“Basal-like” (BL) morphology and the expression of cancer testis antigens (CTA) in breast cancer still have unclear prognostic significance. The aim of our research was to explore correlations of the morphological characteristics and tumor microenvironment in triple-negative breast carcinomas (TNBCs) with multi-MAGE-A CTA expression and to determine their prognostic significance. Clinical records of breast cancer patients who underwent surgery between January 2017 and December 2018 in four major Croatian clinical centers were analyzed. A total of 97 non-metastatic TNBCs with available tissue samples and treatment information were identified. Cancer tissue sections were additionally stained with programmed death-ligand 1 (PD-L1) Ventana (SP142) and multi-MAGE-A (mAb 57B). BL morphology was detected in 47 (49%) TNBCs and was associated with a higher Ki-67 proliferation index and histologic grade. Expression of multi-MAGE-A was observed in 77 (79%) TNBCs and was significantly associated with BL morphology. Lymphocyte-predominant breast cancer (LPBC) status was detected in 11 cases (11.3%) and significantly correlated with the Ki-67 proliferation index, increased number of intratumoral lymphocytes (itTIL), and PD-L1 expression. No impact of BL morphology, multi-MAGE-A expression, histologic type, or LPBC status on disease-free survival was observed. Our data suggest that tumor morphology could help identify patients with potential benefits from CTA-targeting immunotherapy.

The National Colorectal Cancer Early Detection Program was launched towards the end of 2007. The Croatian Society for Oncology contributed signifi cantly to the development of the National Colorectal Cancer Early Detection Program. The Program aims to decrease colorectal cancer (CRC) mortality by 15% in the fi rst fi ve years of the Program’s implementation, by covering 75% of the population aged 50-74 years by 2015. The Program is based on fecal occult blood test (FOBT) screening every two years. Program coordinators are the Croatian Institute of Public Health (CIPH) and regional Institutes for Public Health. The proportion of screened persons is 25% and is insuffi cient for achieving the goals of the National Program. It is considered that family medicine doctors and community health nurses need to get involved more actively in the Program by motivating the persons invited for screening.

To present the response rate results of the Colorectal Cancer early Detection program that is part of the project Colorectal Cancer Early Detection Model Integrated in the Practice of Family Medicine, carried out by the Department of family Medicine of the osijek University school of Medicine and the osijek Health Center in the osijek-Baranja County.Those response rate results were compared with those obtained by the national Colorectal Cancer early Detection program.The project's strategy is based on the central role of family physicians in implementing early cancer detection programs.The project started in the year 2007, and by the end of 2009, a total of 1850 cards on an occult fecal blood test (foBT) were delivered to subjects from two target groups (aged 45-49 and 75-79), i.e., to age groups not covered by the national Colorectal Cancer early Detection program.a relatively high response rate of 1083 tested subjects (58.5%) was recorded for both target groups, which is an advantage in comparison with the relatively low response rate of 19.9% obtained by the end of 2010 by the Croatian national program.The project revealed positive foBT results in 54 subjects (4.9%). of these subjects, 28 underwent colonoscopies, and two had colon cancer detected.The results indicate that family physicians should actively participate in the national Colorectal Cancer early Detection program.

Ovarian cancer has a dismal prognosis. Standard treatment following surgery relies on platinum-based chemotherapy. However, sizeable percentages of patients are unresponsive. Identification of markers predicting the response to chemotherapy might help select eligible patients and spare non-responding patients from treatment-associated toxicity. Cancer/testis antigens (CTAs) are expressed by healthy germ cells and malignant cells of diverse histological origin. This expression profile identifies them as attractive targets for cancer immunotherapies. We analyzed the correlations between expression of MAGE-A10 and New York esophageal-1 cancer (NY-ESO-1) CTAs at the protein level and the effectiveness of platinum-based chemotherapy in patients with advanced-stage high-grade serous ovarian carcinoma (HGSOC). MAGE-A10 and NY-ESO-1 protein expression was analyzed by immunohistochemistry (IHC) in formalin-fixed, paraffin-embedded samples from 93 patients with advanced-stage HGSOC treated at our institutions between January 1996 and December 2013. The correlation between the expression of these markers and response to platinum-based chemotherapy, evaluated according to RECIST 1.1 criteria and platinum sensitivity, measured as platinum-free interval (PFI), progression free (PFS), and overall survival (OS) was explored. The MAGE-A10 protein expression predicted unresponsiveness to platinum-based chemotherapy (p = 0.005), poor platinum sensitivity (p < 0.001), poor PFS (p < 0.001), and OS (p < 0.001). Multivariate analysis identified MAGE-A10 protein expression as an independent predictor of poor platinum sensitivity (p = 0.005) and shorter OS (p < 0.001). Instead, no correlation was observed between the NY-ESO-1 protein expression and response to platinum-based chemotherapy (p = 0.832), platinum sensitivity (p = 0.168), PFS (p = 0.126), and OS (p = 0.335). The MAGE-A10 protein expression reliably identified advanced-stage HGSOC unresponsive to platinum-based chemotherapy. Targeted immunotherapy could represent an important alternative therapeutic option in these cancers.

