Papillary urothelial neoplasm of uncertain malignant potential

papillary urothelial neoplasm of uncertain malignant potential

Adela Nechifor-Boila - Referințe bibliografice Google Academic

Mircea O. Mariusz Z. Kevin R. Stephen P. Richard J. Florian Strasser Cantonal Hospital St. Gallen, Switzerland Prof. Elizabeta C. Stanculeanu D. General Aspects part I Enachescu C. All rights are reserved.

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Rom J Morphol Embryol ; 60 1 :

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În cele mai multe cazuri, evoluţia afecţiunilor neoplazice este silenţioasă, existând simptome doar atunci când masa tumorală este extinsă, creând astfel dereglări în funcţionalitatea organelor sau sistemelor în care apare.

Tratamentul cancerelor presupune o abordare extinsă, multidisciplinară, cuprinzând echipe de medici specialişti în funcţie de localizarea acestora în organismoncologi, radioterapeuţi, chirurgi, fiecare având papillary urothelial neoplasm of uncertain malignant potential rol bine stabilit în funcţie de tipul cancerului, stadiu şi afecţiunile asociate ale pacientului. Tratamentele adiacente necesare în managementul afecţiunilor neoplazice au drept obiectiv asigurarea confortului pacientului, ameliorarea anumitor simptome sau a unor reacţii adverse cauzate de tratamentele specifice.

Printre acestea se numără tratamentul durerii, al infecţiilor din cursul chimioterapiei, controlul simptomelor cauzate de tumorile cerebrale, tratamentul tulburărilor organelor afectate de evoluţia cancerului etc. Astfel, managementului pacienţilor oncologici trebuie orientat către dezvoltarea de teste diagnostice care să depisteze cancerul în formele cele mai precoce, de tehnici superioare de radioterapie, noi tehnici chirurgicale şi papillary urothelial neoplasm of uncertain malignant potential antitumorale.

De la teorie la practică. Drumul Odăi, Nr. Tomosinteza sânului este o tehnologie nouă în lupta împotriva cancerului de sân care permite medicilor să examineze ţesutul sânului strat cu strat.

Urari de ziua de nastere pentru fiica

În timpul examinarii 3D - tomosinteză braţul de raze X se deplasează într-o uşoară curbă peste sân, făcând multiple fotografii ale sânului în doar câteva secunde. Se foloseşte un nivel foarte redus de radiaţii pentru ca expunerea să fie similara cu cea a unei mamografii tradiţionale.

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După aceea, computerul creează o imagine tridimensională a ţesutului mamar în straturi de 1 milimetru. Intr- o imagine 2D suprapunerea de tesut poate ascunde structuri si poate duce la erori de diagnostic. Mamografia 3D elimina efectul papillary urothelial neoplasm of uncertain malignant potential de tesut.

Acum radiologul poate vizualiza în detaliu ţesutul mamar într-un mod care până acum nu era posibil. În loc să vizualizeze toate complexităţile ţesutului mamar pe o imagine în plan, acum medicul poate analiza ţesutul milimetru cu milimetru.

Cele mai mici detalii sunt mai clar vizibile, nemaifiind ascunse de ţesuturi.

Primul sistem cu tomosinteza din tara a fost instalat in septembrie la Institutul Oncologic Cluj. Şef Lucrări Dr.

Mesaj de 8 martie 13 Urare de ziua de nastere pentru copil 2 Urare de ziua de nastere pentru parinti 1 Cugetari.

Lucia Stănculeanu1,2 , Dr. Daniela Zob2 1. Dana Lucia Stanculeanu Email: dlstanculeanu gmail. Rom J Oncol Hematol. Two randomized phase III clinical studies looked for verifying this concept through the dual blockade of the HER2new receptor by associating two molecules: Trastuzumab and Lapatinib.

Breast cancer remains the main cause of morbidity through cancer within the global female population. An other major element comprised the change in the assessment of the clinical studies Stanculeanu D. Med ; The two studies presented at ASCO by Olivia Pagani, try to solve the ovarian suppression antinomyand to answer to the question if the adjuvant aromatase inhibitors treatment in women at premenopause specifically Exemestanum and ovarian suppression improve DFS disease free survival compared to Tamoxifen and ovarian suppression.

