Oncology Commons^™

Advantages Of Mechanical Anastomosis In Rectal Cancer Surgery, Paul Șiancu, Adrian Boicean, Denisa Tănăsescu, Dan Bratu, Ciprian Tănăsescu

Journal of Mind and Medical Sciences

Rectal oncological pathology represents an increased degree of difficulty in terms of surgical approach. Along with the development of minimally invasive surgery, technology has also increased the options for performing digestive anastomoses. A significant increase has been observed among mechanical anastomoses. The evolution of mechanical sutures through the use of the stapler has become a true symbol of technological advancement, as they have led to improvements and effective gains in quality and productivity in suture making. The aim of this paper is to highlight the advantages of the use of staplers in rectal surgery, with their help achieving a lower …

Correlation Between Molecular Prognostic Factors And Bevacizumab Therapeutic Resistance In Patients With Metastatic Colorectal Cancer; The Avamet Study, Adrian Paul Suceveanu, Dragos Serban, Andreea Daniela Caloian, Georgeta Camelia Cozaru, Anca Chisoi, Anca Antonela Nicolau, Ioan Sergiu Micu, Andra Iulia Suceveanu

Journal of Mind and Medical Sciences

Objectives. Colorectal cancer is responsible for more than two million cases diagnosed annually. Despite early diagnosis through screening programs and adequate treatment, 25% of cases are diagnosed with metastatic disease while up to 50% of patients diagnosed early progress to metastatic disease. Materials and Methods. The study of 40 patients aims to identify the role of placental growth factor and heparin-binding growth factor as prognostic tools for current treatments involving resistance to bevacizumab in metastatic colorectal cancer. Results. Our results suggested that overall survival was influenced by serum fibroblast growth factor 1 levels. A cut-off value of 260.71 pg/ml was …

Medical And Psychological Management Of Patients With A History Of Surgical Treatment For Pancreatic Diseases, Magdalena Țone, Daniel Cochior, Oana Denisa Balalau, Tomescu Dana Rodica, Cristian Balalau, Teodora Mocan, Aurelian Udristoiu, Gabriel Petre Gorecki

Journal of Mind and Medical Sciences

Background. Pancreatic cancer, known for its high mortality rate and late diagnosis, remains a significant health concern. Surgery offers a potential therapeutic remedy, but it is only valid in the early stage of detection. Increasing risk factors and an aging population are expected to raise the incidence of pancreatic cancer, further challenging healthcare systems. Methods. The general objective of this study was to analyze doctors' experiences regarding the health status of patients with benign pancreatic pathology who underwent surgery and were admitted to CF2 Clinical Hospital in Bucharest. The research involved a specialized questionnaire addressing various aspects of patient health, …

Surgery Of The Colon; The Impact Of Colostomy And Postoperative Complications On Patients' Quality Of Life, Vlad Denis Constantin, Adrian Silaghi, Dragos Epistatu, Daniela Gabriela Bălan, Florin Silviu Groseanu, Denisa Mihaela Nedelcu, Ioana Paunica

Journal of Mind and Medical Sciences

Introduction. This study aims to evaluate the impact of stoma formation on the quality of life of patients undergoing colonic surgery, considering both emergency and elective procedures. Several factors (demographic data, Charlson comorbidity score, type of surgical intervention, duration of hospitalization, postoperative outcomes and complications, etc.) were analyzed to understand their influence on patients' well-being. Materials and Methods. A retrospective analysis was performed on patients who underwent colorectal surgery that required stoma formation. A total of 270 patients were included in the study, with 69.25% undergoing emergency surgery and 30.74% undergoing elective procedures. Results. The Charlson comorbidity score was significantly …

Genetic And Serological Markers In Colorectal Cancer Surgery, Adrian Silaghi, Vlad Denis Constantin, Dragos Serban, Dragos Epistatu, Ioana Paunica, Daniela Gabriela Bălan, Laura Florentina Rebegea

