Browsing by Author "Ristic, Dusan (8869432800)"

Purpose: To present the experience of our center with cytoreductive surgery (CRS) and hyperthermic intrathoracic chemotherapy (HITHOC) in the treatment of various potentially resectable chemo-sensitive pleural malignancies, primary and metastatic, limited to the unilateral thoracic inlet, as well as to address potential extension of indications for this procedure. Methods: This retrospective study included patients treated with CRS+HITHOC at the Institute for Oncology and Radiology of Serbia from January 2018 to August 2021. Indications for CRS+HITHOC were: (1) potentially resectable chemo-sensitive primary or residual/recurrent thoracic malignancy, with no signs of disease outside the thoracic cavity, and (2) miscellaneous metastatic disease limited to the unilateral thoracic inlet. All HITHOC procedures were performed with 90 min cisplatin perfusion (100 mg/m2 in 1000 ml of 5%-glucose gradually heated to 42°C). Results: A total of 7 patients were included in this study, with a mean age of 41.43 ± 19.25 years (range: 16-62). R0 resections were achieved in all patients. All CRS+HITHOC procedures were uneventful, with no metabolic or hemodynamic disorders intraoperatively. Average follow-up was 25.71±9.83 months (range: 14-40). Overall survival rate was 100%. There were no local relapses in the thoracic cavity. Conclusions: This study showed that CRS+HITHOC procedure might be successfully used not only for current indications, but also for a limited metastatic disease of a primary outside the thoracic cavity. Larger, multicentric studies might provide more data on oncological outcomes and cost-effectiveness of this procedure. © 2021 Zerbinis Publications. All rights reserved.

Purpose: To present the experience of our center with cytoreductive surgery (CRS) and hyperthermic intrathoracic chemotherapy (HITHOC) in the treatment of various potentially resectable chemo-sensitive pleural malignancies, primary and metastatic, limited to the unilateral thoracic inlet, as well as to address potential extension of indications for this procedure. Methods: This retrospective study included patients treated with CRS+HITHOC at the Institute for Oncology and Radiology of Serbia from January 2018 to August 2021. Indications for CRS+HITHOC were: (1) potentially resectable chemo-sensitive primary or residual/recurrent thoracic malignancy, with no signs of disease outside the thoracic cavity, and (2) miscellaneous metastatic disease limited to the unilateral thoracic inlet. All HITHOC procedures were performed with 90 min cisplatin perfusion (100 mg/m2 in 1000 ml of 5%-glucose gradually heated to 42°C). Results: A total of 7 patients were included in this study, with a mean age of 41.43 ± 19.25 years (range: 16-62). R0 resections were achieved in all patients. All CRS+HITHOC procedures were uneventful, with no metabolic or hemodynamic disorders intraoperatively. Average follow-up was 25.71±9.83 months (range: 14-40). Overall survival rate was 100%. There were no local relapses in the thoracic cavity. Conclusions: This study showed that CRS+HITHOC procedure might be successfully used not only for current indications, but also for a limited metastatic disease of a primary outside the thoracic cavity. Larger, multicentric studies might provide more data on oncological outcomes and cost-effectiveness of this procedure. © 2021 Zerbinis Publications. All rights reserved.

Purpose: Bone and soft tissue tumors are rare. There is a variety of types and each one has its own particular behavior, treatment and patient outcome. The assessment of treatment response following the 3rd cycle of chemotherapy is one of the most important aspects of patient care, as therapeutic options and the timing of surgery may vary depending on the achievement of response. Hence, we focused on the advanced imaging technique, proton magnetic resonance spectroscopy (1H MRS), aiming at improving the diagnostic accuracy and the tumor response to therapy, based on the absolute concentration of choline (Cho) as biomarker of malignancy. Methods: Twenty patients were studied. All of them had a pathological diagnosis after biopsy. MRI examinations were performed using a 1.5 T MR scanner (Avanto; Siemens, Erlangen, Germany). Single-voxel 1H MR spectroscopy was performed by using a PRESS with TR/TE 1530/100 ms, before chemotherapy and after the 3rd cycle. 1H MRS was processed in LC model. Results: Of 20 patients, 7 responded to neoadjuvant chemotherapy and 13 did not. In responders, the mean concentration of tCho before therapy was 4.7±2.5 mmol/kg, which showed statistically significant reduction after therapy. In non-responders, the mean tCho concentration before therapy was 2.9±0.9 mmol/kg which remained the same or increased after the 3rd cycle of neoadjuvant chemotherapy (2.7±2.5 mmol/kg; range from 2.05 to 5.79 with no statistical significance). Compared to reference healthy group, tCho concentrations were increased in all cases. Conclusions: 1H MRS appears to be valuable technique for evaluation of response to neoadjuvant chemotherapy of patients with musculoskeletal tumors (MSK). © 2018 Zerbinis Publications. All Rights Reserved.

Purpose: Bone and soft tissue tumors are rare. There is a variety of types and each one has its own particular behavior, treatment and patient outcome. The assessment of treatment response following the 3rd cycle of chemotherapy is one of the most important aspects of patient care, as therapeutic options and the timing of surgery may vary depending on the achievement of response. Hence, we focused on the advanced imaging technique, proton magnetic resonance spectroscopy (1H MRS), aiming at improving the diagnostic accuracy and the tumor response to therapy, based on the absolute concentration of choline (Cho) as biomarker of malignancy. Methods: Twenty patients were studied. All of them had a pathological diagnosis after biopsy. MRI examinations were performed using a 1.5 T MR scanner (Avanto; Siemens, Erlangen, Germany). Single-voxel 1H MR spectroscopy was performed by using a PRESS with TR/TE 1530/100 ms, before chemotherapy and after the 3rd cycle. 1H MRS was processed in LC model. Results: Of 20 patients, 7 responded to neoadjuvant chemotherapy and 13 did not. In responders, the mean concentration of tCho before therapy was 4.7±2.5 mmol/kg, which showed statistically significant reduction after therapy. In non-responders, the mean tCho concentration before therapy was 2.9±0.9 mmol/kg which remained the same or increased after the 3rd cycle of neoadjuvant chemotherapy (2.7±2.5 mmol/kg; range from 2.05 to 5.79 with no statistical significance). Compared to reference healthy group, tCho concentrations were increased in all cases. Conclusions: 1H MRS appears to be valuable technique for evaluation of response to neoadjuvant chemotherapy of patients with musculoskeletal tumors (MSK). © 2018 Zerbinis Publications. All Rights Reserved.