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  • 1
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    Online Resource
    The Impact of the COVID-19 Pandemic on Cancer Patient’s Management—Lithuanian Cancer Center Experience
    MDPI AG ; 2021
    In:  Healthcare Vol. 9, No. 11 ( 2021-11-09), p. 1522-
    Details
    In: Healthcare, MDPI AG, Vol. 9, No. 11 ( 2021-11-09), p. 1522-
    Abstract: The pandemic spread of the COVID-19 virus significantly affected daily life, but the highest pressure was piled on the health care system. Our aim was to evaluate an impact of COVID-19 pandemic management measures on cancer services at the National Cancer Institute (NCI) of Lithuania. We assessed the time period from 1 February 2020 to 31 December 2020 and compared it to the same period of 2019. Data for our analysis were extracted from the NCI Hospital Information System (HIS) and the National Health Insurance Fund (NHIF). Contingency table analysis and ANOVA were performed. The COVID-19 pandemic negatively affected the cancer services provided by NCI. Reductions in diagnostic radiology (−16%) and endoscopy (−29%) procedures were accompanied by a decreased number of patients with ongoing medical (−30%), radiation (−6%) or surgical (−10%) treatment. The changes in the number of newly diagnosed cancer patients were dependent on tumor type and disease stage, showing a rise in advanced disease at diagnosis already during the early period of the first lockdown. The extent of out-patient consultations (−14%) and disease follow-up visits (−16%) was also affected by the pandemic, and only referrals to psychological/psychiatric counselling were increased. Additionally, the COVID-19 pandemic had an impact on the structure of cancer services by fostering the application of modified systemic anticancer therapy or hypofractionated radiotherapy. The most dramatic drop occurred in the number of patients participating in cancer prevention programs; the loss was 25% for colon cancer and 62% for breast cancer screening. Marked restriction in access to preventive cancer screening and overall reduction of the whole spectrum of cancer services may negatively affect cancer survival measures in the nearest future.
    Type of Medium: Online Resource
    ISSN: 2227-9032
    URL: Article
    DOI: 10.3390/healthcare9111522
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2721009-1
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  • 2
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    Online Resource
    PRIEŠOPERACINĖS MAGNETINIO REZONANSO TOMOGRAFIJOS REIKŠMĖ PROSTATOS NAVIKO T DYDŽIUI NUSTATYTI
    Medicinos Mintis ; 2015
    In:  Medicinos teorija ir praktika Vol. 21, No. 4.1 ( 2015-09-10), p. 612-617
    Details
    In: Medicinos teorija ir praktika, Medicinos Mintis, Vol. 21, No. 4.1 ( 2015-09-10), p. 612-617
    Abstract: Tikslas. Įvertinti MRT reikšmę nustatant prostatos kapsulės ir sėklinių pūslelių peraugimą prieš radikalią prostatektomiją. Tyrimo medžiaga ir metodai. Nuo 2013-01-01 iki 2014-07-30 Nacionalinio vėžio instituto Onkourologijos skyriuje atliktos 366 radikalios prostatektomijos. Atlikta retrospektyvinė 36 pacientų, kuriems prieš radikalią prostatektomiją Nacionaliniame vėžio institute atliktas multiparametrinis magnetinio rezonanso tomografijos tyrimas 1,5 T aparatu, naudojant dubens ritę. Tyrimo metu vertintas naviko ekstrakapsulinis plitimas ir plitimas į sėklines pūsleles MRT vaizduose, prostatos tūris, naviko tūris prostatoje, naviko Gleasono suma biopsinėje ir pooperacinėje medžiagoje. Statistinė duomenų analizė atlikta naudojant SPSS programos 22 versiją, statistiniam patikimumui patikrinti naudoti χ2 testas ir t-testas nepriklausomoms imtims. Pasirinktas statistinio reikšmingumo lygis p 〈 0,05. Rezultatai. Į galutinę tiriamąją grupę įtraukti 36 pacientai. Tiriamųjų amžiaus vidurkis ± SD 60,31 ± 7,06 metų, PSA prieš operaciją 8,83 ± 7,69 ng/ml. Radiologinė ir pooperacinė prostatos naviko stadijos (vertinant tik T reikšmę) sutapo 61 proc., naviko stadija, remiantis magnetinio rezonanso tomografijos