The both are phase III multicentric clinical studies that aim to show which is the optimum endocrine adjuvant treatment for the women at premenopause. In both studies the recurrence was due to the secondary determinations soft tissue, bones or internal organs.

The mean follow-up period was of 5,7 years. The Kaplan - Meyer curves showed an improvement in an absolute value papillary urothelial neoplasm of uncertain malignant potential 3.

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The differences show up in time so that in the first 5 years the most aggressive tumors begin to proliferate, which would explain the benefit of aromatase inhibitors in the very aggressive tumors no matter the menopausal status.

Forest plot analysis shows a minimum benefit for the papillary urothelial neoplasm of uncertain malignant potential that were chemotherapy treated in TEXT study. Although the difference in absolute value is small 5. Within this subgroup DFS at 5 years was of So, if one patient out of three had recurrence in the Tamoxifen group, for the Exemestan group only one out of six showed recurrence.

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An other subgroup was that of the patients papillary urothelial neoplasm of uncertain malignant potential over 40 patients who after chemotherapy remained in premenopause.

Bycontrast was the subgroup of women of median age over 46 that recieved chemotherapy, were at perimenopause and for whom the ovarian suppression brought no benefit and where Tamoxifen alone can be considered sufficient. If the ESMO presentation advised for caution and to wait for the final results of the SOFT study,respectively for the Tamoxifen treated subgroup SABCS confirmed through the final results that Tamoxifen with ovarian suppression is more effective than Tamoxifen alone and Exemestan with ovarian suppression is more effective than Tamoxifen and ovarian suppression.

papillary urothelial neoplasm of uncertain malignant potential

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With these results transmitted at the end of there can discussed a new therapeutic standard for women below 35 years and with high reccurence risk for whom the ovarian suppression and the intake of Exemestan increase DFS, but with toxicities that must be known. Conclusively these results create a dilemma: on one hand changing the clinical approach with the well known risk of adverse reactions or on the other hand waiting for a 10 year long period of following that confirms these results.

The only criticism brought on the study is the small number of patients. HER2new positive breast cancer treatment brought up into discussion the role of the neoadjuvant treatment in complete pathological response and the transposition of this concept into OS increase.

Citate duplicat

Two randomized phase III clinical studies looked for verifying this concept through the dual blockade of the HER2new receptor by associating two molecules: Trastuzumab, a humanisedmonoclonal antibody and a small moleculetyrosine kinase inhibitor, Lapatinib.

The explanation is probably because of the too short follow-up interval and of the small number of recorded events. Concerning the HER2 positive metastatic disease treatment two molecules changed the guidelines: Pertuzumab and TrastuzumabEtamsine.

The patients treated in the first line with the association TrastuzumabPertuzumabDocetaxel had a survival of Another question launched by this study is if Docetaxel is the only effective partner of the combination or if the treatment is effective also after disease progression.

The second molecule that produced changes in HER2 metastatic disease guideline is Trastuzumabemtasine Kadcylaan antibody conjugated with a drug that releases DM1 right in the HER2 overexpressed cell. This treatment can be this way an option for the patients progressing under a year from the adjuvant Trastuzumab therapy. THERESA study represents the second study in which the TDM1 treatment proves its efficacy in the third line of treatment on the metastatic disease patients that progressed after two lines of treatment with Trastuzumab, Lapatinib and a taxan, having as main objective papillary urothelial neoplasm of uncertain malignant potential free survival PFS defined by an investigator, overall survival OS and secondary objectives overall response rate ORR defined by the investigator and treatment safety.

Other molecules with a potential effect in treating HER2new metastatic breast cancer: Neratinib HKIoral irreversible tyrosine kinase inhibitor, Ramucirumaban antibody that acts on the receptor 2 of VEGF that inhibits angiogenesis or sarcoma cancer uterine chemotherapics such as Eribulin.

This work is licensed under a Creative Commons Attribution 4. Abstract LBA4. The association between event-free survival and pathological complete response to neoadjuvantlapatinib, trastuzumab, or their combination papillary urothelial neoplasm of uncertain malignant potential HER2-positive breast cancer. Abstract S National Cancer Institute website.

Updated June 1, Accessed June 1, Trial overview. ALTTO trial website. Lapatinib clinical trial update [press release].

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