Klinicka Onkologie最新文献

{"title":"FDG-PET/CT: metabolically active solitary lesion in the gluteal region subcutaneously in a patient with breast cancer - granuloma or metastasis?","authors":"Z Řehák, M Palácová, S Soboličová, P Fabian","doi":"10.48095/ccko2026122","DOIUrl":"https://doi.org/10.48095/ccko2026122","url":null,"abstract":"","PeriodicalId":35565,"journal":{"name":"Klinicka Onkologie","volume":"39 2","pages":"122-124"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating tumor DNA as a biomarker for the prediction of minimal residual disease and the individualization of adjuvant therapy in colorectal cancer - a review of current evidence and perspectives.","authors":"A Pirshtuk, T Büchler, V Vymetálková","doi":"10.48095/ccko2026105","DOIUrl":"https://doi.org/10.48095/ccko2026105","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) remains one of the most common malignancies in the Czech Republic. Despite advances in surgical treatment, the risk of recurrence persists, mainly due to minimal residual disease (MRD). Current surveillance strategies, including colonoscopy, CT imaging, and serum tumor markers (CEA, CA19-9), demonstrate limited sensitivity and specificity. In recent years, circulating tumor DNA (ctDNA) has emerged as a promising biomarker with significant prognostic and predictive potential.</p><p><strong>Methodology: </strong>This review was prepared based on a systematic literature search in PubMed, Web of Science, ScienceDirect, Scopus, and clinicaltrials.gov covering the period 2005-2025. Observational studies, retrospective analyses, and randomized clinical trials evaluating the prognostic and predictive role of ctDNA in patients with CRC were included.</p><p><strong>Results: </strong>Available studies confirm that the presence of ctDNA after curative resection of CRC is a strong predictor of early recurrence and worse survival, whereas ctDNA negativity reliably identifies patients at low risk. Prospective projects (VICTORI, GALAXY, COSMOS) demonstrated that ctDNA can predict relapse several months earlier than standard methods. The BESPOKE CRC study highlighted that only patients with positive ctDNA significantly benefit from adjuvant chemotherapy. The randomized DYNAMIC trial proved that a ctDNA-guided approach enables safe de-escalation of adjuvant therapy without compromising outcomes. Ongoing studies (PEGASUS, SAGITTARIUS, TRACC, DYNAMIC-III, ALTAIR, VEGA) are testing the efficacy of escalation and de-escalation strategies.</p><p><strong>Conclusions: </strong>ctDNA is a highly promising biomarker for early MRN detection, risk stratification, and the individualization of adjuvant therapy in CRC patients. Its implementation in routine clinical practice, however, requires confirmation from ongoing randomized trials and validation in the Czech setting, where the use of ctDNA currently remains limited primarily to research.</p>","PeriodicalId":35565,"journal":{"name":"Klinicka Onkologie","volume":"39 2","pages":"105-111"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Second recurrence of breast cancer 36 years after initial surgery and 18 years after the first recurrence - an extremely rare case.","authors":"Y Maezawa, T Terada, H Kobayashi, G Ohara, T Saito, N Takayashiki, H Satoh","doi":"10.48095/ccko2026117","DOIUrl":"https://doi.org/10.48095/ccko2026117","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is a one of the most common causes of cancer death in the world. Late recurrence is a notable characteristic of this disease.</p><p><strong>Case: </strong>We experienced an extremely rare case of breast cancer that developed a second recurrence 36 years after the initial surgery and 18 years after the first recurrence, manifesting as bilateral pleural effusion and multiple bone metastases.</p><p><strong>Conclusion: </strong>This report highlights that it is important for both patients and doctors to be aware that such patients exist.</p>","PeriodicalId":35565,"journal":{"name":"Klinicka Onkologie","volume":"39 2","pages":"117-121"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Castleman disease from the perspective of the year 2026.","authors":"Z Adam, Z Řehák, I Boichuk, T Horváth, Z Adamová, M Štork, L Pour","doi":"10.48095/ccko202686","DOIUrl":"https://doi.org/10.48095/ccko202686","url":null,"abstract":"<p><strong>Background: </strong>New drugs are continuously entering clinical practice, and therefore opinions on the treatment of Castleman disease are constantly being updated. The text provides information on the treatment of this disease from the perspective of the year 2026.