Sremska Mitrovica, Serbia
Sremska Mitrovica, Serbia

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Mihajlovic J.,University of Groningen | Pechlivanoglou P.,University of Groningen | Miladinov-Mikov M.,Oncology Institute of Vojvodina | Miladinov-Mikov M.,University of Novi Sad | And 2 more authors.
BMC Cancer | Year: 2013

Background: Despite the increase in cancer incidence in the last years in Serbia, no nation-wide, population-based cancer epidemiology data have been reported. In this study cancer incidence and mortality rates for Serbia are presented using nation-wide data from two population-based cancer registries. These rates are additionally compared to European and global cancer epidemiology estimates. Finally, predictions on Serbian cancer incidence and mortality rates are provided.Methods: Cancer incidence and mortality was collected from the cancer registries of Central Serbia and Vojvodina from 1999 to 2009. Using age-specific regression models, we estimated time trends and predictions for cancer incidence and mortality for the following five years (2010-2014). The comparison of Serbian with European and global cancer incidence/mortality rates, adjusted to the world population (ASR-W) was performed using Serbian population-based data and estimates from GLOBOCAN 2008.Results: Increasing trends in both overall cancer incidence and mortality rates were identified for Serbia. In men, lung cancer showed the highest incidence (ASR-W 2009: 70.8/100,000), followed by colorectal (ASR-W 2009: 39.9/100,000), prostate (ASR-W 2009: 29.1/100,000) and bladder cancer (ASR-W 2009: 16.2/100,000). Breast cancer was the most common form of cancer in women (ASR-W 2009: 70.8/100,000) followed by cervical (ASR-W 2009: 25.5/100,000), colorectal (ASR-W 2009: 21.1/100,000) and lung cancer (ASR-W 2009: 19.4/100,000). Prostate and colorectal cancers have been significantly increasing over the last years in men, while this was also observed for breast cancer incidence and lung cancer mortality in women. In 2008 Serbia had the highest mortality rate from breast cancer (ASR-W 2008: 22.7/100,000), among all European countries while incidence and mortality of cervical, lung and colorectal cancer were well above European estimates.Conclusion: Cancer incidence and mortality in Serbia has been generally increasing over the past years. For a number of cancer sites, incidence and mortality is alarmingly higher than in the majority of European regions. For this increasing trend to be controlled, the management of risk factors that are present among the Serbian population is necessary. Additionally, prevention and early diagnosis are areas where significant improvements could still be made. © 2013 Mihajlovic et al.; licensee BioMed Central Ltd.


Mihailovic J.,Oncology Institute of Vojvodina | Stefanovic L.,Oncology Institute of Vojvodina | Stankovic R.,University of Belgrade
Clinical Nuclear Medicine | Year: 2013

PURPOSE: Differentiated thyroid microcarcinoma (DTM) has a good prognosis and survival, but recurrent disease may appear during follow-up. The aim of this study was to evaluate the influence of initial treatment including surgery and radioactive iodine (I) on the survival and recurrence in patients with DTM. METHODS: Between January 1979 and December 2006, 130 patients with DTM were retrospectively evaluated, with a median follow-up of 10 years. Total/near-total thyroidectomy was performed in 121 (93.1%) of 130 patients, followed with I ablation in 71 (54.6%) of 130 patients. RESULTS: The probability of disease-specific survival was 97.7% ± 1.3% after 5 and 10 years; the probability of disease-specific survival was 95.9% ± 2.2% after 15, 20, 25, and 28 years after the initial treatment and was significantly influenced by recurrence, clinical stage, and patients' age (P = 0.0001, P = 0.0005, and P = 0.02, respectively). Sex, histopathological type of the tumor, metastases at presentation, initial treatment, performance of radioactive therapy, and risk categories had no influence on survival (P = 0.8, P = 0.6, P = 0.1, P = 0.4, P = 0.5, and P = 0.1, respectively). The overall recurrence rate was 10.8%, (6.9% in lymph nodes, 1.5% in thyroid bed, and 2.3% at distant sites), with a median appearance time of 30 months. Recurrences were significantly influenced by regional metastases at presentation, radioiodine ablation, and initial treatment (P = 0.0002, P = 0.005, and P = 0.003, respectively); there was no relationship based on age, sex, histological type of the tumor, and tumor multifocality. CONCLUSIONS: To perform more accurate surveillance for recurrence, total/near-total thyroidectomy followed by radioiodine ablation may be the optimal initial treatment for patients with DTM. © 2013 by Lippincott Williams & Wilkins.


