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1
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Surgical site infection among patients after colorectal cancer surgery

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Banaszkiewicz Z., Cierzniakowska K., Tojek K., Kozłowska E., Jawień A.
Polish Journal of Surgery
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2017
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vol. 89(1)
9-15
EN
Wstęp: Zakażenie miejsca operowanego występuje u 2,5–22,3% operowanych chorych. Jest ono wykładnikiem jakości leczenia na oddziałach zabiegowych i ma duży wpływ na jego koszt. Materiał i metodyka: Analizie poddano chorych, u których w obserwacji 30-dniowej wystąpiło zakażenie miejsca operowanego. Grupę wyjściową stanowiło 1581 chorych z rozpoznaniem raka jelita grubego poddanych zabiegowi operacyjnemu w jednym ośrodku. Kryteriami wyłączającymi z badania były: brak wiarygodnej dokumentacji leczenia (szpitalnego lub ambulatoryjnego) i zgon chorego przed 30. dniem po operacji bez rozpoznanego zakażenia miejsca operowanego. Analizę statystyczną wykonano przy użyciu programu Statistica 10. Wyniki: Powikłania pooperacyjne wystąpiły u 262 chorych (16,6%). Najczęściej występującym było zakażenie miejsca operowanego (198 pacjentów; 12,52%). Stwierdzono, że wystąpienie tego powikłania zależne było od zaawansowania klinicznego raka, wieku chorych, chorób współtowarzyszących (cukrzyca i choroby kardiologiczne). Ponadto zauważono, że powikłanie to występowało znamiennie częściej u chorych operowanych w trybie pilnym z powodu powikłań oraz u tych, u których wyłoniono stomię jelitową. Nie stwierdzono natomiast zależności wystąpienia tego powikłania od płci chorych i lokalizacji guza nowotworowego. Wniosek: U chorych po operacji raka jelita grubego największe zagrożenie wystąpienia zakażenia miejsca operowanego wystąpiło u chorych po 75. roku życia, obciążonych cukrzycą i chorobami kardiologicznymi, z dużym zaawansowaniem klinicznym raka, operowanych w trybie ostrego dyżuru, u których konieczne było wyłonienie stomii jelitowej (a szczególnie kolostomii).
2
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Assessment Of the surgical treatment results IN patients with colorectal cancer IN A district hospital versus treatment results IN A highly specialized center

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Ciesielski P., Berut M., Górnicki K., Skoczylas J., Gorajska M., Żuk M., Rutkowski A., Dłubek J.
Polish Journal of Surgery
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2016
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vol. 88(4)
188-195
EN
In Poland there there are about 15‑16 thousand cases of colon cancer per year. The health care system allows the treatment of patients with colorectal cancer in highly specialized hospitals, oncology centers and district hospitals. The results of treatment within different reference level differ. The aim of the study was to evaluate the results of surgical treatment of patients with colorectal cancer at a district hospitals compared with the results of highly specialized center. Material and methods. A retrospective study. The material consisted of 171 consecutively operated patients diagnosed with colorectal cancer treated in the Department of Surgery, District Hospital in Wołomin. The control group consisted of 200 patients treated surgically at the Department of General and Colorectal Surgery, University Hospital in Łódź. In both centers, the patients were operated on by surgeons with experience in operations on the large bowel. The demographic data, information on the type of indication (elective vs emergent), and the severity of the disease by AJCC / TNM scale were collected. In the district hospital there were patients with more advanced disease (p <0.001), older (p = 0.0001), and often operated under emergent indication (p = 0.0001). The telephone survey collected data on survival or the date of death of the patient and set the percentage of five-year survival. Results. The proportion of five-year survival in the study group and control group was respectively 46% and 71% (p <0.0001). The percentage of five-year survival among patients undergoing elective procedure in both centers were respectively for Wołomin and Łódź 58% and 73% (p = 0.008). The proportion of 5-year survival among “younger” patients (<70) was respectively in Wołomin and Łódź 64% and 81% (p = 0.004) for “older” patients with (> 70) 50% and 60% (p = 0.6747) Conclusions. Overall results of surgical treatment of patients with colorectal cancer in the district hospital are inferior to treatment results in a highly specialized center. The population treated in the district hospital is statistically significantly different in comparison to patients treated in highly specialized center. The following differences were captured: severity of the disease, age and type of indication (elective vs emergent). The diffrences has an influence on the outcomes. The five years survival for patients > 70 years undergoing elective procedure is not statistically different between the district hospital and highly specialized center.
3
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K-ras gene mutation as an early prognostic marker of colon cance

