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Novi Beograd, Serbia

Bojic T.,Hirurska klinika Klinickog centra Nis | Djordjevic N.,Hirurska klinika Klinickog centra Nis | Karanikolic A.,Hirurska klinika Klinickog centra Nis | Filipovic S.,Klinika za onkologiju Klinickog centra Nis | And 2 more authors.
Vojnosanitetski Pregled | Year: 2012

Background/Aim. There are a lot of studies aiding to the opinion that the involvement degree of axilla lymph nodes grows depending on increase of breast tumor size, and its histological and nuclear grades. The aim of this study was to assess the risk of axillary lymph nodes involvement, as well as the relation between the tumor size, histological and nuclear grades in a group of female patients who underwent breast cancer surgery, including levels 1-3 axillary dissection. Methods. Investigation covered 900 patients operated on during 2005-2008 who underwent modified radical mastectomy including axillar dissection. We assessed a number of involved lymph nodes, depending on tumor macroscopic size (T), histological grade (HG) and nuclear grade (NG). Results. A total number of examined lymph nodes was 9977. The incidence of involved lymph nodes was from 18.6% with T1 tumor size up to 60.2% with T4 tumor size. Concerning histological grade, the number of involved lymph nodes ranged from 14.2% (HGI) to 45.1% (HGIII); while in terms of nuclear grade, the number of involved lymph nodes ranged from 17.4% (NGI) to 54.5% (NGIV). By using χ2-test for trend and odds ratio (OR), the results showed that the axillary lymph nodes involvement degree was increased with the increase of the tumor size and its histological and nuclear grades. The risk of axillary lymphatic nodes involvement was 1.43 times higher in the group of T2 tumors size compared to the smaller tumors T1 size, and even up to 6.62 times higher in case of T4 tumor size. It was also increasied from 1.79 times for HGII to even 4.98 times for HGIII, and from 1.44 times for NGII to 5.71 times for NGIV. Conclusion. In breast cancer patients, there is a strong correlation between tumor size, its histological and nuclear grades and the risk of axillary lymph nodes involvement. Source


Marisavljevic D.,KBC Bezanijska kosa | Pantic M.,Albert Ludwigs University of Freiburg
Journal of B.U.ON. | Year: 2013

We performed prospective sequential cytogenetic studies in 76 patients with myelodysplastic syndromes (MDS) followed up to 82 months. Their karyotypes were followed routinely, regardless of clinical status. The incidence of evolutive karyotypes was similar in patients with a normal karyotype at referral and in patients with clonal abnormalities at diagnosis (24.5 and 26.1%, respectively). We did not find association between karyotype evolution and leukemic transformation or reduced survival, since the majority of secondary cytogenetic changes in evolutive karyotypes of our patients were aberrations with good or intermediate prognosis. Therefore, we concluded that only particular cytogenetic events are related to disease progression, while others represent secondary changes of little biologic and prognostic significance. Source


Savic A.,University of Novi Sad | Marisavljevic D.,KBC Bezanijska kosa | Marisavljevic D.,University of Belgrade | Stanisavljevic N.,KBC Bezanijska kosa
Acta Haematologica | Year: 2014

The objective of this study is to externally validate the recently published Revised International Prognostic Scoring System (IPSS-R) for myelodysplastic syndrome (MDS) and compare it with the International Prognostic Scoring System (IPSS). We conducted a retrospective study of 173 adult MDS patients who had not received disease-altering treatment. Using the Cox hazard method, we found the IPSS-R to be a significant predictor of survival (p < 0.001, hazard ratio, HR = 1.82, 95% confidence interval, CI 1.57-2.12) and time to acute myeloid leukemia (AML; p < 0.001, HR = 2.05, 95% CI 1.55-2.70). The IPSS-R has greater prognostic power for survival and time to AML compared with the IPSS, given higher Somers' D values (0.41 vs. 0.39 and 0.55 vs. 0.53, respectively). Using the log-rank test, we found a significant difference when comparing IPSS-R groups (p < 0.02), with the exception of the high-risk versus very high-risk group comparison. The IPSS-R reclassified low-risk and intermediate-1 IPSS groups into four groups (log-rank, p < 0.001) and intermediate-2 and high-risk IPSS groups into three groups (log-rank, p < 0.04, excluding high-risk vs. very high-risk comparison). We conclude that the IPSS-R has significant prognostic utility for MDS patients. © 2013 S. Karger AG, Basel. Source


