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Examination of factors affecting the success of combined surgical treatment and heated intraperitoneal chemotherapy in patients with peritoneum carcinomatosis of ovarian origin.

dc.contributor.advisorNinković, Srđan
dc.contributor.otherRadovanović, Dragče
dc.contributor.otherĐurić, Janko
dc.contributor.otherMarković, Ivan
dc.creatorKocić, Milan
dc.date.accessioned2021-04-19T09:37:39Z
dc.date.available2021-04-19T09:37:39Z
dc.date.issued2021-03-05
dc.identifier.urihttp://eteze.kg.ac.rs/application/showtheses?thesesId=8023
dc.identifier.urihttps://fedorakg.kg.ac.rs/fedora/get/o:1336/bdef:Content/download
dc.identifier.urihttps://nardus.mpn.gov.rs/handle/123456789/18248
dc.descriptionUVOD: Karcinom jajnika vodeći je uzrok smrti meĊu ginekološkim malignitetima. Oko 40% pacijentkinja sa ovarijalnim karcinomom razvija lokalnu diseminaciju bolesti u vidu peritonealne karcinoze te se prethodne decenije puno pažnje posvetilo principima primene citoreduktivne hirurgije i intraperitonealne zagrejane hemioterapije. METOD: Ekstenzivnost infiltracije karcinozom izraĉunata je tokom eksploracije trbušne duplje i to koristeći peritonealni kancer indeks (engl. peritoneal cancer index, PCI). Pacijentkinje su podeljene u dve grupe na osnovu PCI. Prva grupa obuhvata pacijentkinje sa PCI od 1 – 13, a druga grupa pacijentkinje sa PCI od 14 i više te je ispitivano i uporeĊivano ukupno preživljavanje kao i preživljavanje bez znakova progresije bolesti shodno PCI. TakoĊe je ispitivano da li histološki tipovi karcinoma utiĉu na obim peritonealne karcinoze. Ispitano je da li lokalizacija karcinoze može da utiĉe na preživljvanje kao faktor prognoze. REZULTATI: U studiji je pokazano da PCI predstavlja bitan prognostiĉki faktor koji znaĉajno utiĉe na kompletno preživljavanje, ali ne i na preživljavanje bez znakova bolesti. Povećanjem PCI za jednu jedinicu šansa za smrtni ishod se znaĉajno povećava. Podtipovi ovarijalnog karcinoma u ovoj studiji nisu pokazali uticaj na obim peritonalne diseminacije, na ukupno preživljavanje kao ni na preživljavanje bez bolesti. Pokazano je da zahvaćenost karcinozom desnog donjeg kvadranta kao i levog donjeg kvadranta utiĉe na obim peritonealne diseminacije, kao i zahvaćenost poĉetnog ileuma. Resekcije omentuma, tankih creva i kolona utiĉu na ukupno preživljavanje pacijentkinja sa ovarijalnom karcinozom. ZAKLJUČAK: Kod dobro selektovanih pacijentkinja sa karcinozom peritoneuma ovarijalnog porekla citoreduktivna hirurgija u kombinaciji sa intraperitonealnom zagrejanom hemioterapijom produžava preživljavanje bez progresije bolesti kao i ukupno preživljavanje.sr
dc.descriptionINTRODUCTION: Ovarian cancer is the leading cause of death among gynecological malignancies. About 40% of patients with ovarian cancer develop local dissemination of the disease in the form of peritoneal carcinomatosis, and in the previous decade a lot of attention was paid to the principles of cytoreductive surgery and intraperitoneal heated chemotherapy. METHOD: The extent of carcinoma infiltration was calculated during abdominal exploration using the peritoneal cancer index (PCI). Patients were divided into two groups based on PCI. The first group included patients with PCI of 1 - 13, and the second group of patients with PCI of 14 and more, and compared overall survival as well as progression free survival compared to PCI. It was also examined whether histological types of cancer affect the extent of peritoneal carcinomatosis. It was investigated whether the localization of carcinomatosis could affect survival as a prognostic factor. RESULTS: The study showed that PCI is an important prognostic factor that significantly affects overall survival but not diseasefree survival. Increasing PCI by one unit significantly increases the chance of death. The ovarian cancer subtypes in this study showed no effect on the extent of peritoneal dissemination, overall survival, or disease free survival. Carcinoma involvement of the right lower quadrant as well as the left lower quadrant has been shown to affect the extent of peritoneal dissemination, as well as involvement of the initial ileum. Resections of the omentum, small intestine and colon affect the overall survival of patients with ovarian cancer. CONCLUSION: In well selected patients with ovarian peritoneal carcinoma, cytoreductive surgery in combination with intraperitoneal heated chemotherapy prolongs progression-free survival as well as overall survival.en
dc.formatapplication/pdf
dc.languagesr
dc.publisherУниверзитет у Крагујевцу, Факултет медицинских наукаsr
dc.rightsopenAccessen
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.sourceУниверзитет у Крагујевцуsr
dc.subjectperitonealni kancer indekssr
dc.subjectperitoneal cancer indexen
dc.subjectcytoreductive surgeryen
dc.subjectintraperitoneal chemotherapyen
dc.subjectovarian canceren
dc.subjectcitoredukrivna hirurgijasr
dc.subjectintraperitonealna hemioterapijasr
dc.subjectkarcinom jajnikasr
dc.titleIspitivanje faktora koji utiču na uspeh kombinovanog hirurškog lečenja i zagrejane intraperitonealne hemioterapije kod pacijentkinja sa karcinozom peritoneuma ovarijalnog poreklasr
dc.title.alternativeExamination of factors affecting the success of combined surgical treatment and heated intraperitoneal chemotherapy in patients with peritoneum carcinomatosis of ovarian origin.en
dc.typePhD thesis
dc.rights.licenseBY-NC-ND
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/71000/Disertacija.pdf
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/71001/Izvestaj_Milan_Kocic_Medicina.pdf
dc.identifier.rcubhttps://hdl.handle.net/21.15107/rcub_nardus_18248


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