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Szpon Ł., Stal A., Zawadzki M., Lis-Nawara A., Kielan W., Grzebieniak Z., Szpon Ł., Stal A., Zawadzki M., Kelan W., Grzebiak Z., Lis-Nawara A.
Polish Journal of Surgery
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2016
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vol. 88(1)
15-19
EN
Due to increased colorectal cancer incidence there is a necessity of seeking new both prognostic and prediction factors that will allow to evolve new diagnostic tests. K-ras gene seems to be such a factor and its mutations are considered to be an early marker of progression of colorectal cancer. The aim of the study was to find a correlation between K-ras gene mutation in patients with diagnosed colorectal cancer and selected clinical parameters. Material and methods. A total of 104 patients (41 women and 63 men) with diagnosed colorectal cancer were included in this study. The average age of male group was 68.3 and in female group – 65.9. Samples were taken from paraffine blocks with tissue from diagnosed patients and K-ras gene mutation were identified. Afterwards the statistical analysis was made seeking the correlation betweenK-ras gene mutation incidence and clinical TNM staging system, tumour localisation, histological type, sex, age. Results. K-ras gene mutations were detected in 20.1% of all colorectal cancers. Significantly higher rate of K-ras gene mutations were diagnosed among patients classified at stage I (40%), stage IIC (50%) and stage IV (50%) according to the TNM classification. Conclusions. The results of our study are compatible with other studies and indicate the correlation between K-ras gene mutation and colorectal cancer incidence. Identification of K-ras gene mutation may complement other diagnostic methods at early stage of colorectal cancer.
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Prevalence ofCryptosporidiumsp. In Patients with Colorectal Cancer

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Sulżyc-Bielicka V., Kołodziejczyk L., Jaczewska S., Bielicki D., Kładny J., Safranow K.
Polish Journal of Surgery
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2012
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vol. 84
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issue 7
348-351
EN
Parasitic protozoans of the Cryptosporidium genus are intracellular intestinal parasites of mammals, causing cryptosporidiosis. Clinically, cryptosporidiosis manifests as chronic diarrhoea. Individuals with immune disorders, including those with neoplasms, are at risk of symptomatic invasion.The aim of the study was the evaluation of Cryptosporidium sp. prevalence in patients with diagnosed colorectal cancer.Material and methods. The studied group encompassed 87 patients with diagnosed colorectal cancer, undergoing surgery at the Department of General and Oncological Surgery, Pomeranian Medical University, in the years 2009-2010. Immunoenzymatic tests for Cryptosporidium sp. on faeces samples were performed with the use of commercial test kit, ProSpecT®Cryptosporidium Microplate Assay (Remel Inc).Results. The presence of Cryptosporidium sp. was found in 12.6% of studied patients with colorectal cancer. The performed statistical analysis did not reveal any correlation between Cryptosporidium sp. infection and gender, age, neoplasm advancement stage as per Astler-Coller scale, neoplasm differentiation grade, or neoplastic tumour localisation in relation to the splenic flexure.Conclusions. There was found high prevalence of Cryptosporidium sp. in patients with colorectal cancer. It was comparable to the prevalence reported for patients with immune deficiency.
5
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Remarkable prolonged progression-free survival time after therapy with trifluridine/ tipiracil. A case report of 57-year-old woman with metastatic colorectal cancer