High infiltration by tumor-infiltrating lymphocytes (TILs) is associated with favorable prognosis in different tumor types, but the clinical significance of their spatial localization within the tumor microenvironment is debated. To address this issue, we evaluated the accumulation of intratumoral TILs (itTILs) and stromal TILs (sTILs) in samples from 97 patients with early triple-negative breast cancer (TNBC) in the center (sTIL central) and periphery (sTIL peripheral) of tumor tissues. Moreover, the presence of primary and secondary lymphoid aggregates (LAs) and the expression levels of the cancer testis antigen (CTA), NY-ESO-1, and PD-L1 were explored. High infiltration by itTILs was observed in 12/97 samples (12.3%), unrelated to age, Ki67 expression, tumor size, histologic type and grade, and LA presence. NY-ESO-1 was expressed in tumor cells in 37 samples (38%), with a trend suggesting a correlation with itTIL infiltration (p = 0.0531). PD-L1 expression was detected in immune cells in 47 samples (49%) and was correlated with histologic grade, sTILs, and LA formation. The presence of primary LAs was significantly correlated with better disease-free survival (DFS) (p = 0.027). Moreover, no tumor progression was observed during >40 months of clinical follow up in the 12 patients with high itTILs or in the 14 patients with secondary LAs. Thus, careful evaluation of lymphoid infiltrate intratumoral localization might provide important prognostic information.

Importance DCVAC/PCa is an active cellular immunotherapy designed to initiate an immune response against prostate cancer. Objective To evaluate the efficacy and safety of DCVAC/PCa plus chemotherapy followed by DCVAC/PCa maintenance treatment in patients with metastatic castration-resistant prostate cancer (mCRPC). Design, Setting, and Participants The VIABLE double-blind, parallel-group, placebo-controlled, phase 3 randomized clinical trial enrolled patients with mCRPC among 177 hospital clinics in the US and Europe between June 2014 and November 2017. Data analyses were performed from December 2019 to July 2020. Interventions Eligible patients were randomized (2:1) to receive DCVAC/PCa (add-on and maintenance) or placebo, both in combination with chemotherapy (docetaxel plus prednisone). The stratification was applied according to geographical region (US or non-US), prior therapy (abiraterone, enzalutamide, or neither), and Eastern Cooperative Oncology Group performance status (0-1 or 2). DCVAC/PCa or placebo was administered subcutaneously every 3 to 4 weeks (up to 15 doses). Main Outcomes and Measures The primary outcome was overall survival (OS), defined as the time from randomization until death due to any cause, in all randomized patients. Survival was compared using 2-sided log-rank test stratified by geographical region, prior therapy with abiraterone and/or enzalutamide, and Eastern Cooperative Oncology Group performance status. Results A total of 1182 men with mCRPC (median [range] age, 68 [46-89] years) were randomized to receive DCVAC/PCa (n = 787) or placebo (n = 395). Of these, 610 (81.8%) started DCVAC/PCa, and 376 (98.4%) started placebo. There was no difference in OS between the DCVAC/PCa and placebo groups in all randomized patients (median OS, 23.9 months [95% CI, 21.6-25.3] vs 24.3 months [95% CI, 22.6-26.0]; hazard ratio, 1.04; 95% CI, 0.90-1.21;P = .60). No differences in the secondary efficacy end points (radiological progression-free survival, time to prostate-specific antigen progression, or skeletal-related events) were observed. Treatment-emergent adverse events related to DCVAC/PCa or placebo occurred in 69 of 749 (9.2%) and 48 of 379 (12.7%) patients, respectively. The most common treatment-emergent adverse events (DCVAC/PCa [n = 749] vs placebo [n = 379]) were fatigue (271 [36.2%] vs 152 [40.1%]), alopecia (222 [29.6%] vs 130 [34.3%]), and diarrhea (206 [27.5%] vs 117 [30.9%]). Conclusions and Relevance In this phase 3 randomized clinical trial, DCVAC/PCa combined with docetaxel plus prednisone and continued as maintenance treatment did not extend OS in patients with mCRPC and was well tolerated. Trial Registration ClinicalTrials.gov Identifier:NCT02111577

