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Wyszukujesz frazę "Nowikiewicz, Tomasz" wg kryterium: Autor


Wyświetlanie 1-5 z 5
Tytuł:
Problems concerning patients’ qualification for surgical procedures allowing for evaluation of the condition of axillary fossa lymph nodes in the radical treatment of breast cancer
Autorzy:
Nowikiewicz, Tomasz
Śrutek, Ewa
Zegarski, Wojciech
Powiązania:
https://bibliotekanauki.pl/articles/1395654.pdf
Data publikacji:
2015-06-01
Wydawca:
Index Copernicus International
Tematy:
breast cancer
conserving treatment
axillary lymphadenectomy
sentinel lymph node biopsy
surgical treatment
Opis:
The presence of metastases in the lymph nodes of the axillary fossa is the most important prognostic factor in patients with breast cancer. The surgical treatment option required for evaluation of the condition of the axillary lymph nodes depends on the results of a preoperative physical examination of the patients. The aim of the study was to evaluate the correctness of breast cancer patients’ qualification to surgical procedures allowing for evaluation of the condition of the axillary lymph nodes. Material and methods. A retrospective analysis of a group of 963 patients with a diagnosed malignancy of the breast, treated surgically in the period from 01 Jan 2011 to 29 Feb 2012. Depending on the result of evaluation of the axillary lymph node clinical condition, the patients underwent sentinel lymph node biopsy or elective axillary lymphadenectomy. Results. In 27.4% of patients subjected to excision of the sentinel lymph node, metastatic lesions were found in the lymph nodes removed during the procedure. In most cases (98.1%) that concerned the lymph nodes of the lower part of the axilla. In 17.4% of patients, metastases were located also in the middle or upper part (9%). In the group of patients primarily qualified to lymphadenectomy, the metastatic lesions in the axillary lymph nodes were diagnosed in 67.2% of patients. They were most commonly located in the lower part of the axillary fossa (in 96.7% of cases), and in 68.8% of patients in the middle or upper part (35.8%). Conclusions. Biopsy of the sentinel lymph node in patients with clinically advanced breast cancer is an effective and safe method of evaluation of the condition of the axillary fossa lymph nodes. A high rate of false positive results concerning the clinical stage of the disease requires changing the rules of patients’ qualification to elective axillary lymphadenectomy.
Źródło:
Polish Journal of Surgery; 2015, 87, 6; 290-294
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Overtreatment in surgery – does it concern also the patients with ductal breast carcinoma in situ
Autorzy:
Nowikiewicz, Tomasz
Zegarski, Wojciech
Głowacka-Mrotek, Iwona
Powiązania:
https://bibliotekanauki.pl/articles/1392549.pdf
Data publikacji:
2018
Wydawca:
Index Copernicus International
Tematy:
overtreatment
overdiagnosis
surgical treatment
breast cancer
ductal carcinoma in situ
Opis:
Overtreatment means treatment that goes beyond current standards, and patients with any disease can be overtreated. Overtreatment is also given to patients with cancer, including those who need surgery. Overtreatment is closely related to the problem of overdiagnosis. In patients with cancer, unnecessary surgery may cause complications and generates unnecessary costs. The size of the problem of unnecessary surgery in patients with cancer can best be shown among patients with the most common cancers, which dedicated screening programs. Breast cancer patients, particularly those with pre-invasive types of the tumor, who typically have ductal carcinoma in situ (80%), are likely to undergo unnecessary surgery. We describe the most common clinical problems caused by overtreating patients with ductal carcinoma in situ.
Źródło:
Polish Journal of Surgery; 2018, 90, 1; 47-51
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Nadmierne leczenie („overtreatment”) w chirurgii – czy dotyczy również pacjentów z rakiem przewodowym piersi in situ?
Autorzy:
Nowikiewicz, Tomasz
Zegarski, Wojciech
Głowacka-Mrotek, Iwona
Powiązania:
https://bibliotekanauki.pl/articles/1392585.pdf
Data publikacji:
2018
Wydawca:
Index Copernicus International
Tematy:
nadmierne leczenie
nadrozpoznawalność
leczenie chirurgiczne
rak piersi
rak przewodowy in situ
Opis:
Pojęcie nadmiernego leczenia oznaczające stosowanie u chorych leczenia wykraczającego poza obowiązujące standardy terapeutyczne, może dotyczyć każdej formy opieki zdrowotnej. Zjawisko to jest spotykane również w onkologii, obejmując także pacjentów z nowotworami złośliwymi wymagających leczenia operacyjnego. Jest ono bezpośrednio związane z problemem nadrozpoznawalności Oprócz istotnego aspektu finansowego (generowanie wymiernych kosztów), możliwe do uniknięcia leczenie operacyjne chorych powoduje także wystąpienie chorobowości związanej z niepożądanymi następstwami wykonanych procedur chirurgicznych. Wymieniony problem kliniczny jest najbardziej widoczny w grupie pacjentów z najczęstszymi przyczynami zachorowań na nowotwory złośliwe, zdiagnozowanymi najczęściej w trakcie badań przesiewowych. Dotyczy to zwłaszcza pacjentów z rakiem piersi, w szczególności z rakiem przedinwazyjnym. W tej grupie zachorowań, rak przewodowy in situ (ductal carcinoma in situ – DCIS) stanowi około 80 % przypadków. W prezentowanej pracy omówiono najczęściej spotykane problemy kliniczne związane z istnieniem zjawiska nadmiernego leczenia w przypadku tej grupy chorych.