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Orlikowska M.
OncoReview
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2020
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vol. 10
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issue 1
27-30
EN
Colorectal cancer is the second leading cause of cancer-related death worldwide. Trifluridine/tipiracil is a novel orally administered antineoplasmatic thymidine-based nucleoside analog which represents an approved option for the treatment of advanced metastatic colorectal cancer in patients who are refractory, or are not considered candidates for, currently available therapies. In this report, we present a case of chemotherapy using trifluridine/tipiracil confirming the effectiveness of this drug primarily in the term of prolongation of progression free survival.
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Diabetes association of polyps and colon cancer

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Miłek T., Forysiński K., Myrcha P., Ciostek P.
Polish Journal of Surgery
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2019
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vol. 91(4)
9-12
EN
Aim: The aim of the study was to retrospectively assess the relationship between the occurrence of polyps and colon cancer in patients with type 2 diabetes. Methods: In 2014–2015, 976 colonoscopies were performed in patients. We compared the number of polyps with high-grade dysplasia and colorectal cancers in patients with and without diabetes. In addition, in the diabetic group we documented the relationship between HbA1C and the occurrence of polyps with high-grade dysplasia, and colon cancer. The data were statistically analyzed. Results: 1. Patients with diabetes show a higher incidence of polyps with high-grade dysplasia/carcinoma – 32/91 (35.16%) in comparison to patients without diabetes – 136/885 (15.37%), P < 0.001; 2. Patients with diabetes show a higher incience of polyps with cancer – 9/91 (9.89%) as compared to patients without diabetes – 18/885 (2.03%), P < 0.001. 3) Colorectal cancer occurred significantly more often in uncontrolled diabetes (P = 0.022). Conclusion: The conducted study shows a significant association between type 2 diabetes and the incidence of colorectal adenomas. These findings may lead to a conclusion that diabetic patients are at a higher risk of developing colorectal cancer, thus are in higher need for controlled colonoscopy. Therefore, it may be worth considering a scheme for screening patients in the above-mentioned group with colonoscopy.
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The role of activation of insulin-like growth factors in colorectal cancer

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Walkiewicz K., Nowakowska-Zajdel E., Strzelczyk J., Walczak M., Copija A., Janion K., Muc-Wierzgoń M.
OncoReview
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2017
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vol. 7
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issue 3
116-120
EN
Co-occurrence of metabolic disorders is a recognized risk factor for the development of colorectal cancer which is currently the leading cause of morbidity due to malignant neoplasms in the world. The pathogenesis of colorectal cancer is not well understood yet. Among the postulated neoplastic mechanisms is the activation of insulin-like growth factors, with both epidemiological and clinical observations of their role. In this paper, the authors synthesize the current knowledge about the importance of activation of insulin-like growth factors in the development of colorectal cancer.
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Usefulness of CEA Concentration Measurement and Classic Colonoscopy in Follow-Up After Radical Treatment of Colorectal Cancer

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Banaszkiewicz Z., Jarmocik P., Frasz J., Tojek K., Mrozowski M., Jawień A.
Polish Journal of Surgery
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2011
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vol. 83
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issue 6
310-318
EN
There is always a certain rate of recurrence after radical treatment for cancer and to get on it an early detection of disease set back is crucial.Material and methods. Medical data of patients operated on for primarily detected colorectal cancer in years 1993-2002 was retrospectively reviewed. Usefulness of follow-up means such as physical examination, or CEA and endoscopic surveillance was analyzed. All mentioned above were applied to scheduled follow-up (in 3, 6 and 12 month intervals following an operation and annually after that by the year 5).Results. Complete and reliable data was obtained from 340 out of 502 follow-up intended subjects (67.7%). Elevated CEA was the most frequent predictor of recurrence within non-symptomatic subjects meeting follow-up appointments (60%). The cancer set back diagnosed by means of either physical or endoscopic examinations was the case only in one out of five patients (20.75% and 18.87% respectively). Clinical onset of recurrence making patients meet an unscheduled appointment was found increasing relative risk of nothing-but-palliative option either for them with local set back, or meta-static spread. Relative risk of onset of meta-chronous colonic cancer was significantly higher in patients being affected by synchronous advanced adenoma at time of surgery compared to those with one-fold changes.Conclusions. CEA scheduled follow-up after treatment for colorectal cancer CRC seems adequate to provide a good outcome of treatment for recurrent tumors. CRC patients presenting with synchronous advanced adenomas at time of surgery are probably to be under more intensive endoscopic surveillance.
9
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Colorectal surgery in elderly population