Mihailovic J.,Oncology Institute of Vojvodina | Mihailovic J.,University of Novi Sad | Goldsmith S.J.,New York Presbyterian Hospital | Goldsmith S.J.,New York Medical College
Seminars in Nuclear Medicine | Year: 2015

Multiple myeloma (MM) is a relatively rare hematologic disorder characterized by proliferation of plasma cells, primarily involving the bone marrow. Extramedullary involvement also occurs with poor prognosis. Asymptomatic plasma cell disorders, monoclonal gammopathy of uncertain significance, and smoldering MM, which do not require therapy, should be distinguished from symptomatic MM, which requires treatment. MM may present with CRAB, elevated Calcium levels, Renal insufficiency, Anemia, and Bone lesions (including lytic lesions and osteopenia), as well as elevated levels of serum M protein or urine M protein or both. Nonsecretory myeloma in which serum and urine M proteins are absent occurs rarely, accounting for 1%-5% of patients with myeloma, but low levels of abnormal immunoglobulins are often present. Staging of patients with MM is done according to the Durie and Salmon criteria based on laboratory testing (determination of hemoglobin, serum calcium, and serum and urine M proteins) and conventional radiography. A variety of diagnostic imaging procedures have been employed to assess the extent of disease in MM and to evaluate the response to treatment as well as provide surveillance for the detection of recurrent disease. These include whole-body x-ray, which despite its limitations is regularly used to detect lytic bone lesions; CT radiography; MRI; and a variety of radionuclide imaging procedures, with 18F-FDG-PET/CT emerging as the radionuclide procedure of choice. Recently, the Durie-Salmon criteria have been upgrade to the Durie-Salmon PLUS system, which includes 18F-FDG-PET/CT and MRI of the spine and pelvis. © 2015 Elsevier Inc. All rights reserved.


Grant
Agency: European Commission | Branch: FP7 | Program: CP-FP | Phase: HEALTH.2012.1.2-1 | Award Amount: 7.69M | Year: 2012

Cervical cancer (CC) is the second most common cause of cancer deaths in women worldwide. The main objective of the RAIDs project is to use this model system which is accessible to repeat biopsies to learn how to stratify patients into targeted therapies. The patients tumors will be classified into molecular subtypes based on their molecular profile by use of high-throughput technologies (sequencing, RPPA) combined with integrative bioinformatics analysis. Stratification is a learning process which will need constant readaptation. It will rely on prognostic and predictive biomolecular information gained from patients who will receive either standard therapy (the cognitive cohort) or patients who receive (first generation) targeted therapy. Bioinformatics will be an essential tool to allow integrative genome/proteome analysis and provide functional interpretation of the results at each step. Machine learning techniques will be used to select the most reliable biomarkers. These tools will be used to predict response to cc treatment or progression. Moreover, systems biology approaches will be used to unravel the gene regulatory networks and signaling pathways involved in the tumor progression and should be helpful to select predictive biomarkers and putative drug targets. Tumor material will be sampled before and following standard therapy or therapeutic HPV vaccination and/or novel targeted drug treatments. Clinical annotation by imaging methods as well as through biomarkers will have quality control procedures and relevant statistical models will be applied. RAIDS is a multidisciplinary approach integrating genomic studies, protein arrays, viral genotyping and immunohistochemical investigations on CC cells and tissues between academic clinical centers and SMEs . The project is expected to provide new tools for early diagnosis and targeted treatments exploited by SMEs and to accelerate innovation of CC therapy and improve quality of life.


