Oncosurgery in the Czech Republic.

The article describes the development of oncosurgery in the Czech Republic since the beginning of the century, as well as other perspectives regarding this specialty. The development of surgical treatment of solid malignant tumours in the Czech Republic was evaluated according to the National Cancer Register database and compared to the neighbouring countries, and the educational system of surgeons in oncosurgery was assessed. Although surgery plays a key role in cancer therapy, starting from the beginning of this millennium it has been pushed aside as a service specialty for other disciplines in oncology. In 2002, these changes were supported by the activities of the newly founded Division of Oncosurgery under the Czech Society for Oncology, which became part of the Czech Surgical Society in 2016. An official educational programme of surgeons in oncology was successfully implemented and since 2011, a specialization examination in oncosurgery has been introduced, organized by the subdepartment of oncosurgery of the Institute of Postgraduate Medical Education (IPVZ), Prague. To date, this examination has been completed by 112 physicians and approximately the same number is currently registered in the educational programme. Currently, 34 centres are accredited for education in oncosurgery. The establishment of Complex Oncology Centres based on an initiative of the Czech Society for Oncology of 2006 only addressed pharmaceutical and radiation oncology. Despite progress in oncosurgery, more clearly defined conditions for this specialty are needed. Conclusion: The education of surgeons in oncosurgery should be continued. It is necessary to expand the number of centres with accreditation for oncosurgery and develop a concept for oncosurgery in the Czech Republic which would be associated with rational concentration of this treatment in connection with organization and provision of continuous urgent and acute surgical care in the Czech Republic, including control mechanisms to ensure its quality. This proposal should be discussed by the Czech Surgical Society in order to further enhance the quality of oncosurgery in the Czech Republic.

Prevalence and evolution of spasticity in patients suffering from first-ever stroke with carotid origin: a prospective, longitudinal study.

BACKGROUND AND PURPOSE: The main aim of the study was to document the occurrence and evolution of post-stroke spasticity (PSS). The secondary goal was to identify predictors for increases and decreases in PSS rates during 12 months of subsequent follow-up. METHODS: In a longitudinal, multicenter, prospective cohort study, assessments were done at 7 days (V1), 6 months (V2), and 12 months (V3) after stroke onset. A total of 307 consecutive patients from four comprehensive stroke centers with the first-ever stroke of carotid origin and the presence of motor deficit at day 7 were included. The demographic data, baseline characteristics, Barthel index, degree and pattern of paresis and muscle tone were evaluated and recorded. Spasticity was assessed using the modified Ashworth scale. RESULTS: Spasticity was present in 45.0% of patients at V1, in 49.5% at V2, and in 43.2% at V3. A significant number of patients experienced changes in spasticity between visits: increased/new occurrence of spasticity in 32.5% (V1 and V2) and in 13.6% (V2 and V3) of patients; decreased occurrence/disappearance of spasticity in 18.5% (V1 and V2) and in 18.3% (V2 and V3) of patients. The number of patients with severe spasticity increased throughout the year, from 2.6% to 13.0% (V2) and 12.5% (V3). CONCLUSIONS: Spasticity developed in almost half of the included patients. The degree of spasticity often changed over time, in both directions. The rate of severe spasticity increased during the first year, with the maximum at 6 months following stroke onset.

Epidemiology of Plasma Cell Leukemia in the Czech Republic.