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Zawadzki M., Krzystek-Korpacka M., Rząca M., Czarnecki R., Obuszko Z., Witkiewicz W.
Polish Journal of Surgery
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2018
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vol. 90(4)
29-34
EN
Introduction: With the rising number of elderly patients and increasing incidence of colorectal cancer, management of geriatric patients has become the forefront of colorectal surgery. Objectives: This study aimed to investigate the short-term surgical outcomes that follow colorectal resection in elderly patients. Materials and methods: A total of 464 patients who underwent surgical resection for colorectal tumor between 2013 and 2017 were included. The patients were divided into a group of the elderly (≥75 years) and the young (<75 years). Clinicopathological data of the patients were reviewed retrospectively. Results: The elderly group constituted 30% of the study population. A greater number of patients in the elderly group underwent Hartmann’s procedure (p = 0.02) and right hemicolectomy (p = 0.029), and younger patients more often received low anterior resection (p = 0.027). The duration of the surgical procedure was shorter in the elderly group (p < 0.01) but they stayed in the hospital one day longer (p = 0.023). Postoperative complications and mortality tended to be higher in seniors (p = 0.088). The younger patients showed a tendency towards a higher rate of distant metastases (p = 0.053). Seniors received fewer preoperative chemoradiation in comparison to the young group (p = 0.014). Conclusion: Older persons constitute one-third of patients treated electively in colorectal departments. Colorectal surgery in geriatric patients is associated with a prolonged hospital stay and a higher potential for complications and mortality.
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Results of Surgical Treatment of Colorectal Cancer in Octogenerians Patients

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Tarnowski W., Kamiński P., Bielecki K.
Polish Journal of Surgery
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2010
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vol. 82
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issue 7
410-416
EN
The aim of the study was to estimate factors affecting results of surgical treatment of colorectal cancer in octogenarian patients in comparison with a group of younger patients.Material and methods. Hospital records were reviewed prospectively and data were collected from a consecutive series of 1021 patients operated on because of primary colorectal cancer between 1988 and 2009.Results. One hundred sixteen patients aged minimum 80 years of life were identified with an average age of 83.6 years. They were compared with 905 younger patients with an average age of 61.9 years. Co-morbidity, presentation in ASA 2, ASA 3 and ASA 4 score were significantly higher in octogenarian than in younger patients group. Emergent operations were performed significantly more often in octogenerians than in younger patients as well (31% versus 14% respectively). Resection of cancer and primary bowel anastomosis was performed less often in patients aged over 80 years than in younger patients (58.6% versus 70.9% respectively). Postoperative complications rate was significantly higher among the older than younger patients (43.9% versus 30.7% respectively). Mortality was higher in older than in younger patients (22.4% vs 5.7% respectively).Conclusions. Results of surgical treatment of colorectal cancer in octogenarian patients are affected by higher co-morbidity and more often presentation of ASA 3 and ASA 4 score than in younger patients. Surgical treatment of colorectal cancer in octogenarians is burdened with higher rate of postoperative complications and almost four times higher mortality rate than in younger patients.
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The use of rifaximin in pre-operative period of patients with tumors of the gastrointestinal tract – a retrospective study (2013-2016)