Beara I.N.,University of Novi Sad | Lesjak M.M.,University of Novi Sad | Orcic D.Z.,University of Novi Sad | Simin N.T.,University of Novi Sad | And 3 more authors.
LWT - Food Science and Technology | Year: 2012

The present study was designed to define the phenolic profile, antioxidant, anti-inflammatory and cytotoxic activity of Plantago altissima L., which has never been studied before and to compare it with closely-related, renowned, well-studied Plantago lanceolata L. The presence and content of 44 phenolics in methanol extracts were studied using LC-MS/MS. A similar qualitative composition including dominant compounds as p-hydroxybenzoic, vanillic, gallic and chlorogenic acid, besides apigenin, luteolin and luteolin-7-O-glucoside was found between both extracts. Antioxidant activity of extracts was determined using several assays. All results of these tests were comparable to butylated hydroxytoluene, a well-known synthetic antioxidant. Anti-inflammatory potential was studied by means of cyclooxygenase-1 (COX-1) and 12-lipoxygenase (12-LOX) inhibitory activity. Activity of P. altissima towards COX-1/12-LOX inhibition (IC 50 = 4.4 and 3.6 mg/mL, respectively) was inferior to activity of P. lanceolata (IC 50 = 2.0 and 0.8 mg/mL, respectively). Treatment of four cell lines resulted in a considerable dose-dependent inhibition of cell growth, where P. lanceolata exerted a stronger effect (IC 50 = 172.3, 142.8, 405.5 and 551.7 μg/mL for HeLa, MCF7, HT-29 and MRC-5 cell lines, respectively). To conclude, P. altissima showed certain bio-potential, but was clearly inferior to P. lanceolata. © 2012 Elsevier Ltd.


Mandic A.,Oncology Institute of Vojvodina
Acta medica (Hradec Králové) / Universitas Carolina, Facultas Medica Hradec Králové | Year: 2013

A definitive diagnosis of cervical intraepithelial neoplasia (CIN) is confirmed after histopathological (HP) examination of the tissue obtained through the biopsy. The aim of this study was to compare histopathological results obtained with punch biopsy and results obtained through one of the excisional techniques. We analysed histology results of 130 patients referred to our institution with abnormal smear. Punch biopsy was performed after colposcopic examination in all patients before one of the excision methods. Excision methods performed were: large loop excision of transformation zone (LLETZ), radio-frequency knife conisation or cold knife conisation. Based on the histopathological examination of the punch biopsy specimen or excisional specimen diagnosis of CIN was established. CIN and invasive cancer were the most common diagnoses in the 31-40 age group at 45.4% (59/130). Discrepancies in the histological diagnosis between punch biopsy and excisional biopsy was identified in 58.5% (76/130) of the patients. In 6% of the of the cases the biopsy did not detect an invasive carcinoma. The most frequent discrepancies between punch biopsy and excisional biopsy were in the group of patients with a higher grade cervical dysplasia. Mild dysplastic changes diagnosed through punch biopsy, require a more conservative approach, as the majority of this group had negative specimens on the cone after excision, especially in the younger population. It is advisable that the patients above 30 years of age and a higher grade dysplasia in the biopsy specimen, should undergo one of the excisional techniques as a diagnostic/therapeutic method of treatment.


Zaric B.,Oncology Institute of Vojvodina | Perin B.,Oncology Institute of Vojvodina
Expert Review of Medical Devices | Year: 2010

Narrow-band imaging (NBI) is a new endoscopic technique designed for detection of pathologically altered submucosal and mucosal microvascular patterns. The combination of magnification videobronchoscopy and NBI showed great potential in the detection of precancerous and cancerous lesions of the bronchial mucosa. The preliminary studies confirmed supremacy of NBI over white-light videobronchoscopy in the detection of premalignant and malignant lesions. Pathological patterns of capillaries in bronchial mucosa are known as Shibuya's descriptors (dotted, tortuous and abrupt-ending blood vessels). Where respiratory endoscopy is concerned, the NBI is still a 'technology in search of proper indication'. More randomized trials are necessary to confirm the place of NBI in the diagnostic algorithm, and more trials are needed to evaluate the relation of NBI to autofluorescence videobronchoscopy and to white-light magnification videobronchoscopy. Considering the fact that NBI examination of the tracheo-bronchial tree is easy, reproducible and clear to interpret, it is certain that NBI videobronchoscopy will play a significant role in the future of lung cancer detection and staging. © 2010 Expert Reviews Ltd.


