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Clinical diagnostic aspects of secondary malignant tumors of unknown primary origin.


Author: Pihut Oxana
Degree:doctor of medicine
Speciality: 14.00.14 - Oncology and Radiotherapy
Year:2010
Scientific adviser: Ion Mereuţa
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific consultant: Iraida Iacovleva
doctor habilitat, professor, Public Medical Sanitary Intitution Institute of Oncology
Institution: Public Medical Sanitary Intitution Institute of Oncology
Scientific council: D 52-14.00.14
Public Medical Sanitary Intitution Institute of Oncology

Status

The thesis was presented on the 10 March, 2010
Approved by NCAA on the 29 April, 2010

Abstract

Adobe PDF document0.21 Mb / in romanian

Keywords

diagnostic algorithm, metastatic malignant tumors, unknown primary origin

Summary

The thesis structure: introduction, 4 chapters, conclusions, bibliography of 297 titles, the base text of 120 pages, 36 tables, 14 figures, 4 supplements. The obtained results were published in 9 scientific papers, 2 patents.

Domain of research: oncologie

Research purpose: Optimization of oncological diagnostics at metastases in organs and tissues of unknown primary origin by development of a diagnostic algorithm.

Objects of the work:
1. Studying of frequency and character of metastatic affections in lymphatic ganglia, organs, and tissues in the cases of unknown primary origin.
2. Revealing of particularities of natural evolution of disease as a function of metastasis localization.
3. Studying of morphologic peculiarities for metastases of tumors of unknown primary origin.
4. Elaboration of the optimal clinical diagnostic techniques, appreciation of their sequence, and argumentation of their usefulness in dependence of localization and spreading of tumors and of histological structure of tumors.
5. Scientific argumentation of the diagnostic algorithm in the cases of metastases of unknown primary origin.

Methodology of research: 238 cases of metastasizes of a malignant tumor with unknown primary site: 93 patients with isolated manifestation at one organ, or lymph nodes of a single lymph one collector; 145 patients with synchronous manifestations at several organs, or organs and lymph nodes, or lymph nodes of several zones.

Scientific novelty: An algorithm to diagnose and locate the primary tumor in the cases of malignant tumor metastases of unknown primary origin was elaborated in the first time in the Republic of Moldova. Terms and costs of the patient examinations were reduced and resources were economized by using rational diagnostic methods that exclude repeating and inutile examinations. As the primary tumor is located, we get the possibility of combined therapy that considerably increases length and quality of life.

Theoretical and applicative value of the work:An algorithm to locate the primary origin in the cases of malignant tumor metastases of unknown primary origin was implemented and used in oncological practice.An algorithm for determination of tumor markers in the cases of malignant tumor metastases in organs and tissues of unknown primary origin was implemented and used in practice.

Implementation of scientific data. The proposed method is currently introduced and used in clinical practice at MSPI SRIO.