Objective: The aim of this study was to evaluate the expression of PD-L1, PD-1, CD3, CD4, and CD8 in tumor tissues of patients with head and neck squamous cell carcinoma from southern Poland, and to assess their prognostic value in relation to disease-free survival (DFS), taking into account HPV16 status and other clinical, pathological, and demographic factors. Material/Methods: This study included 155 unselected patients with head and neck squamous cell carcinoma (HNSCC) from the southern Poland region, who underwent diagnostic evaluation and surgical treatment. Formalin-fixed, paraffin-embedded (FFPE) tissue blocks were obtained from these centers. The patients were treated at the Maria Skłodowska-Curie National Research Institute of Oncology, Kraków Branch, between 1991 and 2014, with treatment approaches including induction therapy (preoperative), adjuvant therapy (postoperative), or definitive chemoradiotherapy with cisplatin. Protein expression was assessed using immunohistochemistry and quantified (TPS, CPS, H-score). Relationships between expression levels and epidemiological, clinical, and histopathological features were analyzed. Results: The results show that PD-L1 overexpression was associated with worse DFS, whereas overexpression of PD-1, CD3, CD4, and CD8 correlated with improved DFS. These associations were statistically significant in the HPV16-negative subgroup, while no such correlations were found in HPV16-positive patients. In multivariate analysis, independent prognostic factors associated with improved DFS included HPV16 infection, absence of PD-L1 overexpression, overexpression of CD4 and CD8, and combined chemoradiotherapy with cisplatin. Conclusions: These findings confirm the prognostic relevance of PD-L1, PD-1, and T-cell markers in HNSCC, particularly in HPV16-negative patients, and support further research into the use of these biomarkers in personalized treatment strategies.

Cervical cancer remains a major public health challenge worldwide and in Poland, where mortality rates are among the highest in the European Union. Persistent infection with high-risk human papillomavirus (hrHPV), particularly genotype HPV16, plays a central role in cervical carcinogenesis. This study aimed to evaluate the regional variability of hrHPV prevalence and genotype distribution in Poland and to assess its potential implications for cervical cancer incidence and prevention strategies. A systematic literature review was conducted using PubMed, Scopus, and Google Scholar to identify studies published up to May 2025 reporting hrHPV prevalence and genotypes among Polish women. Eligible studies included population-based cohorts, women undergoing screening, and patients with cervical lesions or cancer. The analysis revealed substantial heterogeneity in hrHPV prevalence and genotype distribution across regions and study populations. Nationwide data indicate high overall HPV prevalence (up to 50.9%), with HPV16 consistently dominating, followed by HPV31, HPV51, HPV52, and HPV66. Regional differences were observed, including a higher prevalence of HPV51 in southern Poland and HPV56 and HPV45 in central regions. Studies in women with abnormal cytology or cervical cancer showed markedly higher hrHPV prevalence (often >90%), with HPV16 predominating in high-grade lesions and invasive cancer. These findings confirm the dominant oncogenic role of HPV16 while highlighting significant regional variability in other hrHPV genotypes. Such differences may influence the effectiveness of screening and vaccination programs. Strengthening standardized, regionally stratified HPV surveillance is essential to optimize cervical cancer prevention and tailor public health interventions in Poland.

Level I evidence to inform decisions on radiation modality and chemotherapy regimen choice in adult-type diffuse gliomas CNS WHO grade 2 are awaited. The retrospective analysis was performed to assess overall survival (OS), progression-free survival (PFS) and late toxicity including ability to return to work in 2016 CNS WHO grade 1 and grade 2 gliomas (low-grade gliomas [LGG]) patients treated with intensity modulated proton beam radiotherapy (IMPT). Patients with 2016 CNS WHO LGG after surgery, treated with IMPT at our institution from 2016 to 2021 were eligible for this analysis. Data were retrospectively collected from medical and imaging records. 143 patients were identified. Diffuse astrocytoma isocitrate dehydrogenase (IDH) mutant was the predominant phenotype. Median follow-up was 66.5 months. Five-year OS and PFS were 78.21

