Clinical Oncology

[Solid organ transplantation and malignancies]

VÉGSŐ Gyula, MÁTHÉ Zoltán

FEBRUARY 10, 2018

Clinical Oncology - 2018;5(01)

[Recent breakthroughs in the fi eld of organ transplantation and oncology have challenged existing views, and necessitate the revision of several tumor-related issues in transplantation. The need for expanding the donor pool raises the question of how and when it is plausible to transplant the organs of a donor with a history of cancer, such that the risk of tumor inoculation and manifestation due to the graft would be minimal for the recipient. Another point to consider is whether it is acceptable to transplant a recipient with a history of a malignant tumor, and if yes, how much tumor-free survival time is required as a minimum before the transplant. Transplanted patients live longer as a result of modern immunosuppressive therapy. However, the risk of malignant tumors increases proportionally to the length of the immunosuppressed state: their incidence may be as much as 20-30% in the long term. The signifi cance of „de novo” posttransplant tumors is highlighted by the fact that they are among the leading causes of death in transplant patients. Taken together, malignant diseases pose a serious problem from several aspects, the solution for which requires close teamwork of experts in oncology and transplantation, and the integration of up-to-date knowledge in the process of making a therapeutic decision, tailored individually for the patient.]



Further articles in this publication

Clinical Oncology


A szerkesztők

Clinical Oncology

[News from the World]

KLINIKAI Onkológia

Clinical Oncology

[New results from San Antonio Breast Cancer Symposium, 2017]

KAHÁN Zsuzsanna

[SABCS 2017 has been a 40-year jubilee conference with festive appearance and content. The anniversary provides possibility to look back: today we fi nd the knowledge and practice as of twenty years ago schematic and rough while the changes are overwhelming. Therapy became colorful and personally. There is need for precisious care which means consideration all patient and tumor features when surgical or medical therapy, radiotherapy or even diagnostic issues are decided - this has been the most important message of the conference this year. The Symposium always provides the most modern and breakthrough approaches and attitude that support advancement in patient care.]

Clinical Oncology

[Treatment of hepatocellular carcinoma - an update]


[Last time we have described about the modern treatment of hepatocellular carcinoma (HCC) in „Klinikai Onkológia” in 2014 (1) and a detailed guideline regarding epidemiology, treatment according to BCLC staging system has been published as well in a special edition in this year (2). Here, we discuss mainly the fi rst- and second line systemic treatment of HCC according to our experience and the new results of clinical trials. 203 patients were treated in our Department between 2010 and 2016. These results have been presented already on the MKOT conference in 2016. In this year we have started second line systemic therapy with regorafenib in 9 cases.]

Clinical Oncology

[Treatment of locally advanced rectum cancer]

FRÖBE Ana, JURETIC Antonio, BROZIC Marić Jasmina, SOLDIC Zeljko, ZOVAK Mario

[Over the last several decades, local control (LC) for rectal cancer has markedly improved because of advances in surgical technique and the adoption of adjuvant or neoadjuvant chemoradiotherapy (CRT). Total mesorectal excision (TME) during surgical resection of localized rectal cancer, which involves removal of the entire circumferential perirectal tissue envelope, decreases rates of both involved surgical margins and local recurrences. Similarly, for patients with locally advanced rectal cancer (LARC), including T3 and T4 tumors and lymph node-positive disease, adjuvant and more preferably neoadjuvant CRT has exhibited the ability to both improve disease-free survival (DFS) and LC. Some patients undergoing neoadjuvant CRT achieve a complete pathologic response (pCR) to CRT and the oncologic outcomes are particularly favourable in this group. In contrast to improved local control, patients’ overall survival rates are in need of improvement, and the major factor limiting the outcome is the appearance of metachronous distant metastases. The main approach to overcome this issue is the escalation of systemic therapy in the neoadjuvant setting, e.g. by addition of induction or consolidation chemotherapy before or after neoadjuvant chemoradiotherapy (the so-called total neoadjuvant treatment, TNT, approach). The aim was to present a short overview of the role of radiotherapy and radiochemotherapy in the management of rectal cancer with a focus on current treatment stand wasards for locally advanced rectal cancer.]

