To compare cognitive fusion targeted and systematic prostate biopsy in patients with repeated negative systematic biopsy but persistent clinical suspicion for prostate cancer.
The study enrolled 63 ...patients with at least one previously negative systematic biopsy who underwent targeted prostate biopsy using multiparametric magnetic resonance imaging (mpMRI) and transrectal ultrasound (TRUS) in addition to standardized systematic biopsy from July 2016 to May 2018. Multiparametric MRI was performed with 3 Tesla device by uro-radiologists experienced in prostate cancer. Lesions with Prostate Imaging Reporting and Data System 3, 4, and 5 were considered suspicious. Targeted biopsies were performed with cognitive fusion of TRUS and mpMRI.
Prostate cancer detection, using either targeted or systematic biopsy, was 60.32%. Targeted biopsies were positive in 52.38% and systematic biopsies in 47.62% of patients. The median highest percentage of cancer involvement per biopsy core was significantly higher in targeted cylinders. The biopsies obtained by using the two techniques did not significantly differ in Gleason score.
Cognitive targeted prostate biopsy based on mpMRI presents a valuable addition to systematic biopsy in patients with repeated negative systematic biopsies but persistent clinical suspicion of prostate cancer.
The aim of this paper is to show the results of prostate cancer treatment in Prostate Center of Department of Urology at the University Hospital Center Zagreb. The answer to growing demands for ...prostate cancer treatment due to increasing incidence is the formation of specialized, multidisciplinary units/centers that deal mainly with prostate cancer. The need was recognized by European School of Oncology and European Association of Urology, who have proposed their concepts of validating such centers with the aim of promoting high-quality prostate cancer treatment. Following these trends, the Department of Urology at the University Hospital Center Zagreb has established the Prostate Center. This new unit offers specialized and individualized approach to workup, treatment and follow up for prostate cancer patients based on multidisciplinarity. The Prostate Center was also established as a platform for education and research.
The majority of renal neoplasms can be treated surgically using open or minimally-invasive approach. Nephron-sparing surgery should be used when possible, regardless to the operative approach. In ...this retrospective study, we analyzed surgical trends of operative treatment of renal neoplasms in the period from February 2011 until December 2020. There were a total of 1031 procedures, 703 (68.2%) radical nephrectomies (RN) and 328 (31.8%) partial nephrectomies (PN). Laparoscopic approach was used in 211 (20.5%) (111 PN and 100 RN), while open approach was used in 820 (79.5%) (328 PN and 703 RN) cases. There were 12 procedures performed with the use of cardiopulmonary bypass and hypothermic arrest. The median operative time was 161 minutes for open RN and 158 for open PN, 160 for laparoscopic RN, and 162 for laparoscopic PN. The most common pathology was clear cell carcinoma in 693 (67.3%), papillary carcinoma in 115 (11.2%), chromophobe carcinoma in 67 (6.5%), oncocytoma in 46 (4.5%), and angiomyolipoma in 33 (3.2%) patients. Pathologically, pT1 stage was diagnosed in 56.9%, pT2 in 5.8%, pT3 in 22.4% and pT4 in 1.2% of patients. Regional lymphadenectomy was performed in 354 (34.3%) patients, among which lymph nodes were positive in 40 (11.3%) cases. Surgical margins were positive in 27 cases when PN was performed (8.2%). In conclusion, there was an ongoing raising trend in the number of procedures in general, and also in minimally invasive and nephron-sparing surgery in our study.The majority of renal neoplasms can be treated surgically using open or minimally-invasive approach. Nephron-sparing surgery should be used when possible, regardless to the operative approach. In this retrospective study, we analyzed surgical trends of operative treatment of renal neoplasms in the period from February 2011 until December 2020. There were a total of 1031 procedures, 703 (68.2%) radical nephrectomies (RN) and 328 (31.8%) partial nephrectomies (PN). Laparoscopic approach was used in 211 (20.5%) (111 PN and 100 RN), while open approach was used in 820 (79.5%) (328 PN and 703 RN) cases. There were 12 procedures performed with the use of cardiopulmonary bypass and hypothermic arrest. The median operative time was 161 minutes for open RN and 158 for open PN, 160 for laparoscopic RN, and 162 for laparoscopic PN. The most common pathology was clear cell carcinoma in 693 (67.3%), papillary carcinoma in 115 (11.2%), chromophobe carcinoma in 67 (6.5%), oncocytoma in 46 (4.5%), and angiomyolipoma in 33 (3.2%) patients. Pathologically, pT1 stage was diagnosed in 56.9%, pT2 in 5.8%, pT3 in 22.4% and pT4 in 1.2% of patients. Regional lymphadenectomy was performed in 354 (34.3%) patients, among which lymph nodes were positive in 40 (11.3%) cases. Surgical margins were positive in 27 cases when PN was performed (8.2%). In conclusion, there was an ongoing raising trend in the number of procedures in general, and also in minimally invasive and nephron-sparing surgery in our study.
