ULOGA TRODIMENZIONALNOGA TRANSVAGINALNOG 
 ULTRAZVUKA U PROCJENI PROŠIRENOSTI I PROGNOZI 
 RAKA VRATA MATERNICE

Prka, Matija

prikaz prve stranice dokumenta ULOGA TRODIMENZIONALNOGA TRANSVAGINALNOG ULTRAZVUKA U PROCJENI PROŠIRENOSTI I PROGNOZI RAKA VRATA MATERNICE

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doctoral thesis

ULOGA TRODIMENZIONALNOGA TRANSVAGINALNOG ULTRAZVUKA U PROCJENI PROŠIRENOSTI I PROGNOZI RAKA VRATA MATERNICE

Rijeka: University of Rijeka, Faculty of Medicine, 2022. urn:nbn:hr:184:381971

Prka, Matija

University of Rijeka
Faculty of Medicine
Department of Gynaecology and Obstetrics

Cite this document

APA 6th Edition

Prka, M. (2022). ULOGA TRODIMENZIONALNOGA TRANSVAGINALNOG ULTRAZVUKA U PROCJENI PROŠIRENOSTI I PROGNOZI RAKA VRATA MATERNICE (Doctoral thesis). Rijeka: University of Rijeka, Faculty of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:184:381971

MLA 8th Edition

Prka, Matija. "ULOGA TRODIMENZIONALNOGA TRANSVAGINALNOG ULTRAZVUKA U PROCJENI PROŠIRENOSTI I PROGNOZI RAKA VRATA MATERNICE." Doctoral thesis, University of Rijeka, Faculty of Medicine, 2022. https://urn.nsk.hr/urn:nbn:hr:184:381971

Chicago 17th Edition

Harvard

Prka, M. (2022). 'ULOGA TRODIMENZIONALNOGA TRANSVAGINALNOG ULTRAZVUKA U PROCJENI PROŠIRENOSTI I PROGNOZI RAKA VRATA MATERNICE', Doctoral thesis, University of Rijeka, Faculty of Medicine, accessed 15 January 2025, https://urn.nsk.hr/urn:nbn:hr:184:381971

Vancouver

Prka M. ULOGA TRODIMENZIONALNOGA TRANSVAGINALNOG ULTRAZVUKA U PROCJENI PROŠIRENOSTI I PROGNOZI RAKA VRATA MATERNICE [Doctoral thesis]. Rijeka: University of Rijeka, Faculty of Medicine; 2022 [cited 2025 January 15] Available at: https://urn.nsk.hr/urn:nbn:hr:184:381971

IEEE

M. Prka, "ULOGA TRODIMENZIONALNOGA TRANSVAGINALNOG ULTRAZVUKA U PROCJENI PROŠIRENOSTI I PROGNOZI RAKA VRATA MATERNICE", Doctoral thesis, University of Rijeka, Faculty of Medicine, Rijeka, 2022. Available at: https://urn.nsk.hr/urn:nbn:hr:184:381971