BACKGROUND: Plasma cell leukemia (PCL) is a rare but most aggressive form of monoclonal gammopathies. PCL is characterized by the presence of clonal plasma cells in peripheral blood. There are two forms of PCL - primary which presents de novo in patients with no evidence of previous multiple myeloma and secondary which is a leukemic transformation of relapsed or refractory dis-ease in patients with previously recognized multiple myeloma. MATERIALS AND METHODS: This is the first study to provide information on PCL epidemiology in the Czech population us-ing The Czech National Cancer Registry (CNCR) as the basic source of data for the population-based evaluation of PCL epidemiology. RESULTS: Accord-ing to CNCR data, there were on average six newly dia-gnosed cases of PCL and four deaths caused by PCL each year in the Czech Republic in the period 2000- 2015. PCL incidence in the Czech Republic was reported at 0.57 per million in 2000- 2015. We suppose that most reported cases of PCL are primary PCL because secondary PCL is a relapse of a previously reported myeloma and, in most cases, is not coded as an independent dia-gnosis in the CNCR. CONCLUSION: Data from registries such as the CNCR can provide useful information on epidemiology of various dis-eases. These data, however, have several limitations, such as dia-gnostic criteria and proper cod-ing of not only the dis-ease itself, but also its various forms. These limitations have to be taken into account dur-ing the process of results interpretation. Key words plasma cell leukemia -  epidemiology -  Czech National Cancer Registry (CNCR) -  Czech Republic.

Trends in incidence of childhood cancers in the Czech Republic: population- based analysis of national registries (1994-2014).

The purpose of this study is to summarize incidence and trends in the pediatric cancer burden in the Czech Republic over the period 1994-2014. The recently established Childhood Cancer Registry was combined with retrospective data from the Czech National Cancer Registry to analyze the annual patterns of incidence and long-term trends of pediatric cancer patients aged 0-14 years diagnosed between 1994 and 2014. Malignancies were classified according to the International Classification of Childhood Cancer. The distribution of incidence was stratified according to gender, age at diagnosis, type of cancer and geographic area. Annual age-standardized rates were adjusted using the world standard population. Changes over time were quantified as the average annual percentage change. This analysis comprised records of 5,605 children diagnosed with cancer within the period 1994-2014, annually 267 records on average; the overall age-standardized average annual incidence rate was 169 cases per million. Boys were affected more frequently than girls: the M/F crude incidence ratio was 1.2:1. The highest incidence rates were observed for ICCC groups I (27.8%), III (21.8%), II (12.4%) and IV (7.8%); other groups formed 30.2%. There are significant differences in the geographic distribution of incidence between regions. A borderline statistically significant increase (0.6%) in the overall average annual percentage change was detected between 1994 and 2014 (95% CI: 0.01 to 1.12; p = 0.05). This study provides reliable recent information on trends in the incidence of childhood cancers in the Czech Republic.

Epidemiology of Multiple Myeloma in the Czech Republic.

BACKGROUND: Multiple myeloma (MM) is a cancer of plasma cells with an incidence of 4.8 cases per 100,000 population in the Czech Republic in 2014; the burden of MM in the Czech Republic is moderate when compared to other European countries. This work brings the latest information on MM epidemiology in the Czech population. MATERIAL AND METHODS: The Czech National Cancer Registry is the basic source of data for the population-based evaluation of MM epidemiology. This database also makes it possible to assess patient survival and to predict probable short-term as well as long-term trends in the treatment burden of the entire population. RESULTS: According to the latest Czech National Cancer Registry data, there were 504 new cases of MM and 376 deaths from MM in 2014. Since 2004, there has been a 26.9% increase in MM incidence and an 8.3% increase in MM mortality. In 2014, there were 1,982 persons living with MM or a history of MM, corresponding to a 74.4% increase when compared to MM prevalence in 2004. The 5-year survival of patients treated in the period 2010-2014 was nearly 40%. CONCLUSION: The available data make it possible to analyse long-term trends in MM epidemiology and to predict the future treatment burden as well as treatment results.Key words: multiple myeloma - epidemiology - Czech National Cancer Registry - Registry of Monoclonal Gammopathies - Czech Republic.

Cryogenically-cooled Yb:YGAG ceramic mode-locked laser.

