Marek Bębenek - Academia.edu (original) (raw)

Papers by Marek Bębenek

Annals of Surgical Oncology, Jan 23, 2009

Background. Some low-rectal cancers may spread into or recur in the inguinal lymph nodes despite ... more Background. Some low-rectal cancers may spread into or recur in the inguinal lymph nodes despite optimal resection of the primary tumor. Hence, we hypothesized that lymphatic drainage of low-rectal malignancies may be inhomogeneous and that an extramesorectal route may be involved in at least some cases. The idea of our preliminary study was to analyze the potential lymphatic drainages in low-rectal cancer patients. Methods. The first stage of the experiment included two consecutive low-rectal adenocarcinoma patients (free from inguinal lymph node metastases), in whom the lymphatics of the primary tumor were traced with Patentbalu dye. During the second stage the records of 206 consecutive low-rectal cancer patients were analyzed for presence of inguinal lymph node metastases. Results. An evaluation of specimens from two rectal cancer patients revealed extramesorectal lymphatic drainage of the primary tumor besides the mesorectal route. An analysis of 206 patients revealed six cases of inguinal node metastases. Median age of patients was 55 years. They were all diagnosed with rectal adenocarcinoma, T3 or T4 tumors with G2 or G3 grade. Conclusion. The demonstration of an alternative route of lymphatic drainage suggests that more radical surgical procedures are necessary for successful treatment of lowrectal cancers.

Polish Journal of Surgery, 2020

Surgical interventions in patients with peritoneal metastases combined with hyperthermic intraper... more Surgical interventions in patients with peritoneal metastases combined with hyperthermic intraperitoneal chemotherapy (HIPEC) and systemic treatment are becoming more common and, when applied to selected patient groups, they reach 5-year survival rates of 32–52%. Good clinical outcomes require experienced and well-equipped healthcare centers, experienced surgical team and adequate patient qualification process. As a result of the discussion on the need for evaluation of quality of care and treatment outcomes and at the request of the Peritoneal Cancer Section of the Polish Society of Surgical Oncology, accreditation standards have been developed and the Accreditation Committee has been established for healthcare centers providing cytoreductive surgery and HIPEC for the management of primary and secondary peritoneal cancers.

Nowotwory, 2008

Nowotwory pod¶cieliskowe przewodu pokarmowego (GIST) s± najczestszymi nowotworami pochodzenia mez... more Nowotwory pod¶cieliskowe przewodu pokarmowego (GIST) s± najczestszymi nowotworami pochodzenia mezenchymalnego w obrebie przewodu pokarmowego. Dzieki postepom w diagnostyce patologiczno-molekularnej powszechnie rozpoznaje sie je dopiero od kilku lat. W pracy przedstawiono zalecenia dotycz±ce diagnostyki i terapii tych nowotworow opracowane na podstawie danych naukowych oraz do¶wiadczenia ekspertow, ktore s± powszechnie akceptowane i warte rekomendacji. Nadekspresja b³onowego receptora KIT, bed±ca nastepstwem mutacji protoonkogenu KIT, jest wysoce specyficzna dla GIST i mo?liwa do wykrycia metodami immunohistochemicznymi (CD117) w preparatach histopatologicznych z guza, stanowi±c najwa?niejsze kryterium w jego diagnostyce mikroskopowej i wskazaniach do leczenia drobnocz±steczkowymi inhibitorami kinaz tyrozynowych. W ka?dym przypadku zaleca sie przes³anie materia³u do badan molekularnych (w celu analizy mutacji genow KIT i PDGFRA). Radykalne leczenie operacyjne jest nadal najskutecznie...

