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Jun 2017 DOI 10.14302/issn.2470-5020.jnrt-17-1529
Drobnik JaroslawCorresponding author
Gerontology Unit, Public Health Department, Health Sciences Faculty, Wroclaw Medical University,
Epidemiological data concerning malignant neoplasms of meninges and central nervous system parts other than brain in Poland are reported to many medical databases run by various institutions and are incongruent with each other which makes their practical interpretation highly difficult. Data on registered cases of malignant neoplasms of meninges (C70-C70.9 ICD-10) and of spinal cord, cranial nerves and parts of central nervous system other than brain (C72-C72.9 ICD-10) in the years 2006-2012, made available by public healthcare insurance provider Narodowy Fundusz Zdrowia in Lower Silesia region of Poland (NFZ) and data on new cases from Polish national neoplasms registry Krajowy Rejestr Nowotworow (KRN), were analyzed. The study revealed that those neoplasms are rare in Lower Silesia region of Poland population, number of new cases dropped in the analyzed period, but the NFZ/KRN cases ratio increased significantly especially in case of malignant neoplasms of central nervous system parts other than brain or meninges, which suggests big, and increasing with time, amount of medical procedures needed by those patients. It points at the need of respective adjustment of the level of public financing of treatment of malignant neoplasms of meninges and other central nervous system parts than brain. The study results indicate also that epidemiological reporting system in Poland shall be improved as there is growing number of Polish physicians who report mainly unspecific broad ICD-10 categories and there are year-to-year alternations of reported numbers of cases that do not have any explanation other than formal shifting in reported ICD-10 categories.
Jun 2015 DOI 10.14302/issn.2576-182X.jbsc-14-576
Gupta TejpalCorresponding author
Department of Radiation Oncology, Tata Memorial Hospital (TMH) and Advanced Centre for Treatment Research & Education in Cancer (ACTREC), Tata Memorial Centre, Parel, Mumbai: 400 012, INDIA
Multi-modality therapy has led to significant improvement in outcomes for childhood medulloblastoma; however, long-term survivors have become more susceptible to late effects of therapy including induction of second malignant neoplasms and even remain at an increased risk of late relapses including extra-neuraxial metastases. A newly detected solitary lytic/sclerotic osseous lesion in a medulloblastoma survivor away from the radiation field poses considerable diagnostic challenge as it could represent either a second malignant neoplasm or extra-neuraxial metastasis. We report one such case highlighting the importance of contemporary pathology techniques as useful adjuncts to differentiate a second primary osseous Ewing’s sarcoma (ES)/primitive neuro-ectodermal tumor (PNET) from bony metastasis and review the pertinent literature on second malignant neoplasms and extra-neuraxial metastases in medulloblastoma. To the best of our knowledge, this is the first report of a molecularly confirmed second primary osseous ES/PNET in a survivor of childhood medulloblastoma.
Aug 2017 DOI 10.14302/issn.2470-5020.jnrt-17-1530
Suslo RobertCorresponding author
Gerontology Unit, Public Health Department, Health Sciences Faculty, Wroclaw Medical University,
It is crucial for the society, the government and the medical community to retrieve the full and reliable statistical information on malignant brain neoplasms (C71-C71.9 ICD-10) to adjust the medical financing, staff and equipment properly. In order to retrieve information useful for public health policies, data from the years 2006-2012 concerning relevant cases registered by the Polish public healthcare insurance provider Narodowy Fundusz Zdrowia in Lower Silesia region of Poland (NFZ) and by the Polish national neoplasms registry Krajowy Rejestr Nowotworow (KRN) were analyzed. The number of new malignant brain neoplasms cases registered by the KRN has risen slightly in the years 2006-2012. At the same time the number of cases reported by the NFZ rose dynamically, which means a significant increase in medical care intensity, and thus also workload on the medical facilities and stuff associated with the care for grossly the same amount of brain malignant neoplasms patients and, supposedly, their longer survival times. It indicates that the level of public financing of the malignant neoplasms of brain treatment shall be adjusted adequately. The study revealed growing popularity among reporting Polish physicians of the least specific malignant neoplasms of brain ICD-10 categories, despite the rapid diagnostic techniques development and availability. It is alarming since the medical statistics data quality in the field of malignant brain neoplasms is deteriorating that way and proper evaluation of treatment costs and planning future financial allocations by both the public healthcare insurance provider NFZ and the Polish government becomes difficult.