Introduction Clinical oncologists are physicians with the competencies to manage cancer patients through the entire disease pathway combining the competencies of radiation and medical oncologists. The 4th edition of the European Society for Radiotherapy and Oncology Core Curriculum for Radiation Oncology/Radiotherapy (ESTRO curriculum) has received wide support by the clinical oncology community. The aim was to develop a clinical oncology module that could be combined with the ESTRO curriculum to enable clinical oncology trainees to follow a single curriculum. Materials and methods A range of stakeholders including National Society representatives, an oncologist from a low- middle-income country, and a recently appointed specialist, developed and commented on iterations of the curriculum. Further modifications were made by the ESTRO Education Council. Results The module is based on the CanMEDS 2015 framework and identifies 20 enabling competencies in the Medical Expert role that are required in addition to the ESTRO curriculum for the training of clinical oncologists. Recommendations are made for the levels of Entrustable Professional Activities (EPAs) to be attained by the end of training. Conclusions The Clinical Oncology module, when combined with the ESTRO curriculum, covers the entire cancer pathway rather than being modality specific. It is hoped it will aid in the development of comparable standards of training in clinical oncology across Europe and may also have utility in low- and middle-income countries as well as providing a single curriculum for trainees.

INTRODUCTION:In 2017 it was decided to revise the European Core Curriculum for Radiation Oncology/Radiotherapy to produce a 4th edition. The aims of the ESTRO curriculum are to develop comparable standards for training across Europe and to facilitate free movement of specialists across borders. It is also hoped that it will improve the level of training across Europe and will make the non-medical expert roles more explicit.MATERIALS AND METHODS:A wide range of stakeholders including National Society representatives, trainees, recently appointed specialists, members of the European Union Medical Specialists Radiotherapy section, an RTT, a radiobiologist, a physicist and lay members from ESTRO staff developed and commented on iterations of the curriculum.RESULTS:The 4th edition is based on the CanMEDS 2015 framework and identifies 14 Entrustable Professional Activities (EPAs) and the competencies required to perform these. The manager role is replaced by competencies related to leadership. The levels of proficiency required for tumour sites is defined as levels of EPAs.CONCLUSIONS:It is hoped that the inclusive method of developing the 4th edition has resulted in a document that will have utility in the wide range of environments in which radiation oncology is practised in Europe.