Journal of Mind and Medical Sciences

Colon cancer is relatively asymptomatic in the early stages, the manifestations appearing and intensifying with the evolution of the disease, especially when associated with local and/or systemic complications. In such cases, surgical interventions are often emergency and involve more extensive operations (on metabolically and immune-stressed organisms), so that an early diagnosis (endoscopy, tumor markers, etc.) remains not only desirable but even a priority, especially in predisposed patients (genetic factors, lifestyle, etc.). As a consequence, the involvement of tumor markers in colon neoplasms has become more and more investigated in recent times. This review investigates the roles of serological and genetic …

Venous Thrombosis Associated With Pancreatic Cancer, Vlad Buică, Camelia Diaconu, Octavian Andronic

Journal of Mind and Medical Sciences

Introduction. Cancer-associated thrombosis is a significant prognostic marker in pancreatic neoplasia, with a venous thromboembolism incidence of 17-34%. This study focuses on cancer-associated thrombosis risk factors, screening scores, and treatment options. Materials and Methods. Comprehensive database searches were conducted across Web of Science, PubMed, Reaxys, ScienceDirect, and Scopus. Results. Of the 37 articles reviewed, findings include splanchnic vein thrombosis correlating with pancreatic complications and survival rates. Gender differences in cancer-associated thrombosis risk were inconclusive, while African Americans showed a higher incidence of pulmonary embolism. Various cancer-associated thrombosis staging scores were evaluated, with ONKOTEV score outperforming Khorana. Direct oral anticoagulants were …

Diabetic Patients And Postoperative Complications In Colorectal Surgery, Ioana Paunica, Adrian Silaghi, Daniela Gabriela Bălan, Bogdan Socea, Cristian Balalau, Florin Silviu Groseanu, George Alexandru Popescu, Dragos Epistatu, Vlad Denis Constantin

Journal of Mind and Medical Sciences

Diabetes mellitus is one of the most common comorbidities of patients undergoing surgery. Colorectal surgery is frequently associated with postoperative complications, and diabetic patients represent a population that presents a high risk of developing such complications. Understanding the interrelationships between neoplastic disease and diabetes, as well as the pathophysiological mechanisms underlying postoperative complications, are essential for effective therapeutic management. Genetic predispositions, alterations in the gut microbiota, inflammatory response, ischemic, thrombotic and infectious processes contribute significantly to the development of severe surgical complications, such as anastomotic fistulas. Postoperative ileus, characterized by gastrointestinal dysmotility, is common in diabetic patients due to neuropathic …

Periodontal Status And Inflammatory Markers In Gingival Crevicular Fluid Of Patients With Periodontitis And Colorectal Cancer, Sandu Râmboiu, Flavia Mirela Nicolae, Andrada Soancă, Dorin Nicolae Gheorghe, Dora Maria Popescu, Bogdan Silviu Ungureanu, Dragoș Nicolae Mărgăritescu, Adina Turcu-Știolica, Mihail Virgil Boldeanu, Valeriu Marin Șurlin, Dan Ionuț Gheonea, Petra Șurlin

Journal of Mind and Medical Sciences

Objectives. The present pilot study was carried out to evaluate the periodontal status, the levels of interleukin-6 and tumor necrosis factor alpha in gingival crevicular fluid on hospitalized patients with colorectal cancer. Materials and Methods. The sample of our study was represented by 74 patients with colorectal cancer. They were assigned to one of the two study groups, based on cancer’s stages, as follows: (i) stage III-IV: 51 patients (A-group); (ii) stage I-II: 23 patients (B-group). For each participant periodontal parameters were recorded and gingival crevicular fluid samples were collected and immunologically assessed. Results. Statistically significant differences were found between …

Gastric Cancer; Actualities And Perspectives Of Early Diagnosis And Targeted Therapy, Adrian Silaghi, Laura Florentina Rebegea, Daniela Gabriela Balan, Anca Dumitriu, Stana Paunica, Cristian Balalau, Stefăniță Tenea Cojan, Dragos Epistatu, Vlad Denis Constantin

