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Article: Adrenal Cysts: To Operate or Not to Operate?

Bozic Antic, Ivana / Djurisic, Igor / Nikolic, Srdjan

2024 Volume 13, Issue 3

Abstract: Adrenal cysts are uncommon and usually asymptomatic, and therefore are usually incidentally discovered adrenal lesions. They have a broad pathohistological spectrum that includes pseudocysts and endothelial (vascular), parasitic, and epithelial ( ... ...

Abstract	Adrenal cysts are uncommon and usually asymptomatic, and therefore are usually incidentally discovered adrenal lesions. They have a broad pathohistological spectrum that includes pseudocysts and endothelial (vascular), parasitic, and epithelial (mesothelial) cysts. Although most adrenal cysts are benign and hormonally non-functional lesions, some can have ambiguous imaging appearances and mimic malignant adrenal neoplasms. On the other hand, the actual malignant neoplasms could undergo cystic transformation. Additionally, immune cell infiltrations, thrombosis, or haemorrhage seen in sepsis can frequently cause adrenal cyst development, raising a question about the possible connection between severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) and adrenal cystic lesions. Due to the disease's rarity, the likelihood of malignancy, and the lack of specific guidelines, the management of adrenal cysts is always challenging especially in a young person. This review discusses the important diagnostic and the current treatment possibilities for adrenal cystic lesions. Aiming to emphasize clinical dilemmas and help clinicians navigate the challenges when encountering a patient with an adrenal cyst in everyday practice, we based our review on a practical question-answer framework centred around the case of a young woman with an incidentally discovered large adrenal cyst.
Language	English
Publishing date	2024-02-01
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13030846
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Article: Predicting Finite-Bias Tunneling Current Properties from Zero-Bias Features: The Frontier Orbital Bias Dependence at an Exemplar Case of DNA Nucleotides in a Nanogap.

Djurišić, Ivana / Jovanović, Vladimir P / Dražić, Miloš S / Tomović, Aleksandar Ž / Zikic, Radomir

Nanomaterials (Basel, Switzerland)

2021 Volume 11, Issue 11

Abstract: The electrical current properties of single-molecule sensing devices based on electronic (tunneling) transport strongly depend on molecule frontier orbital energy, spatial distribution, and position with respect to the electrodes. Here, we present an ... ...

Abstract	The electrical current properties of single-molecule sensing devices based on electronic (tunneling) transport strongly depend on molecule frontier orbital energy, spatial distribution, and position with respect to the electrodes. Here, we present an analysis of the bias dependence of molecule frontier orbital properties at an exemplar case of DNA nucleotides in the gap between H-terminated (3, 3) carbon nanotube (CNT) electrodes and its relation to transversal current rectification. The electronic transport properties of this simple single-molecule device, whose characteristic is the absence of covalent bonding between electrodes and a molecule between them, were obtained using density functional theory and non-equilibrium Green's functions. As in our previous studies, we could observe two distinct bias dependences of frontier orbital energies: the so-called strong and the weak pinning regimes. We established a procedure, from zero-bias and empty-gap characteristics, to estimate finite-bias electronic tunneling transport properties, i.e., whether the molecular junction would operate in the weak or strong pinning regime. We also discuss the use of the zero-bias approximation to calculate electric current properties at finite bias. The results from this work could have an impact on the design of new single-molecule applications that use tunneling current or rectification applicable in high-sensitivity sensors, protein, or DNA sequencing.
Language	English
Publishing date	2021-11-10
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662255-5
ISSN	2079-4991
ISSN	2079-4991
DOI	10.3390/nano11113021
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Article ; Online: Dermatoscopy in vulvar basal cell carcinoma.