The IN-PATSAT32 and QLQ-INFO25 are questionnaires which can be applied to assess and improve communication with cancer patients, as well as for research and clinical trials aimed at assessing patients’ satisfaction and perception of the information received from nurses and other healthcare providers. Given the recently passed “Polish oncological network” act of law, the issue of patient satisfaction and its regular assessment is finally acknowledged in the socioeconomic and cultural context of Poland. The aim of this study was to validate the EORTC quality of information, QLQ-INFO25, and satisfaction with care, IN-PATSAT32 modules. This prospective cross-sectional study included patients from a cancer reference center in Krakow, Poland. The translated and pilot-tested module QLQ-INFO25 was used together with the core questionnaire QLQ-C30 and the satisfaction module IN-PATSAT32. Adult patients with histological confirmation of any malignancy and the ability to answer the questionnaire were included in the study. A total of 187 patients, including 111 women and 76 men (mean age ± SD; 59.32 ± 10.4), were enrolled. The Cronbach's alpha coefficients, ranged from 0.83–0.85 for the QLQ-INFO25 and 0.82–0.94 for the IN-PATSAT32, indicating positive internal consistency. Acceptable convergent and discriminant validity in multi-trait scaling analyses was observed for both modules, with r < 0.3 for all calculations. Interclass correlations proved satisfactory test–retest reliability. The Polish versions of the IN-PATSAT32 and QLQ-INFO25 are reliable and valid instruments providing domains not covered by the core EORTC module. These tools are suitable for use in daily clinical practice, in research as well as in clinical trials to obtain data regarding patients’ perception of and satisfaction with received information within the socioeconomic and cultural context of Poland.

BackgroundPrimary neuroendocrine neoplasms of the breast (Br-NENs) are rare. The classification has been updated in recent years making interpretation of the data published challenging. It is unclear whether neuroendocrine differentiation is associated with poorer prognosis and what treatment approaches should be applied.MethodsThe database for breast cancer patients treated between 2009 and 2022 at the Maria Sklodowska-Curie National Research Institute of Oncology Branch Krakow was explored to search for Br-NENs. Patients’ medical and pathological data were collected and analyzed.ResultsWe included 22 females with Br-NEN without metastases at the time of diagnosis. The median age was 64 years (range: 28-88), Of the cases, 18 were hormone receptor positive, all were HER-2 negative, the median Ki67 was 27% (10-100%). The median tumor size at the time of diagnosis was 29.5mm (7-75mm), 9 patients were N-positive. DCIS was present in 5 cases. Only one case was negative for chromogranin and synaptophysin staining, but data were missing for 4 cases. Nine patients received adjuvant chemotherapy, mainly based on anthracyclines and taxanes, while 16 received adjuvant hormonal therapy and 15 received postoperative radiotherapy. Radical surgery was performed in all patients, but two underwent suboptimal tumorectomy. One patient had local recurrence, three experienced metastatic disease, all involving the lungs, but these patients are still alive. The median follow-up was 96 months (8–153). Two patients died, with a follow up time of no recurrence >4 years. Our results were compared to twelve case series collecting clinical data on Br-NENs, with median patient number of 10.5 (range: 3-142).ConclusionBr-NENs represent a heterogenous group of diseases, lacking data from prospective studies or clinical trials. There are no established treatment standards tailored for Br-NENs. Our patients’ cohort exhibited a favorable prognosis, potentially attributed to lower tumor stage and Ki67 index compared to other reported case series. We suggest that radical surgery and postoperative radiotherapy be administered akin to standard treatment for breast cancer of no special type. ESMO also advocates for this approach in systemic treatment, although we recommend considering platinum-based chemotherapy for patients with poorly differentiated Br-NENs exhibiting high Ki67.

Metaplastic breast cancer (BC-Mp), which includes a range of epithelial and mixed epithelial-mesenchymal tumours, are rare malignancies with an unfavourable prognosis. The limited literature on BC-Mp focuses mainly on retrospective data for radically treated patients. Notably absent are studies dedicated to the palliative treatment of BC-Mp with distant metastases. The present retrospective study investigated treatment modalities and prognosis in a multi-centre cohort of 31 female participants diagnosed with distant metastatic BC-Mp, including 7 patients with de novo metastatic disease. The median age of the patients was 61 years (range, 33-87 years), with 38.7% presenting local lymph node involvement. Lungs were the most common site for the metastatic disease (61.3%). Median Ki-67 index was 50% (range, 35-70%), and 80.7% of cases were classified as grade 3. Human epidermal growth factor receptor 2 (HER2)+ and estrogen receptor+ were detected in 12.9 and 6.5% of cases, respectively. A total of 62.4% of patients received first-line palliative systemic treatment. The 1- and 2-year overall survival (OS) were 38.5 and 19.2%, respectively. Receiving ≥1 line of palliative treatment was significantly associated with improved OS (P<0.001). Factors such as age, Ki-67 index, HER2 or hormonal status, presence of specific epithelial or mesenchymal components, location of metastases or chemotherapy regimen type did not influence OS. The present study provided insights into the clinicopathological profile, systemic treatment experience, prognostic factors and OS data of BC-Mp with distant metastases, emphasizing the imperative for clinical trials in this population.