This work reports on a liquid-nitrogen-cooled, SESAM mode-locked Yb:YGAG (Yb:Y(3)Ga(2)Al(3)O(12)) ceramic laser. The Yb:YGAG has a similar structure to Yb:YAG, but its emission spectrum at low temperature remains much broader, which is suitable for ultrashort pulse generation and amplification. A stable pulse train with 119-MHz repetition rate was obtained at a wavelength of 1026 nm. The measured pulse duration is 2.4 ps, which is more than four times shorter than that achieved with a cryogenically-cooled Yb:YAG. Furthermore, laser performance of the Yb:YGAG ceramics in continuous-wave operation and wavelength tunability at 80 K was investigated.

Estimating cancer incidence, prevalence, and the number of cancer patients treated with antitumor therapy in 2015 and 2020 -  analysis of the Czech National Cancer Registry.

BACKGROUND: Cancer burden in the Czech population ranks among the highest worldwide, which introduces a strong need for a prospective modelling of cancer incidence and prevalence rates. Moreover, a prediction of number of cancer patients requiring active antitumor therapy is also an important issue. This paper presents the stage-specific predictions of cancer incidence and prevalence, and the stage- and region-specific patients requiring active antitumor therapy for the most common cancer diagnoses in the Czech Republic for years 2015 and 2020. The stage-specific estimates are also presented with regard to the treatment phase as newly diagnosed patients, patients treated for non-terminal recurrence, and patients treated for terminal recurrence. PATIENTS AND METHODS: Data of the Czech National Cancer Registry from 1977 to 2011 has been used for the analysis, omitting the records of patients diagnosed as death certificate only or at autopsy. In total, 1,777,775 incidences have been considered for the estimation using a statistical model utilizing solely the population-based cancer registry data. All estimates have been calculated with respect to the changing demographic structure of the Czech population and the clinical stage at diagnosis. RESULTS: Considering year 2011 as the baseline, we predict 89%, 15%, 31% and 32% increase in prostate, colorectal, female breast and lung cancer incidence, respectively, in 2020 resulting in 13,153, 9,368, 8,695, and 8,604 newly dia-g--nosed cancer patients in that year, respectively. Regarding cancer prevalence in 2020, the estimated increase is 140%, 40%, 51%, and 17% for prostate, colorectal, female breast and lung cancer, respectively, meaning that more than 100,000 prevalent female breast cancer patients as well as more than 100,000 prevalent prostate cancer patients are expected in the Czech Republic. The estimated numbers of patients requiring active antitumor therapy for prostate, colorectal, female breast and lung cancer in the Czech Republic in 2020 are 23,652, 14,006, 14,759 and 8,272; respectively. CONCLUSIONS: The analysis documents a serious increase in cancer incidence and prevalence in the Czech Republic in years 2015 and 2020 when compared to the situation in 2011. Regarding the estimated numbers of patients requiring active antitumor therapy, the model confirms a continuous increase that must be accounted for in the future planning of health care in the Czech Republic.

[Epidemiology of cancers with implemented screening programmes in an international comparison]. / Epidemiologie zhoubných nádoru se zavedeným screeningem v mezinárodním srovnání

International data document that the Czech Republic ranks among the countries with the highest cancer burden in Europe and worldwide. Preventable cancer diseases, i.e. colorectal, breast, and cervical cancer, are among the most frequent types. These international studies also bring some positive information, e.g., stabilised or slightly decreasing mortality, better treatment outcomes and patient survival rates. However, it should be noted that, with regard to the high population burden, these results are achieved at the very high price of costly modern cancer treatment.

[Objective need for cancer prevention in the Czech Republic and Europe, and the state thereof]. / Objektivní potreba a stav nádorové prevence v Ceské republice a v Evrope

