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1.  The AgNORs count in predicting long-term survival in serous ovarian cancer 
Introduction
The value of argyrophilic nucleolar organizer regions (AgNORs) to predict survival in patients with ovarian cancer has not been clearly explained yet. The aim of study was to assess the value of analysis of the mean number of AgNORs per nucleus (mAgNOR) and mean percentage of nuclei with five or more AgNORs per nucleus (pAgNOR) in the prediction of disease-free survival (DFS) and overall survival (OS) in patients with serous ovarian cancer.
Material and methods
The study examined 52 patients treated for serous ovarian cancer with a follow-up period of 2-143 months. After silver staining paraffin specimens from primary surgery, mAgNOR and pAgNOR in cancer cells were counted and analyzed. Age, grading, radicality of surgery and FIGO staging were analyzed as covariates.
Results
Mean mAgNOR equaled 4.4 ±0.9 and pAgNOR equaled 42.2 ±20.8%. Both mAgNOR and pAgNOR were the lowest in G1 tumors. The mAgNOR and pAgNOR were lower in stage I than stage IV cancers. The DFS and OS rates were respectively 15.4% and 21.2%. In univariate analysis FIGO staging, grading, and pAgNOR were associated with worse prognosis, while radicality of surgery remained a significant protective factor in terms of DFS. Higher FIGO staging and older age worsened OS. In multivariate analysis FIGO staging remained significantly associated with both DFS (HR 1.98; 95% CI 1.05-3.71) and OS (HR 1.76; 95% CI 1.00-3.10), while age affected OS rates (HR 1.78; 95% CI 1.04-2.95).
Conclusions
mAgNOR and pAgNOR are useful markers of cellular kinetics. Prospective studies in larger populations are needed to confirm these results in terms of AgNORs’ effects on survival.
doi:10.5114/aoms.2013.36753
PMCID: PMC3953966
nucleolar organizer regions; argyrophilic; serous ovarian cancer; prognostic factors; survival
2.  Response to postoperative radiotherapy as a prognostic factor for patients with low-grade gliomas 
Oncology Letters  2012;4(3):455-460.
Due to the favorable natural history in patients with low-grade gliomas (LGGs), there is no consensus on the treatment strategy following maximal safe surgical resection. A number of studies have been conducted to identify prognostic factors in patients treated for LGG. The present study evaluated the treatment outcomes as well as prognostic factors and their impact on overall survival (OS) and disease-free survival (DFS). We retrospectively reviewed 30 consecutive patients treated for LGG at the Department of Radiotherapy from February 2008 to July 2011. The patients underwent surgical intervention and postoperative radiotherapy. The response to radiotherapy was evaluated from six to eight weeks after the end of treatment using MRI analysis. Kaplan-Maier analysis was used for OS and DFS estimation. The endpoint was mortality as a result of any cause. Within a median follow-up of 21.8 months, 9 patients (30%) with disease progression were reported. The two- and five-year DFS and OS was 85.2 and 68.3% for DFS, and 84.3 and 63.4% for OS, respectively. The response to radiotherapy, evaluated in an MRI study, was found to be highly correlated with OS (p<0.0001). We also observed a significantly higher OS in patients with disease progression treated with salvage chemotherapy after the end of radiotherapy (p=0.08). Improved outcome among patients with LGG may be predicted by response to radiotherapy evaluated by MRI following termination of treatment.
doi:10.3892/ol.2012.759
PMCID: PMC3439013  PMID: 22970043
low-grade gliomas; radiotherapy; prognostic factors
3.  Membrane expression of TRAIL receptors DR4, DR5, DcR1 and DcR2 in the normal endometrium, atypical endometrial hyperplasia and endometrioid adenocarcinoma: a tissue microarray study 
Purpose
To evaluate the membrane expression of DR4, DR5, DcR1 and DcR2 in the normal endometrium (NE), atypical endometrial hyperplasia (AEH) and endometrioid adenocarcinoma (EAC).
Methods
The study comprised 197 patients: 20 NE, 18 AEH and 159 EAC. Tissue microarrays were constructed. Membrane expression of DR4, DR5, DcR1 and DcR2 was examined and presented as total score (TS).
Results
In EAC, the membrane expression of DR4, DR5 and DcR2 was less common compared to NE (p < 0.001; p < 0.001; p = 0.018) and AEH (p < 0.001; p < 0.001; p = 0.004). In EAC the membrane expression of DcR1 did not differ when compared to NE (p = 0.055) and AEH (p = 0.173). A strong correlation was found between the type of endometrial tissue (NE/AEH/EAC) and the TS of DR4 (p < 0.001), DR5 (p < 0.001), DcR1 (p = 0.033) and DcR2 (p < 0.001). In EAC, the TS of DR4, DR5, DcR1 and DcR2 was not related to grading and staging. In EAC, the membrane expression of DR5, but not DR4, DcR1 and DcR2, was related to better disease-free survival (DFS). The overall survival (OS) was not related to membrane TRAIL receptors expression.