Dobrosavljevic Vukojevic, D / Djurisic, I / Lukic, S / Kastratovic-Kotlica, B / Vukicevic, J

Journal of the European Academy of Dermatology and Venereology : JEADV

2016 Volume 31, Issue 4, Page(s) e180–e181

MeSH term(s)	Carcinoma, Basal Cell/pathology ; Dermoscopy/methods ; Female ; Humans ; Middle Aged ; Vulvar Neoplasms/pathology
Language	English
Publishing date	2016-08-22
Publishing country	England
Document type	Case Reports ; Letter
ZDB-ID	1128828-0
ISSN	1468-3083 ; 0926-9959
ISSN (online)	1468-3083
ISSN	0926-9959
DOI	10.1111/jdv.13895
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Article ; Online: Field Effect and Local Gating in Nitrogen-Terminated Nanopores (NtNP) and Nanogaps (NtNG) in Graphene.

Djurišić, Ivana / Dražić, Miloš S / Tomović, Aleksandar Ž / Spasenović, Marko / Šljivančanin, Željko / Jovanović, Vladimir P / Zikic, Radomir

Chemphyschem : a European journal of chemical physics and physical chemistry

2020 Volume 22, Issue 3, Page(s) 336–341

Abstract: Functionalization of electrodes is a wide-used strategy in various applications ranging from single-molecule sensing and protein sequencing, to ion trapping, to desalination. We demonstrate, employing non-equilibrium Green's function formalism combined ... ...

Abstract	Functionalization of electrodes is a wide-used strategy in various applications ranging from single-molecule sensing and protein sequencing, to ion trapping, to desalination. We demonstrate, employing non-equilibrium Green's function formalism combined with density functional theory, that single-species (N, H, S, Cl, F) termination of graphene nanogap electrodes results in a strong in-gap electrostatic field, induced by species-dependent dipoles formed at the electrode ends. Consequently, the field increases or decreases electronic transport through a molecule (benzene) placed in the nanogap by shifting molecular levels by almost 2 eV in respect to the electrode Fermi level via a field effect akin to the one used for field-effect transistors. We also observed the local gating in graphene nanopores terminated with different single-species atoms. Nitrogen-terminated nanogaps (NtNGs) and nanopores (NtNPs) show the strongest effect. The in-gap potential can be transformed from a plateau-like to a saddle-like shape by tailoring NtNG and NtNP size and termination type. In particular, the saddle-like potential is applicable in single-ion trapping and desalination devices.
Language	English
Publishing date	2020-12-16
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1439-7641
ISSN (online)	1439-7641
DOI	10.1002/cphc.202000771
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Article: Evaluation of predictive value of 1H MR spectroscopy for response of neoadjuvant chemotherapy in musculoskeletal tumors.

Cirkovic, Predrag / Mihailovic, Jelena / Paripovic, Lejla / Ilic, Vesna / Ristic, Dusan / Djurisic, Igor / Djordjevic, Aleksandar / Maksimovic, Ruzica

Journal of B.U.ON. : official journal of the Balkan Union of Oncology

2019 Volume 23, Issue 6, Page(s) 1867–1873

Abstract: Purpose: Bone and soft tissue tumors are rare. There is a variety of types and each one has its own particular behavior, treatment and patient outcome. The assessment of treatment response following the 3rd cycle of chemotherapy is one of the most ... ...