Introduction. Adrenocortical carcinoma (ACC) has an incidence of 1–2 cases per million and the 5-year overall survival (OS) is 16–47%. Surgery is the treatment of choice. Post-operative radiotherapy has been shown to prolong overall survival and the purpose of this work was to show our own, first time in Poland, results of adjuvant radiotherapy in tre­ating this disease. Material and methods. Between 2012 and 2021, 12 patients with ACC were treated. The analyzed group included 9 women and 3 men at a mean age of 44 years (range: 33 to 76 years). A significant increase of tumor size was found in 30% of the subjects. In the analyzed group, 12 patients were qualified to adjuvant radiotherapy, but it was feasible only in 7 patients. The other 5 patients did not undergo radiotherapy. Two patients were disqualified due to metastatic disease and in 3 patients radiotherapy could not be performed due to excessive tumor size and too high a risk of com­plications within the critical organs. Results. 3 out of 7 patients who received adjuvant radiotherapy are still alive and 4 of them died. Mean overall survival time was 32 months. The 12-month overall survival rate was 80%. In the group of 5 patients who have not received radiotherapy, 2 patients are still alive. The mean overall survival time is 13.5 months and the 12-month overall survival rate is 60%. Conclusions. Due to rapid disease progression and poor prognosis associated with ACC, patients with tumors located in the adrenal gland require urgent surgical treatment at a reference center. Adjuvant radiotherapy improves treatment results significantly, but is not feasible in some patients due to cancer progression or the tumor location. In patients with ACC, it is important to diagnose the disease and to start adequate treatment as early as possible.

Background: On 24th of February 2022, Ukrainian cancer patients had to face a new war. Here we describe an experience of the Maria Sklodowska-Curie National Research Institute of Oncology Branch Krakow in providing cancer care for Ukrainian refugees during the initial 6 weeks of war. We present patients' characteristic, point out the main challenges and share initiatives undertaken. Materials and methods: For this cross-sectional analysis, we have gathered demographic and clinical data together with date of crossing the Polish-Ukrainian border for 112 Ukrainian refugees with cancer who had their first-time oncology consultation between 24th February and 8th April 2022. We have also implemented national guidelines and created local procedures, interventions and policies to manage this situation. Results: The peak of patient inflow was the third week of War and refugees accounted for 13% of all first-time patients within that period of time. The majority of refugees were women (86%), treated radically (57%) with breast cancer (43%). Most of the patients required systemic treatment (67%). Amongst the main challenges at the time were differences in the reimburse-ment system, communication issues, lack of patients' documentation or tissue samples, pro-longed diagnostic or treatment interruptions, increased risk of COVID-19 infections, chemotherapy side effects, and lack of procedures. Legal, procedural and organizational steps implemented at the local and national level were described.Conclusions: The Russian invasion on Ukraine forced an unexpectedly high number of Ukrai-nian cancer patients to seek help abroad, leading to the

Regarding attempts to find de-escalation methods of treatment for patients with HPV16-positive squamous cell carcinoma of the oropharynx (OPSCC), there is an urgent need to identify new prognostic factors which allow physicians to differentiate the prognosis of these patients. The aim of the study is to compare the incidence of transcriptionally active HPV16 infection and its type as well as other epidemiological, clinical, and histopathological features between SCC of the base of the tongue (BOTSCC) and tonsils (TSSCC). The analysis was performed in a group of 63 patients with OPSCC, for which, in our earlier studies, we assessed transcriptionally active HPV16 infection and its type (viral load and viral genome status). Transcriptionally active HPV16 infection was significantly more common in TSSCC (96.3%) than in BOTSCC (3.7%). Patients with TSSCC had significantly higher disease-free survival rates (84.1%) than those with BTSCC (47.4%); the same was true in the subgroup with HPV16 positivity. The obtained results are an important indication for further research on the development of new prognostic and/or predictive factors for patients with HPV16-positive squamous cell carcinomas of the oropharynx.