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Moroz N., Sitarz R., Mruk A., Bakalarz R., Maciąg E., Litwiński J., Wierzbicki R.
Polish Journal of Surgery
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2018
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vol. 90(1)
35-40
EN
Introduction: One of the most important goals of preparing a patient for elective gastrointestinal cancer surgery is to prevent postoperative complications. The literature presents many ways to prepare for surgery, but only few sources suggest that preoperative use of rifaximin provides benefits in the form of fewer perioperative complications and reduced severity of pain during this period. Objective: The presented project is a retrospective analysis of the effectiveness of rifaximin in the prevention of perioperative complications in patients treated at the Department of General Surgery with Orthopedics and Trauma Division and Urology Division of the Ministry of Interior and Administration Hospital in Lublin, and a review of international literature in this subject. Materials and methods: A retrospective analysis of the results of preoperative use of rifaximin was performed in patients scheduled for rectal and colorectal cancer surgeries at the Department of General Surgery with Orthopedics and Trauma Division and Urology Division of the Ministry of Interior and Administration Hospital in Lublin in the period between 2013 and 2016. Patients undergoing emergency surgeries were excluded from the study. Patients were divided into 2 groups, as follows: The first group consisted of 139 patients operated on for rectal and colorectal cancer in years 2013-2015, in whom rifaximin was not used in the preoperative period. The second group consisted of 42 patients operated on in 2016, in whom rifaximin was used in the preoperative period at the dose of 2 x 2 tablets (400 mg) per day at 12-hour intervals, for 7 days before the scheduled surgery. Additionally, a probiotic was administered for 7 days. Drugs were ordained at the Oncological Outpatient Clinic as part of pre-hospitalization checks. Results: The use of rifaximin in the preoperative period in patients with colorectal cancer shortened the time of postoperative hospitalization and reduced postsurgical pain in comparison with the control group. The analysis revealed no differences in the numbers and the intensity of surgical complications in both groups. Conclusions: No large studies have been published to date on the influence of rifaximin on the development of colorectal cancer. Suggestions that rifaximin has a positive effect on the perioperative period of patients treated for colorectal cancer had been presented in isolated reports; these observations are confirmed by our retrospective analysis.
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The - 801 G/A Polymorphism ofCXCL12Promoter Gene as Unfavorable Genetic Prognosis factor involved in Colorectal Cancer

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Langner E., Przybyłowska K., Sygut A., Mik M., Dziki Ł., Dziekiewicz M., Majsterek I., Dziki A.
Polish Journal of Surgery
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2010
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vol. 82
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issue 8
459-463
EN
CCXL12 also called stromal derived factor-1 (SDF-1), a protein related to angiogenesis and inflammation, has been correlated with the progression of a number of malignancies. Single nucleotide - 801G/A polymorphism of CXCL12 gene has been described and is regarded as a target for cis-acting factor that has the ability to up-regulate CXCL12 expression.The aim of the study. Based on the suggested role of CXCL12 in the pathogenesis of cancer we examined the association of the gene variant CXCL12-A with colorectal cancer.Material and methods. We genotyped - 801G/A polymorphism of CXCL12 gene in 164 colorectal patients and 184 age-matched healthy subjects. Genotyping was done with PCR-RFLP.Results. There were no significant differences in the frequencies of SDF1-3'A allele, between patients and controls. The frequency of CXCL12 G/A and G/A plus A/A genotype was significantly higher in a group of patients with lymph node metastasis compared with those without metastasis.Conclusions. The CXCL12 gene G/A polymorphism was not related to colorectal cancer risk but is associated with the induction of lymph-node metastasis of colorectal cancer disease in Polish.
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Oxidative protein damage in patients with colorectal cancer