Abstract	Purpose: Bone and soft tissue tumors are rare. There is a variety of types and each one has its own particular behavior, treatment and patient outcome. The assessment of treatment response following the 3rd cycle of chemotherapy is one of the most important aspects of patient care, as therapeutic options and the timing of surgery may vary depending on the achievement of response. Hence, we focused on the advanced imaging technique, proton magnetic resonance spectroscopy (1H MRS), aiming at improving the diagnostic accuracy and the tumor response to therapy, based on the absolute concentration of choline (Cho) as biomarker of malignancy. Methods: Twenty patients were studied. All of them had a pathological diagnosis after biopsy. MRI examinations were performed using a 1.5 T MR scanner (Avanto; Siemens, Erlangen, Germany). Single-voxel 1H MR spectroscopy was performed by using a PRESS with TR/TE 1530/100 ms, before chemotherapy and after the 3rd cycle. 1H MRS was processed in LCmodel. Results: Of 20 patients, 7 responded to neoadjuvant chemotherapy and 13 did not. In responders, the mean concentration of tCho before therapy was 4.7±2.5 mmol/kg, which showed statistically significant reduction after therapy. In non-responders, the mean tCho concentration before therapy was 2.9±0.9 mmol/kg which remained the same or increased after the 3rd cycle of neoadjuvant chemotherapy (2.7±2.5 mmol/kg; range from 2.05 to 5.79 with no statistical significance). Compared to reference healthy group, tCho concentrations were increased in all cases. Conclusions: 1H MRS appears to be valuable technique for evaluation of response to neoadjuvant chemotherapy of patients with musculoskeletal tumors (MSK).
MeSH term(s)	Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Case-Control Studies ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging/methods ; Magnetic Resonance Spectroscopy/methods ; Male ; Middle Aged ; Musculoskeletal Diseases/drug therapy ; Musculoskeletal Diseases/pathology ; Neoadjuvant Therapy/methods ; Prognosis ; ROC Curve ; Young Adult
Language	English
Publishing date	2019-01-04
Publishing country	Greece
Document type	Evaluation Studies ; Journal Article
ZDB-ID	2040386-0
ISSN	2241-6293 ; 1107-0625
ISSN (online)	2241-6293
ISSN	1107-0625
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Article ; Online: Sentinel lymph node biopsy in medullary thyroid microcarcinomas.

Santrac, Nada / Markovic, Ivan / Medic Milijic, Natasa / Goran, Merima / Buta, Marko / Djurisic, Igor / Dzodic, Radan

Endocrine journal

2019 Volume 67, Issue 3, Page(s) 295–304

Abstract: The aim of this prospective study was to analyze accuracy of sentinel lymph node biopsy with methylene blue dye for intraoperative detection of lateral metastases in clinically N0M0 medullary microcarcinomas with calcitonin <1,000 pg/mL and selection of ... ...

Abstract	The aim of this prospective study was to analyze accuracy of sentinel lymph node biopsy with methylene blue dye for intraoperative detection of lateral metastases in clinically N0M0 medullary microcarcinomas with calcitonin <1,000 pg/mL and selection of true-positive patients for one-time therapeutic lateral dissection. In addition to total thyroidectomy and central neck dissection, all patients had bilateral sentinel biopsy of jugulo-carotid regions after methylene blue injection to decide upon necessity for lateral dissection. If sentinels were benign on frozen section, additional non-sentinels were extirpated, with no further lateral dissection. If sentinels were malignant, one-time lateral dissection was performed. 20 patients were included in this study. Hereditary disease form was observed in 3/20 (15%) of patients with RET proto-oncogene mutation C634F; remaining 17/20 (85%) were negative for germline mutations. There were no allergic reactions to methylene blue and identification rate of sentinels was 100%. In total, 2/20 (10%) cN0 patients had lymphonodal metastases, thus were reclassified as pN1b. Remaining 18/20 (90%) were classified pN0 based on standard pathohistology. Frozen section findings on sentinels were 100% match with standard pathohistology, and there were no skip metastases in lateral compartments. Sensitivity, specificity and accuracy of sentinel biopsy method with methylene dye and frozen section were 100%. Dzodic's sentinel lymph node biopsy method can be used for intraoperative assessment of lateral compartments and optimization of initial surgery of medullary microcarcinomas with calcitonin <1,000 pg/mL. This way, cN0 patients with sentinel metastases can receive one-time lateral dissection, and those without benefit from less extensive surgery.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Calcitonin/blood ; Carcinoma, Medullary/blood ; Carcinoma, Medullary/pathology ; Carcinoma, Medullary/surgery ; Female ; Humans ; Lymphatic Metastasis/diagnosis ; Lymphatic Metastasis/pathology ; Male ; Methylene Blue ; Middle Aged ; Prospective Studies ; Sentinel Lymph Node/pathology ; Sentinel Lymph Node Biopsy ; Thyroid Gland/pathology ; Thyroid Gland/surgery ; Thyroid Neoplasms/blood ; Thyroid Neoplasms/pathology ; Thyroid Neoplasms/surgery ; Thyroidectomy ; Young Adult
Chemical Substances	Calcitonin (9007-12-9) ; Methylene Blue (T42P99266K)
Language	English
Publishing date	2019-12-03
Publishing country	Japan
Document type	Journal Article
ZDB-ID	1151918-6
ISSN	1348-4540 ; 0918-8959
ISSN (online)	1348-4540
ISSN	0918-8959
DOI	10.1507/endocrj.EJ19-0409
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Article: Prognostic factors and outcomes of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy in patients with advanced ovarian cancer - A single tertiary institution experience.