vaizdais, hiperdiagnozuota 36 proc., hipodiagnozuota 2,8 proc. atvejų. Daugumai pacientų atliktos TRUS biopsijos, dviem transperinealinės biopsijos. Po operacijos blogesnės diferenciacijos navikas buvo nustatytas 44 proc. atvejų. Vienam pacientui po operacijos rastas geresnės diferenciacijos navikas. Stebėtas ~31 proc. prostatos tūrio sumažėjimas pooperacinėje medžiagoje. Pooperacinės medžiagos naviko tūrio vidurkis 22,1 proc. MRT tikslumas, jautrumas ir specifiškumas ekstrakapsuliniam plitimui atitinkamai 64 proc., 60 proc. (95 proc. PI 14,66 proc. iki 94,73 proc.) ir 64,52 proc. (95 proc. PI 45,37 proc. iki 80,77 proc.), plitimo į sėklines pūsleles tikslumas, jautrumas ir specifiškumas 86 proc., 71,43 proc. (95 proc. PI 29,04 proc. iki 96,33 proc.) ir 89,66 proc. (95 proc. PI 72,65 proc. iki 97,81 proc.). Vertinant paciento amžiaus, PSA prieš operaciją, Gleasono sumos biopsinėje ir pooperacinėje medžiagoje, naviko tūrio prostatoje ir visos prostatos tūrio skirtumus tarp grupių be ir su kapsulės peraugimu ir tarp grupių be ir su peraugimu į sėklines pūsleles, statistiškai patikimų skirtumų nerasta. Išvados. Multiparametrinė MRT nėra pakankamai tikslus tyrimas prostatos naviko ekstrakapsulinio plitimo, bei plitimo į sėklines pūsleles įvertinimui. Pobiopsinės hemoragijos požymiai magnetinio rezonanso tomografijos vaizduose gali lemti klaidingą T3 stadijos įvertinimą. Pastebėtas ženklus prostatos tūrio sumažėjimas pooperacinėje medžiagoje lyginant su apskaičiuotu tūriu iš magnetinio rezonanso vaizdų.
    Type of Medium: Online Resource
    ISSN: 1392-1312
    URL: Article
    DOI: 10.15591/mtp.2015.096
    Language: Unknown
    Publisher: Medicinos Mintis
    Publication Date: 2015
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  • 3
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    Transanal endoscopic microsurgery: results of the first 50 cases
    Vilnius University Press ; 2012
    In:  Acta medica Lituanica Vol. 19, No. 1 ( 2012-03-01), p. 45-49
    Details
    In: Acta medica Lituanica, Vilnius University Press, Vol. 19, No. 1 ( 2012-03-01), p. 45-49
    Abstract: The aim of the study was to share the experience and first results of implementation of transanal endoscopic microsurgery (TEM) technique for the removal of rectal adenomas, early rectal cancer or rectal stricture in the Center of Oncosurgery, Oncology Institute of Vilnius University. Materials and methods. From October 2009 to October 2011, a total of 50 patients underwent TEM for rectal adenomas, early rectal cancer or rectal stricture. The patients were 25 women and 25 men, 31 to 87 years of age (average 65 years). Rectal lesions were from 0.9 to 7.0 cm in diameter, 3–13 cm fro m the anal verge. Full thickness excision with 1 cm safety margin was achieved in all cases except two (mucosal excision), followed by closing of the rectal wall defect in one-layer running monocryl 3.0 suture using silver clips. In one case (TEM was performed for T2 rectal cancer), abdominal cavity was penetrated and two-layer closure was preferred. Results. In these series of 50 patients there was 1 (2%) complication (cystitis). No postoperative exitus occurred. The hospitalisation period ranged from 2 to 13 days (average 6 days). Final histology revealed 30 (60%) tubular or villous adenomas, 6 (12%) carcinomas in situ (pTis), 7 (14%) T1, 4 (8%) T2 cancers, and well-differentiated neuroendocrine tumors in 3 (6%) were diagnosed. One patient underwent open partial TME in pT1 group; the tumor was in the upper third of rectum and preoperatively evaluated as pTis disease. In two cases (pT1 group) lymphovascular invasion was present on final pathology, so they were offered a postoperative adjuvant chemoradiotherapy. Other 4 patients in T1 group are under surveillance. All 4 patients with T2 lesions were offered adjuvant chemoradiotherapy, one patient refused further treatment. Conclusions. TEM is an alternative for transanal excision of rectal adenomas and early rectal cancer. Further follow-up is necessary to evaluate the recurrence rate of cancer in invasive cancer patients group.