Background & aims: Cancer cachexia (CC) syndrome and anorexia-cachexia syndrome are common terms used to describe changes in metabolism with increased inflammatory activity and can progressively develop through various stages such as pre-cachexia; cachexia; and refractory cachexia. Therefore in year 2007 Croatian guidelines for use of eicosapentaenoic acid and megestrol acetate in cancer cachexia syndrome were published. Aim of this study was to assess the awareness and implementation of Croatian guidelines for use of eicosapentaenoic acid (EPA) and megestrol acetate (MA) into clinical practice among Croatian oncologists approximately 10 years after the publication, but also to point out the importance of adequate recognition and treatment of CC. Methods: Survey with questions was designed to assess the awareness and implementation of Croatian guidelines for use of EPA and MA into clinical practice and was distributed among all Croatian oncologists in secondary and tertiary hospital centers. Survey was conducted in January 2011 (40 months following release of the guidelines), February 2013 and June 2018, and were formed in a way of yes/no answers. Additional multiple choice questions that focus on the implementation of guidelines were added in June 2018. Results: A total of 128 oncologists completed a questionnaire. There was no statistically significant difference in follow up period (2011-2018) of percentage of oncologists that are familiar with Croatian guidelines for use of EPA and MA in CC, percentage of oncologists in which Croatian national guidelines changed their approach in treating patients with CC syndrome and proportion of oncologists that are using MA, enteral nutrition formulas with EPA or their combination. Most of the oncologists 38% (N = 44) are using >2.2 g of EPA per day. Nutritional support is prescribed in 25-50% of patients by 42% (N = 48) of oncologists and most of the oncologists (35%, N = 41) start with nutritional support when a body mass loss is >5%. Oncologists mostly recommend patients to use nutritional support during 1 year or more (43%, N = 49) or two months to 1 year (42%, N = 48). Compliance of patients with malignant diseases for using nutritional support was mostly evaluated as medium (69%, N = 60). Conclusions: Results have shown that majority of oncologists who filled the questionnaire believe that the Croatian national guidelines for use of EPA and MA in CC syndrome changed their approach in treating patients with CC, but also that there are several targeted issues that can be significantly improved. The awareness of and adherence to national guidelines was maintained at high level even 11 years after the guidelines were published. (C) 2019 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Introduction: Esophageal cancer is one of the solid malignant diseases with the worst prognosis. The five-year overall survival is less than 20% even in more developed countries. According to the data from the cancer registry for the year 2015, 169 patients have been diagnosed with this disease in the Republic of Croatia. Methods: The aim of this non-randomized, retrospective study was to evaluate the survival rate of patients with esophageal and esophagogastric junction (EGJ) cancers who were treated with radical radiotherapy in the University Hospital Centre Zagreb between 2011 and 2018. The excluding criteria were metastatic disease and palliative radiotherapy. The data was collected from the medical records stored in the hospital information system. Results: A total of 77 patients were included in this research; 71 were male (92.2%). The median follow-up was 4.3 years. Primary radiotherapy was applied in 38 patients (49.4%). Twenty-eight of them were treated with concomitant chemoradiotherapy (CRT). Due to comorbidity, 8 patients could not be treated with chemotherapy. Neoadjuvant CRT was given to 15.5% of patients and adjuvant to 35.1%. In the primary and neoadjuvant CRT, cisplatin and 5-fluorouracil (5-FU) was used while in the adjuvant CRT, leucovorin and 5-FU was used. The median age of patients was 61 years (range 43 – 85). Squamous cell carcinoma was found in 55.8% of patients, adenocarcinoma in 40.3% and 3.9% patients were diagnosed with cancer without further histological differentiation. The most common sites were distal esophageal and EGJ sites (49.4%), followed by cervical (23.4%) and thoracic (22.1%) site and the cancer overtook the whole esophagus in 5.1% patients. The majority of patients had advanced disease (75% stage 3 or 4). The five-year overall survival was 17%. The survival rate was statistically better in patients with adenocarcinoma than in the patients with squamous cell carcinoma (31.8% vs 11.3%, P = .003). Patients with stage 1 or 2 had better survival rates than patients with stage 3 or 4, but, this was not statistically significant (45% vs 13%, P = .306). There was no difference in the distribution of a disease stage between the 2 histological subgroups (P = .173). Progression of the disease was verified in 70.1% of patients. A locoregional recurrence was found in 29.8% of patients, metastatic disease in 36.4%, and local recurrence with metastatic disease in 3.9% of patients. The median progression time was 9.1 months. Conclusion: The end results are aligned with the data in the literature. To improve treatments results it is necessary to increase the use of neoadjuvant therapy which can be accomplished by better utilization of the multidisciplinary team.

Although the incidence of the most frequent malignant gastric tumour, adenocarcinoma, has been decreasing, during the last decades the incidence of proximal localizations of gastric cancer as well as esophagogastric cancer has been increasing. Due to the late detection of initially advanced disease the outcomes of treatment for the patients are unsatisfactory. Diagnosis is set by tumour biopsy during endoscopy. The basis of treatment of locoregional disease is surgery in combination with perioperative chemotherapy. Alternatively, if no preoperative chemotherapy is administered, adjuvant chemoradiotherapy or chemotherapy should be performed. Metastatic disease is treated with palliative chemotherapy and best supportive care. Treatment decisions should be individualized according to patients’ characteristics and made after multidisciplinary team discussion. The following text presents the clinical guidelines in order to standardize the diagnostic procedures, treatment and monitoring of patients with gastric cancers in the Republic of Croatia.

