Monika Sobocan

University Medical Centre Maribor | UKC · Clinic of Gynecology and Perinatology

BRCA genetic testing is available for UK Jewish individuals but the provision of information online for BRCA is unknown. We aimed to evaluate online provision of BRCA information by UK organisations (UKO), UK Jewish community organisations (JCO), and genetic testing providers (GTP). Google searches for organisations offering BRCA information were p...

Background : Parallel panel germline and somatic genetic testing of all patients with ovarian cancer (OC) can identify more pathogenic variants (PVs) that would benefit from PARP inhibitor (PARPi) therapy, and allow for precision prevention in unaffected relatives with PVs. In this study, we estimate the cost-effectiveness and population impact of...

Background 1 in 40 UK Jewish individuals carry a pathogenic variant in BRCA1/BRCA2 . Traditional testing criteria miss half of carriers, and so population genetic testing is being piloted for Jewish people in England. There has been no qualitative research into the factors influencing BRCA awareness and testing experience in this group. This study...

Introduction/Background The International Federation of Gynecology and Obstetrics (FIGO) recently revised the staging system for endometrial cancer (EC) from FIGO2008 to FIGO2023. This revision entails a more detailed classification, incorporating both clinical and molecular characteristics. This study aimed to assess the influence of the FIGO revi...

Introduction/Background There is increasing availability, accessibility and awareness of BRCA1/BRCA2 genetic-testing. Recently population-based BRCA1/2 genetic-testing is available for UK Jewish individuals. Most UK individuals use the internet for health information, but the provision, extent and quality of information on BRCA1/BRCA2 online is cur...

Introduction/Background Optimal information provision is pivotal for patients with endometrial cancer, fostering informed decision-making, treatment adherence, enhanced health-related quality of life, reduced distress, and heightened satisfaction with care. Notably, the most commonly reported unmet need among cancer patients is information provisio...

Triple negative breast cancer (TNBC) is a subtype of breast cancer which does not express or expresses a minimum amount of estrogen receptors (ER), progesterone receptors (PR) and human epidermal growth factor receptor 2 (HER2) protein. TNBCs include a heterogenic group of cancers that are aggressive, grow rapidly and are associated with poor progn...

Introduction/Background Endometrial carcinoma (EC) is the most common gynaecological malignancy in the developed world. Currently, no valid non-invasive diagnostic or prognostic methods exist, making diagnosis and treatment rely on histopathological and surgical findings. The clinical study ’Biomarkers for Diagnosis and Prognosis of Endometrial Car...

Introduction/Background Integration of molecular markers has initiated more individualised approaches to treatment of endometrial cancer (EC). These are determined on tissue samples procured during diagnostic procedures or after surgical treatment, contributing to long turnaround times. Hence, their clinical utilisation is challenging. To overcome...

Introduction/Background To establish the correlation between ultrasound characteristics of endometrial cancer (EC) and the value of molecular characteristics for individualised preoperative management. Methodology A single university based centre prospective study including all consecutive women undergoing surgical management for EC. All patients...

Objective To evaluate patient preference for short (gist) or detailed/extensive decision aids (DA) for genetic testing at ovarian cancer (OC) diagnosis. Design Cohort study set within recruitment to the Systematic Genetic Testing for Personalised Ovarian Cancer Therapy (SIGNPOST) study (ISRCTN: 16988857). Setting North‐East London Cancer Network...

Background and Objectives: Gestational trophoblastic disease (GTD) is a group of pregnancy-related malignant and premalignant diseases. The aim of this study was to assess the prognostic value of clinical characteristics to predict treatment outcomes in women with GTD. Materials and Methods: In this retrospective study, 34 patients treated for GTD...

Endometrial and cervical cancers are the two most common gynaecological malignancies and among the leading causes of death worldwide. The extracellular matrix (ECM) is an important component of the cellular microenvironment and plays an important role in developing and regulating normal tissues and homeostasis. The pathological dynamics of the ECM...

Endometrial cancer is the most common gynecologic malignancy in the developed world. Risk stratification and treatment approaches are changing due to better understanding of tumor biology. Upregulated Wnt signaling plays an important role in cancer initiation and progression with promising potential for development of specific Wnt inhibitor therapy...