Cetojevic-Simin D.D.,Oncology Institute of Vojvodina
Journal of medicinal food | Year: 2010

In this study we investigated antioxidative and antiproliferative activity of different horsetail (Equisetum arvense L.) extracts. The antioxidative activity was measured by the electron spin resonance (ESR) spectroscopy-spin trapping method. The influence of different horsetail extracts during lipid peroxidation of (1) sunflower oil induced by the lipophilic azo-initiator 4,4'-azobis(4-cyanovaleric acid) and (2) soybean phosphatidylcholine liposomes induced by the hydrophilic azo-initiator 2,2'-azobis(2-amidinopropane) dihydrochloride was studied. Antiproliferative activity was measured using the sulforhodamine B colorimetric assay on the human cancer cell lines HeLa, HT-29, and MCF7. The results of ESR analysis confirmed that the extracts investigated suppressed the formation of lipid peroxyl radicals in both systems investigated in a dose-dependent manner. The results indicate that n-butanol, methanol, ethyl acetate, and water extracts had significant peroxyl radical scavenging activity. Extracts inhibited cell growth that was dependent on cell line, type of extract, and extract concentration. Ethyl acetate extract exhibited the most prominent antiproliferative effect, without inducing any cell growth stimulation on human tumor cell lines. The results obtained suggest that the horsetail extracts could be used as an easily accessible source of natural antioxidants and as potential phytochemicals.


Mihailovic J.,Oncology Institute of Vojvodina
Archive of Oncology | Year: 2012

The diagnostic imaging procedures that have a role in detection of malignant thyroid tissue are radioiodine (131I) diagnostic whole-body scintigraphy (WBS), neck ultrasound, and CT and MRI for evaluation of the mediastinal area. Despite excellent morphologic characterization of metastatic nodal recurrences, MRI cannot reliably make a differentiation between benign and malignant lymph nodes. Although it detects enlarged metastatic lymph nodes, there are also many small nodal metastases that are usually missed. In one-third of patients with well differentiated thyroid carcinoma, there are carcinomas with dedifferentiated tumor cells: Metastatic tissue may not concentrate radioiodine well; thus 131I-WBS is negative despite elevated thyroglobulin (Tg) levels. Although MRI helps in detection of these non-iodine avid metastases, FDG PET/CT can perform more effectively. Due to its high glycolytic rate, changes in glucose transport systems and hexokinase activity, [18F] fluorodeoxyglucose (FDG) accumulates in malignant tissue and is useful for identification of distant metastases in these patients. Iodine positive metastases are often negative with FDG-PET imaging while iodine negative metastases exhibit increased FDG-uptake. If a metastatic lesion is identified by FDG positron emission tomography/ computed tomography (PET/CT), the usual approach is to first send the patient to surgery for removal of neoplastic tissue, if possible. This is followed by re-treatment with 131I therapy after tumor redifferentiation with retinoic acid. In a limited number of patients, iodine negative thyroid cancer may express somatostatin receptors and radiopeptide therapy may be utilized. FDG PET/CT is a hybrid imaging diagnostic tool which helps in detection of non-iodine avid metastases. It has a role in exact localization of recurrences which will assist in the decision to remove the malignant tissue surgically. © 2012, Oncology Institute of Vojvodina, Sremska Kamenica.


Mandic A.,Oncology Institute of Vojvodina
Journal of B.U.ON. | Year: 2012

Human papillomavirus (HPV) is one of the most common sexually transmitted diseases worldwide. Cervical and anal intraepithelial neoplasia, genital warts, and recurrent respiratory papillomatosis such as cervical and other anogenital cancers, are HPV-associated diseases. Prophylactic HPV vaccines are composed of HPV L1 capsid protein that self-assembles into virus-like particles (VLPs) when expressed in recombinant systems. The two types of prophylactic vaccines are designed a bivalent vaccine to protect against high-risk HPV types 16 and 18 and a quadrivalent vaccine designed to protect against HPV 16 and 18, and low-risk, genital wart-causing HPV 6 and 11. Proof-of-principle trials have suggested that intramuscular injections of VLPs result in strong adaptive immune responses that are capable of neutralizing subsequent natural infections. Recent research on the safety and efficacy of candidate prophylactic vaccines against HPV have shown very promising results with nearly 100% efficacy in preventing the development of persistent infections and cervical precancerous lesions in vaccinated individuals. © 2012 Zerbinis Medical Publications.

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