Introduction Cancer/testis antigens (CTA) are a large family of tumor-associated antigens expressed in human tumours of different histological origin, but not in normal tissues except for testis and placenta. Several immunohistochemical studies confirmed the association of CT antigen expression and ER negativity in breast tumours and demonstrated their frequent expression in tumours with higher nuclear grade. The expression of cancer/testis antigens in ductal carcinoma in situ is not studied so extensively as in invasive breast cancer. Material and methods This retrospective study included archived paraffin-embedded specimens from 83 patients diagnosed with DCIS in the period between 2007. and 2014, a mean follow up time for local recurrence was 6.5 years. Antigens multi-MAGE-A, MAGE-A1, MAGE-A10 and NY-ESO-1 and were demonstrated by immunostaining. TILs were determined on all sections together with the histopathological variables of DCIS. Results and discussions All tested antigens showed association (positive or negative) with histopathological parameters. Expression of MAGE-A1 was significantly associated with cytoplasmic staining (p=0,007). Simultaneously cytoplasmic and nuclear staining was in statistically significant positive correlation with local recurrence (p=0,005) and central necrosis (p=0,016) and in negative correlation with expression of ER receptors (p=0,003) and PR receptors (p=0,009). Antigen MAGE-A10 was significantly associated with tumor-infiltrating lymphocytes (p=0.05). The additional analysis of TILs showed statistically significant positive correlation with grade (p=0.023), and central necrosis (p<0.001), and negative with tumour size (p=0.623), ER receptors (p=0.003) and PR receptors (p=0.027). Conclusion Cancer/testis antigens from MAGE family (MAGE-A1, multi-MAGE-A and MAGE-A10) and NY-ESO-1 correlate with histopathological predictive variables of DCIS. The expression of antigen MAGE-A10 could have an important role in treatment of patients with negative histopathological predictive variables, but further analysis is required. Simultaneous cytoplasmic and nuclear protein expression of MAGE-A family and NY-ESO-1 cancer-testis antigens represent an independent marker for local recurrence. Cancer/testis antigens are not perfect indicators of invasiveness for DCIS, but in combination with others histopathological predictive variables they can be used as a guidance for better treatment of this patients. But, this is the small study and further larger studies are necessary to confirm our findings.

Cancer/testis antigens (CTAs) are a large family of tumor-associated antigens expressed in human tumors of different histological origin, but not in normal tissues, with the exception of the testes and placenta. Numerous immunohistochemical studies have reported associations between CTA expression and a negative estrogen receptor (ER) status in breast tumors, and demonstrated that CTAs are frequently expressed in tumors with higher nuclear grade. The expression of CTAs has not been studied as extensively in ductal carcinoma in situ (DCIS) as it has been in invasive breast cancer. The present retrospective study included archived paraffin-embedded specimens from 83 patients diagnosed with DCIS in the period between January 2007 and December 2014. The follow-up time for local recurrence ranged between 1 and 8 years (mean, 5.02 years). Antigens from the melanoma-associated antigen gene (MAGE) family, namely multi-MAGE-A, MAGE-A1, MAGE-A10 and New York esophageal squamous cell carcinoma 1 (NY-ESO-1) antigen, were evaluated by immunostaining and their subcellular location was investigated. Presence of tumor-infiltrating lymphocytes (TILs) was evaluated on all sections, together with the histopathological variables of DCIS. Specific tested antigens exhibited associations with histopathological parameters for DCIS and all demonstrated statistically significant associations with nuclear staining, simultaneous cytoplasmic and nuclear staining, and local recurrence. Antigen MAGE-A10 demonstrated a significant association with higher expression of ER (P=0.005) and higher tumor nuclear grade (P=0.001), cytoplasmic staining (P=0.029) and antigen NY-ESO-1 with higher tumor size (P=0.001), expression of TILs (P=0.001) and R1 resection (P=0.001). A χ2 test revealed significant associations between simultaneous cytoplasmic and nuclear staining and local recurrence (P=0.005), central necrosis (P=0.016), and the expression of ER (P=0.003) and progesterone receptor (PR) (P=0.010). Additional analysis revealed an association between antigen MAGE-A10 and TILs (P=0.05). Additional analysis of TILs indicated that they were significantly associated with tumor grade (P=0.023), central necrosis (P<0.001), ER (P=0.003) and PR (P=0.029). Overall, CTAs from the MAGE family (MAGE-A1, multi-MAGE-A and MAGE-A10) and NY-ESO-1 associate with histopathological predictive variables of DCIS. The expression of antigens NY-ESO-1 and MAGE-A10 could serve an important role in the treatment of patients with negative histopathological predictive variables, but further analysis is required. Simultaneous cytoplasmic and nuclear protein expression of MAGE-A family and NY-ESO-1 CTAs may represent an independent marker for local recurrence. Taken together, the present data suggest that CTAs are not perfect indicators of invasiveness for DCIS, but could inform treatment strategies for patients when taken in combination with other histopathological predictive variables. However, this was a small study and further larger studies will be necessary to confirm the current findings.

