| Sažetak | Cilj istraživanja: Analiza rezultata liječenja (OS, PFS) bolesnika oboljelih od tumora testisa
na Klinici za onkologiju i radioterapiju KBC Split od 2003. do 2012. godine. Prikaz
epidemiologije rada testisa u RH i KBC Split od 2003. do 2012. godine te utjecaj
implementiranja multidisciplinarnih timova na broj bolesnika liječenih na Klinici za
onkologiju i modalitete liječenja,a time i na uspješnost liječenja.
Materijali i metode: U retrospektivnom istraživanju provedenom na Klinici za onkologiju
KBC Split je sudjelovalo 167 bolesnika sa seminomskim i neseminomskim tumorom testisa.
Prikupljeni su opći podaci o bolesniku i bolesti (dob u trenutku dijagnoze, histološki tip
tumora, klinički stadij, tumorski biljezi), podaci o modalitetu specifičnog onkološkog
liječenja (kemoterapija, radioterapija) i praćenju, vrstama kemoterapijskih protokola
(monoterapija karboplatinom, PEB, PEI, VIP), kirurškim zahvatima povezanim s liječenjem
(primarna retroperitonealna limfadenektomija, postkemoterapijska resekcija ostatne bolesti),
toksičnosti liječenja te ishodu liječenja.
Rezultati: Tijekom desetogodišnjeg praćenja uočen je trend porasta broja oboljelih od tumora
testisa u Republici Hrvatskoj i KBC Split. U KBC Split je zabilježeno 10.5% od ukupnog
broja novooboljelih u RH. Broj bolesnika koji su nakon operacije ostajali na liječenju na
Klinici za onkologiju KBC Split se s godinama povećavao (60% operiranih u KBC Split
2003. naspram 85% operiranih u KBC Split 2012. godine). Seminome je imalo 96 (57.5%), a
neseminome 71 (42.5%) bolesnik. Adjuvantnu radioterapiju (27%), koja se najviše provodila
prvih nekoliko godina u liječenju seminoma, je postupno zamijenila monoterapija
karboplatinom (45.8%), a posljednjih godina i praćenje (9.6%). Kod bolesnika s
neseminomom kemoterapija po PEB – protokolu se najviše koristila adjuvantno u liječenju
neseminoma stadija I i II. (43.7%) te u sklopu terapije za metastatsku bolest (40.8%).
Zaključci: Klinika za onkologiju i radioterapiju KBC Split, prateći vodeće onkološke
smjernice, bilježi izvanredne rezultate u liječenju tumora testisa svih stadija. Ukupno
preživljenje i preživljenje bez progresije bolesnika s tumorom testisa je po rezultatima u razini
vodećih svjetskih onkoloških centara. Implementiranje multidisciplinanih timova 2003.
godine na Klinici za onkologiju i radioterapiju KBC Split je imalo znatni utjecaj na liječenje,
praćenje i preživljenje bolesnika s tumorom te na sve manji broj odlazaka bolesnika nakon
operacije na liječenje u drugu ustanovu. |
| Sažetak (engleski) | Objectives: To analyse the treatment results (OS, PFS) of patients with testicular cancer at
the Department of Oncology and Radiotherapy, Clinical Hospital Split between 2003 and
2012. A review of the epidemiology of testicular cancer in Croatia and Clinical Hospital Split
from 2003 to 2012 and the impact of implementing multidisciplinary teams on the number of
patients treated at the Department of Oncology and Radiotherapy, treatment modalities and
the success of treatment.
Materials and methods: A total of 167 patients with seminomatous and nonseminomatous
testicular cancer were reviewed between 2003 and 2012 in a retrospective study conducted at
the Department of Oncology, Clinical Hospital Split. General data about the patient and the
disease (age at time of diagnosis, histological type of cancer, clinical stage, tumor markers)
were collected as well as information about specific modalities of cancer treatment
(chemotherapy, radiotherapy) and surveillance after orchiectomy, chemotherapy regimens
(carboplatin monotherapy, PEB, PEI, VIP), surgical procedures associated with testicular
cancer (primary retroperitoneal lymphadenectomy, postchemotherapy resection of residual
disease), toxicity of treatment and treatment outcome.
Results: An increasing number of patients with testicular cancer were recorded in Croatia
and Clinical Hospital Split during the 10 – year follow-up. The Clinical Hospital Split
recorded 10% of new cases of testicular cancer in Croatia. The number of patients who
remained after surgery at the Department of Oncology, Clinical Hospital Split for treatment
increased during the years ( from 60% who remained after surgery at Clinical Hospital Split
in 2003 to 85% who remained after surgery in 2012). There were 96 ( 57.5%) patients with
seminoma and 71 (42.5%) with nonseminomas. Adjuvant radiotherapy (27%), mostly used
the first few years in the treatment of seminomas, was replaced by carboplatin monotherapy
(45.8%), and in recent years, by surveillance (9.6%). In patients with nonseminomatous germ
cell tumors the chemotherapy regimen of cisplatin, bleomycin and etopozide (PEB protocol)
is the most used adjuvant treatment for stage I and II nonseminomas (43.7%) and is part of
treatment for metastatic disease (40.8%).
Conclusions: The Department of Oncology and Radiotherapy of the Clinical Hospital Split,
following the latest guidelines, recorded excellent results in the treatment of testicular cancer
of all stages. The results of overall survival and progression-free survival of patients with
testicular cancer are at the same level as the world's leading oncology centers. Implementing
multidisciplinary teams at the Department of Oncology and Radiotherapy in 2003 had a
significant impact on treatment, follow-up and survival of patients with testicular cancer and
on the decreasing number of patients who went after surgery at another facility for treatment. |
