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Kala Z.,Chirurgicka klinika FN Brno a LF MU | Kysela P.,Chirurgicka klinika FN Brno a LF MU | Ostrizkova L.,Interni Hematoonkologicka Klinika FN Brno A LF MU | Kiss I.,Klinika Komplexni Onkologicke Pece | And 2 more authors.
Onkologie | Year: 2011

Background: The incidence of colorectal carcinoma has been increasing. Only a multimodal treatment provides the best results. Surgical R0 resection of all tumour sites is the goal of all treatment regimes. Material and methods: A survey on the literature and our experiences has been conducted. Results: Surgical treatment comprises endoscopic submucosal dissection, transanal endoscopic microsurgery, laparoscopy, open surgery and cytoreduction surgery with the hyperthermic intraperitoneal chemotherapy. The news is the total mesocolic excision that similarly to the total mesorectal excision provides fewer local relapses and higher long-term survival. Conclusion: Similarly to anti-tumoral medical therapy, the surgery has been developing as well. It is necessary to enrol the patients into suitable databases to state the proper position of all surgical methods in the multimodal treatment algorithm. Source

Halamkova J.,Klinika Komplexni Onkologicke Pece | Kiss I.,Klinika Komplexni Onkologicke Pece | Tomasek J.,Klinika Komplexni Onkologicke Pece | Pavlovsky Z.,Patologicko anatomicky Ustav FN Brno A LF MU | And 5 more authors.
Klinicka Onkologie | Year: 2011

Urokinase (uPA) plays an essential role in the activation of plasminogen to plasmin, a serine protease participating in the activation of matrixmetaloproteinases, latent elastases, growth factors and cytokines involved in the degradation of extracellular matrix elements. Together with its receptor (uPAR), tissue activator (tPA) and urokinase inhibitors (PAI-1, PAI-2, PAI-3 and protease nexin), it forms the plasminogen activator system (PAS), a component of metastatic cascade importantly contributing to the invasive growth and angiogenesis of malignant tumours. Plasminogen activator inhibitor 1 inhibits uPA-dependent invasiveness of some cancer cell lines. The vitronectin-PAI-1 complex inhibits migration of smooth muscle cells by binding αvβ3 integrin to vitronectin. PAI-1 or its deficiency interferes with signalling pathways such as PI3K/Akt and JAK/STAT and it is included in the processes of maintaining the integrity of the endothelial cells and thereby regulation of cell death. PAI-1 affects apoptosis by reducing cell adhesion and functioning of intracellular signalling pathways. The individual components of PAS undoubtedly play an important role in angiogenesis and metastasising of malignant tumours. In the near future, results of published studies with various types of cancer could be reflected in diagnostic and therapeutic algorithms and, at the same time, could serve as the goal for targeted therapies. Source

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