transition are more connected with ethics and psychology, then with legislation.Law and economics, legal norms, (de)regulation, State
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