The aim of this paper is to show the results of prostate cancer treatment in Prostate Center of Department of Urology at the University Hospital Center Zagreb. The answer to growing demands for ...prostate cancer treatment due to increasing incidence is the formation of specialized, multidisciplinary units/centers that deal mainly with prostate cancer. The need was recognized by European School of Oncology and European Association of Urology, who have proposed their concepts of validating such centers with the aim of promoting high-quality prostate cancer treatment. Following these trends, the Department of Urology at the University Hospital Center Zagreb has established the Prostate Center. This new unit offers specialized and individualized approach to workup, treatment and follow up for prostate cancer patients based on multidisciplinarity. The Prostate Center was also established as a platform for education and research. Key words: Prostate cancer; Cancer Care Facility; Patient Care Team; Urology; Medical Oncology; Radiation Oncology. Cilj ovog rada je prikazati rezultate lijecenja pacijenata oboljelih od raka prostate u Centru za prostatu Klinike za urologiju Klinickog bolnickog centra Zagreb. U svijetu i Hrvatskoj incidencija raka prostate je u porastu zbog cega se javlja povecana potreba za lijecenjem takvih pacijenata. Temeljem tih trendova zapocelo je stvaranje specijaliziranih, multidisciplinarnih timova koji se bave iskljucivo ovom bolecu. Europska kola onkologije i Europsko uroloko drutvo prepoznali su vanost tog koncepta te su ubrzo predstavili svoje kriterije vrednovanja i akreditiranja takvih centara kako bi se potaknulo podizanje kvalitete lijecenja pacijenata s rakom prostate. Klinika za urologiju Klinickog bolnickog centra Zagreb je, potaknuta ovim trendovima, oformila Centar za prostatu koji pacijentima s rakom prostate nudi specijalizirani i individualizirani pristup dijagnostici, lijecenju i pracenju utemeljen na multidisciplinarnosti. Centar za prostatu je takoder osmiljen i kao platforma za edukaciju i znanstvena istraivanja. Kljucne rijeci: Rak prostate; Jedinica za lijecenje raka; Timsko lijecenje bolesnika; Urologija; Internisticka onkologija; Radijacijska onkologija
Aim To compare cognitive fusion targeted and systematic prostate biopsy in patients with repeated negative systematic biopsy but persistent clinical suspicion for prostate
cancer.
Methods The study ...enrolled 63 patients with at least one
previously negative systematic biopsy who underwent
targeted prostate biopsy using multiparametric magnetic resonance imaging (mpMRI) and transrectal ultrasound
(TRUS) in addition to standardized systematic biopsy from
July 2016 to May 2018. Multiparametric MRI was performed
with 3 Tesla device by uro-radiologists experienced in prostate cancer. Lesions with Prostate Imaging Reporting and
Data System 3, 4, and 5 were considered suspicious. Targeted biopsies were performed with cognitive fusion of
TRUS and mpMRI.
Results Prostate cancer detection, using either targeted
or systematic biopsy, was 60.32%. Targeted biopsies were
positive in 52.38% and systematic biopsies in 47.62% of patients. The median highest percentage of cancer involvement per biopsy core was significantly higher in targeted
cylinders. The biopsies obtained by using the two techniques did not significantly differ in Gleason score.
