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master's thesis
Kliničko-patološke karakteristike bolesnika s karcinomom bubrežnih stanica liječenih sunitinibom
Zagreb: University of Zagreb, Faculty of Pharmacy and Biochemistry, 2018. urn:nbn:hr:163:622322
Antunović, Domagoj
University of Zagreb
Faculty of Pharmacy and Biochemistry

Institutional repository: Repository of Faculty of Pharmacy and Biochemistry University of Zagreb

Cite this document

Antunović, D. (2018). Kliničko-patološke karakteristike bolesnika s karcinomom bubrežnih stanica liječenih sunitinibom (Master's thesis). Zagreb: University of Zagreb, Faculty of Pharmacy and Biochemistry. Retrieved from https://urn.nsk.hr/urn:nbn:hr:163:622322

Antunović, Domagoj. "Kliničko-patološke karakteristike bolesnika s karcinomom bubrežnih stanica liječenih sunitinibom." Master's thesis, University of Zagreb, Faculty of Pharmacy and Biochemistry, 2018. https://urn.nsk.hr/urn:nbn:hr:163:622322

Antunović, Domagoj. "Kliničko-patološke karakteristike bolesnika s karcinomom bubrežnih stanica liječenih sunitinibom." Master's thesis, University of Zagreb, Faculty of Pharmacy and Biochemistry, 2018. https://urn.nsk.hr/urn:nbn:hr:163:622322

Antunović, D. (2018). 'Kliničko-patološke karakteristike bolesnika s karcinomom bubrežnih stanica liječenih sunitinibom', Master's thesis, University of Zagreb, Faculty of Pharmacy and Biochemistry, accessed 22 November 2024, https://urn.nsk.hr/urn:nbn:hr:163:622322

Antunović D. Kliničko-patološke karakteristike bolesnika s karcinomom bubrežnih stanica liječenih sunitinibom [Master's thesis]. Zagreb: University of Zagreb, Faculty of Pharmacy and Biochemistry; 2018 [cited 2024 November 22] Available at: https://urn.nsk.hr/urn:nbn:hr:163:622322

D. Antunović, "Kliničko-patološke karakteristike bolesnika s karcinomom bubrežnih stanica liječenih sunitinibom", Master's thesis, University of Zagreb, Faculty of Pharmacy and Biochemistry, Zagreb, 2018. Available at: https://urn.nsk.hr/urn:nbn:hr:163:622322