There is no doubt today of the need for cancer prevention. The growing incidence of cancer itself provides a sufficient justification for prevention programmes. A review of literature presented in this paper also documents the strong background of evidence-based cancer prevention programmes. The article also provides a critical analysis of the current status of primary cancer prevention and cancer screening in the Czech Republic in contrast with available international comparisons. Relevant international data have been obtained from the regularly repeated "Health at a Glance" studies (published by the OECD). Although the Czech Republic is one of the countries with the highest cancer burden in Europe, it has failed to develop and support a cancer prevention policy on a central level, and this also applies to smoking prevention. The Czech population needs an effective national strategy for the support of cancer prevention, as well as a strategy which would ensure equitable cancer care in terms of both quality and correct indication; a strategy which would be sustainable for at least 10 to 15 years to come.Key words: oncology - screening - risk factor - prevention - population burden This study was supported by the project 36/14//NAP "Development and implementation of methodology for the evaluation of effectiveness of personalised invitations of citizens to cancer screening programmes" as part of the pro-gram-me of the Czech Ministry of Health "National action plans and conceptions". The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE "uniform requirements" for biomedical papers.

[Epidemiology of screening-targeted cancers according to new data of the Czech National Cancer Registry]. / Epidemiologie zhoubných nádoru cílených screeningem dle nových dat Národního onkologického registru Ceské republiky.

The Czech Society for Oncology has developed an information system which combines the population-based Czech National Cancer Registry with clinical databases in order to cover the main areas of health care assessment - monitoring of the population burden, prediction of the number of cancer patients, diagnostic and treatment results. The presented data demonstrate a high cancer burden within the Czech population - each year there are approximately 8,000 new cases of colorectal cancer, 6,500 new cases of breast cancer, and 1,000 new cases of cervical cancer. And each year, about 4,000 people die from colorectal cancer, around 2,000 women die from breast cancer, and approximately 400 women die from cervical cancer in the Czech Republic. Population-based screening programmes focus on all of the above-mentioned groups of malignant tumours; therefore, it is essential to monitor epidemiological trends in order to assess the screening impact. Despite the high incidence rates of all three cancer types, the trend in mortality rates has been stable or has even decreased in the long term, which has inevitably led to a significant increase in the total prevalence of cancer patients. In 2011, the prevalence of colorectal cancer, breast cancer and cervical cancer amounted to 51,064 people, 67,261 women and 17,398 women, respectively. When compared with the year 2001, there was a 59%, 69% and 25% increase in the prevalence of colorectal cancer, breast cancer, and cervical cancer, respectively. Undoubtedly, taking care of high numbers of cancer patients will continue to require significant financial resources in the near future. As the epidemiological burden is still on the increase, preventive programmes need to be further promoted, including secondary prevention, which is provided through organised screening programmes. Although effective methods exist for timely diagnosis of all three of the above-mentioned cancer types, the epidemiological situation in the Czech Republic is being steadily worsened by a relatively high proportion of primary cancers being diagnosed too late. Each year, more than 50% of new colorectal cancer cases are diagnosed in clinical stage III or higher; in cervical cancer, this proportion is nearly 35%. By contrast, the well-promoted breast cancer screening programme has led to more than 75% of new cases of breast cancer being diagnosed in stages I or II, when the chance of successful treatment is significantly higher.

[On the importance of standardization in the assessment of population-based cancer patient survival in the Czech Republic -  methodology and results from the Czech National Cancer Registry]. / Význam standardizace v hodnocení populacního prezití onkologických pacientu v CR -  metodický koncept a výsledky analýzy dat Národního onkologického registru.

BACKGROUND: Calculating 5-year overall and relative survival is the standard method for population-based analyses in oncology. Survival rates based on population data do not, however, guarantee standardized benchmarks for comparison of different patient populations, which is especially true when compared populations differ considerably in age structure and representation of clinical stages. In this paper, we present and compare statistical methods for standardization of cancer survival rates. PATIENTS AND METHODS: Using data of the Czech National Cancer Registry, we estimated 5-year overall and relative survival estimates for periods 2001- 2005 and 2006- 2010. To demonstrate the effect of standardization, we calculated crude and age -standardized survival rates as well as survival rates standardized for both age and clinical stage. RESULTS: Our results show that the particular standardization method influences resulting 5-year overall and relative survival rates regarding both within and between time periods comparisons. In addition, our results document a recent improvement in 5-year relative survival between periods 2001- 2005 and 2006- 2010 for 19 of 20 evaluated diagnoses. All most prevalent cancers including prostate, lung, colorectal, breast, kidney, and uterine cancer and melanoma were observed among the diagnoses with statistically significantly improved patient survival. CONCLUSION: Unless the use of standardization to the age and stage of tumor is limited due to a small number of patients in individual age-  and stage- specific subgroups, this method can be considered as a proper statistical methodology for the population assessment of Czech cancer patient survival rates.

