Introduction : Paragangliomas (PGLs) related to hereditary syndromes are rare mediastinal tumors. Paragangliomas are caused by mutations in genes encoding subunits of succinate dehydrogenase enzyme (SDH). Aim: To evaluate clinical, anatomical and functional characteristics of mediastinal...

Objectives In young patients with borderline tumors the fertility-sparing treatment is indicated, thus the preoperative investigation is important. The aim of this study was to perform a comparative assessment of sensitivity and specificity of selected ultrasonographic and clinical parameters for the diagnoses of borderline tumors and ovarian cancers. Methods We retrospectively analyzed 57 patients who underwent surgical treatment in the Maria Sklodowska-Curie Memorial Cancer Center from Jan 01, 2008 to Dec 31, 2009. Ovarian cancers were diagnosed in 41 patients, and borderline ovarian tumors in 16 patients. Statistical model was developed to determine independent predictive factors that would be useful in preoperative differentiation between both tumors. The model included the following factors: menopausal status, tumor morphology, wall thickness (including outgrowths), septal thickness, echogenicity, resistive index, serum CA-125 level, and free fluid in the peritoneal cavity. Results Based on the statistical model developed, independent predictive factors in the differentiation between ovarian cancers and borderline tumors included the menopausal status (P = 0.005), tumor echogenicity (P = 0.047) and the presence of free fluid in the Douglas pouch (P = 0.043). With the cutoff value of 13 (with scores below 13 indicating a borderline ovarian tumor, and scores of ≥13 indicating ovarian cancer), sensitivity was 90.2 % and specificity was 87 %. Conclusions Our proposed model of preoperative evaluation has a sensitivity of 90 % in the differentiation between ovarian cancers and borderline tumors. When combined with intraoperative findings, it allows optimal surgical therapeutic decisions to be made in patients with borderline ovarian tumors.

Cancer and its treatment can lead in men to testosterone deficiency, accompanied by somatic and mental symptoms. Germ cell tumours and their treatment may disturb the pituitary–gonadal axis, hence leading to significant clinical abnormalities. In some prostate cancer patients, castration, temporary or permanent, is a desired therapeutic condition. Yet, it is burdened with various side effects of complex intensity and significance. Last but not least, patients in the terminal stage of a malignancy present with low testosterone concentrations as a part of anorexia–cachexia syndrome. Oncological management of such patients disturbs their homeostasis, androgen metabolism included, which results in numerous complications and worsens their quality of life. In the present paper, we analysed the frequency and sequelae of testosterone deficiency in some clinical scenarios, on the basis of original papers, meta-analyses and reviews available in PubMed. Androgen secretion disorders in male cancer patients depend on a cancer type, stage and methods of treatment. Number of testicular cancer survivors is increasing, and as a consequence, more patients cope with late complications, testosterone deficiency included. Hormone therapy in prostate cancer patients significantly prolongs survival, and then numerous men experience long-term adverse effects of androgen deficiency. Those, in turn, particularly the metabolic syndrome, may contribute to increased mortality. Androgen deficiency is a part of cancer anorexia–cachexia syndrome. The role of androgen deficiency in cancer patients is still under debate, and further studies are urgently needed to establish appropriate clinical guidelines.

DOI: 10.20452/pamw.16186, Published online: January 05, 2022, Authors: Marcin Skowroński, Wojciech Michalski, Dorota Zozulińska-Ziółkiewicz, Anna Halicka, Aleksander Barinow-Wojewódzki

The RAPIDO and PRODIGE-23 randomised trials of neoadjuvant versus adjuvant chemotherapy for rectal cancer showed that disease-free survival (DFS) curves diverged early, suggesting that much of the benefit from neoadjuvant chemotherapy occurred within six months. We aimed to determine whether the DFS benefit at six months in trials evaluating neoadjuvant chemotherapy can predict the benefit at 36 months, and to compare the timing of DFS benefit in trials of neoadjuvant versus in those of adjuvant chemotherapy. A systematic review identified ten randomised trials comparing neoadjuvant with adjuvant chemotherapy and 37 randomised trials of adjuvant chemotherapy eligible for meta-analysis in rectal or colon cancer. Absolute differences in DFS between experimental and control groups at six and 36 months were extracted from Kaplan-Meier curves. The increment in the DFS benefit between the sixth and 36th months was calculated. In neoadjuvant chemotherapy trials, DFS benefit at six months (3.7 %, 95 % confidence interval [CI]: 1.9 to 5.4) did not differ significantly from that at 36 months (4.1 %, 95 % CI: 2.0 to 6.3), and the pooled absolute increment in DFS benefit between the sixth and 36th months was only 0.8 % (95 % CI: -1.6 to 3.2). The DFS benefit emerged earlier in neoadjuvant than in adjuvant chemotherapy trials. In randomised trials comparing neoadjuvant with adjuvant chemotherapy, most of the DFS benefit from neoadjuvant chemotherapy manifests itself within the first six months. Therefore, assessing DFS at six months may potentially serve as an early indicator of long-term efficacy.