Madalina Nicoleta Mitroiu

Dr. Madalina Nicoleta Mitroiu


Research Focus & Metrics

Academic Career Length

3Years (2024-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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13 June 2024 in Cancers
Verified
Journal Article
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Elena ChitoranElena Chitoran
Elena Chitoran
VRVlad Rotaru
Vlad Rotaru
MMMadalina Nicoleta Mitroiu
Madalina Nicoleta Mitroiu
CDCristiana-Elena Durdu
Cristiana-Elena Durdu
RBRoxana-Elena Bohiltea
Roxana-Elena Bohiltea
Laurentiu SimionLaurentiu Simion
Laurentiu Simion
(1) Background: Currently, an increasing number of women postpone pregnancy beyond the age of 35. Gynecological cancers affect a significant proportion of women of reproductive age, necessitating the development of fertility preservation methods to fulfill family planning. Consequently, providing treatment options that preserve fertility in women diagnosed with gynecological cancers has become a crucial component of care for survivors. (2) Methods: We conducted an extensive search of relevant scientific publications in PubMed and Embase databases and performed a narrative review, including high-quality peer-reviewed research on fertility after being treated for gynecologic cancers, reporting pregnancy rates, birth rates, and pregnancy outcomes in cancer survivors as well as therapeutic options which partially preserve fertility and methods for obtaining a pregnancy in survivors. (3) Discussion: The medicine practiced today is focused on both treating the neoplasm and preserving the quality of life of the patients, with fertility preservation being an important element of this quality. This leads to an improved quality of life, allowing these women to become mothers even in the seemingly adverse circumstances posed by such a pathology. However, although there are guidelines on female fertility preservation in the context of neoplasms, an analysis shows that physicians do not routinely consider it and do not discuss these options with their patients. (4) Conclusions: Advancements in medicine have led to a better understanding and management of gynecological neoplasms, resulting in increased survival rates. Once the battle against these neoplasms is won, the issue of preserving the quality of life for these women arises, with fertility preservation being an important aspect for women who have not yet fulfilled their family planning desires at the time of diagnosis. It is important for patients to be informed about the available options for fertility preservation and to be encouraged to make informed decisions in collaboration with their medical team. Standardized recommendations for onco-fertility into guidelines should be taken into consideration in the future.

19 July 2024 in Cancers
Verified
Journal Article
Open access
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Elena ChitoranElena Chitoran
Elena Chitoran
VRVlad Rotaru
Vlad Rotaru
Sinziana IonescuSinziana Ionescu
Sinziana Ionescu
AGAisa Gelal
Aisa Gelal
CCCristina Mirela Capsa
Cristina Mirela Capsa
Laurentiu SimionLaurentiu Simion
Laurentiu Simion
Overall, it is estimated that more than 3,500,000 patients have received Bevacizumab as part of systemic oncologic treatment. Bevacizumab and its biosimilars are currently marketed in over 130 countries. Given the wide usage of Bevacizumab in current oncological practice, it is very important to compare the “real-world” results to those obtained in controlled clinical trials. This study aims to describe the clinical experience of using Bevacizumab in a large cohort of cancer patients in “non-controlled real-world” conditions with regard to effectiveness, safety, and cost of therapy. Methods: For this purpose, we conducted an open, observational, retrospective study involving all patients treated for solid malignant tumors in the Bucharest Institute of Oncology with “Prof. Dr. Al. Trestioreanu” with Bevacizumab-based systemic therapy, between 2017 and 2021. Results: The study consisted of 657 treatment episodes in 625 patients (F/B = 1.62/1, with a median age of 57.6 years) which were treated for malignant tumors (majority colorectal, non-small cell lung, ovarian, and breast cancer). First-line treatment was administered in 229 patients, and the rest received Bevacizumab as second or subsequent lines of treatment. The overall response rate to Bevacizumab-based therapies was around 60–65% across all indication except for subsequent treatment lines in colorectal and ovarian cancers, where lower values were recorded (27.1%, and 31.5% respectively). Median PFS for the entire cohort was 8.2 months (95% CI 6.8–9.6), and the median OS was 13.2 months (95% CI 11.5–14.9). Usual bevacizumab-related toxicities were observed, including bleeding, hypertension, wound-healing complications, gastrointestinal perforation, other types of fistulas, septic complications, and thromboembolic events. Although the clinical benefits are undeniable, the addition of Bevacizumab to standard chemotherapy increased the overall treatment cost by 213%. Conclusions: Bevacizumab remains a high-cost therapy, but it can add to clinical benefits (like overall survival, progression-free survival, and response rate) when used in conjunction with standard chemotherapy. Similar results as those presented in various controlled trials are observable even on unselected cohorts of patients in the uncontrolled conditions of “real-world” oncological practice. Off-label usage is encountered in clinical practice, and this aspect should be monitored given the potential adverse effects of the therapy.