Rak gruczolu krokowego zalicza sie do grupy nowotworow zlośliwych specyfi cznych dla krajow rozwi... more Rak gruczolu krokowego zalicza sie do grupy nowotworow zlośliwych specyfi cznych dla krajow rozwinietych. Dane epidemiologiczne wskazują, ze obok oskrzeli i pluca oraz jelita grubego prostata zalicza sie do najczestszych umiejscowien nowotworow zlośliwych u mezczyzn w Europie i Stanach Zjednoczonych. W 2008 r. procentowy udzial wymienionych umiejscowien wśrod zachorowan polskich mezczyzn na nowotwory zlośliwe wyniosl 46,2%, a wspolczynnik zachorowalności na raka gruczolu krokowego wyniosl 29,9 na 100 000. Warto jednak zwrocic uwage na znaczne geografi czne zroznicowanie czestości wystepowania raka gruczolu krokowego w naszym kraju: w 2008 r. wspolczynniki zachorowalności nowotworu w poszczegolnych wojewodztwach wahaly sie bowiem od 20,5 do 43,6 na 100 000. Ciekawych wnioskow dostarcza szczegolowa analiza danych epidemiologicznych na poziomie regionu. W ostatnim 25-leciu w wojewodztwie dolnośląskim u mezczyzn obserwuje sie systematyczny spadek liczby nowych przypadkow raka oskrzeli i...

Oncology in Clinical Practice, 2010

Bone sarcomas comprise a heterogenous group of rare mesenchymal tumors (less than 0.5% of maligna... more Bone sarcomas comprise a heterogenous group of rare mesenchymal tumors (less than 0.5% of malignant neoplasms in adults). From clinical point of view they can be divided into two main groups: spindle-cell sarcomas (osteosarcomas, majority of chondrosarcomas and less common subtypes) and small-cell sarcomas (mainly Ewing family of tumors). Correct diagnosis and effective therapy is performed by cooperation of radiologists, oncological and orthopedics surgeons, clinical oncologists, radiotherapists, rehabilitants, pathologists, nuclear medicine specialists and molecular biologists. The most important principle in diagnostics and therapy of primary malignant bone tumors is multidisciplinary work in experienced centers. Improvement of diagnostics, implementation of combined therapy and technological developments caused the increase of limb-sparing surgery indications and better long-term results of their treatment. Onkol. Prak. Klin. 2010; 6, 6: 355–369

European journal of cancer (Oxford, England : 1990), May 1, 2017

Incidence rates of thyroid cancer (TC) increased in several countries during the last 30 years, w... more Incidence rates of thyroid cancer (TC) increased in several countries during the last 30 years, while mortality rates remained unchanged, raising important questions for treatment and follow-up of TC patients. This study updates population-based estimates of relative survival (RS) after TC diagnosis in Europe by sex, country, age, period and histology. Data from 87 cancer registries in 29 countries were extracted from the EUROCARE-5 dataset. One- and 5-year RS were estimated using the cohort approach for 86,690 adult TC patients diagnosed in 2000-2007 and followed-up to 12/31/2008. RS trends in 1999-2007 and 10-year RS in 2005-2007 were estimated using the period approach. In Europe 2000-2007, 5-year RS after TC was 88% in women and 81% in men. Survival rates varied by country and were strongly correlated (Pearson ρ = 75%) with country-specific incidence rates. Five-year RS decreased with age (in women from >95% at age 15-54 to 57% at age 75+), from 98% in women and 94% in men wi...

Radiotherapy and Oncology, 2016

ESTRO 35 2016 S229 ______________________________________________________________________________... more ESTRO 35 2016 S229 ______________________________________________________________________________________________________ improvement in the prediction of pulmonary function loss using fMLD as opposed to MLD. Conclusion: Reduction in lung function, measured by spirometry, can be predicted by functional as well as physical lung dose, but no statistically significant difference in their predictive ability was observed in these patients. The actual biological impact of radiation on normal lung tissue might be underestimated in spirometry data (as well in patient/oncologist reported outcomes) since a significant fraction of the patients actually observe an improved lung function during treatment. This improvement is likely related to re-ventilation of obstructed airways due to tumour regression, which could mask underlying radiation damage. Another possibility is that regional ventilation may vary over a course of treatment. Analysis of 4D cone beam CT scans during treatment, and of post-treatment radiographic changes in follow-up CT scans may help untangle these "competing" effects.