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Murlikiewicz Ł., Sygut A., Trzciński R., Grzegorczyk K., Rutkowski M., Dziki A.
Polish Journal of Surgery
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2010
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vol. 82
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issue 8
454-458
EN
Colorectal cancer is a major public health concern particularly in developed countries. Despite decades of advances in the treatment and prevention of colorectal cancer, it remains the second most common cause of cancer death. There now exists convincing evidence that reactive oxygen species play an important role in the etiology and progression of a number of human diseases including colorectal cancer. Reactive oxygen species may damage all types of biological molecules. However, proteins are possibly the most immediate vehicle for inflicting oxidative damage on cells since they are often catalysts rather than stoichiometric mediators, hence, the effect of damage to one molecule is greater than stoi-chiometric.The aim of the study was to investigate oxidative protein damage in patients with colorectal cancer and its correlation with the clinical stage of the disease.Material and methods. The study group comprised 102 patients operated on for colorectal cancer in different clinical stages of the disease. Plasma carbonyl levels were determined using Levin's method.Results. Patients in all tumor groups showed significantly higher levels of plasma carbonyls when compared to healthy people. We observed an increase in mean plasma carbonyl levels correlating with an increase in the degree of disease advancement.Conclusions. This study demonstrates that reactive oxygen species may have a role in pathogenesis of colorectal cancer. The outcomes of this research seem to confirm that antioxidants may play a role in chemoprevention of colorectal cancer.
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Relationships between Insulin-Like Growth Factor I and Selected Clinico-Morphological Parameters in Colorectal Cancer Patients

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Kukliński A., Kamocki Z., Cepowicz D., Gryko M., Czyżewska J., Pawlak K., Kędra B.
Polish Journal of Surgery
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2011
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vol. 83
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issue 5
250-257
EN
Insulin Like Growth Factor (IGF I) as the one of the strongest growth factors which can affect cancers development including colorectal cancer. IGF I induces processes of the cells growth and division. It regulates cells cycle and inhibits apoptosis. There is limited data about correlation between IGF I and staging of the tumor.The aim of the study was estimation of the clinical usefulness of IGF I concentration in the serum of the patients with colorectal cancer.Material and methods. We have examined 125 individuals with colorectal cancer. The age range was 36 to 92 years. They have been operated in the 2nd Departament of The Gastrointestinal Surgery of the Medical University in Białystok. Serum concentration of the IGF I have been estimated using immunoassay ELISA before and after operation. Correlation between serum level of IGF I and clinicopathologic features: age, gender, localisation of the primary tumor, TNM stage of tumor, histological type and histological grade (G) of the cancer have been estimated.Results. Our study revealed statistically significant increased serum concentration of IGF I in patients with locally advanced colorectal cancer (pT3 and pT4) comparing to less advanced (pT2) The investigations showed higher serum concentration of IGF I in patients with poorly differentiated cancers (G3) than in moderately differentiated. Similarly higher serum concentration of IGF I were found in male, in patients older than 60 years and in mucigenous colorectal cancers.Conclusions. Our results indicated that IGF I can be one of the factors of the prognosis in colorectal cancer development.
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Carcinoembryonic antigen and matrix metalloproteinase 2 serum and peritoneal washes concentration in staging and prognosis in colorectal cancer patients

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Guzel T., Mirowska-Guzel D., Lech G., Wroński M., Iwanowska M., Słodkowski M.
Polish Journal of Surgery
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2018
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vol. 90(5)
36-43
EN
Purpose: The aim of the study was to determine the significance of carcinoembryonic antigen and matrix metalloproteinase 2 peritoneal washes and serum concentration in patients suffering from colorectal cancer concerning tumor staging and 5-year survival rate in these patients. Methods: 80 patients who underwent curative surgery for colorectal cancer were included in the study. Preoperative serum and intraoperative peritoneal washes CEA and MMP-2 concentrations were measured. Results: Regarding tumor penetration, CEA-s and CEA-p concentrations were higher in subsequent stages from T2 to T4. Both CEA-s and CEA-p concentrations were lower in T2 compared to T3 and T4. Significant difference of CEA-s and CEA-p was noted between T2 and T4 stages. MMP-2-s concentration was higher in T3 compared to T2, the highest MMP-2-p concentration was in T4, with no statistical significance. Regarding nodular status, a significant difference of CEA-s was noted between N0 and N1. For CEA-p, significance was found between N0 and N2 as between N1 and N2. MMP-2-s concentration was the highest in N1, MMP-2-p concentration was the highest in T4, with no statistical significance. The 5-year survival rate for all patients was 63.53%. There were significant differences in CEA-s and CEA-p concentrations between patients with negative and positive 5-year survival. Conclusion: Intraoperative peritoneal washes concentration of CEA may potentially serve as an important factor for more precise colorectal cancer staging. CEA-p and CEA-s concentrations correlate with survival rate in patients suffering from colorectal cancer and can be useful as an additional prognostic factor. The usefulness of MMP-2 measurement still requires further studies.
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Complications of palliative antiangiogenic therapy in patients with colorectal cancer