Conclusions
The membrane expression of the receptors for TRAIL DR4, DR5, DcR1 and DcR2 is greater in NE than EAC. The level of membrane staining of the receptors in EAC is not dependent on grading and staging. In EAC patients, membrane expression of DR4, DR5, DcR1 and DcR2 are not independent predictors of survival.
doi:10.1007/s00404-013-2840-x
PMCID: PMC3778234  PMID: 23584885
Tissue microarray; TRAIL receptors; Normal endometrium; Atypical endometrial hyperplasia; Endometrial adenocarcinoma
4.  Assessment of the argyrophilic nucleolar organizer region area/nucleus ratio in ovarian serous epithelial adenomas, borderline tumors and cancers 
Introduction
There is a need to assess the value of the novel potentially useful biomarkers in ovarian tumors. The aim of study was to assess the value of sAgNOR analysis in ovarian serous epithelial tumors.
Material and methods
The analysis was performed in ovaries from 113 patients treated operatively due to serous ovarian tumors (30 adenomas, 14 borderline tumors and 69 cancers). After silver staining of paraffin specimens from surgery, sAgNOR in tumor cells was analyzed. Additionally, the value of the argyrophilic nucleolar organizer region area/nucleus ratio (sAgNOR) in the prediction of disease-free survival (DFS) and overall survival (OS) in 52 patients with serous ovarian cancer with complete follow-ups in November 2009 was evaluated. Age, grading, radicality of surgery and FIGO staging were analyzed as additional factors.
Results
sAgNOR in adenomas, borderline tumors and cancers was in the following ranges: (0.73 ±0.23) × 106, (0.81 ±0.18) × 106 and (0.96 ±0.33) × 106 [AgNOR/cm2] respectively. In cancers from G1 to G3 sAgNOR was (1.02 ±0.32) × 106 (G1), (0.98 ±0.37) × 106 (G2) and (0.82 ±0.24) × 106 (G3) [AgNOR/cm2] respectively. In univariate analysis, but not in multivariate analysis, staging negatively correlated with better DFS and OS. sAgNOR, age of patients, grading and radicality of surgery were not associated with DFS or OS in either univariate or multivariate analysis.
Conclusions
sAgNOR analysis is not sufficient to precisely characterize cellular kinetics in serous ovarian tumors, and the analysis of sAgNOR, mAgNOR and pAgNOR should be performed commonly. The prognostic significance of sAgNOR in patients with serous ovarian cancer was not proven.
doi:10.5114/aoms.2013.33066
PMCID: PMC3598139  PMID: 23515230
nucleolar organizer regions; argyrophilic; ovarian tumors; serous
5.  A Comparison of Attitudes Toward Euthanasia Among Medical Students at Two Polish Universities 
Journal of Cancer Education  2012;28(2):384-391.
The aim of the study conducted upon completion of obligatory palliative medicine courses among 588 medical students at two universities was to compare their attitudes toward euthanasia. Four hundred ninety-two (84.97 %) students were Catholics; 69 (11.73 %) declared they would practice euthanasia, 303 (51.53 %) would not, and 216 students (36.73 %) were not sure. The idea of euthanasia legalisation was supported by 174 (29.59 %) respondents, opposed by 277 (47.11 %), and 137 (23.30 %) were undecided. Five hundred fifty-six (94.56 %) students did not change their attitudes toward euthanasia after palliative medicine courses. Students from the two universities were found to have different opinions on practicing euthanasia, euthanasia law and possible abuse which might follow euthanasia legalisation, but they shared similar views on the choice of euthanasia if they themselves were incurably ill and the legalisation of euthanasia. Gender and religion influenced students’ answers. Differences observed between medical students at the two universities might be related to gender and cultural differences.
doi:10.1007/s13187-012-0414-4
PMCID: PMC3664753  PMID: 23055130
Ethics; Euthanasia; Medical students; Palliative medicine; Physician assisted suicide
6.  The comparison of common cancer types and the coincidence of concomitant chronic diseases between palliative home care patients in Lodz Voivodeship and the general Polish population 
Introduction
The continued growth in the number of elderly with cancer and age-related chronic diseases will cause in Poland an increase in demand for palliative care. The aim of the study was to identify chronic comorbidities and cancer types in palliative home care patients and to compare their incidence with the general Polish population.