World Journal of Colorectal Surgery, 2009

Influence of neoadjuvant radio(chemo)therapy on wound healing in lower-rectal cancer patients sub... more Influence of neoadjuvant radio(chemo)therapy on wound healing in lower-rectal cancer patients subjected to abdominosacral resection (ASR)

Nowotwory Journal of Oncology, 2013

Rak gruczołu krokowego zalicza się do grupy nowotworów złośliwych specyfi cznych dla krajów rozwi... more Rak gruczołu krokowego zalicza się do grupy nowotworów złośliwych specyfi cznych dla krajów rozwiniętych. Dane epidemiologiczne wskazują, że obok oskrzeli i płuca oraz jelita grubego prostata zalicza się do najczęstszych umiejscowień nowotworów złośliwych u mężczyzn w Europie i Stanach Zjednoczonych. W 2008 r. procentowy udział wymienionych umiejscowień wśród zachorowań polskich mężczyzn na nowotwory złośliwe wyniósł 46,2%, a współczynnik zachorowalności na raka gruczołu krokowego wyniósł 29,9 na 100 000. Warto jednak zwrócić uwagę na znaczne geografi czne zróżnicowanie częstości występowania raka gruczołu krokowego w naszym kraju: w 2008 r. współczynniki zachorowalności nowotworu w poszczególnych województwach wahały się bowiem od 20,5 do 43,6 na 100 000. Ciekawych wniosków dostarcza szczegółowa analiza danych epidemiologicznych na poziomie regionu. W ostatnim 25-leciu w województwie dolnośląskim u mężczyzn obserwuje się systematyczny spadek liczby nowych przypadków raka oskrzeli i płuca (najczęstszego nowotworu złośliwego w regionie) przy jednoczesnym wzroście częstości występowania nowotworów złośliwych jelita grubego i gruczołu krokowego. Tendencja wzrostowa w zakresie zachorowalności na raka gruczołu krokowego jest jeszcze bardziej wyraźna, gdy weźmie się pod uwagę wyłącznie dane dotyczące Wrocławia-stolicy i największego miasta Dolnego Śląska. Począwszy od 2004 r. nowotwory złośliwe prostaty rozpoznaje się tu częściej niż raka jelita grubego, a w 2009 r. liczba nowych przypadków zbliżyła się do liczby nowych rozpoznań raka oskrzeli i płuca. Powyższe dane wskazują na rosnącą częstość rozpoznawania raka prostaty-szczególnie wśród mężczyzn z dużych aglomeracji miejskich. Jednak rosnąca częstotliwość występowania raka gruczołu krokowego wydaje się być nie tyle następstwem epidemii tego nowotworu złośliwego, co skutkiem starzenia się społeczeństwa i poprawy możliwości diagnostycznych.

European Journal of Cancer, 2015

Background In Europe skin melanoma (SM) survival has increased over time but differences between ... more Background In Europe skin melanoma (SM) survival has increased over time but differences between countries and areas of Europe remain. Methods We calculated European relative survival estimates and geographical comparisons for 241,485 cases of invasive SM, in ages 15 years and over, diagnosed in Europe (2000-2007), with survival time trends estimated using the period approach during 1999-2007, for 213,101 cases. Results In Europe, estimated 5-year relative survival was 83.2% (95% confidence interval, CI 82.9%-83.6%). The highest values were in Northern (87.7%; 87.2%-88.2%) and Central (87.6%; 87.2%-88.0%) Europe, followed by Ireland and UK (85.6%; 85.2%-86.0%) and Southern Europe (82.6%; 82.1%-83.2%). The lowest survival estimate was in Eastern Europe (74.3%; 73.6%-75.1%). Within regions the inter-country absolute difference in percentage points of survival varied from 3.9% in Northern to 33.8% in Eastern Europe. Relative survival decreased markedly with age and was higher in women than men. Differences according to SM morphology and skin sub-sites also emerged. Survival has slightly increased from 1999 to 2007, with a small improvement in Northern and the most pronounced improvement in Eastern Europe. Discussion SM survival is high and still increasing in Europe. The gap between Northern and Southern and especially Eastern European countries, although still present, diminished over time. Differences in early detection practices may presumably explain most of the geographical differences, better survival in women and in younger ages. However, part of the improvement in survival may be attributed to overdiagnosis.