The role of estrogens and progesterone in the development and progression of endometrial cancer is well-established, but there are very little data about the role of androgens. There are five different androgens produced in women: dehydroepiandrosterone sulphate (DHEAS), dehydroepiandrosterone (DHEA), androstenedione (A4), testosterone (T) and dihy...

Gestational choriocarcinoma of the ovary is an exceptionally rare and highly aggressive tumor. Preoperative diagnosis of extrauterine choriocarcinoma is difficult due to nonspecific clinical presentation and its resemblance to ectopic pregnancy. Without molecular genetic analysis, it is not possible to reliably differentiate gestational from non-ge...

Introduction/Background Gestational trophoblastic disease (GTD) represents a heterogeneous, rare group of disorders characterised by abnormal proliferation of trophoblastic tissue. Hydatidiform mole (HM) is the most common type of GTD. Partial (PHM) and complete (CHM) molar pregnancies represent a challenge for diagnosis and management, as especial...

Introduction/Background Understanding biological characteristics of endometrial cancer (EC) has opened possibilities of treatment individualisation. Enabling non-invasive methods of evaluation in patients with EC can therefore aid decision making in the office setting. Herein, we present the feasibility study evaluating endometrial cytological samp...

Introduction/Background Genetic-testing at ovarian cancer (OC) diagnosis is recommended in all clinical guidelines. The level of detailed information patients should be provided for informed decision making regarding genetic-testing is unknown. We evaluate patient preference for short or detailed/extensive Decision-Aids (DA) or written information-...

Introduction/Background Parallel panel-germline and somatic-testing in all women with ovarian-cancer (OC) identifies more pathogenic-variants (PV) benefitting from poly-ADP-ribose (PARP) inhibitor (PARP-i) therapy, and unaffected PV-relatives for precision prevention. This study aims to estimate cost-effectiveness and population impact of parallel...

Introduction/Background Phthalates are endocrine-disrupting chemicals (EDCs) widely used in consumer products. They can competitively bind to oestrogen and androgen receptors and impact signalling. In-vitro studies have shown certain phthalates to cause considerable inflammatory reaction. Analysis of EC cell lines exposure indicates butyl-benzyl ph...

Introduction/Background Breast cancer represents a heterogenous disease with different biological profiles. Regardless of recent developments in disease management, breast cancer remains a disease with a lifetime recurrence risk. GATA binding protein 3 (GATA3) represents a potential biomarker of breast cancer with prognostic properties. The aim of...

Introduction/Background Ashkenazi-Jewish (AJ) population-based BRCA-testing is acceptable, does not detrimentally impact psychological well-being or quality of life, is cost-effective and amplifies primary prevention for breast cancer (BC) ovarian cancer (OC). However, prospective data describing lifestyle impact are lacking. We report long-term re...

Introduction/Background Endometrial cancer is the most common gynaecological malignancy and is treated primarily surgically. An increasing body of evidence suggests frailty is an important predictor of postoperative morbidity. Yet, data on pre-operative assessment tool use to assist surgical decision making is limited. This study sought to assess d...

Background Gestational trophoblastic disease (GTD) is a heterogeneous group of rare tumours characterised by abnormal proliferation of trophoblastic tissue. It consists of benign or premalignant conditions, such as complete and partial molar pregnancy and variants of malignant diseases. The malignant tumours specifically are commonly referred to as...

The overall survival of women with endometrial cancer is excellent after management. Different management strategies are associated with variable patient-reported outcomes (PROs). Evaluating PROs in the follow-up period can aid in better counseling and intervention for PRO improvement. This study aimed to evaluate the properties of the Slovenian tr...

Objective: Ashkenazi-Jewish(AJ) population-based BRCA-testing is acceptable, cost-effective and amplifies primary prevention for breast-&-ovarian cancer. However, data describing lifestyle impact are lacking. We report long-term results of population-based BRCA-testing on lifestyle behaviour and cancer-risk perception. Design: Two-arm RCT (ISRCT...