Journal of Mind and Medical Sciences

Gastric cancer is an extremely aggressive form of malignancy that, if left untreated, is life-threatening. Improved survival rates depend on early detection of the disease, as well as on the combination of different forms of treatment (surgery, chemotherapy, radiotherapy, immunotherapy, etc.). Screening methods have brought real benefit in early detection of malignancies, but many cases are still diagnosed at advanced stages. The current study is a review related to actualities and perspectives of early diagnosis and targeted therapy of gastric cancer. After an extensive review of the literature, epidemiological, diagnostic and treatment data are presented. The open surgical approach is …

Barrett's Esophagus As A Premalignant Condition; Medical And Surgical Therapeutic Management, Vlad Denis Constantin, Adrian Silaghi, Laura Florentina Rebegea, Stana Paunica, Anca Silvia Dumitriu, Doina Andrada Mihai, Ioana Paunica, Dragos Epistatu

Journal of Mind and Medical Sciences

Barrett's esophagus (BE) represents a special clinical entity, which may have reduced symptoms, but an increased potential for malignant degeneration. The factors that lead to the appearance of Barrett's esophagus are multiple, the most important being gastro-esophageal reflux, as well as smoking and obesity. BE occurs as a result of damage of the esophageal mucosa, caused by acid/basic gastroesophageal reflux and resulting in the transformation of the epithelium from squamous to intestinal type. The diagnosis of BE is primarily based on endoscopic examination. This method has not only a diagnostic role, but also a therapeutic one through the minimally invasive …

Matrix Gla Protein – A New Marker For Colorectal Cancer Detection? A Systematic Review, Mirela-Georgiana Perné, Lorena Ciumărnean, Olga-Hilda Orășan, Vasile Negrean, Teodora-Gabriela Alexescu, Mircea Vasile Milaciu, Ioana Roșca, Răzvan Dan Togănel, Gabriel Emil Petre, Lucia Procopcoiuc, Cristina Drugan, Alexandra Crăciun

Journal of Mind and Medical Sciences

Background. Colorectal cancer is a real public health issue, with high morbidity and severe impact on quality of life. Although mortality from this type of cancer is decreasing due to modern diagnostic and treatment methods, the understanding of its genetic and molecular mechanisms is important to develop a broader range of diagnostic and therapeutic approaches. Genetic therapy is an important strategy in cancer treatment, and the matrix Gla protein (MGP) gene expression has been described in numerous studies as increased in tumour pathology. In this article, we have summarized the currently available evidence on the connection between MGP and colorectal …

Diagnosis And Management Of Colon Cancer Patients Presenting In Advanced Stages Of Complications, Vlad Denis Constantin, Adrian Silaghi, Dragos Epistatu, Anca Silvia Dumitriu, Stana Paunica, Daniela Gabriela Bălan, Bogdan Socea

Journal of Mind and Medical Sciences

Colorectal cancer is an important health problem with a significant impact on the individual and society. Malignancy (including colorectal cancer) is usually slightly symptomatic in its initial stages. This causes cancer to be discovered in some patients accidentally (either through screening tests in predisposed individuals or during routine investigations for other diseases), while in other patients the colorectal cancer is discovered in late stages, when the symptoms are much more intense due to complications. Unfortunately, such advanced cases of the disease have high rates of morbidity and mortality even with treatment. Current treatment methods are usually complex, interdisciplinary, causing significant …

Diet And Food Chemicals Increasing The Risk Of Colorectal Cancer – Literature Review, Mihail Silviu Tudosie, Andreea Pauna, Cristian Stefani, Iulia Madalina Staicu

Journal of Mind and Medical Sciences

Colorectal cancer is a common form of cancer nowadays. There are many risk factors in the pathogenesis of colorectal cancer. The malignant proliferation is caused by one or more genetic mutations, which activate oncogenes and deactivate tumor suppressor genes. Some factors cannot be changed, such as a person's age or family history. An essential aspect in the pathogenesis of colorectal cancer is the choice of lifestyles, such as a high-fat diet, smoking, and excess alcohol. Carcinogens can be either natural or chemical. The mechanisms by which carcinogens initiate tumor formation are genetic or non-genotoxic. The most common form of colorectal …