Material and methods
The data was obtained from 543 patients who received palliative home care between 2005-2009. The occurrence of the most common chronic conditions such as arterial hypertension, ischemic heart disease, diabetes, chronic pulmonary diseases and central nervous system diseases were analysed together with the cancer types.
Results
The study group included 259 women (47.7%) and 284 men (52.3%) aged 25-91 years old. The most common primary neoplasm locations for men were lung (28.2% vs. 21.4% in general population) and colorectal cancer (18.7% vs. 11.4% in general population), and in women breast (19.7% vs. 22.8% in general population) and colorectal cancer (17.4% vs. 9.2% in general population). The incidence of ischemic heart disease, diabetes, and chronic pulmonary diseases was significantly different in comparison to the general populations (47.0% vs. 11.3%; 20.3% vs. 6.8%; 16.6% vs. 27.5%, respectively). The mean number of concomitant diseases was 1.6 for women and 1.8 for men vs. 1.7 and 1.2 in the general Polish population respectively.
Conclusions
The majority of the patients had concomitant disease, with cardiovascular diseases being most common. The most common primary neoplasm diagnoses in palliative home care patients were lung and colorectal cancer, which corresponds to the cancer prevalence in the general population.
doi:10.5114/aoms.2012.29406
PMCID: PMC3400916  PMID: 22852006
advanced cancer; palliative care; comorbidities; elderly
9.  Long-term survival of endometrioid endometrial cancer patients 
Introduction
To establish risk factors for onset and progression of endometrioid endometrial cancer still remains the aim of scientists. The aim of the study was to determine disease-free survival (DFS) and overall survival (OS) in women with endometrioid endometrial cancer.
Material and methods
A retrospective review of 142 patients with endometrioid endometrial cancer after surgery treated with adjuvant radiotherapy and/or chemotherapy in the Regional Cancer Centre in Lodz between 2002 and 2004 was performed. Clinical and pathological data were correlated with clinical outcome and survival.
Results
In 3 patients (2.1%) clinical progression was diagnosed during the treatment. In 23 patients (16.7%) after primary remission, relapse was diagnosed 2-56 months after treatment. DFS and OS were 81.7% and 83.1% respectively. Better DFS significantly correlated with larger number of pregnancies (> 1), stage I of the disease and optimal surgery. Lower stage of disease, pelvic lymph node dissection, optimal surgery and depth of myometrial infiltration ≤ 50% were independent prognostic factors for better OS.
Conclusions
The results of our study provided significant evidence that early detection of endometrioid endometrial cancer enables optimal surgery. It reduces the indications for adjuvant therapy in stage I of the disease, and makes the prognosis significantly better. Other clinical and pathological factors such as numerous pregnancies, pelvic lymphadenectomy, and depth of myometrial infiltration, although important, are of less significance. Further prospective, randomized studies are necessary to prove the role of these factors.
doi:10.5114/aoms.2010.19305
PMCID: PMC3302708  PMID: 22427770
endometrioid endometrial cancer; prognostic factors; disease-free survival; overall survival
10.  The analysis of prognostic factors affecting post-radiation acute reaction after conformal radiotherapy for non-small cell lung cancer 
Introduction
The aim was to evaluate the risk of acute side effects in the lung after 3-dimensional conformal radiotherapy (3D-CRT) in patients treated for non-small cell lung cancer (NSCLC). An attempt was made to single out clinical factors and factors related to treatment technique which may induce acute post-radiation pneumonitis.
Material and methods
The analysis concerned 34 consecutive patients who underwent radical radiation therapy for NSCLC. Intensity of early toxicity was evaluated using modified RTOG/EORTC toxicity score. The endpoint for this analysis was the occurrence of radiation pneumonitis of grade 2 or higher. Factors related to treatment techniques were included in the statistical analysis.
Results
Fifty-three percent of patients included in the study suffered from acute post-radiation pneumonitis. The results of the study revealed the existence of lung tissue sensitivity to low doses of ionizing radiation. The multivariate analysis showed that total lung volume receiving a low dose of 10 Gy increased the risk of post-radiation pneumonitis (p = 0.01).
Conclusions
Acute post-radiation pneumonitis was a relevant clinical problem in patients who underwent radical radiotherapy for non-small cell lung cancer. The lung volume receiving a dose of 10 Gy was the most important dosimetric factor which influenced the post-radiation acute pneumonitis.
doi:10.5114/aoms.2010.17092
PMCID: PMC3298346  PMID: 22419936
NSCLC; conformal radiotherapy; post-radiation pneumonitis

Results 1-10 (10)