High grade epithelial ovarian cancer (EOC) represents a diagnostic and therapeutic challenge due to its aggressive features and short recurrence free survival (RFS) after primary treatment. Novel targets to inform our understanding of the EOC carcinogenesis in the translational machinery can provide us with independent prognostic markers and provid...

Objective: Clinical registries are designed to collect quality data generated during diagnosis and cancer treatment, post-treatment monitoring, and survival and to enhance patient treatment. Evaluation of registry data allows an improvement of patient care and a comparison between healthcare providers. Our goal is to present a computer-based endome...

Objecitve: The incidence of endometrial cancer in young women is increasing. Since survival after management is in most cases excellent, the focus on long-term patient reported outcomes (PROs) is crucial. Herein we examine the characteristics and oncological and reproductive outcomes of young women with endometrial cancer. Methods: We have identifi...

Genetic testing for cancer susceptibility genes in gynaecologic oncology is expanding rapidly. All gynaecologists and gynaecological oncologists involved in the diagnosis and treatment of gynaecological cancer need to be able to understand the applicability and implications of genetics, counsel women about these issues and offer their patients gene...

Endometrial cancer (EC) is the most common gynaecologic malignancy in the developed countries. Recent evidence suggests that histopathological subtyping together with molecular subgrouping can lead to more accurate assessment of the risk profile for the patient. Clinical studies suggest the currently used molecular classification improves the risk...

Adenomyosis, endometriosis, endometritis, and typical endometrial hyperplasia are common non-cancerous diseases of the endometrium that afflict many women with life-impacting consequences. The mammalian target of the rapamycin (mTOR) pathway interacts with estrogen signaling and is known to be dysregulated in endometrial cancer. Based on this knowl...

Triple-negative breast cancer (TNBC) is a breast cancer (BC) subtype that accounts for approximately 15–20% of all BC cases. Cancer cell lines (CLs) provide an efficient way to model the disease. We have recently isolated a patient-derived triple-negative BC CL MFUM-BrTNBC-1 and performed a detailed morphological and molecular characterisation and...

Purpose: We report on the first patient with refractory hypoxemia treated with venovenous extracorporeal membrane oxygenation (VV ECMO) at the Medical Intensive Care Unit of the University Medical Centre Maribor. Case report: A 52-year-old male was admitted after successful cardiopulmonary resuscitation from out-of-hospital cardiac arrest (first rh...

Monitoring of low grade and early treatment of recurrent high grade squamous intraepithelial lesions (HSILs) are the cornerstones of cervical cancer prevention. Although current knowledge provides us with the ability to identify patients at risk for redeveloping HSIL, specifically patients with persistent human papilloma virus (HPV) 16 and 18 infec...

Background Effective clinical reasoning is a core competency of health professionals that is necessary to assure patients’ safety. Unfortunately, adoption of longitudinal clinical reasoning curricula is still infrequent. This study explores the barriers that hinder the explicit teaching of clinical reasoning from a new international perspective. M...

Objectives: The role of oestrogen (ER) and progesterone receptors (PR) is well known in the risk stratification of the endometrial cancer (EC); however the role of androgen receptor (AR) expression remains to be defined. We aimed to evaluate the association of AR expression with traditional factors for risk stratification. Methods: A single-centre...

Izhodišča: Rak endometrija je najpogostejša ginekološka maligna bolezen v razvitih državah. Standardni poseg za določitev stadija bolezni je odstranitev retroperitonealnih bezgavk. Biopsija varovalne bezgavke (SNB) se uveljavlja kot metoda izbire kirurške postavitve stadija pri na videz začetnem karcinomu endometrija po oceni pred operacijo. Na Odd...

Trojno negativni rak dojk (TNRD) predstavlja 10–20 % vseh primerov raka dojk. Zanj je značilno, da estrogenski receptorji, progesteronski receptorji in receptor HER2 niso izraženi. Kadar je tumor negativen tudi za androgene receptorje, govorimo o četverno negativnem raku dojk. TNRD se v številnih lastnostih razlikuje od ostalih tipov raka dojk. Inc...