6 December 2024 in Medicina
Verified
Journal Article
Open access
PDF file
Elena ChitoranElena Chitoran
Elena Chitoran
RBRoxana Bohiltea
Roxana Bohiltea
VRVlad Rotaru
Vlad Rotaru
CDCristiana-Elena Durdu
Cristiana-Elena Durdu
MMMadalina Nicoleta Mitroiu
Madalina Nicoleta Mitroiu
Laurentiu SimionLaurentiu Simion
Laurentiu Simion
Lynch syndrome, one of the most common genetic syndromes predisposing to cancer, is associated with a series of malignant conditions, among which the most frequent is colorectal cancer, but gynecologic cancers (especially endometrial) are also quite common. Despite the significant progress made in understanding this condition over time, there are still aspects in managing this condition that have not demonstrated clear benefits. This article aims to summarize the recommendations of international societies and present the latest developments in managing Lynch syndrome, focusing on gynecologic cancer screening and possible prevention strategies. Advances in genetic testing procedures and discoveries related to the association between oncological pathology frequency and the affected pathogenic variant type will probably lead to personalized medicine focused on the individual patient in the coming years. Although various screening methods for gynecological cancers in patients with Lynch syndrome have been used over time, they have not shown significant survival benefits. This highlights the need for studying and implementing new screening and diagnostic methods, which have been under investigation in recent years and are mentioned in this article.

22 May 2024 in Medicina
Verified
Journal Article
Open access
PDF file
VRVlad Rotaru
Vlad Rotaru
Elena ChitoranElena Chitoran
Elena Chitoran
MMMadalina Nicoleta Mitroiu
Madalina Nicoleta Mitroiu
Sinziana IonescuSinziana Ionescu
Sinziana Ionescu
ANAriana Neicu
Ariana Neicu
Laurentiu SimionLaurentiu Simion
Laurentiu Simion
Background: Clear cell sarcoma (CCS) is an extremely rare form of sarcoma representing less than 1% of all soft-tissue sarcomas. It has morphological, structural, and immunohistochemical similarities to malignant melanoma, affecting young adults and equally affecting both sexes, and is usually located in the tendinous sheaths and aponeuroses of the limbs. Gastrointestinal localization is exceptional, with less than 100 cases reported thus far. The gene fusion of activating transcription factor 1 (ATF1) and the Ewing sarcoma breakpoint region 1 (EWSR1) are pathognomonic for clear cell sarcoma, representing the key to the diagnosis. CCS is an extremely aggressive tumor, with >30% having distant or lymphatic metastasis at the time of diagnostic, and it has a high recurrence rate of over 80% in the first year after diagnosis and a high tendency for metastatic dissemination. Given the rarity of this tumor, there is no standardized treatment. Early diagnosis and radical surgery are essential in the treatment of CCS both for the primary tumor and for recurrence or metastasis. Chemo-radiotherapy has very little effect and is rarely indicated, and the role of targeted therapies is still under investigation. Case presentation: We present an extremely rare case of intestinal CSS in a 44-year-old Caucasian female. The patient, asymptomatic, first presented for a routine checkup and was diagnosed with mild iron-deficiency anemia. Given her family history of multiple digestive cancers, additional investigations were requested (gastroscopy, colonoscopy, tumoral markers and imaging) and the results were all within normal limits. In the subsequent period, the patient experienced mild diffuse recurrent abdominal pain, which occurred every 2–3 months. Two years later, the patient presented with symptoms of intestinal obstruction and underwent an emergency laparotomy followed by segmental enterectomy and regional lymphadenectomy for stenotic tumor of the jejunum. Histology, immunohistochemistry, and genetic testing established the diagnosis of CCS. No adjuvant therapy was indicated. Initially, no signs of recurrence or metastasis were detected, but after 30 and 46 months, respectively, from the primary treatment, the patient developed liver metastasis and pericolic peritoneal implants treated by atypical hepatic resections and right hemicolectomy. The patient remains under observation.