Metaplastic breast cancer (BC-Mp) presents diagnostic and therapeutic complexities, with scant literature available. Correct assessment of tumor size by ultrasound (US) and full-field digital mammography (FFDM) is crucial for treatment planning. Methods: A retrospective cohort study was conducted on databases encompassing records of BC patients (2012–2022) at the National Research Institutes of Oncology (Warsaw, Gliwice and Krakow Branches). Inclusion criteria comprised confirmed diagnosis in postsurgical pathology reports with tumor size details (pT) and availability of tumor size from preoperative US and/or FFDM. Patients subjected to neoadjuvant systemic treatment were excluded. Demographics and clinicopathological data were gathered. Results: Forty-five females were included. A total of 86.7% were triple-negative. The median age was 66 years (range: 33–89). The median pT was 41.63 mm (6–130), and eight patients were N-positive. Median tumor size assessed by US and FFDM was 31.81 mm (9–100) and 34.14 mm (0–120), respectively. Neither technique demonstrated superiority (p > 0.05), but they both underestimated the tumor size (p = 0.002 for US and p = 0.018 for FFDM). Smaller tumors (pT1-2) were statistically more accurately assessed by any technique (p < 0.001). Only pT correlated with overall survival. Conclusion: The risk of underestimation in tumor size assessment with US and FFDM has to be taken into consideration while planning surgical procedures for BC-Mp.

Background: The prognosis of squamous cell carcinoma of head and neck (HNSCC) patients remains relatively poor over the last years. Tobacco, alcohol and active human papillomavirus (HPV) infection are involved in HNSCC development. Akt is a serine-threonine protein kinase with main phosphorylation sites at Thr308 and Ser473, which are critical to generate a high level of Akt activity. Materials and methods: The aim of the study was to compare the expression and prognostic potential of total Akt and its 2 phosphorylated forms - pAkt(Ser473) and pAkt(Thr308) in relation to HPV status in HNSCC patients. The expression levels of proteins were assessed immunohistochemically. To select independent prognostic factors univariate and multivariate analyses with Cox proportional regression model were performed. Results: Among HNSCC with active HPV16 infection significantly more tumors with high Akt (67.86%, p = 0.026) and low pAkt(Ser473) (64.29%, p = 0.000) expressions were found as compared to those with HPV negativity, while there was no significant difference in the pAkt(Thr308) expression level between HPV positive and negative tumors (p = 0.359). In the whole group of HNSCC patients independent favorable prognostic factors were low T stage, low pAkt(Thr308) expression, HPV16 active infection presence (for OS and DFS) and female gender (for OS only). Conclusions: Our results indicate an important role of pAkt(Thr308) as prognostic biomarker for HNSCC patients. There is a high probability that using Akt inhibitors would improve therapeutical benefits and treatment effectiveness, especially in HNSCC patients with high expression of pAkt.

INTRODUCTION Recently, the prognosis of patients with HER2-positive breast cancer (BC) has improved significantly owing to the use of combined treatment modalities. However, systemic treatment is associated with increased risk of cardiotoxicity. OBJECTIVES We aimed to assess subclinical cardiac alterations during the final stage of adjuvant combined therapy, that is, trastuzumab therapy (TT), as potential predictors of late cardiac complications in patients with HER2-positive BC. PATIENTS AND METHODS We enrolled 251 patients with HER2-positive BC treated with radical local therapy, adjuvant chemotherapy (anthracyclines or anthracyclines+taxanes), and immunotherapy (trastuzumab). Patients underwent 6 echocardiographic examinations: at baseline, during TT, and after TT, with assessment of left ventricular ejection fraction (LVEF), degree of valvular regurgitation, cardiac chamber diameters. RESULTS Valvular fibrosis (28.4% of patients) was associated with older age, hypertension at baseline, and a higher degree of regurgitation during TT. Reduced LVEF, greater regurgitation, and larger cardiac chamber diameters were noted during TT. Patients who received higher anthracycline doses showed a greater degree of aortic insufficiency and a larger right ventricular diameter. Reduced LVEF during TT was associated with radiotherapy or chemotherapy and degree of valvular regurgitation. Significantly larger diameters were observed in older patients and in those with comorbidities at baseline, high body mass index, and regurgitation. CONCLUSIONS Asymptomatic subclinical cardiac alterations during TT may predict late cardiac complications; however, longer follow-up is necessary to confirm this hypothesis. Patients with HER2-positive BC should be closely monitored for possible cardiac alterations during and after therapy to ensure optimal care and guide therapeutic decision-making.