Introduction/Background* The molecular characterisation of endometrial cancer (EC) represents a step towards personalised management. The current ESGO-ESTRO-ESP guidelines classify EC into four groups: POLE mutated (POLEmut), p53 abnormal (p53abn), mismatch repair deficient (MMRd) and the largest group of no specific mutational profile (NSMP). Wome...

Introduction/Background* Breast cancer is uncommon in young women in developed countries. It is very heterogenous disease and studies showed, that young patients often have biologically complex and often more agressive tumours. However, little is known on markers available to improve assessment of prognosis or provide an additional therapeutic targ...

Introduction/Background* Improved survival in patients with endometrial cancer has led to increased awareness about the quality of life (QoL) after treatment. QoL refers to a multidimensional assessment that includes physical, emotional, and psychological domains. An important part of QoL are patient reported outcomes (PROs). This study assessed PR...

Introduction/Background* Ovarian cancer represents the most lethal gynaecological cancer. Although treatment options for patients with ovarian cancer have expanded, many patients suffer from disease relapse early after primary treatment. Different targeted therapies based on signalling pathways in ovarian cancer have yielded limited clinical succes...

Introduction/Background* Universal screening for mismatch repair deficiency (MMRd) in endometrial cancer has been included as a component of the integrated molecular risk assessment and can be used for screening patients with a genetic predisposition for cancer (eg. Lynch syndrome). MMR status is also emerging as an important marker for choosing ca...

Background The aim of this study was to evaluate changes in prognostic risk profiles of women with endometrial cancer by comparing the clinical risk assessment with the integrated molecular risk assessment profiling. Patients and methods This prospective study recruited patients with biopsy proven endometrial cancer treated at the University Medic...

We present findings of a cancer multidisciplinary-team (MDT) coordinated mainstreaming pathway of unselected 5-panel germline BRCA1/BRCA2/RAD51C/RAD51D/BRIP1 and parallel somatic BRCA1/BRCA2 testing in all women with epithelial-OC and highlight the discordance between germline and somatic testing strategies across two cancer centres. Patients were...

Background: To analyze the mode of delivery and the outcome of a trial of labor in women with one prior caesarean birth. Methods: We extracted from the national database our hospital's information on women with a prior caesarean section from January 2014 to July 2019. They were then divided into groups that either opted for a trial of labor or repe...

Triple-negative breast cancers represent a group of hormone receptor-negative and HER2-negative breast cancers. Within TNBC exist subtype whose cells express androgen receptor (AR). Studies have shown absence of AR to be an important negative predictive factor. In addition, presence of AR has been found to be a promising target for treatment with t...

Endometrial cancer (EC) in women younger than 50 years make up 10% of EC cases with a trend of increasing incidence. In young women EC tends to be early stage, of endometrioid histology that is commonly preceded by a precancerous atypical endometrial hyperplasia (AEH). Standard treatment of early-stage disease includes hysterectomy with a bilateral...

Simple Summary Triple-negative breast cancer (TNBC) represents a heterogeneous group of breast cancers that lack estrogen receptor (ER), progesterone receptor (PR), and human epidermal factor 2 (HER2) amplifications. This triple negativity represents a challenge in choosing the right treatment, as without the aforementioned biomarkers there are no...

Cell lines are widely used for various research purposes including cancer and drug research. Recently, there have been studies that pointed to discrepancies in the literature and usage of cell lines. That is why we have prepared a comprehensive overview of the most common gynaecological cancer cell lines, their literature, a list of currently avail...

Simple Summary Endometrial cancer is a common gynecological malignant disease. Its incidence in women of reproductive age in developed countries is increasing. The standard treatment is surgical in the form of hysterectomy and bilateral salpingo-oophorectomy, which has a significant impact on the quality of women’s lives and precludes further ferti...

Objective To determine the prevalence of lower urinary tract symptoms (LUTS) in female adolescent population. Study design We performed a questionnaire-based study in nine randomly selected high schools in our country. Our primary aim was to evaluate the prevalence of certain LUTS in adolescent girls: frequency, urgency, nocturia, feeling of incom...