Cancer incidence and mortality in the Czech Republic.

BACKGROUND: The Czech Republic ranks among the countries with the highest cancer burden in Europe as well as worldwide. The purpose of this study is to summarize longterm trends in the cancer burden and to provide up-to-date estimates of incidence and mortality rates after 2011. DATA AND METHODS: The Czech National Cancer Registry (CNCR) was instituted in 1977 and contains information collected over a 34-year period of standardized registration covering 100% of cancer diagnoses within the entire Czech population. The CNCR analysis is supported by demographic data and by the Death Records Database. An overview of the epidemiology of malignant tumors in the Czech population is available online at www.svod.cz. RESULTS: All neoplasms, including nonmelanoma skin cancer, reached a crude incidence rate of almost 802 cases per 100,000 men and 681 cases per 100,000 women in 2011. The annual mortality rate exceeded 258 deaths per 100,000 individuals; in other words, more than 27,000 individuals die of cancer each year. The overall incidence of malignancies has increased with a growth index of +27.6% during the last decade (2001- 2011), while the mortality rate has been stabilized over the time span (growth index in 2001- 2011: - 5.0%). Consequently, the prevalence has significantly increased in the observed period and exceeded 475,000 cases in 2011. In addition to demographic aging of the Czech population, the cancer burden has also increased due to the growing incidence of multiple primary tumors (recently more than 15% of the total incidence). The most frequent diagnoses include colorectal cancer, lung cancer, breast cancer, and prostate cancer. Although some neoplasms are increasingly diagnosed at an early stage (e. g. the proportion of stage I or II was 75.3% for female breast cancer and 84.2% for skin melanoma), the numbers of early diagnosed cases are generally insufficient, even in the case of highly prevalent cancers such as colorectal carcinoma (only 46.1% of incident cases are diagnosed at stage I or II, according to recent data). CONCLUSION: Population-based data on malignant tumors are available in the Czech Republic. The data survey can help us define national cancer management priorities. The current priority is to achieve a sustained reduction of cases diagnosed at an advanced stage and reduction of the significant regional differences in diagnostic efficiency.

The outcome of allogeneic HSCT in older AML patients is determined by disease biology and not by the donor type: an analysis of 96 allografted AML patients ≥ 50 years from the Czech acute leukaemia clinical register (alert).

Older patients with AML have poor prognosis after chemotherapy and allo-SCT was historically limited to the young patients. In the multicentre retrospective study we analyzed 96 consecutive AML patients ≥ 50 years allografted with related (n=59) or unrelated (n=37) donor. The 2- year OS and DFS rates were 45 % and 42 % for the whole group. The corresponding figures for related patients were 48% and 42% whereas for unrelated 42% and 42%, respectively (OS p=0,721, DFS p= 0,896). The cumulative incidences of relapse (28% of all patients) and NRM mortality (26%) were low with no significant differences among related and unrelated cohorts. Multivariate analysis revealed the only major independent variables associated with an inferior OS were unfavourable cytogenetics (RR 3.36; CI 1.66-6.83; p=0.001) and advanced disease status (RR 2.30; CI 1.21-4.37; p=0.011). Unfavourable cytogenetics (RR 3.00; CI 1.50-5.99; p=0.002) and advanced disease at SCT (RR 2.27; CI 1.22-4.22; p=0.009) were also the only independent variables associated with inferior DFS. In conclusion, our analysis indicates that outcomes of allografted AML patients aged ≥ 50 years are determined by cytogenetic risk category and disease status at transplantation and not by the type of donor.