    Type of Medium: Online Resource
    ISSN: 2029-4174 , 1392-0138
    URL: Article
    DOI: 10.6001/actamedica.v19i1.2309
    Language: Unknown
    Publisher: Vilnius University Press
    Publication Date: 2012
    detail.hit.zdb_id: 2559084-4
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  • 4
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    Trends in Breast Cancer Incidence and Stage Distribution Before and During the Introduction of the Mammography Screening Program in Lithuania
    SAGE Publications ; 2019
    In:  Cancer Control Vol. 26, No. 1 ( 2019-01-01), p. 107327481882109-
    Details
    In: Cancer Control, SAGE Publications, Vol. 26, No. 1 ( 2019-01-01), p. 107327481882109-
    Abstract: The aim of this study was to analyze the incidence trends of localized and advanced breast cancer (BC) before and during the implementation of the mammography screening program (MSP) in Lithuania. Methods: The study period was divided into 2 intervals: the prescreening period (1998-2005) and implementation period (2006-2012). Analysis was performed for 3 age-groups: 0 to 49 years, 50 to 69 (target population), and older than 70. Results: In all age-groups, the incidence of localized BC has shown a steady increase, while the incidence of advanced stage BC has decreased. In the target population, during the study period, the stage I BC incidence increased statistically significantly by 10.3% per year (from 3.3 per 100 000 in 1998 to 12.2 per 100 000 in 2012). The increase in localized BC was faster in the period before the implementation of the MSP than during the implementation in 2006 to 2012 (10.3% and 5.7%). A slightly statistically significant decrease was observed for advanced BC during the study period (−1.1% per year), while during the implementation of the MSP, significant changes were not seen. Conclusions: The results of our study indicate that the implementation of the MSP in Lithuania did not significantly influence trends of localized and advanced BC. Changes observed during the study period, including the prescreening and screening introduction periods, may reflect the general trends in the awareness of BC and improvements in diagnostics.
    Type of Medium: Online Resource
    ISSN: 1073-2748 , 1073-2748
    URL: Article
    DOI: 10.1177/1073274818821096
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2004182-2
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  • 5
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    The role of different PI-RADS versions in prostate multiparametric magnetic resonance tomography assessment
    Vilnius University Press ; 2017
    In:  Acta medica Lituanica Vol. 24, No. 1 ( 2017-04-25), p. 44-50
    Details
    In: Acta medica Lituanica, Vilnius University Press, Vol. 24, No. 1 ( 2017-04-25), p. 44-50
    Abstract: Background. Standardised Prostate Imaging Reporting and Data System (PI-RADS) guidelines for the assessment of prostate alterations were designed for the assessment of prostate pathology. Published by the ESUR in 2012, PI-RADS v1 was based on the total score of different MRI sequences with subsequent calculation. PI-RADS v2 was published by the American College of Radiology in 2015 and featured different assessment criteria for prostate peripheral and transitory zones. Aim. To assess the correlations of PI-RADS v1 and PI-RADS v2 with Gleason score values and to define their predictive values of the diagnosis of prostate cancer. Materials and methods. A  retrospective analysis of 66 patients. Prostate specific antigen (PSA) value and the  Gleason score (GS) were assessed. One the most malignant focal lesion was selected in the peripheral zone of each lobe of the prostate (91 in total). Statistical analysis was carried out applying SPSS software, v.23, p 
    Type of Medium: Online Resource
    ISSN: 2029-4174 , 1392-0138
    URL: Article
    DOI: 10.6001/actamedica.v24i1.3462
    Language: Unknown
    Publisher: Vilnius University Press
    Publication Date: 2017
    detail.hit.zdb_id: 2559084-4
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  • 6
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    Position paper on screening for breast cancer by the European Society of Breast Imaging (EUSOBI) and 30 national breast radiology bodies from Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Israel, Lithuania, Moldova, The Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Spain, Sweden, Switzerland and Turkey
    Springer Science and Business Media LLC ; 2017