Anticancer research

Bones belong to the most frequent localizations of breast cancer metastases. Several studies on f... more Bones belong to the most frequent localizations of breast cancer metastases. Several studies on female breast malignancies have indicated that Fas/Fas-ligand status may have a significant impact on survival. Hence, the aim of our study was to determine if these molecules might serve as the predictors of skeletal dissemination in radically-treated breast cancer patients. Tumor samples from 147 radically-treated breast cancer patients were studied immunohistochemically for Fas/Fas-ligand expression. Both Fas and Fas-ligand expression in the primary tumor were considerably less frequent among breast cancer patients with bone metastases compared to women without skeletal spread. Moreover, negative staining for Fas or the lack of Fas-ligand expression proved to be significant predictors for the survival free from bone metastases under univariate analysis. Our results suggest that the probability of bone metastases may be assessed on the basis of Fas/Fas-ligand expression in primary breas...

World Journal of Surgery, 2012

$Research paper thumbnail of Sphincter preservation following preoperative radiotherapy for rectal cancer: report of a randomised trial comparing short-term radiotherapy vs. conventionally fractionated radiochemotherapy$

Radiotherapy and Oncology, 2004

Background and purpose: The aim was to verify whether preoperative conventionally fractionated ch... more Background and purpose: The aim was to verify whether preoperative conventionally fractionated chemoradiation offers an advantage in sphincter preservation in comparison with preoperative short-term irradiation. Patients and methods: Patients with resectable T3-4 rectal carcinoma without sphincters' infiltration and with a lesion accessible to digital rectal examination were randomised into: preoperative 5 £ 5 Gy short-term irradiation with subsequent total mesorectal excision (TME) performed within 7 days or chemoradiation to a total dose of 50.4 Gy (1.8 Gy per fraction) concomitantly with two courses of bolus 5fluorouracil and leucovorin followed by TME after 4-6 weeks. Surgeons were obliged to base the type of operation on the tumour status at the time of surgery. Results: Between 1999 and 2002, 316 patients from 19 institutions were enrolled. The sphincter preservation rate was 61% in the 5 £ 5 Gy arm and 58% in the radiochemotherapy arm, P ¼ 0:57: The tumour was on average 1.9 cm smaller ðP , 0:001Þ among patients treated with chemoradiation compared with short-term schedule. For patients who underwent sphincter-preserving procedure, the surgeons generally followed the rule of tailoring the resection according to tumour downsizing; the median distal bowel margin was identical (2 cm) for both randomised groups. However, in the chemoradiation group, five patients underwent abdominoperineal resection despite clinical complete response. Conclusions: Despite significant downsizing, chemoradiation did not result in increased sphincter preservation rate in comparison with short-term preoperative radiotherapy. The surgeons' decisions were subjective and based on pre-treatment tumour volume at least in clinical complete responders.

Journal of Medical Genetics, 2002

Experimental Gerontology, 2012

Two mechanisms of innate immunity, i.e. resistance to viral infection and the production of cytok... more Two mechanisms of innate immunity, i.e. resistance to viral infection and the production of cytokines by leukocytes, were compared in blood isolated from four groups of donors: healthy young (19-35 years old), healthy elderly (over 60), elderly Alzheimer's disease (AD) patients, and elderly patients with alimentary tract cancer (CA). Peripheral blood leukocytes (PBLs) were isolated by gradient centrifugation in Gradisol G. The degree of resistance was calculated from the kinetics of vesicular stomatitis virus (VSV) replication in the PBLs. Cytokine (TNFα, IFNα, IFNγ, IL-12, and IL-10) levels were determined by ELISA. The antiviral resistance of the PBLs varied, but a difference was observed only between the young and elderly groups and not between the healthy elderly controls and those with AD or cancer. Differences observed in all the groups concerned the ability and intensity of cytokine production. The most impressive results were obtained for spontaneous TNF and IFNα release. While TNF was released spontaneously by the PBLs of the elderly CA patients and the young healthy group, it was usually undetected in the AD and only sometimes in the healthy elderly group. Leukocytes isolated from the elderly groups responded to VSV infection with more intense IFNα and IFNγ production than the younger group.