Conclusion Cognitive targeted prostate biopsy based on
mpMRI presents a valuable addition to systematic biopsy
in patients with repeated negative systematic biopsies but
persistent clinical suspicion of prostate cancer
Pacijenti sa nemetastatskim, svijetlostaničnim karcinomom bubrega stadija T3, predstavljaju klinički izazov za urologe. Doseg tumorskog tromba unutar donje šuplje vene je glavna odrednica složenosti ...krurškog zahvata. Tumorski trombi razine III i IV zahtijevaju upotrebu kardiopulmonalnog premoštenja I hipotermijskog aresta. Pažljiva preoperativna procjena i multidisciplinarni pristup je neophodan. U našem centru je liječeno 12 pacijenata sa svijetlostaničnim karcinomom bubrega i tumorskim trombom u donjoj šupljoj veni. Ukupno preživljenje nakon 29 mjeseci je za ove pacijente bilo 69%. U ovom trenutku, od 9 preživjelih pacijenata, 6 je bez recidiva bolesti, a 3 imaju progresiju. U našoj studiji smo pokazali da pažljivo izabrani pacijenti sa svijetlostaničnim karcinomom bubrega i tumorskim trombom razine III i IV mogu biti izliječeni agresivnim kirurškim pristupom.
Cilj ovog rada je prikazati rezultate liječenja pacijenata oboljelih od raka prostate u Centru za prostatu Klinike za urologiju Kliničkog bolničkog centra Zagreb. U svijetu i Hrvatskoj incidencija ...raka prostate je u porastu zbog čega se javlja povećana potreba za liječenjem takvih pacijenata. Temeljem tih trendova započelo je stvaranje specijaliziranih, multidisciplinarnih timova koji se bave isključivo ovom bolešću. Europska škola onkologije i Europsko urološko društvo prepoznali su važnost tog koncepta te su ubrzo predstavili svoje kriterije vrednovanja i akreditiranja takvih centara kako bi se potaknulo podizanje kvalitete liječenja pacijenata s rakom prostate. Klinika za urologiju Kliničkog bolničkog centra Zagreb je, potaknuta ovim trendovima, oformila Centar za prostatu koji pacijentima s rakom prostate nudi specijalizirani i individualizirani pristup dijagnostici, liječenju i praćenju utemeljen na multidisciplinarnosti. Centar za prostatu je također osmišljen i kao platforma za edukaciju i znanstvena istraživanja.
The organization and work of the medical corps of the 105th Croatian Army Brigade from Bjelovar, from October 18, 1991 to September 27, 1992, are presented. The brigade operated on the battlefields ...in East Slavonia, West Slavonia (Novska), and Posavina. Health care was also provided to the civilians living in the area. On their arrival at the battlefield, all members of the 105th Croatian Army Brigade underwent blood group and Rh factor determination and were vaccinated against tetanus. At the battalion and brigade stations, 4,220 diseased and wounded were examined, and 242 surgical procedures were performed, 189 of them under local and 20 under general anesthesia. Respiratory diseases were most common (27.2%), followed by locomotor (14.5%) and gastrointestinal (11.2%) disease. Wounding was recorded in 5.4% of the total number of patients, with 29.3 and 17.5% referring to explosive and gunshot wounds, respectively. Primary care of war wounds was provided in 42.5% of the patients. Total mortality was 2.2%. Wound infection or lethal outcome was not recorded during the triage, treatment, and evacuation.
Snažna i iznenadna agresija na Hrvatsku tijekom 1991. i 1992. godine, praktično izjednačavanje bojišnice i pozadine, prekinute prometnice, gospodarsko osiromašenje te snažan psihološki učinak kako na ...civilno stanovništvo tako i na vojne postrojbe zahtijevali su osnivanje visokostručnih, neovisnih mobilnih sanitetskih timova osposobljenih za pružanje visoko diferencirane zdravstvene zaštite neposredno nakon nastanka ozljede te za evakuaciju i prijevoz ranjenika pod najtežim uvjetima. Prikazuje se rad i organizacija brigadnog sanitetskog voda 105. brigade Hrvatske vojske iz Bjelovara u razdoblju od 1. rujna 1991. do 1. listopada 1992. godine, koji je djelovao kao mobilna kirurška ekipa. Ovakav ustroj je skratio put ozlijeđenih prema kirurškoj sali i tako smanjio pobol i smrtnost ranjenika, a konačni invaliditet sveo na najmanju moguću mjeru. U navedenom razdoblju liječeno je 228 ranjenika u kojih su izvedena 242 operacijska zahvata, od toga 122 u lokalnoj, a 20 u općoj anesteziji. Ukupna smrtnost u 105. brigadi bila je 2,16%.
PDF