</p><p><strong>Objective: </strong>The treatment of choice for unicentric Castleman disease is surgical removal of the lesion. If its size does not allow for surgery, preoperative pharmacological treatment may be used. There is less experience with radiotherapy in this indication. For multicentric Castleman disease (MCD), it is necessary to rule out possible but rarely detectable etiological causes, infection with human herpesvirus-8 (HHV-8), and association with POEMS syndrome. In HHV-8 positive cases, combinations of rituximab with cytostatics (liposomal doxorubicin, etoposide, or polychemotherapy) are used. In cases of MCD associated with POEMS syndrome, the aim of treatment is to suppress monoclonal gammopathy, which is considered the cause of both MCD and POEMS syndrome. Siltuximab is the treatment of choice for idiopathic multicentric Castleman disease (iMCD). It achieves a therapeutic response in less than 50% of unselected patients. If siltuximab treatment is administered only to patients with markedly elevated inflammatory markers, the number of therapeutic responses is higher. For patients who do not respond adequately to siltuximab, it is necessary to seek second- or third-line treatments. The efficacy of certain drugs in iMCD has been demonstrated not only through case reports but also in clinical studies (rituximab in combination with cytostatics, cyclophosphamide in combination with thalidomide or bortezomib, and sirolimus monotherapy). The efficacy of several other drugs has been shown through case reports or small patient series (anakinra, ruxolitinib, lenalidomide). Given the low incidence of the disease (3-5 per 1 million inhabitants), individual documented cases also provide valid guidance for treatment decisions. This text provides an overview of all experience with the treatment of this disease.</p><p><strong>Conclusion: </strong>The first-line treatment for iMCD is siltuximab. However, the disease has multiple etiopathogeneses, which is why siltuximab achieved disease symptom resolution in only half of the cases in an unselected population. For second- or third-line treatment, it is necessary to use one of the drugs with proven efficacy in iMCD.</p>","PeriodicalId":35565,"journal":{"name":"Klinicka Onkologie","volume":"39 2","pages":"86-98"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravascular propagation of adenomyosis within the blood vessels of the myometrium and uterine leiomyoma in a patient harboring germline mutation in the fumarate hydratase gene - a rare finding simulating malignancy.","authors":"V Bartoš, B Hudec, E Baloghová","doi":"10.48095/ccko2026112","DOIUrl":"https://doi.org/10.48095/ccko2026112","url":null,"abstract":"<p><strong>Background: </strong>Hereditary leiomyomatosis and renal cell carcinoma is a rare genetic disorder characterized by a predisposition to the development of multiple cutaneous and uterinne leiomyomas with a potential for malignant transformation and a risk of renal carcinoma.</p><p><strong>Case: </strong>A 39-year-old woman suffered from this disease underwent hysterectomy due to uterus myomatosus. Histologically, some tumors showed typical appearance of fumarate hydratase-deficient leiomyomas. There were foci of adenomyosis in the myometrium. As an incidental finding, multiple thin-walled blood vessels filled with conglomerates of endometrial stroma and glandular epithelium were found in the myometrium and leiomyoma. At the first look, this feature suggested an intravascular cancer propagation. However, this endometrial tissue showed bland appearance with no atypia or mitoses and revealed low proliferative activity. Even after extensive sampling of the uterus, no malignant neoplasia was revealed. The finding was reported as intravascular form of adenomyosis.</p><p><strong>Conclusion: </strong>A propagation of adenomyosis within the uterine blood vessels is a rare histological finding causing diagnostic difficulties as it resembles intravascular spreading of malignant neoplasm. Although this is not a tumor entity, it represents an important differential diagnosis in the oncopathological practice. The pathologist's knowledge about this phenomenon is crucial to avoid confusion with vascular dissemination of malignancy.