Brno, Czech Republic
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Moukova L.,Oddeleni Gynekologicke Onkologie | Nenutil R.,Oddeleni Onkologicke Patologie | Fabian P.,Oddeleni Onkologicke Patologie | Chovanec J.,Oddeleni Gynekologicke Onkologie
Klinicka Onkologie | Year: 2013

Standardized gynecological oncological therapeutical guidelines are based on ordinary predictive factors, such as depth of stromal invasion, histopathological type of tumor, lymphovascular space invasion, lymph node metastases. Unfortunately, the power of these prognostic factors is not able to determine the safety of this procedure in the relation to disease recurrence in a group of patients who are indicated for conservative operations. This is the appropriate area for new, especially biomolecular prognostic factors (proteins: p63, TAp63, p16, p21, p27, COX-2, genes: hTERC, MYCC). Moreover, comprehensive evaluation of cervical cancer prognostic factors and assessment of new biomarkers of cancer can ease prediction of risk of spread outside primary localization and determine probability of disease recurrence. This information can help to individualize surgical, radiotherapeutic and chemotherapeutic treatment.


Nalezinska M.,Oddeleni gynekologicke onkologie | Kalabova R.,Oddeleni gynekologicke onkologie | Kleinova J.,Oddeleni gynekologicke onkologie | Kolarova H.,Oddeleni gynekologicke onkologie | And 2 more authors.
Onkologie (Czech Republic) | Year: 2015

The authors present a case report of a 65-years old woman who suffered of metachronous breast carcinoma and mucous type ovarian carcinoma. She was admitted to the department of gynaecological onkology with dyspnoea, chest pain, fever, and was extremely exhausted. At that time she received chemotherapy: topotecan in monotherapy for the recurent ovarian carcinoma. According to the clinical status, X-ray, CT picture and according to the negativity of broncho-alveolar splashing it was thought that we delt with a case of topotecan pneumotoxicity. Therapeuticaly we subscribed to start the treatment with corticoids, bronchodilatants and mucolytics. Finaly the result of the histopathological examination of transbronchial biopsy confirms the presence of adenocarcinomatous tissue well compatible with the ovarian adenocarcinoma of the mucose type previously diagnosed at this pacient. The régime of chemotherapy was changed to FUFA de Gamont. The patient passed away after the 2nd application due to fast spreading of the ovarian carcinoma to brain structures. We present the diagnostic difficuilties to distinguish between non-specific clinical signs and X-rays at patients with polychemotherapy and lung generalisation of the oncological disease.


Feranec R.,Oddeleni Gynekologicke Onkologie | Moukova L.,Oddeleni Gynekologicke Onkologie | Stanicek J.,Oddeleni Nuklearni Mediciny | Stefanikova L.,Oddeleni Gynekologicke Onkologie | Chovanec J.,Oddeleni Gynekologicke Onkologie
Klinicka Onkologie | Year: 2010

Backgrounds: Endometrial carcinoma is the most frequent gynecologic malignancy. The incidence is 30:100,000 with an increasing tendency. The main therapeutic modality remains radical surgery. The purpose of the study is to evaluate the feasibility of sentinel lymph node (SLN) detection in endometrial cancer using hysteroscopic administration of radiocolloid and the combination of preoperative lymphoscintigraphy with intraoperative gamma-detection probe examination. Patients and Methods: From May 2006 to January 2009, 99mTc-labelled nanocolloid (100 MBq) was administered preoperatively in 21 patients with endometrial cancer. On the day of surgery, radiocolloid together with blue dye was injected via 20-gauge needle under the endometrium using hysteroscopy. Lymphoscintigraphy was performed in all patients after 60 minutes. Therapeutic surgery followed the tracer administration 2 hours later in extensity of abdominal hysterectomy, bilateral salpingo-oophorectomy, peritoneal wash, pelvic lymphadenectomy and in patients with positive high-risk prognostic factors of paraaortic lymphadenectomy. SLN was located by use of gamma-detecting probe intraoperatively. Results: At least one SLN was detected in 17 of 21 (81%) patients included in the study. The mean number of detected SLNs was 2 (range 1-5). 8 of 17 (47%) patients had radioactive nodes only in the paraaortic area. Synchronic appearance of SLNs in the pelvic and paraaortic areas was detected in 1 of 17 (6%) cases. Overall, in 4 of 9 (44%) cases of sentinel lymph node localization in the paraaortic area the SLNs were detected at the level above the inferior mesenteric artery. The metastatic involvement of 3 sentinel lymph nodes was detected in one patient (3 lymph nodes with micrometastases). All the remaining lymph nodes not labelled as SLNs were histologically negative in this case. The sensitivity and specificity for SLN metastases detection was 100%. Conclusion: SLN detection in endometrial cancer appears to be a promising method with the potential to reduce unnecessary surgery radicality and to clarify staging. The utilization of hysteroscopic application of radiocolloid respects the anatomical consequences and natural lymphatic drainage of the endometrium. The combination of pre-operative lymphoscintigraphy and intra-operative detection using a handheld gamma probe can be beneficial.


Chovanec J.,Oddeleni gynekologicke onkologie | Nalezinska M.,Oddeleni gynekologicke onkologie
Onkologie (Czech Republic) | Year: 2014

Three types of standard treatment of cervical cancer are used: surgery, radiation therapy, chemotherapy. New types of treatment are being tested in clinical trials. Treatment decisions should be individualized and based on prognostic factors including the stage of the disease, age, medical condition of the patient, histological type and grade of tumor and lymph nodes status.


