ACTA ENDOCRINOLOGICA (BUC)

Background. Chronic inflammation is associated with different cancers, and is identified as a key pathogenic mechanism in ovarian cancer. The purpose of our study was to evaluate systemic inflammation markers, as predictive and prognostic factors, in ovarian cancer patients with initial surgical treatment. Subjects and Methods. We performed a retrospective study on 60 ovarian cancer patients with primary cytoreduction surgery, between 2010-2018, with a follow-up period of at least one year. We analyzed systemic inflammation markers and their correlations with the clinical, paraclinical, tumor characteristics, or treatment particularities, and evaluated them as prognostic factors for overall survival. Results. In the univariate analysis, no statistically significantly differences were observed, by correlating the systemic inflammation markers with age, reproductive status, FIGO stage, or type of cytoreduction. Higher neutrophillymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were statistically significant associated with deceased patients, and lower lymphocyte-monocyte ratio (LMR) had statistical significance for living patients. For the patients in the group, the increase of NLR, as well as of PLR leads to the increased risk of death, and the increase of LMR leads to the decrease of this risk. In the multivariate regression analysis, the increase of NLR determined an increased risk of death by 9.7%, and for LMR a reduced risk of death by 46.9%. Conclusions. Systemic inflammation markers had no statistical significance correlated with age, reproductive status, FIGO stage, serous cancer type, or type of cytoreduction but only with overall survival. NLR is an independent risk factor, while LMR is an independent protection factor as well as optimal cytoreduction.

Background. We describe a case of denosumab-related osteonecrosis of the jaw in a 58-year-old patient with a diagnosis of osteoporosis, treated with Denosumab and a short-time course of bisphosphonates. This case illustrates that use of anti-RANKL agents can lead to a type of osteonecrosis resembling bisphosphonate-related osteonecrosis of the jaws, so this medical condition can be categorized as of antiresorptive - induced osteonecrosis of the jaw. The consensus of present day medical opinion is that the benefits of antiresorptive therapy outweigh the disadvantages. However, to provide optimal management for individual patients, the risk-benefit ratio of osteoporosis therapy must be repeatedly assessed at all stages of a patient’s treatment, and therapeutic decisions taken in the light of the ratio as it applies to the individual.

Bisphosphonate-related osteonecrosis of the jaws (BRONJ) has been a rarely recognized condition. As the prescription of\r\noral bisphosphonates is universalized and the number of people treated with bisphosphonates is increasing, an accurate understanding and proper management of BRONJ are required.\r\nAim. Our aim was to describe the clinical features, treatments and prognosis of patients with oral bisphosphonate-related osteonecrosis of the jaws.\r\nMaterials and Methods. In our study BRONJ is reported in 20 consecutive patients who received BP therapy for osteoporosis with different drug schedules. The length of therapy was 7-73 months before osteonecrosis was observed; in 16 patients BRONJ involved the mandible and in 4 the maxilla. Systemic co-morbidities were present in seven patients, namely, rheumatoid arthritis (20), diabetes mellitus type 2 (10%) and chronic anemia (5%).\r\nResults. Nine of the 14 patients who did not suspend BP therapy demonstrated decreased pain and a clinically significant improvement in function. By using the authors? case series of 20 patients, which are reported in the article and the authors? clinical orientation to evaluation and treatment of oral bisphosphonate-related\r\nosteonecrosis of the jaws are presented.