    In:  European Radiology Vol. 27, No. 7 ( 2017-7), p. 2737-2743
    Details
    In: European Radiology, Springer Science and Business Media LLC, Vol. 27, No. 7 ( 2017-7), p. 2737-2743
    Type of Medium: Online Resource
    ISSN: 0938-7994 , 1432-1084
    URL: Article
    DOI: 10.1007/s00330-016-4612-z
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2017
    detail.hit.zdb_id: 1472718-3
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  • 7
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    SU BRCA 1 IR 2 MUTACIJOMIS SUSIJUSIO KRŪTIES VĖŽIO RADIOLOGINIAI IR MORFOLOGINIAI POŽYMIAI: TRUMPA LITERATŪROS APŽVALGA IR PATIRTIS NVI
    Medicinos Mintis ; 2015
    In:  Medicinos teorija ir praktika Vol. 21, No. 4.1 ( 2015-09-10), p. 528-534
    Details
    In: Medicinos teorija ir praktika, Medicinos Mintis, Vol. 21, No. 4.1 ( 2015-09-10), p. 528-534
    Abstract: Tikslas. Apžvelgti su BRCA 1 ir 2 mutacijomis susijusio krūties vėžio radiologinius bei kitus požymius, atkreipiant dėmesį į jo skirtumus nuo krūties vėžio, nesusijusio su mutacijomis. Apžvelgti rekomendacijas, skirtas BRCA genų mutacijų nešiotojų stebėsenai ir krūties vėžio diagnostikai bei gydymui. Medžiaga ir metodai. Atlikta literatūros apžvalga remiantis reikšminiais žodžiais. Retrospektyviai išnagrinėti 69 moterų, kurioms buvo nustatytos BRCA1/2 genų mutacijos, ir dalis jų dėl krūties vėžio buvo tirtos ir kurios gydytos Nacionaliniame vėžio institute (NVI) 2010–2015 metais, klinikinių ir radiologinių tyrimų duomenys. Rasta 30 pacienčių su BRCA mutacijomis, kurioms nustatytas krūties vėžys. Nagrinėti pacientėms atliktų radiologinių ir morfologinio tyrimų duomenys. Rezultatai ir išvados. Su BRCA 1 ir 2 mutacijomis susijęs krūties vėžys dažniausiai nustatomas blogos diferenciacijos, dažniausiai trejopai neigiamo fenotipo, sunkiai ar pavėluotai diagnozuojamas radiologiniais metodais dėl tipiškų krūties vėžio radiologinių požymių stokos. Būtinas šeiminės bei didelės rizikos moterų nustatymas bei profilaktinių priemonių ir aktyvios stebėsenos taikymas siekiant pagerinti su BRCA susijusio vėžio diagnostiką ir prailginti šių moterų išgyvenimo trukmę.
    Type of Medium: Online Resource
    ISSN: 1392-1312
    URL: Article
    DOI: 10.15591/mtp.2015.083
    Language: Unknown
    Publisher: Medicinos Mintis
    Publication Date: 2015
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  • 8
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    Online Resource
    Breast cancer screening program in Lithuania: trends in breast cancer mortality before and during the introduction of the mammography screening programme
    Vilnius University Press ; 2020
    In:  Acta medica Lituanica Vol. 27, No. 2 ( 2020-12-23), p. 61-69
    Details
    In: Acta medica Lituanica, Vilnius University Press, Vol. 27, No. 2 ( 2020-12-23), p. 61-69
    Abstract: BackgroundBreast cancer is the most frequent oncological disease as well as the leading cause of cancer death among women worldwide. Decline in mortality in economically strong countries is observed. This decline is mostly related to early diagnosis (improvement in breast cancer awareness and mammography screening program (MSP)) and more effective treatment. In the end of 2005, the MSP started in Lithuania. The main aim of this article was to evaluate breast cancer mortality during 22 years in Lithuania, as well as changes before the start of the MSP and during its implementation, in order to assess the influence of the MSP on mortality. Materials and MethodsAnalysis was based on data from the population-based Lithuanian Cancer Registry. Analysis of changes in mortality included the period from 1998 to 2019. Age standardized mortality rates were calculated for assessment of changes. Join-point regression analysis was used. ResultsApplying the segmental regression model, it was found that during the study period mortality was statistically significantly decreasing by -1.1% each year.  Mortality among women under the age of 50 decreased both before and during the implementation of MSP. Mortality in the target population also was already decreasing until the implementation of the program, but since 2006 significant reduction in mortality was observed in this group. ConclusionsOverall breast cancer mortality is decreasing in Lithuania. After the implementation of MSP the largest reduction in mortality was observed among the target population, however, it is not as pronounced as it could be with the well-organized MSP.