The Impact Of Patient-Dependent Risk Factors On Morbidity And Mortality Following Gastric Surgery For Malignancies, Bogdan Dumitriu, Sebastian Valcea, Gabriel Andrei, Mircea Beuran

Journal of Mind and Medical Sciences

Gastric cancer remains a leading cause of mortality worldwide. The treatment for gastric cancer is multimodal, in which gastrectomy remains the only curative approach. However, gastric resection is often associated with increased morbidity and mortality rates, depending on several factors. These factors can be attributed to the patient as comorbidities or effects of the disease upon him and, on the other hand, there are risk factors independent of the patient, such as aspects of the tumor (type, staging, location), experience of the surgical and anesthetic team, logistics of the hospital, yield of adjuvant therapies etc. We recognize the fact that …

Intestinal Dysbiosis – A New Treatment Target In The Prevention Of Colorectal Cancer, Florinela-Andrada Dumitru, Sergiu Ioan Micu, Roxana Emanuela Popoiag, Marilena Musat, Andreea Daniela Caloian, Valentin Calu, Vlad Denis Constantin, Daniela Gabriela Balan, Cornelia Nitipir, Florin Enache

Journal of Mind and Medical Sciences

The gastrointestinal microbiome contains at least 100 trillion microorganisms (bacteria, viruses, fungi), whose distribution varies from the mouth to the rectum spatially and temporally throughout one's lifetime. The microbiome benefits from advancing research due to its major role in human health. Studies indicate that its functions are immunity, metabolic processes and mucosal barrier. The disturbances of these functions, dysbiosis, influence physiology, lead to diabetes, inflammatory bowel disease, obesity and colon tumorigenesis. The third most common form of cancer, colorectal cancer, is the result of many factors and genes, and although the link between dysbiosis and this type of cancer is …

How Opportune Is Multigene Testing In Metastatic Colorectal Cancer? A Review, Cristina Orlov-Slavu, Andreea Parosanu, Mihaela Olaru, Dragos Serban, Ioana Paunica, Cornelia Nitipir

Journal of Mind and Medical Sciences

Personalized treatment in oncology is the most innovative method of care. The best method to establish personalized treatment is by genetic characterization of the malignant cell.

Theoretically, the more detailed the characterization, the more effective the choice of treatment becomes. Currently, there are fast and relatively low-cost options that allow such genetic characterization. However, test results sometimes do not detect targetable alterations and, even if they do detect, the use of the treatment-alteration combination does not always generate a satisfactory oncological response.

The present paper aims to answer two questions. First, how targetable can the most common gene alterations in …

A Pedunculated Esophageal Chondromatous Hamartoma In A Child, Dan-Alexandru Iozsa, Maria Puscasu, Catalin Gabriel Cirstoveanu, Vlad Denis Constantin, Anca Silvia Dumitriu, Stana Paunica, Nicolae Sebastian Ionescu

Journal of Mind and Medical Sciences

Esophageal tumors are uncommon in pediatric population and most of them are benign. Esophageal hamartomas have been reported extremely rare in children. These can present as intramural tumors of the esophageal wall or as polyps. Dysphagia is the main symptom described in their case, but other specific symptoms are also reported. Such symptoms encountered in clinical practice are represented by obstructive apnea episodes and bradycardia, poor weight gain, epigastric or retrosternal pain, hematemesis or melena, dysphonia or tracheal sounds. Diagnosis can be delayed due to the insidious onset and non-specific symptoms, therefore patient’s compliance to follow-up and broad, careful evaluation …

Immunohistochemical Pattern– A Prognostic Factor For Synchronous Gastrointestinal Cancer, Catalin Alius, Catalin Gabriel Cirstoveanu, Cristinel Dumitru Badiu, Valeriu Ardeleanu, Vasile Adrian Dumitru

