Contemporary Challenges and Innovations in Oncological Diagnosis and Treatment: The Romanian Landscape

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (30 June 2024) | Viewed by 3768

Special Issue Editors


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Guest Editor
1. Department of Oncology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
2. Institute of Oncology "Prof. Dr. Alexandru Trestioreanu", 022328 Bucharest, Romania
Interests: clinical diagnosis; cancer; chemotherapy; targeted therapy; immunotherapy; radiotherapy
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
1. Department of Oncology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
2. Institute of Oncology "Prof. Dr. Alexandru Trestioreanu", 022328 Bucharest, Romania.
Interests: clinical diagnosis; cancer; chemotherapy; targeted therapy; immunotherapy; microbiome
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is with great enthusiasm that we unveil a new Special Issue entitled "Contemporary Challenges and Innovations in Oncological Diagnosis and Treatment: The Romanian Landscape". This endeavor is not only a continuation, but also an expansion of work we initiated in our previous successful Special Issue, "Cancer Diagnosis and Oncological Treatments in Romania" (Diagnostics | Special Issue: Cancer Diagnosis and Oncological Treatments in Romania (mdpi.com)), which saw the publication of 15 significant papers, a testament to the dedication of our research community.

The field of oncology remains one of the most dynamic and demanding medical disciplines, with cancer’s impact stretching across the globe and touching lives regardless of borders. In Romania, we confront a unique set of healthcare circumstances shaped by our country's medical history, infrastructure, and the spirit of innovation that Romanian professionals bring to the fore.

After our previous Special Issue’s success, we are inspired to delve deeper into the advancements and confront the challenges that characterize oncological work in Romania. We invite contributions that offer insightful research, critical analysis, and reports on innovative practices that address cancer diagnosis and treatment within our national healthcare ecosystem.

We are seeking submissions that cover a diverse range of topics, including, but not limited to, the following:

  • Innovative diagnostic modalities and their efficacy in Romanian clinical settings;
  • Progress in molecular targeted therapies and personalized medicine;
  • Integration and impact of digital health technologies in oncology;
  • Epidemiological studies on cancer trends in the Romanian population;
  • Economic evaluations of cancer treatment modalities and their implications for healthcare policy;
  • Narratives of collaborative, multidisciplinary treatment approaches;
  • Reports from clinical trials examining new treatments for Romanian cancer patients;
  • Discussions on the ethical, legal, and social implications of oncological practices in Romania.

Original research articles, comprehensive review articles, insightful case reports, and brief communications are all welcome. Each manuscript should contribute constructively to our understanding of the oncological landscape in Romania, with potential reverberations in the wider international medical community. We invite you to share your latest findings and experiences.

Please make sure to submit your articles through the journal's online system by the deadline, and rest assured that every paper will undergo thorough peer review to ensure it meets the high standards our readers demand.

With warm regards,

Prof. Dr. Dana Lucia Stănculeanu
Dr. Adelina Gheorghe
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

  • diagnosis
  • biopsy
  • histopathology
  • imaging tests
  • biomarkers
  • molecular tests
  • chemotherapy
  • targeted therapy
  • immunotherapy
  • radiotherapy
  • tumor board
  • multidisciplinary management

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Published Papers (4 papers)