Cite this item: https://urn.nsk.hr/urn:nbn:hr:184:381971

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Title	ULOGA TRODIMENZIONALNOGA TRANSVAGINALNOG ULTRAZVUKA U PROCJENI PROŠIRENOSTI I PROGNOZI RAKA VRATA MATERNICE
Title (english)	THE ROLE OF THREE-DIMENSIONAL TRANSVAGINAL ULTRASOUND IN STAGING AND PROGNOSIS OF CERVICAL CANCER
Author	Matija Prka
Mentor	Alemka Brnčić-Fischer (mentor)
Committee member	Marko Klarić (predsjednik povjerenstva)
Committee member	Sanja Dolanski-Babić (član povjerenstva)
Committee member	Damir Miletić (član povjerenstva)
Granter	University of Rijeka Faculty of Medicine (Department of Gynaecology and Obstetrics) Rijeka
Defense date and country	2022-11-30, Croatia
Scientific / art field, discipline and subdiscipline	BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Gynecology and Obstetrics
Universal decimal classification (UDC)	61 - Medical sciences
Abstract	Cilj istraživanja: Značenje trodimenzionalnih (3D) volumetrijskih i doplerskih istraživanih parametara primarnog raka vrata maternice (RVM) u prognozi tumorskog odgovora na kemoiradijaciju i brahiterapiju, te uloga trodimenzionalnoga transvaginalnog ultrazvuka (3D TV UZV) u procjeni proširenosti RVM. Ispitanice i metode: Sedamdeset pet ispitanica s primarnim RVM FIGO stadija ≥IIB u istraživanoj skupini (razdoblje praćenja minimalno 24 mjeseca), te 150 ispitanica u pre- i postmenopauzi s normalnim vratom maternice u kontrolnoj skupini, podvrgnuto je 3D TV UZV-u. Rezultati: U univarijatnoj analizi, među volumetrijskim parametrima primarnog RVM, širina primarnog tumora u 3D multiplanarnom prikazu bila je statistički značajna nezavisna varijabla s najvećim omjerom izgleda p = 0.0002, OR 3.32 (95% CI 1.77 - 6.23) za parcijalni klinički odgovor na kemoiradijaciju. Diskriminacijske granične vrijednosti širine primarnog tumora u 3D multiplanarnom prikazu (>4.3 cm) i prodora u donji uterini segment (>1.86 cm) imale su visoku specifičnost, redom 95.5% i 90.9%, tj. s velikom točnošću su predviđale ispitanice s kompletnim kliničkim odgovorom. Indeks protoka (FI) je jedina statistički značajna nezavisna varijabla u univarijatnoj analizi za dva istraživana ishoda: klinički odgovor na kemoiradijaciju p = 0.0192, OR 0.89 (95% CI 0.79 - 0.98) i ukupno preživljenje p = 0.0316, OR 0.89 (95% CI 0.79 - 0.99), omjer izgleda ukazuje na to da niža vrijednost FI povećava vjerojatnost obaju nepovoljnih ishoda. Uz FI, parcijalni klinički odgovor, recidiv bolesti, te diskriminacijske granične vrijednosti latero-lateralne (L-L) udaljenosti (primarnog tumora, nakon kemoiradijacije i na prvom praćenju) u omjeru s anatomskom (kontrolnom) L-L udaljenosti - pokazatelji infiltracije parametrija, statistički značajno predviđaju ukupno preživljenje. Klinički najvrjedniji multivarijatni modeli imali su visoku uspješnost u predviđanju kliničkog odgovora na kemoiradijaciju (80%) i ukupnog preživljenja (83.6%). Zaključak: Istraživanje je dokazalo značajnu kliničku važnost 3D TV UZV-a kao nove i komplementarne slikovne metode u lokoregionalnoj procjeni proširenosti, praćenju i prognozi primarnog RVM, u sklopu revidirane FIGO 2018 klasifikacije bolesti.
Abstract (english)	Objectives: The role of primary cervical cancer (CC) volumetric and Doppler measurements by three-dimensional transvaginal ultrasound (3D TV US) in predicting tumor response to chemoradiotherapy and brachytherapy, and the role of 3D TV US in CC staging. Patients and methods: 3D TV US was performed in 75 patients with primary CC FIGO stage ≥IIB (study group, minimal follow up for 24 months), and 150 pre- and postmenopausal women with normal cervix (control group). Results: Considering volumetric parameters of primary CC, univariate analysis revealed the primary tumor size on 3D multiplanar image to be a statistically significant independent variable with the highest odds ratio p = 0.0002, OR 3.32 (95% CI 1.77 - 6.23) for partial clinical response to chemoradiotherapy. Discriminative borderline values of primary tumor size on 3D multiplanar imaging (>4.3 cm) and lower uterine segment involvement (>1.86 cm) showed high specificity of 95.5% and 90.9%, respectively, i.e., predicted patients with complete clinical response with high accuracy. On univariate analysis, flow index (FI) was the only statistically significant independent variable for the two study outcomes, i.e., clinical response to chemoradiotherapy p = 0.0192, OR 0.89 (95% CI 0.79 - 0.98) and overall survival p = 0.0316, OR 0.89 (95% CI 0.79 - 0.99); odds ratio suggested a lower FI value to increase the likelihood of both unfavorable outcomes. Besides FI, overall survival was statistically significantly predicted by partial clinical response, disease relapse, and discriminative borderline values of the latero-lateral (L-L) distance (primary tumor, after chemoradiotherapy and on first follow up) relative to the anatomic (control) L-L distance as indicators of parametrium infiltration. The clinically most valuable multivariate models were very successful in predicting clinical response to chemoradiotherapy (80%) and overall survival (83.6%). Conclusion: The study established the significant clinical role of 3D TV US as a novel and complementary imaging method in loco-regional staging, follow up and prognosis of primary CC, according to the revised 2018 FIGO CC staging.
Keywords
Keywords (english)
Language	croatian
URN:NBN	urn:nbn:hr:184:381971
Study programme	Title: Biomedicine Postgraduate (doctoral) study programme Study programme type: university Study level: postgraduate Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
Type of resource	Text
File origin	Born digital
Access conditions	Access restricted to students and staff of home institution
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Repository	Repository of the University of Rijeka, Faculty of Medicine
Created on	2023-01-18 11:41:12