[Registry of neuroendocrine tumors (NET) in Czech Republic after three years of data collection]. / Registr neuroendokrinních nádoru (NET) v CR po trech letech sberu dat.

BACKGROUND: Neuroendocrine tumors are traditionally considered to be "rare" diseases. On contrary, the prevalence of neuroendocrine tumors is high. Therefore, the diagnostics, treatment and follow-up of neuroendocrine tumors are subjected to an evolving interest. There are various specifics of neuroendocrine tumors requiring an appropriate feedback of each intervention i.e. data collection and central data evaluation. The "Cooperative Group for Neuroendocrine Tumors" (KSPNN) has been conducting a nationwide neuroendocrine tumors registry since June 2009. The first data summary after three years is aimed at evaluation of feasibility and data utility. MATERIAL AND METHODS: The anonymous data on diagnostics, therapy and follow up of patients with neuroendocrine tumors of any primary site are collected in the registry. The contribution is conditioned by morphologically proven diagnosis according to the current WHO 2010 classification, in earlier cases WHO 2000 classification. The registry is operated by the Institute of Biostatistics and Analyses, Masaryk University (Brno). The initial analysis includes data from June 2009 to October 2012. RESULTS: Data of a substantial share of neuroendocrine tumor carriers have been collected -  742 subjects with a valid record, i.e. about 14% of presumed prevalence. Moreover, the registry covers nearly one fourth of incidence in the period 2009- 2011. The morphological diagnoses with the sign of nonspecific "neuroendocrine tumors" comprise the majority of records (75%); the most frequent is "carcinoid tumor neuroendocrine tumors". This results in a clear requirement for more detailed specifications of morphology as well as separation of small cell (neuroendocrine) carcinoma possessing principal bio-logic differences to neuroendocrine tumors itself. There is an apparent polarity of recorded clinical stages. Both stage I and stage IV comprise 30% of the records. This result is presumably related to how the diagnosis is established, either early and incidentally in initial stage or late with a developed endocrine symptomatology, in advanced stage. There is an evident selection bias. The treatment data reflect current trends, dominance of surgical therapy including reasonable cytoreductive surgery, vast use of somatostatine analogues in advanced disease and persistent position of chemotherapy for high grade tumors. The distribution of treatment modalities in the records documents a certain adherence to international treatment standards (ENETS, ESMO, NCCN). CONCLUSION: The dynamics of data contributions confirm feasibility of data collection in the registry. The registry reveals a clear requirement for more detailed analyses of biopsies and more detailed disease morphology classification. In the near future, the registry is aimed to maintain the increasing volume of collected data and to cover the majority of neuroendocrine tumors incidence.

Long-term trends in the development of the epidemiology of breast cancer in the Slovak and Czech Republic with reference to applied screening and international comparisons.

Breast cancer represents a major problem in oncology and epidemiology, especially because of the growing trends in its incidence, which are most pronounced in countries with historically low levels of incidence of this disease and because of the increasingly unfavorable mortality trends even in some countries where screening has been established. The purpose of this study is to analyse the incidence of breast cancer and resulting mortality in two neighbouring countries with national population-based cancer data in central Europe and to assess possible reasons for any differences discovered. The recorded increase in the incidence of breast cancer in the Slovak and Czech Republic is apparently the result of a westernizing lifestyle. In the Czech Republic the acceleration of the incidence of this disease recorded after 1991 was more pronounced than in the Slovak Republic, which may be influenced especially by the more pronounced increase in the number of mammograms but also by a higher prevalence of risk factors of the disease. After the year 1991 a stabilization of mortality was recorded in both countries. However, this stabilization is not satisfactory but is correlated with the unsatisfactory extent (in the case of the Slovak Republic still unorganized) of screening, with the low number (or unused) mammograms, with slow onset of anti-cancer therapy and with expenditures for health care below the European average. The existing situation with an unfavourable mortality trend in all age groups indicates the importance of implementing intervention measures.