Źródło:
Polish Journal of Surgery; 2018, 90, 1; 47-51
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Clinical Significance of Van Nuys Prognostic Index As A Qualification Criterion to Sentinel Lymph Node Biopsy in Patients Diagnosed with Ductal Carcinoma in Situ
Autorzy:
Nowikiewicz, Tomasz
Wiśniewska, Magdalena
Wiśniewski, Michał
Zegarski, Wojciech
Powiązania:
https://bibliotekanauki.pl/articles/1395856.pdf
Data publikacji:
2015-02-03
Wydawca:
Index Copernicus International
Tematy:
breast cancer
ductal carcinoma in situ
sentinel lymph node biosy
Van Nuys Prognostic Index
surgical treatment
Opis:
Diagnose of ductal carcinoma in situ (DCIS) requires, at least in a part of cases, assessment of auxiliary lymph nodes. The aim of the study was to analyze clinical value of Van Nuys Prognostic Index (VNPI) as the important criterion for qualification of DCIS patients to sentinel lymph node biopsy (SLNB). Material and methods. Analysis included patients diagnosed with DCIS and qualified to SLNB, operated in years 2004-2013. We performed a statistical analysis to assess correlation between VNPI value and positive pathological verification of excised sentinel lymph node (SLN). The influence of other clinical factors on presence of metastases in SLN was also determined. Results. 3,6% of DCIS patients were diagnosed with metastases in SLN. Metastases were diagnosed in 6.7% patients with VNPI > 10 points vs 3.4% in patients with VNPI < 10 points. In 75% of patients with metastatic SLN the value of VNPI was at least 10 points. In premenopausal patients metastases in SLN were diagnosed in 8.1% of cases vs 1.4% in postmenopausal patients. In patients diagnosed with cancer of the other breast metastases in SLN were found in 6.3% of cases vs 3.2% in one-sided cancer. Patients with multifocal cancer were over twice as often diagnosed with metastases in SLN (5% vs 2%). There was no correlation found between VNPI value and positive pathological verification of SLN. No differences between prevalence of SLN metastases depending on selected clinical features were found. Conclusions. Recommendation of VNPI as the criterion of qualification to SLNB starting with 10 points could be more favourable in patients with DCIS. Deciding on SLNB in DCIS patients, we should also take into consideration other clinical features.
Źródło:
Polish Journal of Surgery; 2014, 86, 10; 479-485
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Evaluation of the effects of mammography screening program on cancer progression and implemented treatment in patients with breast cancer
Autorzy:
Nowikiewicz, Tomasz
Zegarski, Wojciech
Piątkowska, Magdalena
Klag, Michał
Powiązania:
https://bibliotekanauki.pl/articles/1396169.pdf
Data publikacji:
2013-04-01
Wydawca:
Index Copernicus International
Tematy:
brest cancer
staging
conserving treatment
mammography screening
Opis:
The primary goal of mammography screening is to decrease mortality in patients with breast cancer. The aim of the study was evaluation of the screening program results on course of implemented therapy and its results in breast carcinoma patients. Material and methods. Evidence includes data on the group of 1818 patients with breast cancer that were subject to surgical treatment at the Clinic of Breast Cancer and Reconstructive Surgery of the Oncology Center in Bydgoszcz (558 patients hospitalized from January 2006 to December 2006 and 1260 patients treated from January 2011 to June 2012). Analysis included type of diagnostic procedure implemented before surgical treatment, as well as grade of cancer progression, results of pathology tests done on specimens and type of surgical procedure. Additionally, the screening group (tumor diagnosed based on screening mammography) and symptomatic group (cancer diagnosed otherwise that within the screening program) were identified. Results. In 2006, in 28.4% of patients included in the study, primary tumor was discover in screening process (vs 61.5% in 2011-2012). In the first period, 35.7% of changes did not exceed 2 cm - cT1 (vs 48.3% in 2011-2012), while the percentage of cT4 was 9.9% (vs 4.7% in 2011-2012). In 2006, 30.8% of patients were treated in the grade I of clinical progression (vs 44.2% in 2011-2012), 53.4% in the grade II, 14% in grade III and 0.2% in grade IV (vs 45.7%, 9.7%, and 0.4%, respectively). In 45.5% (2006) and 39.9% (in 2011-2012) of patients, metastases were found in axillary lymph nodes. Differences were similar both in screening and symptomatic group. In 2006, in 12.4% of surgical patients breast conserving therapy (BCT) was implemented (vs 49.8% in 2011-2012). In the screening group, it was applied in 15.2% of patients (in 2006) and in 63% (in 2011- 2012), while in symptomatic group the percentages were 11.8% and 41%, respectively. Conclusions. In both periods of analysis, significant differences were observed as to implementation of breast cancer screening program, as well as to grade of clinical and pathological progression of the cancer. Observable increase of screening tests allowed for significantly more frequent implementation of breast conserving surgical procedures.
Źródło:
Polish Journal of Surgery; 2013, 85, 4; 204-209
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
    Wyświetlanie 1-5 z 5

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