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Research

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17 pages, 20570 KiB  
Article
How Morphology Shapes Survival in Invasive Squamous Cell Carcinoma of the Lung
by Angela-Ștefania Marghescu, Silviu Vlăsceanu, Mădălina Preda, Beatrice Mahler, Ioana Anca Bădărău, Loredana Sabina Cornelia Manolescu, Mirela Țigău, Cristina Teleagă, Corina Elena Toader, Alexandru Daniel Radu, Alexandru Stoichiță and Mariana Costache
Diagnostics 2024, 14(20), 2264; https://doi.org/10.3390/diagnostics14202264 - 11 Oct 2024
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Abstract
Background and Objectives: Squamous cell carcinoma (SQCC) represents a significant proportion of human malignancies affecting various anatomical sites, including the lung. Understanding the prognostic factors is crucial for establishing effective risk stratification in these patients, as multiple critical aspects significantly impact overall survival. [...] Read more.
Background and Objectives: Squamous cell carcinoma (SQCC) represents a significant proportion of human malignancies affecting various anatomical sites, including the lung. Understanding the prognostic factors is crucial for establishing effective risk stratification in these patients, as multiple critical aspects significantly impact overall survival. Materials and Methods: A retrospective study was conducted on 99 patients with operable lung SQCC treated at a tertiary center. The exclusion criteria included patients under 18, those with in situ or metastatic SQCC, and those who received neoadjuvant therapy. The surgical specimens were re-analyzed, and data were collected on multiple variables, including pTNM staging, tumor characteristics, and overall survival (OS). The Kaplan–Meier survival analysis and Cox regression models were used to identify significant prognostic factors. Results: The Kaplan–Meier analysis showed a median survival of 36 months with a 65.65% mortality rate. Significant factors influencing survival included keratinization, histological grading, tumor size and stage, pleural invasion, tumor cell arrangement, tumor budding, spread through air space (STAS), and mitotic index. A multiple Cox regression highlighted the nonkeratinizing tumors, advanced pT stages, single-cell invasion, and high mitotic index as key predictors of poorer outcomes. The nonkeratinizing tumors showed higher mortality and shorter median survival rates compared to keratinizing tumors. The tumor staging, cell arrangement, and tumor budding significantly impacted the survival curves. Conclusions: The study underscores the importance of detailed histopathological evaluations in lung SQCC. The nonkeratinizing tumors, advanced pT stage, single-cell invasion, and high mitotic index were associated with higher hazard rates, emphasizing the need for a comprehensive grading system incorporating these factors to improve prognostic accuracy and guide treatment strategies. Full article
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13 pages, 1965 KiB  
Article
Pelvic Exenteration in Advanced, Recurrent or Synchronous Cancers—Last Resort or Therapeutic Option?
by Vlad Rotaru, Elena Chitoran, Daniela-Luminita Zob, Sinziana-Octavia Ionescu, Gelal Aisa, Prie Andra-Delia, Dragos Serban, Daniela-Cristina Stefan and Laurentiu Simion
Diagnostics 2024, 14(16), 1707; https://doi.org/10.3390/diagnostics14161707 - 6 Aug 2024
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Abstract
First described some 80 years ago, pelvic exenteration remain controversial interventions with variable results and ever-changing indications. The previous studies are not homogenous and have different inclusion criteria (different populations and different disease characteristics) and methodologies (including evaluation of results), making it extremely [...] Read more.
First described some 80 years ago, pelvic exenteration remain controversial interventions with variable results and ever-changing indications. The previous studies are not homogenous and have different inclusion criteria (different populations and different disease characteristics) and methodologies (including evaluation of results), making it extremely difficult to properly assess the role of pelvic exenteration in cancer treatment. This study aims to describe the indications of pelvic exenterations, the main prognostic factors of oncologic results, and the possible complications of the intervention. Methods: For this purpose, we conducted a retrospective study of 132 patients who underwent various forms of pelvic exenterations in the Institute of Oncology “Prof. Dr. Al. Trestioreanu” in Bucharest, Romania, between 2013 and 2022, collecting sociodemographic data, characteristics of patients, information on the disease treated, data about the surgical procedure, complications, additional cancer treatments, and oncologic results. Results: The study cohort consists of gynecological, colorectal, and urinary bladder malignancies (one hundred twenty-seven patients) and five patients with complex fistulas between pelvic organs. An R0 resection was possible in 76.38% of cases, while on the rest, positive margins on resection specimens were observed. The early morbidity was 40.63% and the mortality was 2.72%. Long-term outcomes included an overall survival of 43.7 months and a median recurrence-free survival of 24.3 months. The most important determinants of OS are completeness of resection, the colorectal origin of tumor, and the presence/absence of lymphovascular invasion. Conclusions: Although still associated with high morbidity rates, pelvic exenterations can deliver important improvements in oncological outcomes in the long-term and should be considered on a case-by-case basis. A good selection of patients and an experienced surgical team can facilitate optimal risks/benefits. Full article