INTRODUCTION:In our earlier publications, in the group of 63 patients with oropharyngeal cancer, we have found HPV16 infection (assessed by qPCR) in 25 tumours (39.7%), immunohistochemical overexpression of CD44, CD98, ALDH1/2 and Nanog in, respectively: 43 (68.2%), 30 (47.6%), 33 (52.4%), and 53 (84.1%) cancers. Analysing CD44, CD98, ALDH1/2, we have also shown that lack of CD44 overexpression indicates excellent prognosis in patients with HPV16 positivity. The aim of the present study was to compare prognostic potential of Nanog, Oct3/4, Sox-2 expression in relation to CD44, CD98, ALDH1/2 immunoreactivity (assessed by us earlier) and clinicopathological features in the subgroups of patients: with HPV16 positivity and HPV16 negativity.METHODS:Status of Oct3/4 and Sox-2 expression was assessed for 63 patients with oropharyngeal cancers based on immunohistochemistry. In survival analysis, two endpoints were applied: overall survival (OS) and disease-free survival (DFS).RESULTS:Overexpression of Oct3/4 and Sox-2 was found in 0 (0.0%) and 27 (42.9%) of patients. In the subgroup with HPV16 positivity, the DFS for patients with lack of Sox-2 overexpression was significantly (p = 0.003) higher than for patients with Sox-2 overexpression. In the subgroup with HPV16 negativity, Nanog and Sox-2 immunoexpression did not significantly influence OS and DFS. In multivariate analysis performed for the subgroup with HPV16 positivity, lack of CD44 overexpression (p = 0.012) and lack of Sox-2 overexpression (p = 0.027) were positive independent prognostic factors.CONCLUSION:Based on CD44 and Sox-2 immunoreactivity, it is possible to differentiate the prognosis of HPV16-positive patients with oropharyngeal cancers.

Trastuzumab-induced cardiotoxicity (TIC) can lead to early treatment discontinuation. The aim of this study was to evaluate: N-terminal brain natriuretic peptide (NT-proBNP), creatine kinase-MB (CK-MB), myoglobin, and selected biochemical and clinical factors as predictors of TIC. One hundred and thirty patients with HER2-positive BC receiving adjuvant trastuzumab therapy (TT) were enrolled. Measurement of cardiac markers and biochemical tests as well as echocardiography were performed prior to TT initiation and every three months thereafter. Cardiotoxicity leading to treatment interruption occurred in 24 patients (18.5%). While cardiotoxicity caused early treatment discontinuation in 14 patients (10.8%), the TIC resolved in 10 (7.7%) and TT was resumed. The most common complication was a decrease in left ventricular ejection fraction of more than 10% from baseline or below 50% (7.7%). In patients with TIC, there was no increase in the levels of NT-proBNP, myoglobin, and CK-MB. BMI, hypertension, ischemic heart disease, diabetes, age, cancer stage, type of surgery, use of radiotherapy, chemotherapy, and hormone therapy were shown to not have an effect on TIC occurrence. NT-proBNP, myoglobin, and CK-MB are not predictors of TIC. There is an ongoing need to identify biomarkers for TIC.

Infection with HPV16 in cancers of the oral cavity (OCSCC) and oropharynx (OPSCC) is, today, an important etiological and prognostic factor. Patients with HPV-positive OPSCC have a better prognosis than uninfected patients. However, in over 40% of these patients, cancer progression is noticed. Their identification is particularly important due to the ongoing clinical trials regarding the possibility of de-escalation of anticancer treatment in patients with HPV-positive OPSCC. Some studies suggest that there is possibility to differentiate prognosis of HPV16-positive patients by STING (Stimulator of Interferon Genes) immunoexpression. The aim of the present study was to analyze the influence of STING immunoexpression on overall (OS) and disease-free survival (DFS) of patients with HPV16-positive and -negative OCSCC and OPSCC. The study was performed in a group of 87 patients with OCSCC and OPSCC for which in our earlier study active HPV16 infection was assessed by P16 expression followed by HPV DNA detection. To analyze STING immunoexpression in tumor area (THS) and in adjacent stromal tissues (SHS) H score (HS) was applied. In the subgroup with HPV16, active infection patients with tumors with THS had significantly better DFS (p = 0.047) than those without THS. In this subgroup, TSH did not significantly influence OS, and SHS did not significantly correlate with OS and DFS. In the subgroup of patients without active HPV16 infection, THS and SHS also did not significantly influence patients' survival. Presented results indicated prognostic potential of tumor STING immunoexpression in patients with active HPV16 infection in cancers of oral cavity and oropharynx.

