Components of NOTCH Signaling for Uterine Cancer Patients' Prognosis.

New molecular biomarkers that could have an independent prognostic value in endometrial cancer are currently under investigation. Recently, it was suggested that genetic changes in the Notch signaling pathway could be associated with the development of endometrial carcinoma. This study aimed to determine the expression of the Notch signaling pathway components in tumour and adjacent normal uterine tissue and to evaluate their importance for the survival of uterine cancer patients. The present study was performed on uterine body samples collected from 109 patients and paired adjacent noncancerous endometrial tissue samples. Kaplan-Meier curves and Cox regression were used for survival analyses. Expression alterations of NOTCH2, NOTCH3, NOTCH4, JAG2, and HES1 were evaluated as independent and significant prognostic factors for uterine cancer patients.

[Effect of combined treatment methods on quality of life in patients with pancreatic cancer]. / Kasos vezio kompleksinio gydymo itaka ligoniu gyvenimo kokybei.

In Lithuania, about 400 cases of pancreatic cancer are diagnosed each year, and more than 50% of patients are diagnosed with stage IV disease. Quality of life is an important issue in pancreatic cancer patients. A prospective randomized clinical study on the treatment of patients with resectable and unresectable pancreatic cancer was conducted at the Department of Oncology of Kaunas University of Medicine Hospital, and in this study, quality of life was analyzed. The aim of the study was to analyze the effect of combined treatment methods on quality of life in patients diagnosed with pancreatic cancer. MATERIAL AND METHODS. During 2000-2005, two concomitant chemoradiation treatment methods (radiotherapy with 5-fluorouracil and radiotherapy with gemcitabine) were analyzed in the study. A total of 60 patients were enrolled: 41 patients diagnosed with resectable and 19 patients diagnosed with unresectable pancreatic cancer. Quality of life was assessed using European Organization for Research and Treatment of Cancer Quality of Life Core 30 (EORTC QLQ-C30) questionnaire. Three main quality of life scales (general health status, functional, and symptom scales) were assessed and compared between two treatment groups. RESULTS. The analysis of quality of live assessment showed a statistically significant decrease in quality of life after treatment in patients with resectable pancreatic cancer and treated with radiotherapy and gemcitabine. Decreased quality of life later after treatment was also observed in patients diagnosed with unresectable pancreatic cancer and treated with the same regimen. Treatment with radiotherapy and 5-fluorouracil changed only some aspects of quality of life and did not have a significant impact on quality of life.

Evaluation of clinical factors and treatment results in patients with advanced pancreatic cancer.

OBJECTIVE: The aim of the study was to assess the benefit of treatment modalities on the survival in patients with advanced pancreatic cancer and clinical factors affecting treatment efficacy and survival. MATERIAL AND METHODS: One hundred eleven patients with advanced pancreatic cancer were analyzed retrospectively. Patients were grouped by treatment method, clinical stage, and Karnofsky Performance Index. Fifty-three patients were diagnosed with locally advanced disease and 58 with metastatic pancreatic cancer. Thirty-three patients at the time of diagnosis had Karnofsky Performance Index higher than 70, and in 78 patients it was 70 or lower. Fourteen patients were treated by concomitant chemoradiotherapy with gemcitabine or 5-fluorouracil, 25 - with gemcitabine only, and 72 patients underwent surgical palliation or observation alone. RESULTS: Patients treated with gemcitabine alone survived for 9.5 months, p<0.001. Overall median survival of patients treated with concomitant chemoradiation was 8.5 months. Comparison of survival results between groups of patients treated with gemcitabine alone and the patients who have received radiation therapy with 5-fluorouracil (median survival 6.4 months) or gemcitabine (median survival - 8.8 months) revealed no difference. Median survival after surgical palliation or observation was 1.9 months. Patients diagnosed with locally advanced pancreatic cancer and patients with Karnofsky Performance Index higher than 70 at diagnosis lived statistically longer than patients diagnosed with metastatic disease or Karnofsky Performance Index of 70 or lower. CONCLUSIONS: Patients diagnosed with locally advanced pancreatic cancer, better performance status at diagnosis and treated with monochemotherapy with gemcitabine or combination of gemcitabine or 5-fluorouracil with radiation survived longer, than patients diagnosed with metastatic disease, patients of worse functional status and treated by palliative methods only.

[The update on pancreatic cancer chemotherapy]. / Siuolaikine kasos vezio chemoterapija.

In the world five-year overall survival of patients with pancreatic cancer is low, i.e. about 5-6%. Patients without treatment live few months. Patients with pancreatic cancer are treated with combined treatment modalities. Chemotherapy is one of the three treatment methods. In the article we review chemotherapeutic agents that are used in everyday practice like fluorouracil and it's use in combination with other chemotherapeutic agents, and also, new drugs like gemcitabine, taxanes, capecitabine and other. Effectivity of the treatment with these agents, results of survival, toxicity and particularities of intraarterial chemotherapy are discussed. New perspectives in the treatment of patients with pancreatic cancer and methods of new chemotherapeutic strategies are analyzed.

[Molecular factors of pancreatic cancer pathogenesis and prognosis]. / Molekuliniai kasos vezio patogenezes ir prognozes faktoriai.

There are more than 400 new pancreatic cancer cases in Lithuania each year. More than half of these cases are a stage four diseases. The survival of patients with pancreatic cancer is short (median survival of patients with metastatic disease is about 6 months) and the treatment is not very effective. Analysis of the etiopathogenesis of pancreatic cancer and search for the effective early diagnostic methods, which could predict the response to treatment and increase the survival of these patients, is important. This article is the review of literature about molecular pathogenetic and prognostic factors of pancreatic cancer. Most important of these factors to date are K-ras gene mutation and p53 abnormal protein detection. The detection of K-ras mutation has prognostic value. This mutation could be detected in different human tissues: in the tumor, in regional lymph nodes, plasma, pancreatic juice, stool and other body fluids. Analysis of factors of pancreatic cancer pathogenesis and prognosis will not only help in earlier diagnosis of this cancer, but also will help to apply the current treatment methods more effectively. Research on such factors will be the basis for creation of new treatment modalities like biological therapies.