Kocic, Milan / Nikolic, Srdjan / Zegarac, Milan / Djurisic, Igor / Soldatovic, Ivan / Milenkovic, Petar / Kocic, Jovana

Journal of B.U.ON. : official journal of the Balkan Union of Oncology

2016 Volume 21, Issue 5, Page(s) 1176–1183

Abstract: Purpose: Ovarian cancer (OC) ranks fifth in mortality among females cancer patients. Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) have radically changed the treatment of OC. The aim of this study was to evaluate ... ...

Abstract	Purpose: Ovarian cancer (OC) ranks fifth in mortality among females cancer patients. Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) have radically changed the treatment of OC. The aim of this study was to evaluate overall survival (OS) and disease-free survival (DFS) in our patient population after the application of combined CRS and HIPEC treatment. Methods: The study included patients who met defined inclusion and exclusion criteria and had undergone CRS of peritoneal carcinomatosis from 2006 to 2011. Tumor extension was intraoperatively calculated using peritoneal cancer index (PCI). After CRS had been performed, selected patients underwent closed HIPEC. Assessment of successful surgery was estimated with the completeness of cytoreduction score. Results: The study involved 31 patients. The median DFS was 19 months. The DFS for 1 and 2-year period were 69.2 and 35.2%, respectively. The mean OS was 51 months. The 1-, 2- and 5-year OS was 85.4, 63.3 and 56.3%, respectively. PCI ranged from 1 to 24 and the majority (77.4%) of the patients had PCI score below 13. The most frequent carcinomatosis was observed in the omentum (80.6%), followed by adnexae (61.3%), uterus (58.1%), colon (58.1%). spleen (25.8%), diaphragm (25.8%), small intestine (19.4%), bursa omentalis 19.4, liver (9.7%), and pancreas (3.2%). Conclusion: The results of the current study are in concordance with the literature which clearly favors combined the CRS and HIPEC treatment. The reported data suggest that this method could be successfully applied in our region and outline the necessity of future multicentric studies that will involve major regional hospitals.
MeSH term(s)	Adult ; Aged ; Antineoplastic Agents/administration & dosage ; Antineoplastic Agents/adverse effects ; Chemotherapy, Adjuvant ; Cytoreduction Surgical Procedures/adverse effects ; Cytoreduction Surgical Procedures/mortality ; Databases, Factual ; Disease-Free Survival ; Female ; Humans ; Hypothermia, Induced/adverse effects ; Hypothermia, Induced/mortality ; Kaplan-Meier Estimate ; Middle Aged ; Ovarian Neoplasms/mortality ; Ovarian Neoplasms/pathology ; Ovarian Neoplasms/therapy ; Peritoneal Neoplasms/mortality ; Peritoneal Neoplasms/secondary ; Peritoneal Neoplasms/therapy ; Proportional Hazards Models ; Risk Factors ; Serbia ; Time Factors ; Treatment Outcome
Chemical Substances	Antineoplastic Agents
Language	English
Publishing date	2016-09
Publishing country	Greece
Document type	Journal Article
ZDB-ID	2040386-0
ISSN	2241-6293 ; 1107-0625
ISSN (online)	2241-6293
ISSN	1107-0625
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Article ; Online: Recurrent Laryngeal Nerve Liberations and Reconstructions: A Single Institution Experience.