Journal of Mind and Medical Sciences

Recent advancements in medical genetics and molecular biology are reflected in the modern understanding and approach to colorectal carcinoma (CRC). Understanding the cellular mechanisms and mutational patterns that promote carcinogenesis could enhance the predictive accuracy of the TNM classification. Furthermore, this will allow for a much more documented stratification and tailored oncological treatment. This paper presents an illustrative case of a relatively young patient (50 years old) with no family history of cancer who was diagnosed with four synchronous gastrointestinal (GI) adenocarcinomas displaying a wild type P53, negative BRAF testing, and mutated MLH1 and PMS2 proteins. This case report contributes …

Duodenal Carcinoid Tumour – A Case Report, Vasile Negrean, Cristina Buchman, Mirela Georgiana Perne, Mircea Milaciu, Iacob Domsa, Teodora Gabriela Alexescu, Ioana Para, Olga Hilda Orasan

Journal of Mind and Medical Sciences

Duodenal carcinoids are rare tumours of the small intestine with heterogenous clinical and pathological characteristics. The long-term prognosis is very good if discovered in the early stages. We present the case of a patient with a non-functional duodenal carcinoid tumour discovered incidentally during an upper gastrointestinal endoscopy. The diagnosis was confirmed through immunohistochemistry. Treatment consisted of the endoscopic resection of the tumour and the surveillance of the patient for the following 2 years, with no signs of recurrence. We have conducted a literature review regarding the clinical manifestations, diagnosis, treatment, and follow-up of patients with this type of tumours.

Laparoscopic Resection Of Gastric Gists. Where Do We Stand Now? A Single-Centered Experience, Iulian Slavu, Lucian Alecu, Adrian Tulin, Dana L. Stanculeanu, Cornelia Nitipir

Journal of Mind and Medical Sciences

Introduction. Gastrointestinal stromal tumors (GISTs) represent a rare type of gastrointestinal neoplasms. Resection with negative margins has been established as a mainstay treatment, but laparoscopic resections are still open to debate. Material and method. This retrospective study was conducted at a single institution, with data collected over 2 years (01.01.2017-01.01.2019). The variables examined were age, tumor location with regard to the gastric wall, the results of the intraoperative endoscopy, intraoperative and postoperative complications, the surgical technique, and histopathological reports. Results. We identified 12 relevant cases, of which 8 were females and 4 males. The average tumor diameter was 2.3 cm. …

Mandatory Multidisciplinary Approach For The Evaluation Of The Lymph Node Status In Rectal Cancer, Marian Diaconescu, Cosmin V. Obleaga, Cecil S. Mirea, Mihai C. Ciorbagiu, Emil Moraru, Ionica D. Vilcea

Journal of Mind and Medical Sciences

Colorectal cancer is the third most frequently reported malignancy and also the third leading cancer-related cause of death worldwide. Lymph node evaluation, both preoperatively and postoperatively, represents an important aspect of the diagnosis and therapeutic strategy in colorectal cancer, such that an accurate preoperative staging is required for a correct therapeutic strategy. Treatment of rectal cancer with positive lymph nodes, a very important predictive prognostic parameter, is currently based on neoadjuvant chemoradiotherapy followed by total/ surgical mesorectal excision and adjuvant regimen.

Preoperative evaluation of the lymph node status in rectal cancer is based on endoscopic ultrasound and magnetic resonance imaging, …

The Substrate Of The Biopsychosocial Influences In The Carcinogenesis Of The Digestive Tract, Georgică C. Târtea, Cristina Florescu, Daniel Pirici, Daniel Caragea, Elena A. Târtea, Cristin C. Vere

Journal of Mind and Medical Sciences

Digestive cancer represents a severe public health problem, being one of the main causes of death. It is considered a multifactorial disease, with hereditary predisposition, environmental factors, and other factors involved in carcinogenesis. Both the evolution and the pathogenesis of digestive neoplasms remain incompletely elucidated. As a multifactorial disease, it can be approached by taking into account the biopsychosocial influences via enteric nervous system. Many peptides and non-peptides having a neurotransmitter role can be found in the enteric nervous system, which can influence the neoplastic process directly or indirectly by affecting some angiogenic, growth, and metastasis factors. However, neurotransmitters can …