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Domagała-Haduch M., Jasiówka M., Nowak Ł., Cedrych I.
OncoReview
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2016
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vol. 6
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issue 4
A199-204
EN
Introduction: Bevacizumab is an antiangiogenic drug used in the therapy of numerous solid tumours including colorectal adenocarcinoma. The efficacy and safety of bevacizumab has been demonstrated in many multicenter clinical trials. The scope of this paper is to analyze the safety profile of bevacizumab in patients with stage IV colorectal cancer. Aim of the study: Analysis of toxicity and safety of the treatment with bevacizumab patients with colorectal cancer in the metastatic stage. Material and methods: Retrospective analysis of medical records of 42 patients with advanced colorectal cancer treated in the Department of Systemic and Generalized Malignancies, Maria Skłodowska-Curie Memorial Institute of Oncology, Kraków Branch, in the period 2007–2014. Results: The median time of treatment with bevacizumab was 6 months. The median duration of progression-free survival (PFS) was 8.5 months. Toxicity of treatment with bevacizumab affected 43 percent of patients. The most common adverse events observed was hypertension and bleeding. In 6 patients (14.3%) the treatment with bevacizumab was interrupted due to adverse events (thromboembolic events, bleeding and gastrointestinal perforation). Conclusions: Bevacizumab is a safe therapeutic option in patients with metastatic colorectal cancer, provided that patients are provided close oncological and general medical monitoring.
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Tyrosine phosphatases as a superfamily of tumor suppressors in colorectal cancer

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Laczmanska I., Sasiadek M. M.
Acta Biochimica Polonica
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2011
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vol. 58
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issue 4
467-470
EN
Phosphorylation and dephosphorylation processes catalyzed by numerous kinases and phosphorylases are essential for cell homeostasis and may lead to disturbances in a variety of vital cellular pathways, such as cell proliferation and differentiation, and thus to complex diseases including cancer. As over 80 % of all oncogenes encode protein tyrosine kinases (PTKs), protein tyrosine phosphatases (PTPs), which can reverse the effects of tyrosine kinases, are very important tumor suppressors. Alterations in tyrosine kinase and phosphatase genes including point mutations, changes in epigenetic regulation, as well as chromosomal aberrations involving regions critical to these genes, are frequently observed in a variety of cancers. Colorectal cancer (CRC) is one of the most common cancers in humans. CRCs occur in a familial (about 15 % of all cases), hereditary (about 5%) and sporadic (almost 75-80 %) form. As genetic-environmental interrelations play an important role in the susceptibility to sporadic forms of CRCs, many studies are focused on genetic alterations in such tumors. Mutational analysis of the tyrosine phosphatome in CRCs has identified somatic mutations in PTPRG, PTPRT, PTPN3, PTPN13 and PTPN14. The majority of these mutations result in a loss of protein function. Also, alterations in the expression of these genes, such as decreased expression of PTPRR, PTPRO, PTPRG and PTPRD, mediated by epigenetic mechanisms have been observed in a variety of tumors. Since cancer is a social and global problem, there will be a growing number of studies on alterations in the candidate cancer genes, including protein kinases and phosphatases, to determine the origin, biology and potential pathways for targeted anticancer therapy.
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Synchronous Gastric and Rectal Cancer in a 50 Year-Old Man – Case Report