Pesova Z.,Oddeleni gynekologicke onkologie
Onkologie (Czech Republic) | Year: 2014

In the treatment of cervical cancer is the use of the three treatment modalities-surgery, radiotherapy and chemotherapy. Possible complications could appear at all modes. We can achieve early detection of signs of complications by intensive monitoring of patients undergoing treatment for cervical cancer. This will greatly increase the success rate of treatment.


Chovanec J.,Oddeleni Gynekologicke Onkologie | Moukova L.,Oddeleni Gynekologicke Onkologie | Feranec R.,Oddeleni Gynekologicke Onkologie
Klinicka Onkologie | Year: 2013

For preinvasive lesions of vulva, a common term VIN - vulval intraepithelial neoplasia is used. VIN is a histological diagnosis based on abnormal squamous epithelial proliferation. There are two types of VIN apart from their association with human papillomavirus (HPV). Undifferentiated (usual) vulval intraepithelial neoplasia is commonly associated with carcinogenic genotypes of HVP, whereas differentiated vulval intraepithelial neoplasia is not associated with high-risk genotypes of HPV. The article presents an overview of VIN occurence and epidemiology, its classification system and diagnostics. In conclusion, VIN therapeutical possibilities are presented. It can be treated with surgical therapy (local excision, partial vulvectomy, vulvectomy, laser vaporization) or medical therapy (imiquimod).


Feranec R.,Oddeleni Gynekologicke Onkologie | Moukova L.,Oddeleni Gynekologicke Onkologie
Klinicka Onkologie | Year: 2013

In comparison to malignant tumors of vulva, vagina, cervix and uterine corpus, clear morphologic and molecular genetic features of precursor lesions of ovarian carcinoma have not been defined yet. We can see an effort to describe preinvasive lesions to allow diagnostics and treatment prior to development of invasive ovarian cancer. This tendency is magnified by the fact that ovarian carcinomas have the highest mortality from all gynecological malignancies. Currently, reports confirming different morphology, pathogenesis and molecular alterations in heterogeneous group of ovarian carcinomas have been described. There is a tendency to divide epithelial malignant tumors into two groups . Low-grade ovarian serous carcinoma, low-grade endometrioid, clear-cell, mucinous ovarian cancers and Brenner tumors of ovary are categorized as type I ovarian tumors. High-grade serous carcinoma, undifferentiated carcinomas and malignant mixed mesodermal tumors of the ovary (MMMTs) belong to type II tumors. A potential precursor lesion of high-grade serous ovarian cancer has been defined - serous tubal intraepithelial carcinoma.


Moukova L.,Oddeleni Gynekologicke Onkologie | Feranec R.,Oddeleni Gynekologicke Onkologie | Chovanec J.,Oddeleni Gynekologicke Onkologie
Klinicka Onkologie | Year: 2013

Preinvasive lesion of the uterine cervix can give rise to cervical cancer. High-risk human papillomaviruses with high oncogenic potential are considered to be the main etiopathological factors with interaction of other risk factors (recurrent inflammation of the cervix, injury of the cervix, immunosuppressive conditions, sexual promiscuity, etc.). Early diagnosis of these changes at regular gynecological examinations and adequate treatment can prevent of malignant transformation. Organized cervical screening and implementation of nationwide vaccination against human papillomavirus promises to reduce the incidence of cervical cancer.


Feranec R.,Oddeleni Gynekologicke Onkologie | Moukova L.,Oddeleni Gynekologicke Onkologie | Chovanec J.,Oddeleni Gynekologicke Onkologie
Klinicka Onkologie | Year: 2013

Preinvasive lesions of the vagina are relatively rare, clearly defined afflictions, originating most of all in association with the high-risk human papillomavirus infection (HR-HPV). The most frequent appearance is in coincidence with preinvasive lesions of uterine cervix and in vaginal cuff after hysterectomy. Preinvasive vaginal lesions are divided into squamous lesions (vaginal intraepithelial neoplasia) and non-squamous lesions. Vaginal adenosis belongs to non-squamous vaginal preinvasive lesions and is a precursor lesion of vaginal clear-cell carcinoma. Surgical and non-surgical techniques including laser destructive methods and local administration of 5-fluorouracile are used in the treatment of preinvasive lesions of vagina.


Feranec R.,Oddeleni Gynekologicke Onkologie | Moukova L.,Oddeleni Gynekologicke Onkologie | Chovanec J.,Oddeleni Gynekologicke Onkologie
Klinicka Onkologie | Year: 2013

Preinvasive lesions of the endometrium are histopathological and molecular alterations related to high-risk of uterine carcinoma development. Incidence has increasing tendency. Atypical endometrial hyperplasia is the preinvasive lesion of type I endometrial carcinoma, developing under a hyperestrogenic background. Carcinoma in situ of the endometrium is considered to be precursor lesion of type II endometrial carcinoma, first of all uterine serous carcinoma. Hysterectomy and bilateral oophorectomy is the main therapeutical modality in both preinvasive lesions of the endometrium. The hormonal therapy with progestogens is the possibility of fertility sparing approach in treatment of histological findings of atypical endometrial hyperplasia in young women. Even though preinvasive lesions of the endometrium are clearly defined, the possibilities of endometrial cancer screening are markedly limited.

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