</p>","PeriodicalId":35565,"journal":{"name":"Klinicka Onkologie","volume":"39 2","pages":"112-116"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ewing sarcoma - current diagnostic and therapeutic approaches.","authors":"A Nohejlová Medková, P Pacas, K Kopečková","doi":"10.48095/ccko202699","DOIUrl":"https://doi.org/10.48095/ccko202699","url":null,"abstract":"<p><strong>Background: </strong>Ewing sarcoma belongs to the family of undifferentiated small round cell sarcomas of bone and soft tissue. It is characterized by a gene fusion involving EWSR1 and an ETS-family transcription factor gene. In 85-96% of cases, a specific chromosomal translocation results in the EWSR1-FLI1 fusion gene, whose product functions as an oncogene essential for tumorigenesis. Ewing sarcoma is most common in adolescents and young adults. It primarily affects the diaphyses of long bones, the pelvis, and the axial skeleton, although extraosseous involvement is not uncommon. This is a highly malignant neoplasm, and in most cases, micrometastases are already present at the time of diagnosis. The treatment is multimodal and includes local therapy (surgery and/or radiotherapy) and systemic chemotherapy. One of the greatest therapeutic challenges remains the long-term systemic control of the disease. To improve overall survival - especially in high-risk patients - innovative treatment strategies are essential, as the potential for intensifying chemotherapy has reached its limit due to treatment-related toxicity. Both diagnostic and therapeutic management should take place in specialized sarcoma centers.</p><p><strong>Aim: </strong>This article aims to provide an up-to-date overview of current diagnostic and therapeutic approaches in Ewing sarcoma.</p>","PeriodicalId":35565,"journal":{"name":"Klinicka Onkologie","volume":"39 2","pages":"99-104"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Registration of childhood cancer - current status and perspectives.","authors":"M Makohusová, E Kaiserová, A Kolenova, E Bubanská, T Stančoková, I Oravkinová, V Halušková, L Žilinčanová, A Hrašková, J Puškáčová, J Fedoráková, H Fillová, P Bician, L Deák, P Švec, V Hlodáková, G Valachová, K Krištof, E Steliarovafoucher","doi":"10.48095/ccko2025427","DOIUrl":"https://doi.org/10.48095/ccko2025427","url":null,"abstract":"<p><strong>Background: </strong>Childhood cancer is a serious health issue that still does not receive sufficient attention on a global scale compared to cancer in adults. Specialized pediatric cancer registries play a crucial role in collecting detailed data on tumor types, treatment outcomes, genetic determinants, predisposition syndromes, and long-term treatment toxicity.</p><p><strong>Aim: </strong>The aim of this review is to emphasize the importance of collaboration between general and specialized pediatric cancer registries in epidemiological research of childhood malignancies and its impact on improving completeness of ascertainment, diagnosis, treatment, and follow-up care.</p><p><strong>Conclusion: </strong>The effective integration of data collected in general and pediatric cancer registries improves data quality and enables analysis of all relevant data, leading to advances in research, optimization of treatment, and improvement in the quality of care for pediatric cancer patients.</p>","PeriodicalId":35565,"journal":{"name":"Klinicka Onkologie","volume":"38 6","pages":"427-435"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total mesometrial resection for the treatment of cervical cancer - an exploratory study of feasibility, safety and oncological outcomes in developing countries.","authors":"P Sorokin, S Kulikova, A Stepanyan, H Davtyan, M Kuryllo, R Oliveira, B Rezende","doi":"10.48095/ccko2025201","DOIUrl":"10.48095/ccko2025201","url":null,"abstract":"<p><strong>Background: </strong>Total mesometrial resection (TMMR) has shown excellent locoregional control for treatment of cervical cancer without adjuvant radiation therapy in highly selected centers. However, this procedure was never evaluated in resource-limited setting. We hypothesized that the procedure can be reproduced outside the university centers without compromising results.</p><p><strong>Materials and methods: </strong>This is a retrospective, observational, multicenter cohort study of patients with IB1-IIB cervical cancer who underwent TMMR in developing countries and omitted adjuvant radiation therapy.