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12 pages, 1669 KiB  
Article
Early-Onset Colorectal Cancer—A Retrospective Study from a Tertiary Referral Hospital in Romania
by Elena Savu, Valeriu Șurlin, Liviu Vasile, Ileana Octavia Petrescu, Cristina Elena Singer, Nicolae-Daniel Pirici and Stelian Stefanita Mogoanta
Diagnostics 2024, 14(10), 1052; https://doi.org/10.3390/diagnostics14101052 - 19 May 2024
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Abstract
Early-onset colorectal cancer emerges as a distinctive clinical and biological entity and is generally defined as the onset of colon or rectal neoplasia before the age of 50. Several reports describe an increasing incidence worldwide of colorectal cancers occurring in individuals younger than [...] Read more.
Early-onset colorectal cancer emerges as a distinctive clinical and biological entity and is generally defined as the onset of colon or rectal neoplasia before the age of 50. Several reports describe an increasing incidence worldwide of colorectal cancers occurring in individuals younger than 50 years, along with particular histologic and molecular features. Although heredity may be an explanation in some cases with young-onset colorectal cancer, other driving factors remain partially unknown. The present study explores demographic, clinical, and pathological features within a group of patients diagnosed with colorectal cancer before the age of 50. It is a retrospective survey based on data collected between 2017 and 2023 within three surgical departments from a tertiary Romanian hospital. The clinical and pathological features we identified (later-stage disease, distal colon tumor localization, mucinous histology) are mainly superimposed with the existing data in the literature regarding this pathology. In order to lower the burden that colorectal neoplasia diagnosed in the young implies, a change of paradigm should be made in terms of establishing effective and targeted screening programs but also in the direction of enhancing complex clinical, pathological, and molecular diagnosis. Full article
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16 pages, 4637 KiB  
Case Report
Long-Term Survival in BRCA1 Mutant Advanced Ovarian Cancer: Unveiling the Impact of Olaparib
by Vlad-Adrian Afrăsânie, Alexandra Rusu, Adelina Silvana Gheorghe, Eliza Maria Froicu, Elena Adriana Dumitrescu, Bogdan Gafton, Teodora Alexa-Stratulat, Lucian Miron, Dana Lucia Stănculeanu and Mihai Vasile Marinca
Diagnostics 2024, 14(17), 1898; https://doi.org/10.3390/diagnostics14171898 - 29 Aug 2024
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Abstract
Ovarian cancer is one of the most frequent malignancies in women. The treatment landscape underwent significant changes as new agents were introduced in ovarian cancer management over the last decade. We present two cases of long responses to Olaparib in BRCA (BReast CAncer [...] Read more.
Ovarian cancer is one of the most frequent malignancies in women. The treatment landscape underwent significant changes as new agents were introduced in ovarian cancer management over the last decade. We present two cases of long responses to Olaparib in BRCA (BReast CAncer gene) mutant ovarian cancer patients. The first case belongs to a 42-year-old female diagnosed with advanced ovarian carcinoma with a rare germinal mutation (BRCA1 c.68_69delAG, commonly found in descendants of Ashkenazi Jewish populations, but also Arabic and Asian ones) and a significant family history of ovarian and breast cancers. After poorly tolerated neoadjuvant chemotherapy, the patient underwent total hysterectomy, bilateral adnexectomy, and intraperitoneal hyperthermic chemotherapy. After eight months, the disease progressed, and first-line platinum chemotherapy was administered. Although not well-tolerated (grade 3 anemia, allergic reactions), chemotherapy resulted in a partial response, and given the patient’s characteristics, maintenance with Olaparib was recommended. Treatment is ongoing (total current duration 69 months) and tolerated well (grade 1 side effects). This case illustrates the long-term benefits that novel therapies like Olaparib may offer in patients with platinum-sensitive relapsed ovarian cancer harboring a rare BRCA mutation. The second case highlights a 55-year-old postmenopausal woman diagnosed with ovarian cancer, FIGO stage IVA. Initial treatment included six cycles of chemotherapy, which led to a partial response, followed by interval debulking surgery and another four cycles of chemotherapy. Subsequent Olaparib maintenance therapy post BRCA1 mutation identification contributed to a significant progression-free survival of 65 months until disease recurrence and secondary cytoreductive surgery, showcasing the effectiveness of PARP inhibitors in personalized oncology treatment of ovarian cancer. Full article
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