Metadata
TitleKliničko-patološke karakteristike bolesnika s karcinomom bubrežnih stanica liječenih sunitinibom
Title (english)Clinical and pathological characteristics of patients with renal cell carcinoma treated with sunitinib
AuthorDomagoj Antunović
MentorStela Bulimbašić (mentor)
Committee memberStela Bulimbašić (predsjednik povjerenstva)
Committee memberMirna Sučić (član povjerenstva)
Committee memberIvica Horvatić (član povjerenstva)
GranterUniversity of Zagreb
Faculty of Pharmacy and Biochemistry
Zagreb
Defense date and country2018-09-05, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Pharmacy
Pharmacy
Abstract
Karcinom bubrega je zloćudni tumor porijekla epitela bubrežnih kanalića, a najčešći histološki tip je tzv. svijetlostanični karcinom bubrega. Kirurško liječenje je metoda izbora za rane stadije karcinoma bubrega, dok je u slučaju metastatske bolesti neophodno i sistemno liječenje. U ovome radu prikazane su kliničke i patološke karakteristike bolesnika s metastatskim karcinomom bubrega liječenim antiangiogenim terapeutikom-sunitinibom u KBC Zagreb u vremenskom razdoblju od 6 godina (1. 7. 2010 - 30. 6. 2016.) Za 85 bolesnika liječenih sunitinibom bili su dostupni relevantni klinički i patološki podaci. Radilo se o 62 muškaraca i 23 žene (omjer 2,7:1), dobi od 33 do 80 godina (medijan 59 godina). Svijetlostanični karcinom bubrega je dijagnosticiran u 96,5% slučajeva, a ostatak čine neklasificirani karcinomi sa sarkomatoidnom slikom. Veličina primarnih tumora kretala se od 4 do 13 cm; prosječno 7,9 cm. Primarno metastatski karcinom bubrega je dijagnosticiran u 47 (55,3%) analiziranih bolesnika, dok su u ostalih metastaze nađene u razdoblju od 1 do čak 19 godina od dijagnoze primarnog karcinoma bubrega. Najčešća metastatska sijela bila su pluća (77,6%), kosti (56,4%) i jetra (22,3%). U analiziranoj skupini, liječenje sunitinibom je trajalo od nekoliko mjeseci do 8 godina, a u 62 (73%) bolesnika je sunitinib naknadno zamijenjen drugim lijekom, najčešće sorafenibom (18 bolesnika), nivolumabom (15 bolesnika) te everolimusom (13 bolesnika). U razdoblju praćenja 55 (64,7%) bolesnika je preminulo; 19 (22,4%) je živo s metastatskom bolešću, a 11 (12,9%) je izgubljeno iz praćenja. Petogodišnje preživljenje od dijagnoze karcinoma bubrega izračunato za 72 bolesnika iznosilo je 38,9%. Preživljenje bolesnika s primarno metastatskim karcinomom bubrega je bilo znatno lošije, s 32 (68,08%) bolesnika preminula u prve dvije godine od postavljanja dijagnoze. Od 19 i danas živih bolesnika ispitivane skupine, 9 je na terapiji sunitinibom (trajanje terapije od 3-8 godina); 6 bolesnika prima nivolumab, 3 aksitinib i 1 bolesnik prima pazopanib. Sunitinib je pokazao najveću učinkovitost u slučajevima oligometastatske bolesti te u slučajevima plućnih metastaza. Sunitinib i ostali terapeutici nisu pokazali značajnu učinkovitost kod pacijenata s prisutnim višestrukim metastatskim sijelima u sklopu brzo napredujuće bolesti te u slučaju moždanih metastaza.
Abstract (english)
Renal cell carcinoma (RCC) is malignant tumor originating from epithelial lining of renal tubules. The most common type is clear cell renal cell carcinoma. Surgical approach is treatment of choice for early stage of RCC, while systemic therapy is needed for more advanced cases. This study included patients with advanced RCC treated with sunitinib at University Hospital Centre Zagreb between July 2010 and June 2016. Main clinical and pathological features were analyzed. Of 91 patients, relevant clinical and pathological data were available for 85 patients; 62 males and 23 females (ratio 2,7:1), with age range 33-80 years (median 59 years). Clear cell RCC was diagnosed in 96,5% and sarcomatoid unclassified RCC in rest of the cases. Size of primary tumors varied from 4 to 13 cm (average 7,9 cm). Primary metastatic RCC was diagnosed in 47 (55,3%) cases, in other metastases occurred in period from less than 1 year to up to 19 years after primary RCC. The most common metastatic sites were lungs (77,6%), bones (56,4%) and liver (22,3%). Sunitinib as a treatment for advanced RCC was used in wide period range, from few months to up to 8 years. During treatment and follow-up of 62 patients, sunitinib has been replaced with other therapeutics, most commonly with sorafenib (18 patients), nivolumab (15 patients) or everolimus (13 patients). In follow-up period 55 (64,7%) of patients included in this study died; 19 (22,4%) are alive with metastatic disease and 11 (12,9%) were lost from follow-up. Overall 5-year survival available for 72 analyzed patients was 38,9%. Patients with primary metastatic RCC had worse prognosis; 32 (68,08%) died in the first 2 years after diagnosis. Of 19 still alive patients, 9 are treated with sunitinib (duration of therapy 3-8 years); 6 with nivolumab, 3 with axitinib and one with pazopanib. Sunitinib showed the best efficacy in cases of oligometastatic disease and lung metastases. Sunitinib and other mentioned therapeutics were less efficient in cases with high tumor volume, multiple metastatic sites, highly advanced metastatic disease and brain metastases.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:163:622322
Study programmeTitle: Pharmacy
Study programme type: university
Study level: integrated undergraduate and graduate
Academic / professional title: magistar/magistra farmacije (magistar/magistra farmacije)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2019-04-12 11:00:35