Introduction Endometrial cancer (EC) is the most common gynaecological malignancy in developed countries. Early and accurate diagnostic assessment is crucial for appropriate treatment planning. Information obtained by pre-operative imaging with transvaginal ultrasound (TVUS) and histological endometrial biopsy assessment is often the cornerstone fo...

Background: Identifying women at risk for small-for-gestational-age newborns (SGA) is an important challenge in obstetrics. Several different risk factors have been suggested to contribute to the development of SGA. Previous research is inconclusive on the role selenium (Se) plays in the development of SGA. The aim of the study was therefore to ex...

Endometrial cancer (EC) is a common gynecologic malignancy which continues to have a poor prognosis in advanced stages due to current therapeutic limitations. A significant mechanism of chemoresistance in EC has been shown to also be the enhancement of epithelial to mesenchymal transition (EMT) and the subsequent obtainment of stem cell-like charac...

Purpose: To present the results of implementation and compliance with enhanced recovery after surgery (ERAS®) in a low-volume gynecologic oncology department. Methods: In the Department of Gyne-cologic and Breast Oncology (Maribor, Slovenia) the ERAS® protocol was prepared by a gynecologist, anesthesiologist, and abdominal surgeon in 2015. A prospe...

Background: Clinical reasoning is a key ability essential for practising health professionals. However, little is known about the current global adoption of clinical reasoning teaching and assessment. Purpose: We aimed to provide insights into how clinical reasoning is deliberately taught and assessed in curricula worldwide and to identify needs an...

Studies of the mechanistic (mammalian) target of rapamycin inhibitors (mTOR) represent a step towards the targeted treatment of gynecological cancers. It has been shown that women with increased levels of mTOR signaling pathway targets have worse prognosis compared to women with normal mTOR levels. Yet, targeting mTOR alone has led to unsatisfactor...

Purpose: To analyze the distribution and pattern of neck metastasis in breast cancer (BC) patients. Methods: The clinicopathological characteristics of 41 patients with BC and confirmed neck metastasis (NM) treated at our institution between 2010 and 2016 were retrospectively analyzed by reviewing medical records. The diagnosis of NM was confirmed...

Objective: Clinical and pathological characteristics of triple negative breast cancer (TNBC) treatment are required for escalation or de-escalation of treatment because of a lack of druggable targets. This study aimed to identify the factors affecting the risk of disease recurrence and disease-related death in patients with TNBC. Methods: Patien...

Introduction/Background Currently available imaging techniques are often inadequate for early breast cancer detection, hence the interest for novel non-invasive biologic markers. Liquid biopsies, e.g. the analysis of circulating tumor DNA (ct-DNA), represent an alternative to tissue biopsies and characterize tumor genetic features in a non-invasive...

Introduction/Background Triple negative breast cancer (TNBC) is characterized by worse prognosis compared to other breast cancer subtypes. However due to different molecular subtypes within TNBC and thus different disease aggressiveness there is a need to establish clinical markers signalling disease aggressiveness and thus treatment. The aim of th...

Breast cancer is the second most common cancer worldwide and ranked first in incidence in women living either in developed or developing countries. It is ranked as the fifth common cause of cancer death. Annually, there are 1310 new cases of breast cancer in Slovenia. There are many types of breast cancer that we can differentiate based on their hi...

Nowadays, women want a more intimate and familiar atmosphere during labour, which results in increased planned home birth rates. Every woman has the autonomy to decide where she will give birth; however, it is important that she is informed of risks and advantages beforehand. Home births can be distinguished between planned and unplanned home birth...

Testing the impact of ability to self-evaluate knowledge on readiness for self-directed learning during the formative assessment progress test (PT) at the Faculty of Medicine, University of Maribor, Slovenia in year 2018.

Nowadays, women want a more intimate and familiar atmosphere during labour, which results in increased planned home birth rates. Every woman has the autonomy to decide where she will give birth; however, it is important that she is informed of risks and advantages beforehand. Home births can be distinguished between planned and unplanned home birth...