Introduction: Inflammatory diseases of the locomotor system are a very heterogeneous group of ailments, including enthesopathies. They arise as a result of long-term overload in the area of tendon attachments, which may lead to chronic inflammation and then, degeneration, which are the cause of chronic pain. The main methods of treatment are physiotherapy, physical agents treatment, pharmacological and orthopaedic treatment, i.e. manual therapy, the use of appropriate insoles correcting posture defects, cryotherapy, shock waves, iontophoresis, non-steroidal anti-inflammatory drugs, steroid injections, surgery and platelet-rich plasma therapy. Another, lesser-known method of treatment is low-dose radiation therapy (LDRT). Research objective: To evaluate the efficacy, time to improvement and analgesic effect duration after low dose radiotherapy (LDRT) in patients with enthesopathies. Materials and methods: A retrospective analysis included a group of 90 patients (51 women, 39 men) with a diagnosis of enthesopathy and treated with conformal radiotherapy using photon radiation at the NIO in Kraków from July 2018 to April 2021. The treated group included patients with heel, elbow, knee, shoulder and wrist problems. In each case, the total dose of radiation was 6 Gy, divided into 6 fractions administered on subsequent working days, given in a vacuum form to the patient immobilised. Pain was assessed with the use of an 11-point numerical rating scale (NRS). Pain was assessed by implementing the above mentioned scale prior to the commencement of radiotherapy, during the treatment, and then 1 month and 6 months following the completion of treatment. Results: In the vast majority of patients (92%), with a mean age of 51 years, at least temporary, partial improvement of pain has been demonstrated in the irradiated joints. The median time to treatment response was 30 days. Median pain intensity, as measured via the NRS scale, was 8.0 (IQR 7.0-10.0) before the treatment, 5.0 (IQR 3.0-7.0) after 1 month, and 2.0 (IQR 0-4.0) after 6 months from treatment completion. Persistent improvement in pain control after LDRT was shown in 85% of patients, with a mean follow-up period of 522 days (range: 55-952 days). The best response was observed in patients with heel spurs (a decrease of median NRS score by 7.0). Conclusions: Low dose RT is a very effective method of pain reduction in enthesopathies, particularly among patients with heel spurs. Most patients experienced pain reduction as early as 1 month after LDRT. Continuous pain reduction was observed during the follow-up period up to the 6th month and in most cases, the analgesic effect was long-lasting.

This study aimed to compare prognostic potential of Nanog expression analysed by three immunohistochemical scores in the group of 63 squamous cell carcinomas of oropharynx. Immunoreactivity of Nanog expression was analyzed by semiquantitative score, immunoreactive score and H-score. For all three scores, the cut-off points for Nanog overexpression and its lack, allowing for optimal separation of overall and disease free survival curves, were search by minimal p-value method. In semiquantitative score, the best separation of overall and disease free survival curves was obtain by cut-off point lack of staining vs. week/moderate/strong staining, although statistical significance was not reach (OS: HR = 1.016, p = 0.081, DFS: HR = 6.876, p = 0.061). The cut-off points for immunoreactive score and H-score were, respectively: 1 (OS: HR = 6.977, p = 0.014, DFS: HR = 6.002, p = 0.019) and 50 (OS: HR = 6.977, p = 0.014, DFS: HR = 6.002, p = 0.019). The cut-off points found for these two scores allow to identify the same subgroups of patients with lack of Nanog expression (11.1%) and its overexpression (88.9%). All patients with tumors characterized by lack of Nanog overexpression identifying by immunoreactive score and H-score survived 5 years without evidence of cancer progression. In multivariate analysis Nanog immunoreactivity analysed by QRS and IRS was independent prognostic factor for OS (HR = 10.195, p = 0.024). Immunohistochemical score using to distinguish Nanog overexpression or its lack has influence on prognostic potential of this biomarker.