</p><p><strong>Results: </strong>A total of 124 patients who met the inclusion criteria were identified between 2015 and 2024 in three centers. The median follow-up was 29 months. The relapse rate was 6.1% (2 out of 33) for IB1, 3% (1 out of 33) for IB2, 11.1% (2 out of 18) for IB3, 20% (1 out of 5) for IIA1, and 16% (6 out of 24) for node-positive patients. No relapses were detected among IIA2 and IIB stages (3 and 8 patients, respectively). There was no significant difference (P = 0.36) in the relapse rate between patients who met the Sedlis criteria (2.9%) and those who did not (8.8%).</p><p><strong>Conclusion: </strong>According to the study, TMMR outcomes can be reproduced without compromising oncologic outcomes. However, prospective evaluation, longer follow-up and a larger cohort are needed to confirm these preliminary data.</p>","PeriodicalId":35565,"journal":{"name":"Klinicka Onkologie","volume":"38 3","pages":"201-208"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT-guided microwave ablation of renal cell carcinoma in a horseshoe kidney - a case report.","authors":"A Papagianni, V Balomenos, E Sfakianaki, N Arkoudis, K Palialexis, O Papakonstantinou, D Filippiadis","doi":"10.48095/ccko2025386","DOIUrl":"https://doi.org/10.48095/ccko2025386","url":null,"abstract":"<p><strong>Background: </strong>Horseshoe kidney (HSK) is the most common congenital renal fusion anomaly. While the incidence of renal cell carcinoma (RCC) in HSK is not higher than in anatomically normal kidneys, altered renal anatomy makes surgical management technically challenging. Minimally invasive, image-guided therapies such as microwave ablation (MWA) have emerged as promising alternatives.</p><p><strong>Observation: </strong>We present the case of a 65-year-old male with HSK and a 2.0 cm RCC in the right renal moiety who underwent CT-guided MWA with no complications. Hydrodissection was used to protect the psoas muscle and lumbosacral nerves. Follow-up imaging confirmed local tumor control with no signs of remnant or recurrence. Only a limited number of similar cases have been reported.</p><p><strong>Conclusion: </strong>This case highlights the feasibility and safety of percutaneous MWA for RCC in HSK. It adds to the growing evidence supporting MWA as a minimally invasive option in anatomically complex renal tumors.</p>","PeriodicalId":35565,"journal":{"name":"Klinicka Onkologie","volume":"38 5","pages":"386-389"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From traditional Chinese medicine to molecular oncology - pleiotropic effects of tauroursodeoxycholic acid.","authors":"B Vavrušáková, R Bartošová, M Svoboda, L Moráň","doi":"10.48095/ccko2025270","DOIUrl":"https://doi.org/10.48095/ccko2025270","url":null,"abstract":"<p><strong>Background: </strong>Tauroursodeoxycholic acid (TUDCA) is a naturally occurring hydrophilic bile acid in the human body. Its therapeutic effects have been recognized in traditional Chinese medicine since ancient times and continue to be used in contemporary Western medicine. TUDCA is classified as a secondary bile acid and is formed by conjugating ursodeoxycholic acid (UDCA) with taurine. Due to its hepatoprotective properties and ability to promote bile production and flow, UDCA has been approved by the US Food and Drug Administration (FDA) for the treatment of primary biliary cholangitis. TUDCA was originally used in the treatment of liver disease, but according to recent findings of current research, TUDCA has therapeutic potential beyond the hepatobiliary area.</p><p><strong>Purpose: </strong>In this paper, we aim to summarize the latest findings on the therapeutic potential of TUDCA in a broader clinical context. New findings show that TUDCA finds use not only in the treatment of hepatic disorders, but also in the treatment of cancer, neurodegenerative and cardiovascular diseases, gastrointestinal dysfunctions and glucose metabolism disorders. Due to its multifunctional effects, TUDCA appears to be a promising substance with the potential to become an important part of modern medicine in the treatment of diverse pathological conditions.</p>","PeriodicalId":35565,"journal":{"name":"Klinicka Onkologie","volume":"38 4","pages":"270-282"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}