Verified
Journal Article
Open access
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RBRoxana-Elena Bohîlțea
Roxana-Elena Bohîlțea
RCRobert Ciortan
Robert Ciortan
CVCristina Vaida
Cristina Vaida
CDCristiana-Elena Durdu
Cristiana-Elena Durdu
MMMadalina Nicoleta Mitroiu
Madalina Nicoleta Mitroiu
Ovarian cancer is a highly aggressive disease with a poor prognosis, largely due to challenges in early detection. Traditional screening methods, including transvaginal ultrasound (TVS) and CA125 testing, have notable limitations in detecting early-stage disease and are not advised for widespread use. This article examines emerging early detection technologies, such as novel biomarkers, circulating DNA, PCR assays from Pap swabs, autoantibodies, microRNAs, and advanced imaging techniques. Future advancements in therapeutic methods may enhance survival outcomes linked to early detection. While general population screening remains unendorsed, targeted screening might be valuable for high-risk groups, such as those with Lynch syndrome, but should not replace risk-reducing surgeries. Developing comprehensive screening guidelines for high-risk individuals is essential for improving early detection and survival rates in ovarian cancer.

Verified
Journal Article
Open access
PDF file
RBRoxana Bohiltea
Roxana Bohiltea
BTBianca Tache
Bianca Tache
LGLavinia Elena Gaina
Lavinia Elena Gaina
MMMadalina Nicoleta Mitroiu
Madalina Nicoleta Mitroiu
BSBianca-Margareta Salmen
Bianca-Margareta Salmen
CDCristiana-Elena Durdu
Cristiana-Elena Durdu
This article presents the report of the First International Congress of Preventive Medicine, organized by the Romanian Society of Preventive Medicine (SRMP) in March 2025, in Bucharest, Romania. The congress featured 11 discussion panels and workshops, bringing together over 85 experts from a wide range of medical disciplines, including oncology, vaccination, cardiology, endocrinology, gynecology, gastroenterology, surgery, family medicine, physical therapy, pulmonology, epidemiology, pediatrics, dentistry, pathology, ENT, genetics, pediatric cardiology, psychiatry, dermatology, plastic surgery, urology, infectious diseases, regenerative medicine, and other key stakeholders in preventive healthcare. The event served as a comprehensive platform for addressing critical public health challenges, with a focus on cancer prevention, anti-aging, oral health, genetics in preventive medicine, preventive cardiology and neurology, the correlation between craniofacial dysfunctions and posture, vaccination strategies, management of congenital malformations, neonatal screening, and the prevention of lifestyle-related diseases such as obesity and tobacco addiction. Furthermore, the congress highlighted the importance of interdisciplinary collaboration and evidence-based interventions in improving population health outcomes. It emphasized the urgent need for coordinated actions to address preventable diseases both at the national and international levels.