We have read with great interest the article by Yadav et al ( 1 Yadav B.S. Sharma S.C. A phase II study of 2-weeks of adjuvant whole breast/chest wall and/or regional nodal radiotherapy in patients with breast cancer. Int J Radiat Oncol Biol Phys. 2018; 100: 874-881 Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar ), which was published in your estemeed journal. The aim of the study was to report results in terms of the feasibility and early toxicity of hypofractionated adjuvant whole breast–chest wall and regional nodal radiation therapy in patients with breast cancer. According to the authors, a two-week hypofractionated radiotherapy [34 Gy/10x (+ boost 10 Gy/5x)] appears to be feasible in patients with breast cancer and was associated with acute and late skin toxicity profiles that are similar to what has been observed during 3 weeks of treatment (35 Gy/15x). Disease free and overall survival rates at 3 years were 94% and 96%, respectively. A Phase 2 Study of 2 Weeks of Adjuvant Whole Breast/Chest Wall and/or Regional Nodal Radiation Therapy for Patients With Breast CancerInternational Journal of Radiation Oncology • Biology • PhysicsVol. 100Issue 4PreviewTo report the results in terms of feasibility and early toxicity of hypofractionated adjuvant whole breast/chest wall and/or regional nodal radiation therapy for patients with breast cancer. Full-Text PDF In Reply to Juretić and SutonInternational Journal of Radiation Oncology • Biology • PhysicsVol. 101Issue 5PreviewI appreciate the important question raised by Professor Juretić pertaining to selection of patients for adjuvant radiotherapy in our study (1, 2). The protocol has been developed to reduce the waiting period for the patients who need adjuvant radiation for breast cancer. At present, the boost is delivered with 8Gy/2#/2days. Full-Text PDF

Onkologija je integralna disciplina u kojoj su sadržana mnoga znanja, disciplina koja zahtijeva razumijevanje, posvecenost, ljubav i zajednistvo. Osnove onkologije su preduvjet međusobnog razumijevanja i zajednistva, uspjesnosti onkoloskog lijecenja, a te osnove donosi ovaj udžbenik. Danas svjedocimo onkoloskoj revoluciji, promjeni neizljecivoga statusa raka do bolesti s relativno, ili u nekim sijelima apsolutno dobrim izgledima za izljecenje. Svjedocimo promjeni akutnoga u kronicno stanje raka. Danas bolesnici s metastatskim rakom imaju znacajno bolje sanse za dugotrajna preživljenja, a sve zahvaljujuci multidisciplinarnom pristupu u lijecenju i novim ciljanim terapijskim mogucnostima. Eticki zahtjevi koji se postavljaju pred lijecnika vrlo su specificni za ovo podrucje medicine, a najteže je donositi odluke u situacijama za koje ne postoje jasna pravila i utvrđena stajalista. Lijecnik mora istodobno zadržati otvorenost i kriticnost prema razlicitim pristupima i ne smije, bez jasnih razloga, odbaciti ni jedan cimbenik kojim bi na bilo koji nacin mogao pomoci bolesniku pa makar se to odnosilo i na neznatno poboljsanje kakvoce života. Lijecnik koji se bavi onkologijom mora prepoznati ulogu istraživacke, znanstvene, bazicne i klinicke onkologije, koja je danas sve cesce temelj klinickoj nadogradnji i implementaciji novih terapijskih modaliteta. Svrha je ovog udžbenika pružiti racionalni sažetak golemog teorijskog i prakticnog znanja koje se desetljecima prikupljalo u borbi protiv raka. Udžbenik ce pomoci studentima medicine, ali i lijecnicima drugih, neonkoloskih specijalnosti u razumijevanju vecine problema vezanih uz bavljenje ovom vrlo specificnom, ali istodobno i interdisciplinarnom i izazovnom granom medicine.

sažetak.iako se učestalost najčešćega malignog tumora želuca, adenokarcinoma, posljednjih desetljeća smanjuje, raste učestalost proksimalnih lokalizacija raka želuca i ezofagogastričnog prijelaza