Do we know the cause of the highest colorectal cancer incidence, the changes in the mortality trends and the clinical stages in the Slovak and Czech Republic, the representatives of the Central European region?

Slovak (SR) and Czech (CR) Republics reach up the highest recorded incidence rates of colorectal cancer. In analysis of the development and changes in colorectal cancer incidence in the above-mentioned countries, it was reported the most considerable incidence increase of the disease in males in the SR, then in males in the CR, subsequently in females in the SR and the slowest incidence rate was reported in females in the CR. Colorectal cancer mortality increased most rapidly in males in the SR, then in males in the CR, slower increase was reported in females in the SR and in females in the CR the mortality was in the long term stabilized. In both countries and both sexes clinical stage II is noted most frequently, also the decrease of the disease number in the clinical stage I and in undefined stage, and a slight decrease in other clinical stages. The trends in risk factors of colorectal cancer in the SR and CR would support the hypotheses of the later culmination of incidence and on the higher levels than in other developed countries. The purpose of this study is to analyse the character and changes in development of incidence, mortality and clinical stages of colorectal cancer (1980-2005) and to assess the influence of selected risk factors on the highest disease incidence in above-mentioned two Central European countries.

Trends in the kidney cancer incidence and mortality in the Slovak and Czech Republics in 1980-2005 - in the context of an international comparison.

Incidence rates of kidney cancer vary in global standards more than tenfold, the highest worldwide rates are repeatedly registered in the Czech Republic (hereafter CR) and in other geographically neighbouring countries in Central Europe, including the Slovak Republic (hereafter SR). The aim of the study was to analyse the changes in time trends of incidence and mortality from kidney cancer in two geographically close countries (CR and SR) and to compare detected differences with the worldwide data. In spite of high rates of incidence and its global growth in analyses in 1980 - 2005, the character of its progress in time was changed in both countries. While in 1980 - 1994 the incidence of kidney cancer in males and females in both analysed countries increased significantly, after 1994 (to 2005) stagnation in males in SR and significant slowdown of its growth in males in CR were reported. In females in SR after 1994 significant slowdown of the incidence growth was reported and in CR there was even its non-significant fall. Mortality trend in both sexes in both countries in 1980-2005 was slower than the incidence. After 1994 (to 2005) in males in SR statistically non-significant slowdown of mortality growth was reported, in CR it was statistically significant fall of mortality rates. In women after 1994 (to 2005) statistically non-significant decrease was reported, in CR the decrease was significant. The increase of total incidence of the disease is not explained only by the growth of asymptomatic localized tumors due to high quality diagnostic methods, but it likely reflects actual growth of new cases of the disease. Assumed partial cause of the mortality stabilization and slowdown of the incidence growth after its previous culmination in 1994 is the decline of smoking and obesity prevalence in the last decades in men, although this fact does not reflect situation in women. More striking mortality decrease in CR in comparison with SR might be influenced by potentially more radical surgical therapy (rate of the amount of surgery within primary therapy according to the data in National Cancer Registry CR raises, in SR the data are not available) and by more significant increase of the disease rate in the clinical stages I and II in CR (in SR only short-time data are available).

Incidence of second malignancies during treatment of chronic myeloid leukemia with tyrosine kinase inhibitors in the Czech Republic and Slovakia.

