Katedra i Klinika Chirurgii Onkologicznej

Centrum, Poland

Katedra i Klinika Chirurgii Onkologicznej

Centrum, Poland
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Sentinel lymph node (SLN) biopsy procedure in patients with non-advanced breast cancer made it possible to considerably reduce the intensity of unfavourable after-effects connected with classical axillary lymphadenectomy. The presence of metastatic changes in SLN coexists in some patients with metastases to non-SLN. Depending on the size of the metastases detected in SLN, the above mentioned clinical situation may affect from 10-41% of cases. Therefore in about 3/5ths of patients with diagnosed SLN metastasis, histopathologi cal examination of removed axillary lymph nodes - within the radicalization of surgical treatment, will not reveal further changes. Presently available calculation devices (nomograms) for measuring the likelihood of metastases in non-SLN of the armpit make it possible to accurately determine the probability of their occurrence. They therefore simplify further therapeutic decisions. © 2013, Polskie Towarzystwo Onkologiczne.

Zielinski J.,Katedra I Klinika Chirurgii Onkologicznej | Jaworski R.,Katedra I Klinika Chirurgii Onkologicznej | Swierblewski M.,Katedra I Klinika Chirurgii Onkologicznej | Kruszewski W.J.,Medical University of Gdańsk | And 5 more authors.
Nowotwory | Year: 2010

Introduction. The ever-increasing number of breast cancer cases and the strife for improving the results of treatment have brought on the introduction of a new method of evaluating the lumen of the lactiferous ducts using a sophisticated apparatus called the ductoscope. Ductoscopy (fiberoptic ductoscopy; FDS) is a minimally invasive method. The aim of this paper is to describe the possibilities offered by ductoscopy in women with pathologic nipple discharge and to present our experiences with this method. Material and methods. The paper presents the possibilities offered by ductoscopy in women with pathologic nipple discharge. Between the years 2004 and 2009 151 ductoscopies were performed at the Clinic of Surgical Oncology in Gdansk. The main indication for ductoscopy was pathologic nipple discharge. Results. In the entire group of 151 patients in 118 pts. (78.2%) the discharge was idiopathic, while in the remaining 33 cases (21.8%) it was forced. In the course of ductoscopy the results were normal in 47% of patients, papillomas were found in 17.2% of patients, amputated ducts in 20.1% of patients, circular constrictions or hyperplasia in 6.7% of patients and the picture was considered unspecific in 9% of patients. We observed no complications in the entire patient group. Discussion. Pathologic nipple discharge constitutes from 1.8% to 8.9% of all diseases of the breast. Most common causes include intraductal papilloma, ductal carcinoma in situ and benign lesions (ductectasiae). Although pathologic nipple discharge has been recognized as a problem and investigated for a long time there is still a constant search for a diagnostic tool to evaluate pathologic lesions within the lactiferous ducts. The first attempts at ductoscopy in patients with pathologic nipple discharge were made at the beginning of the nineties and due to technologic progress many improvements have been made in the method. Conclusions. Ductoscopy is a useful method in the diagnosis of lesions within lactiferous ducts. In case of pathologic nipple discharge ductoscopy allows to limit the scope of surgical excision. Diagnostic ductal lavage creates new diagnostic possibilities but the discrepancies in the methods and the interpretations call for large, multicentered studies.

Sobjanek M.,Medical University of Gdańsk | Michajlowski I.,Medical University of Gdańsk | Biernat W.,Katedra I Zaklad Patomorfologii | Drucis K.,Katedra I Klinika Chirurgii Onkologicznej | And 2 more authors.
Przeglad Dermatologiczny | Year: 2011