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Pierko J., Łukaszewicz J., Sawicka-Pierko A., Hady H. R., Dadan J.
Polish Journal of Surgery
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2012
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vol. 84
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issue 11
582-584
EN
The occurrence of synchronous tumors of the gastrointestinal tract is rarely observed in general surgery, diagnosis is frequently incidental, often intraoperatively. The aim of this study was to present a case of a 50 year-old male patient admitted to the Department of Gastroenterology, University Hospital in Białystok, due to abdominal pain, significant weakness and excretion of tarry stools. Imaging diagnostics revealed the presence of a large gastric tumor (histopathological type - adenocarcinoma), and single metastasis to the liver. The patient was qualified for total gastrectomy. Surgery was performed at the 1st Department of General and Endocrinological Surgery, University Hospital in Białystok. Rectal cancer, which was observed during the operation was removed simultaneously.
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The influence of bowel preparation on postoperative complications in surgical treatment of colorectal cancer

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Małek Z., Małek P., Dziki Ł.
Polish Journal of Surgery
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2019
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vol. 91(3)
10-14
EN
Introduction Colorectal cancer is the most common gastrointestinal cancer treated by departments and surgical clinics in Poland. Currently, the biggest challenge of surgery is to reduce the number of leaks in the bowel anastomoses and postoperative wound infections to a minimum. Objective Whether bowel preparation before surgery affects the early results of treatment? Methods The study was retrospective and included patients operated electively on one surgical center due to colorectal and rectal cancer in years 2013-2018. Patients who underwent surgery were divided into two groups in the study. The first was 109 patients with mechanical bowel irrigation. The second group of 118 patients, in addition to mechanical bowel preparation, received an oral antibiotic. Results The studied groups did not differ significantly in terms of traits that could affect the results of treatment within 30 days of surgery. Postoperative mortality was 0,9% and 0,85%. Complications: leakage of the bowel anastomosis 1,8% and 1,7%, postoperative obstruction 3,7% and 5,0%, wound dehiscence 2,75% and 0,85%, infection of the surgical site 13,8% and 3,4% respectively in the first and second group of patients. Conclusion 1. Mechanical bowel preparation in combination with the oral supply of antibiotic significantly reduces the frequency of surgical site infection compared to the mechanical rinsing itself. 2. Type of preparation of the intestine before the surgery does not significantly affect postoperative mortality and other complications, including anastomotic leak, but may be important for the frequency of postoperative wound dehiscence.
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Analysis of 7965 screening colonoscopies and treatment results of detected colorectal cancers – experiences of one center

80%
Nowicki A., Kula Z., Lemanowicz M.
OncoReview
|
2016
|
vol. 6
|
issue 3
A134-142
EN
Introduction: Colorectal cancer is one of the most common cancers in both sexes and is one of the leading causes of death in Poland and the world. An effective method to prevent the development of colorectal cancer (CRC) is the detection of polyps during a screening colonoscopy and their removal. Objective: The aim of the study was to evaluate results of screening for early detection of colorectal cancer by colonoscopy. Material and methods: The study was based on analysis of medical records of 7965 patients who underwent colonoscopy as part of the National Screening Program (NSP) for Early Detection of Colorectal Cancer in the 2000–2014 period. Results: Polyps were removed in 2900 (36.4%) patients, among whom 1885 (23.6%) had adenomas, which were more frequent in men (32.9%). Tubular adenomas were observed in 1685 patients (21.1%), tubulo-villous adenomas were detected in 157 patients (2%) and villous adenomas – in 43 (0.5%) of them. Sixty-three (0.79%) colorectal cancers were detected in various clinical stages, including adenocarcinoma in situ in 3 patients. Probability of 5-year survival rate of colorectal cancer amounted to 74% while 10-years survival was reached in 63% of patients. Conclusions: The detection rate of polyps, adenomas and carcinomas thanks to screening colonoscopy was 36.4%, 23.6% and 0.79% respectively, while the probability of 5-year survival was 74%. An improvement in the quality of colonoscopy was observed in subsequent years of the NSP, which translated into better detection of adenomas.
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