Dzodic, Radan / Markovic, Ivan / Santrac, Nada / Buta, Marko / Djurisic, Igor / Lukic, Silvana

World journal of surgery

2016 Volume 40, Issue 3, Page(s) 644–651

Abstract: Background: Recurrent laryngeal nerve (RLN) palsy rates vary from 0.5 to 10%, even 20% in thyroid cancer surgery. The aim of this paper was to present our experience with RLN liberations and reconstructions after various mechanisms of injury.: Methods! ...

Abstract	Background: Recurrent laryngeal nerve (RLN) palsy rates vary from 0.5 to 10%, even 20% in thyroid cancer surgery. The aim of this paper was to present our experience with RLN liberations and reconstructions after various mechanisms of injury. Methods: Patients were treated in our institution from year 2000 to 2015. First group (27 patients) had large benign goiters, locally advanced thyroid/parathyroid carcinomas, or incomplete previous surgery of malignant thyroid disease. Second group (5 patients) had reoperations due to RLN paralysis on laryngoscopy. Liberations and reconstructions of injured RLNs were performed. Results: Surgical exploration of central compartment enabled identification of the RLN injury mechanism. Liberations were performed in 11 patients, 2 months to 16 years after RLN injury, by removing misplaced ligations. Immediate or delayed (18 months to 23 years) RLN reconstructions were performed in 21 patients, by direct suture or ansa cervicalis-to-RLN anastomosis (ARA). RLN liberation provided complete voice recovery within 3 weeks in all patients. Patients with direct sutures had better phonation 1 month after reconstruction. Improved phonation was observed 2-6 months after ARA in 43% of patients. Conclusions: Vocal cords do not regain normal movement once being paralyzed after RLN transection, but they restore tension during phonation by reconstruction. Nerve liberation is a useful method which enables patients with RLN paresis/paralysis a significant improvement in phonation, even complete voice recovery. Reinnervation of vocal cords, using one of the mentioned techniques, should be a standard in thyroid and parathyroid surgery, with aim to improve quality of patient's life.
MeSH term(s)	Child, Preschool ; Female ; Humans ; Infant ; Laryngoscopy/methods ; Male ; Reconstructive Surgical Procedures/methods ; Recurrent Laryngeal Nerve/surgery ; Recurrent Laryngeal Nerve Injuries/complications ; Recurrent Laryngeal Nerve Injuries/surgery ; Thyroid Neoplasms/surgery ; Thyroidectomy/adverse effects ; Treatment Outcome ; Vocal Cord Paralysis/etiology ; Vocal Cord Paralysis/surgery ; Young Adult
Language	English
Publishing date	2016-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-015-3305-0
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Article: Multifocality as independent prognostic factor in papillary thyroid cancer - A multivariate analysis.

Markovic, Ivan / Goran, Merima / Besic, Nikola / Buta, Marko / Djurisic, Igor / Stojiljkovic, Dejan / Zegarac, Milan / Pupic, Gordana / Inic, Zorka / Dzodic, Radan

Journal of B.U.ON. : official journal of the Balkan Union of Oncology

2018 Volume 23, Issue 4, Page(s) 1049–1054

Abstract: Purpose: The incidence of multifocality of papillary thyroid carcinoma (PTC) ranges from 18 to 87.5% The mechanisms of multifocal spreading, correlation with tumor size, histology variants of PTC, lymph node metastases, and prognostic impact remains ... ...