European Journal of Surgical Oncology (EJSO), 2014

Extralevator abdominoperineal excision (ELAPE) is a relatively new surgical technique for low rec... more Extralevator abdominoperineal excision (ELAPE) is a relatively new surgical technique for low rectal cancers. It is a more radical approach than conventional abdominoperineal excision (APE) with potentially better oncological outcome. Technical difficulty associated with operating deep in the pelvis through abdominal approach during conventional APE is overcome by extended perineal dissection in the prone Jack-knife position in ELAPE, therefore removing the anal canal, levators and low mesorectum altogether. One advantage is en block removal of levator muscles creating more cylindrical specimen with better clearance thus reducing CRM involvement. The prone position gives the surgeon better visualization, hence reducing the chances of entering the wrong surgical plane and causing perforation. Early reports suggest that ELAPE can improve patients' prognosis without a significant increase in morbidity with superior oncologic outcome as compared to standard techniques.

European Journal of Cardio-Thoracic Surgery, 2010

Objective: Lymph node metastasis is a characteristic of malignant cancers and is observed more fr... more Objective: Lymph node metastasis is a characteristic of malignant cancers and is observed more frequently in oesophageal cancer than in other digestive tract cancers, making it one of the most important prognostic factors. Vascular endothelial growth factors C (VEGF-C) and D (VEGF-D) are important lymphangiogenic factors in human cancers and lymphangiogenesis is associated with lymph node metastasis. The aim of the study was to determine the correlation between pre-treatment serum levels of VEGF-C (sVEGF-C) and VEGF-D (sVEGF-D) and clinicopathologic features in patients with oesophageal cancer. Methods: Serum VEGF-C and sVEGF-D were measured by enzyme-linked immunoadsorbent assay (ELISA) on 149 patients with oesophageal cancer, 29 patients with benign oesophageal diseases and 30 healthy controls. Results: Serum VEGF-C and sVEGF-D levels were significantly higher in patients with oesophageal carcinoma than in the control group (p < 0.001 and p = 0.001, respectively) or in the benign oesophageal diseases group (p = 0.04 and p = 0.03, respectively). Subgroup analysis showed that lymph node metastasis (p = 0.001), stage (p = 0.001), tumour depth (p = 0.006), resectability (p = 0.002), tumour size (p = 0.01), distant metastases (p = 0.01) and histological grading (p = 0.04) were correlated with an elevated level of sVEGF-C. Elevated levels of sVEGF-D were associated with tumour depth (p = 0.002), stage (p = 0.01) and lymph node metastasis (p = 0.02). Among the patients (n = 83) who underwent potentially curative surgery, the overall survival time (p = 0.008) was shorter for patients with a high level (>8667 pg ml À1) of sVEGF-C than for those with a low level (<8667 pg ml À1), when the cutoff value was determined on the basis of the median value in oesophageal cancer patients. On univariate regression analysis, tumour size, tumour depth, stage, lymph node metastases, distant metastases, resectability and sVEGF-C were found to be significant prognostic factors. Conclusions: These results suggest that pre-treatment levels of sVEGF-C and sVEGF-D reflect lymph node metastases and advanced stage of oesophageal cancer. Serum VEGF-C may be useful in predicting poor outcome for patients undergoing a potentially curative oesophagectomy.

Cancer Letters, 2013

Alternate colorectal cancer (CRC) screening and surveillance strategies are needed to pre-select ... more Alternate colorectal cancer (CRC) screening and surveillance strategies are needed to pre-select candidates for invasive methods. We compared systemic inflammatory profiles in CRC (n = 99), health (n = 98), high CRC-risk conditions (n = 48) and overt inflammation (n = 69) by multiplexed analysis of IL-1b, IL-6, IL-8, FGF-2, G-CSF, GM-CSF, MCP-1, MIP-1a, TNF-a, VEGF-A, and PDGF-B and CEA. Cytokines corresponded with CRC advancement. FGF2, GM-CSF, IL-1b, IL-6, MIP-1a, PDGF-BB, TNF-a, and VEGF-A were higher than in controls already in stage I CRC with FGF2, IL1-b, and MIP-1a higher than in high CRC-risk individuals as well. Cytokine panels devised to differentiate early CRC from controls, adenomas, or inflammatory bowel disease patients (IBD) had good accuracy but only IBD panel had promising specificity at 95% sensitivity.