All articles in the issue

Related contents

Journal of Nursing Theory and Practice

[Judgement of organ donations’ nursing-related problems by nurses in the light of a Hungarian survey ]


[Aim of the study: The research aims to map the opinions of nurses working on transplantation wards about the preparedness of laic people in relation to the theme of organ donation. In addition, we wanted to examine whether nurses give preference to religious beliefs and ethical principles against legal regulation. We also wondered whether nurses working on transplantation wards would offer their own organs. Materials and methods: The descriptive study was conducted among transplant nurses in Budapest, Szeged and Pécs, using a self-constructed questionnaire. Our results were obtained using a Pearson’s Chi-square test (all statistically significant levels were set at P<0.05), as well as using the one sample t-test. Results: The total sample size was 37. According to nurses, the laic population does not have the sufficient knowledge about the current legal rules. Nurses are positively committed to offering their own organs for a possible donation. In relation to organ donation, nurses prefer the religious and ethical principles against legal rules. Conclusions: The laic population is not fully aware of organ donation, which puts the success of organ donation at risk. It would worth to involve transplant nurses into the education of the laic population to improve the general acceptance of organ donation who work in transplantation fields and who do donor care, so laics would be more accepting and less conflict would occur, supposedly more organ transplants would occur.]

Lege Artis Medicinae



[INTRODUCTION - The aim of this study was to explore the common knowledge and the opinion of the Hungarian population on organ transplants as part of a larger international study about the reception of new achievements in biotechnology and medical science. METHODS - The basis of the study was a representative national survey conducted in 2003 on a sample of 1000 people. We analysed the significant differences in the attitudes towards organ donation using the background variables of gender, age, education, family situation, place of residence, self-rated health and religious beliefs. To explain the differences in the willingness to donate we applied the method of binomial regression. Logistic regression was used to analyse the strength and direction of the linear relationship between dependent and predictor variables. The probability of willingness in a given group was represented by odds ratios. RESULTS - The respondents’ knowledge level differed by gender, age and education. The greater part of the population was not knowledgeable about the legal regulations concerning the transplantation of cadaver organs but after they were properly informed they agreed with the regulations. The odds of the motivation to donate organs after death differed significantly by age, education, family situation and self-rated health. The motivation to be living donors was influenced by age, place of residence and the level of altruism. CONCLUSION - The concerns expressed on the decrease of donation willingness due to the increase of the knowledge level of the population seem to be unfounded.]

Clinical Neuroscience

Alexithymia is associated with cognitive impairment in patients with Parkinson’s disease

SENGUL Yildizhan, KOCAK Müge, CORAKCI Zeynep, SENGUL Serdar Hakan, USTUN Ismet

Cognitive dysfunction (CD) is a common non-motor symptom of Parkinson’s disease (PD). Alexithy­mia is a still poorly understood neuropsychiatric feature of PD. Cognitive impairment (especially visuospatial dysfunction and executive dysfunction) and alexithymia share com­mon pathology of neuroanatomical structures. We hypo­thesized that there must be a correlation between CD and alexithymia levels considering this relationship of neuroanatomy. Objective – The aim of this study was to evaluate the association between alexithymia and neurocognitive function in patients with PD. Thirty-five patients with PD were included in this study. The Toronto Alexithymia Scale–20 (TAS-20), Geriatric Depression Inventory (GDI) and a detailed neuropsychological evaluation were performed. Higher TAS-20 scores were negatively correlated with Wechsler Adult Intelligence Scale (WAIS) similarities test score (r =-0.71, p value 0.02), clock drawing test (CDT) scores (r=-0.72, p=0.02) and verbal fluency (VF) (r=-0.77, p<0.01). Difficulty identifying feelings subscale score was negatively correlated with CDT scores (r=-0.74, p=0.02), VF scores (r=-0.66, p=0.04), visual memory immediate recall (r=-0.74, p=0.01). VF scores were also correlated with difficulty describing feelings (DDF) scores (r=-0.66, p=0.04). There was a reverse relationship bet­ween WAIS similarities and DDF scores (r=-0.70, p=0.02), and externally oriented-thinking (r=-0.77,p<0.01). Executive function Z score was correlated with the mean TAS-20 score (r=-62, p=0.03) and DDF subscale score (r=-0.70, p=0.01) Alexithymia was found to be associated with poorer performance on visuospatial and executive function test results. We also found that alexithymia was significantly correlated with depressive symptoms. Presence of alexithymia should therefore warn the clinicians for co-existing CD.