Tyrosine kinase inhibitors (TKI) have completely changed the prognosis of patients with Ph+ chronic myeloid leukemia (CML). The occurrence of a second malignancy (SM) in CML patients successfully treated with TKI may significantly affect their prognosis. In a retrospective study of 1,038 patients with CML treated at 10 centers in the Czech Republic and Slovakia between 2000 and 2009, SM was detected in 35 (3.37%) patients after TKI therapy was initiated. The median intervals from the diagnosis of CML and from the start of TKI therapy to the diagnosis of SM were 58 months (range 2 - 214) and 32 months (range 1 - 102), respectively. The observed age-standardized incidence of SM after the start of TKI therapy was 8.95 / 1,000 person-years. Comparison of the incidence of SM in CML patients with population data was performed only for patients from the Czech Republic. The age-standardized incidence rate of all malignant tumors except non-melanoma skin cancers was 6.76 (95% CI: 6.74; 6.78) / 1,000 person-years in 2000 - 2007 while the incidence rate of SM in 708 CML patients from the Czech Republic treated with TKI was 9.84 (95% CI: 6.20; 13.48) / 1,000 person-years, i.e. 1.5-fold higher, although the difference was statistically insignificant. The distribution of SM types in CML patients treated with TKI was similar to that in the age-standardized general Czech population. The median overall survival (OS) of patients treated with TKI who also developed SM (57 months) was shorter than the OS of patients treated with TKI but not suffering from SM (median OS not reached, log rank test p < 0.001. Prospective long-term population-based studies in CML patients treated with TKI as first-line therapy are needed to determine the relationship of SM to KTI therapy.

Prostate cancer incidence and mortality in selected countries of Central Europe.

BACKGROUNDS: This paper analyzes the incidence and mortality of prostate cancer in the Slovak (SR) and Czech (CR) Republics (as Central European countries with population-based cancer registries) before and after the introduction of PSA testing, the possible reasons for any differences disclosed, and compares the results with selected regions and countries around the world. MATERIAL, METHODS AND RESULTS: In SR, the age-adjusted incidence of prostate cancer rose from 14.6/100,000 in 1968 to 36.2/100,000 in 2005. The estimated annual increase of incidence from 1968 to 1991 (before nation-wide PSA testing) was 0.421 and 1991-2003 it reached 0.941. The mortality rates rose from 7.3/100,000 in 1968 to 14.9/100,000 in 2005. The increase in incidence occurred faster in CR than in SR, from 15.8/100,000 in 1977 to 59.5/100,000 in 2005. The estimated annual increase of incidence in CR in 1977-1991 was 0.581,while in 1991-2003 it reached 1.981. Before 1991, mortality rose more sharply in CR than in SR while after the introduction of PSA testing mortality stabilized more quickly in the CR than in SR. In SR a significant reduction of mortality was observed after 2002 and is probably affected by more factors than those associated with the increase in PSA testing. CONCLUSION: The difference in the incidence and mortality of prostate cancer in SR and in CR results from a difference in the intensity of PSA testing as well as from the earlier introduction of effective treatment in CR.

LIPSS-based functional surfaces produced by multi-beam nanostructuring with 2601 beams and real-time thermal processes measurement.

A unique combination of the ultrashort high-energy pulsed laser system with exceptional beam quality and a novel Diffractive Optical Element (DOE) enables simultaneous production of 2601 spots organized in the square-shaped 1 × 1 mm matrix in less than 0.01 ms. By adjusting the laser and processing parameters each spot can contain Laser Induced Periodic Surface Structures (LIPSS, ripples), including high-spatial frequency LIPSS (HFSL) and low-spatial frequency LIPSS (LSFL). DOE placed before galvanometric scanner allows easy integration and stitching of the pattern over larger areas. In addition, the LIPSS formation was monitored for the first time using fast infrared radiometry for verification of real-time quality control possibilities. During the LIPSS fabrication, solidification plateaus were observed after each laser pulse, which enables process control by monitoring heat accumulation or plateau length using a new signal derivation approach. Analysis of solidification plateaus after each laser pulse enabled dynamic calibration of the measurement. Heat accumulation temperatures from 200 to 1000 °C were observed from measurement and compared to the theoretical model. The temperature measurements revealed interesting changes in the physics of the laser ablation process. Moreover, the highest throughput on the area of 40 × 40 mm reached 1910 cm2/min, which is the highest demonstrated throughput of LIPSS nanostructuring, to the best of our knowledge. Thus, showing great potential for the efficient production of LIPSS-based functional surfaces which can be used to improve surface mechanical, biological or optical properties.