Dragan R.,University of Belgrade | Dejan S.,KBC Dr. Dragisa Misovic | Nebojsa M.,KBC Dr. Dragisa Misovic | Vinka V.,KBC Dr. Dragisa Misovic | And 4 more authors.
Hepato-Gastroenterology | Year: 2011

Gastrointestinal stromal tumors (GIST) represent the most usual mesenchymal tumors of the gastrointestinal tract. In this paper we present a case of a 59-year-old patient with an adenocarcinoma of the transversal colon near the lienal flexure without breaking of the intestinal membrane synchronous with an intramural tumor in the antral region of the stomach which was not registered before the operation. Final immunohistochemical findings of the operation specimens: 1. Adenocarcinoma of the large intestine (histological grade 1, nuclear grade I, Dukes A, invasion to submucosa) and 2. GIST with low malignant potential. Synchronous ap-pearance of GISTs and colorectal adenocarcinoma, although very rare, has been increasingly observed in the last five years. Because of the small number of cases, a causal connection between these different types of tumors cannot be proven. Through this case report we hope to contribute to the adequate preoperative preparation, operation technique and postoperative monitoring of such patients. Surgical treatment is a dominant way of treating these synchronous tumors, so the surgeon has high responsibility for adequate selection of operative procedure on these patients. © H.G.E. Update Medical Publishing S.A. Source


Markovic O.,KBC Bezanijska kosa | Marisavljevic D.,KBC Bezanijska kosa | Marisavljevic D.,University of Belgrade | Cemerikic-Martinovic V.,Beolab | And 8 more authors.
Medical Oncology | Year: 2012

Survivin is one of the inhibitors of apoptosis proteins (IAP) that might play an important role in the pathogenesis of diffuse large B cell lymphoma (DLBCL). The present study was designed to investigate the clinical and prognostic significance of survivin expression in nodal DLBCL. We analyzed lymph node biopsy specimens obtained from 56 patients with newly diagnosed nodal DLBCL, treated with immunochemotherapy (R-CHOP). The expression of survivin was analyzed using the standard immunohistochemical method on formalin-fixed and routinely processed paraffin-embedded lymph node specimens and evaluated semiquantitatively as a percentage of tumor cells. Survivin immunoexpression (>45 % positive tumor cells) was found in 22 (39.28 %) and observed as cytoplasmic staining in 15 patients, or mixed (cytoplasmic and nuclear) staining in 7 patients. A significant difference in survivin immunoexpression was noticed between the GCB and the non-GCB subtypes of DLBCL (p = 0.031). However, survivin immunoexpression had no significant association with IPI, "bulky" disease, extranodal localization, hemoglobin, Ki-67 immunoexpression or other clinicopathological parameters. A univariate analysis showed that survivin positivity was an unfavorable factor for therapy response and a predictor of shorter survival in patients with DLBCL (p = 0.048 and p = 0.034, respectively). Patients with survivin overexpression experienced a relapse more often than patients without expression of this apoptotic protein (27.3 vs. 11.8 %), but this difference did not reach statistical significance (p = 0.131). The results of this study showed that disregulation of survivin expression had an important role in the determination of the course of the disease in patients with nodal DLBCL treated with R-CHOP. Therefore, survivin represents a potential target for therapeutic intervention in DLBCL. © 2012 The Author(s). Source

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