Introduction. Nail apparatus melanoma is an uncommon type of cutaneous melanoma with poor prognosis. Tumour accounts for 1% of all cutaneous melanoma in Caucasians. Objective. Investigation on frequency, clinical and histopathological characteristics of nail apparatus melanoma in a Northern Poland population. Material and methods. One thousand five hundred and eighty-eight patients with various nail apparatus pathology who were referred to the Department of Dermatology, Venerology and Allergology, Medical University of Gdańsk, from 2005 to 2010, were included in the study. Among all these patients 8 cases of nail apparatus melanoma were diagnosed. There were 5 women and 3 men (mean age 59 years). Results. Nail apparatus melanoma was observed in 0.504% of patients with nail pathology. All patients were of Fitzpatrick skin type III or IV. Tumours were located in the majority of cases on the great toe and thumb. The most common histopathological variant was acral lentiginous melanoma. The average Breslow thickness was 7.2 mm (range 2.5-18 mm). The 20-month survival rate was 37.5%. Conclusions. Nail apparatus melanoma is rare in the Northern Poland population but it is the most common nail apparatus malignancy. In our population tumours were diagnosed in advanced stages, which is related to poor prognosis.

Staniuk T.,Katedra I Klinika Chirurgii Onkologicznej | Jankowski M.,Katedra I Klinika Chirurgii Onkologicznej | Zegarski W.,Katedra I Klinika Chirurgii Onkologicznej | Malkowski B.,Zaklad Medycyny Nuklearnej | Kula Z.,Zaklad Endoskopii
Wspolczesna Onkologia | Year: 2010

Aims: Evaluation of FDG-PET usefulness in diagnosis and qualification for surgical treatment of advanced gastric cancer. Material and methods: Sixteen advanc ed gastric cancer patients (T2,N0-3,M0-1) who underwent FDG-PET/CT imaging and surgical treatment were evaluated retrospectively. Detailed data influencing cancer detection such as primary tumour size, depth of invasion, histological and Lauren classification type as well as tumour location were analysed. Correspondence between FDG-PET/CT and postoperative histo pathological evaluation of nodal involvement was assessed. Results: 60% of tumours larger than 4 cm, 75% of pT2 and pT3 tumours, 60% of mucocellular type and 75% of poorly or undifferentiated type tumours, and 77% of non-intestinal Lauren type tumours were detected. No tumour smaller than 4 cm was identified. 75% of tumours located in the middle one-third of the stomach were not detected. Also no resectable gastric cancer patient with nodal involvement was N(+) with FDG-PET/CT. Conclusions: 1. Primary tumour size and location may influence FDG-PET/CT results. 2. FDG-PET/CT is not a sufficient method of detection of all histological types of gastric cancer. 3. FDG-PET/CT is not a sufficient method of preoperative assessment of perigastric lymph nodes; thus this examination does not enable proper qualification for radical operative treatment in advanced gastric cancer (T2-4,N0-3,M0-1). 5. Detection of increased FDG uptake in perigastric lymph nodes may support unresectability of gastric cancer.

Pikula M.,Zaklad Immunologii Klinicznej I Transplantologii | Imko-Walczuk B.,Oddzial Dermatologii Pomorskiego Centrum Traumatologii Im. M. Kopernika | Nowacka-Pikula D.,Oddzial Rehabilitacji Dla Dzieci Wojewodzkiego Zespolu Reumatologicznego | Okuniewska A.,Oddzial Dermatologii Pomorskiego Centrum Traumatologii Im. M. Kopernika | And 3 more authors.
Przeglad Dermatologiczny | Year: 2012

Treatment of chronic wounds is still a serious problem in contemporary medicine. In the majority of cases it requires multi-disciplinary cooperation of specialized doctor and nursing teams and significant financial expenses. In many cases the conventional treatment of chronic wounds does not bring the expected therapeutic results, although new alternative therapeutic methods are being researched. One such method is the transplantation of in vitro cultured keratinocytes. The presented work focuses on methods of keratinocyte and epidermal stem cell culture, and the possibility of their transplantation. Safety aspects as well as the limitations of the analysed techniques are discussed. Also the authors present their experience concerning with epidermal cell culture for therapeutic purposes.

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