Abstract	Purpose: The incidence of multifocality of papillary thyroid carcinoma (PTC) ranges from 18 to 87.5% The mechanisms of multifocal spreading, correlation with tumor size, histology variants of PTC, lymph node metastases, and prognostic impact remains unclear. The purpose of this study was to clarify the prognostic significance of multifocality on relapse and survival rates of patients with PTC by analyzing the correlation of multifocality with patient age, gender, tumor size, histological variants of PTC, presence of lymph node metastases and extent of surgery. Methods: 153 patients with PTC were included in this study. Patients with pT4 tumors or initially distant metastases were excluded from study. Total thyroidectomy was done in all 153 patients. Central and level III and IV lateral neck lymph node dissection was done in 76.5% of the patients, followed by modified radical neck dissection if positive. Results: Multifocality was found in 43 (28%) whole thyroid gland specimens, and was significantly more frequent in patients older than 45 years and in tumors greater than 4 cm in diameter (p<0.01). Presence of multifocality didn't significantly correlate with gender, histology variants of PTC or lymph node metastases. In a median follow up of 84 months locoregional relapse occurred in 8.4% and 1.3% of the patients, while 7.2% patients died due to PTC. The incidence of relapse was significantly higher (p<0.01), and relapse free interval and survival were significantly shorter (p=0.0095, p=0.0004, respectively) in patients with multifocal PTC. Cox multivariate regression analysis showed that multifocality was independent prognostic factor for both disease-free interval (DFI) and cancer-specific survival (CSS) of patients with PTC. Conclusion: Due to high incidence of multifocality and potential prognostic impact, total thyroidectomy should be advocated in all patients with PTC, aiming to reduce relapse rate and improve DFI and CSS.
MeSH term(s)	Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Survival Analysis ; Thyroid Cancer, Papillary/mortality ; Thyroid Cancer, Papillary/pathology ; Thyroid Neoplasms/mortality ; Thyroid Neoplasms/pathology ; Young Adult
Language	English
Publishing date	2018-10-25
Publishing country	Greece
Document type	Journal Article
ZDB-ID	2040386-0
ISSN	2241-6293 ; 1107-0625
ISSN (online)	2241-6293
ISSN	1107-0625
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Article: Goblet cell carcinoid of the appendix. Review of the literature a propos of a rare case of endometrial metastases.

Zegarac, Milan / Nikolic, Srdjan / Kolarevic, Daniela / Kocic, Milan / Djurisic, Igor / Inic, Zorka / Buta, Marko / Cvetkovic, Ana / Markovic, Ivan

Journal of B.U.ON. : official journal of the Balkan Union of Oncology

2018 Volume 23, Issue 4, Page(s) 867–871

Abstract: Background: Carcinoid tumors are rare tumors most commonly found in the gastrointestinal tract. They represent the most common malignancies of the appendix. As a distinct entity from both adenocarcinomas and carcinoids, Goblet cell carcinoid (GCC) was ... ...

Abstract	Background: Carcinoid tumors are rare tumors most commonly found in the gastrointestinal tract. They represent the most common malignancies of the appendix. As a distinct entity from both adenocarcinomas and carcinoids, Goblet cell carcinoid (GCC) was initially described in the literature in 1969. The GCC is almost exclusive to the appendix, but rarely can be found in rectum, ileum and colon. More than 50% of the patients at the time of diagnosis already have advancedstage disease. The most common metastatic sites are the peritoneal surfaces of the pelvis and abdominal cavity, and ovaries in women. Surgery is the main form of treatment in patients with GCC. Case presentation: A 49-year-old woman was treated at the Institute of Oncology and Radiology of Serbia with histopathological findings of GCC. In a 8-year period the patient was treated with initial appendectomy and three more operations because of locoregional disease progression. The last operation was performed in March 2016 because of endometrial metastases. Since then the patient is on regular follow up without disease progression. Conclusion: GCC is a very rare entity. Multidisciplinary approach is necessary for adequate patient treatment.
MeSH term(s)	Adult ; Appendiceal Neoplasms/complications ; Appendiceal Neoplasms/mortality ; Appendiceal Neoplasms/pathology ; Carcinoid Tumor/complications ; Carcinoid Tumor/mortality ; Carcinoid Tumor/pathology ; Endometrial Neoplasms/mortality ; Endometrial Neoplasms/pathology ; Endometrial Neoplasms/secondary ; Female ; Humans ; Prognosis ; Survival Analysis
Language	English
Publishing date	2018-10-24
Publishing country	Greece
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	2040386-0
ISSN	2241-6293 ; 1107-0625
ISSN (online)	2241-6293
ISSN	1107-0625
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