    Type of Medium: Online Resource
    ISSN: 2029-4174 , 1392-0138
    URL: Article
    DOI: 10.15388/Amed.2020.27.2.3
    Language: Unknown
    Publisher: Vilnius University Press
    Publication Date: 2020
    detail.hit.zdb_id: 2559084-4
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  • 9
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    Breast Cancer Screening Program in Lithuania: Interval Cancers and Program Sensitivity After 7 Years of Mammography Screening
    SAGE Publications ; 2019
    In:  Cancer Control Vol. 26, No. 1 ( 2019-01-01), p. 107327481987412-
    Details
    In: Cancer Control, SAGE Publications, Vol. 26, No. 1 ( 2019-01-01), p. 107327481987412-
    Abstract: Analysis of interval cancers is critical in determining the sensitivity of screening and represents an objective measure of the quality of mammography screening program (MSP). Methods: Period analyzed: from 2006 to 2012. The rate of screen-detected, interval cancers and program sensitivity were measured. A comparison of screen-detected and interval cancers was performed. Results: During the period of the study, 429 473 women were screened and 1297 were found to have cancer. The overall screen-detected cancer rate was 30.2 per 10 000 women screened. Four hundred thirty-one case of interval cancers have occurred during the period of the study. The interval cancer ratio (ICR) was 0.25. Overall sensitivity of MSP amounted to 75.1%. Slightly lower sensitivity was found among the youngest age-group, especially for those with lobular cancers. Interval cancers were bigger in size, more often with metastases in lymph nodes, than screen-detected cancers, but these differences were not statistically significant. Conclusions: Overall program sensitivity in Lithuania is about 75%, ICR is 0.25, and these parameters are comparable to other European countries.
    Type of Medium: Online Resource
    ISSN: 1073-2748 , 1073-2748
    URL: Article
    DOI: 10.1177/1073274819874122
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2004182-2
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  • 10
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    ATRANKINĖS MAMOGRAFINĖS PATIKROS VYKDYMO PATIRTIS NACIONALINIAME VĖŽIO INSTITUTE
    Association of Lithuanian Serials (Publications) ; 2017
    In:  Visuomenės sveikata Vol. 27, No. 6 ( 2017-12-28), p. 161-168
    Details
    In: Visuomenės sveikata, Association of Lithuanian Serials (Publications), Vol. 27, No. 6 ( 2017-12-28), p. 161-168
    Abstract: Atrankinės mamografinės patikros tikslas – nustatyti krūties vėžį anksti, kol jis dar nesukelia simptomų ir kai specifinis gydymas gali būti maksimaliai efektyvus. Nustatyta, kad mirtingumas vykdant atrankinę mamografinę patikrą gali sumažėti 20–35 %. Nors pagal atrankinę patikros programą atliktų mamogramų nauda yra akivaizdi, ne mažiau svarbu nuolatinė atrankinės mamografinės patikros programos (AMPP) vykdymo priežiūra nuo pat jos įdiegimo pradžios. Iki šiol nebuvo atlikta išsamių darbų, kuriuose būtų vertinama Lietuvoje vykdomos AMPP eiga bei efektyvumo rodikliai. Šio straipsnio tikslas apibendrinti AMPP vykdymo patirtį Nacionaliniame vėžio institute (NVI), kaip viename didžiausių pagal AMPP atliekančių mamogramas ir jų vertinimo paslaugas teikiančių centrų, bei apibūdinti pagrindinius šiuo metu vykdomos AMPP rodiklius, identifikuoti dažniausiai pasitaikančias problemas. Šio tyrimo metu atlikta retrospektyvinė duomenų analizė. Vertinti 2006–2016 metais NVI pagal AMPP atliktų mamogramų duomenys. Tyrimo metu vertinta mamogramų atlikimo ir vertinimo dinamika, atliktų papildomų tyrimų skaičius, nustatytų piktybinių navikų skaičius, pasiskirstymas pagal stadiją. Atskirai analizuoti intervaliniai navikai. Mūsų atlikta NVI sukauptų duomenų analizė parodė, kad atrankinė mamografinė patikra ne visada naudojama pagal paskirtį – pasitikrinti pagal AMPP neretai siųstos gydytos dėl krūties vėžio ar akivaizdžių krūties simptomų turinčios moterys. Vykdant programą NVI net 19 % navikų nustatyti pažengusios stadijos ir tik 46 % pirmos stadijos, kas neatitinka programos vykdymo rekomendacijų.
    Type of Medium: Online Resource
    ISSN: 2335-867X
    URL: Article
    DOI: 10.5200/sm-hs.2017.113
    Language: Unknown
    Publisher: Association of Lithuanian Serials (Publications)
    Publication Date: 2017
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