Monitoring of low grade and early treatment of recurrent high grade squamous intraepithelial lesions (HSILs) are the cornerstones of cervical cancer prevention. Although current knowledge provides us with the ability to identify patients at risk for redeveloping HSIL, specifically patients with persistent human papilloma virus (HPV) 16 and 18 infec...

Projekt VPMed je nastal s sodelovanjem Medicinske fakultete Univerze v Mariboru, Filozofske fakultete Univerze v Mariboru in Zdravstvenega doma Murska Sobota v okviru javnega razpisa »Študentski inovativni projekti za družbeno korist 2016-2018«. Namen projekta je bil razviti učni pripomoček osnovan na potrebah zdravstvenega osebja za učenje timskeg...

Background: The self-evaluation ability serves in developing critical thinking and learning skills. Students need to assess their own knowledge level in order to learn new material effectively. Self-evaluation is also important in clinical work. Our study aims at estimating the self-assessment ability of undergraduate medical students. Summary of w...

Progress test (PT) is a longitudinal assessment tool which follows the knowledge acquisition throughout the educational process. Students of different years in medical school are given the same written test which covers all the relevant disciplines in a medical curriculum. For effective implementation of PT it is important to know how students them...

The present study aimed to determine the amount of fluid medium passing through the Fallopian tubes into the peritoneal cavity during a hysteroscopy. This was done to understand the pathophysiology of complications related to the hysteroscopy. Conducted in a general hospital setting, the study examined the fluid inflow–outflow during a hysteroscopy...

Background: Student engagement (SE) in the curriculum is a positive indicator in the development of students deeply involved in their learning. It also has several benefits for the schools’ level of educational innovation and quality assurance. Method: In order to identify the most important pearls from the last decade of educational developments w...

SDL evolvement in undergraduate medical education

Clinical reasoning is assumed to be an important feature of virtual patients (VPs). The assumption is: allowing students to evaluate patients from history, diagnostics to treatment allows them to develop better diagnostic patterns to improved clinical reasoning. Growing evidence on VPs has not translated into diagnostic thinking gains.

Student led seminar work (SLSW) is a form of student centred teaching where the responsibility for the educational activity shifts from the educator to the students. The teacher is mainly a supervising tutor. In this poster, we are presenting students’ and educators’ views on SLSW predominantly done as a topic paper and a presentation, followed by...

Objective An increasing number of breast-conserving surgeries (BCS) has lead clinicians to the dilemma how to provide patients with the best pathological, short-term and long-term outcomes, while at the same time improving the cosmetic outcome and the patients’ quality of life. A proposed solution is the use of intraoperative ultrasound (IOUS) for...

An increasing number of virtual patients (VPs) are being used in the classroom, which raises questions about how to implement VPs to improve students' satisfaction and enhance their learning. This study developed and validated a scale that measures acceptability and attitudes of medical students towards the use of the VP education tool in the class...

Background: Teaching using paper problem-based learning (p-PBL) sessions has left some students fatigued with the learning process. Therefore, attempts have been made to replace p-PBL with digitally enhanced, decision-making PBL in the form of virtual patients (VPs). Student enthusiasm for substituting p-PBL with VPs has not been quantitatively ev...

Theoretical background: Virtual patients have been in use as an add on educational methods to traditional methods for some time. Through multimedia and interactive elements along with the virtual simulation of the clinical work with patients, medical students get an insight into the numerous forms of artificially created substitutes for real patien...

Background: Virtual patients, computer-assisted patient scenarios, have been used in different medical disciplines over several years. Researchers have already gained knowledge on how it helps foster clinical thinking, fills knowledge gaps and enables patient management. Nonetheless, despite these advances in knowledge, the use of virtual patients...

Objectives: Virtual patients (VP) have been present within the medical education process for some time. Although they are assumed to be of great benefit for student learning, very little is know about student perception and outcomes of learning, especially during the pre-clerkship years. Therefore we have decided to investigate the use of VPs duri...

Background: CD4+ T cells play a critical role during hepatic ischemia-reperfusion (I/R) injury although the mechanisms of their migration in the postischemic liver remain unclear. We answered the questions of whether hepatic stellate cells (HSCs) interact with CD4+ T cells during I/R of the liver and whether modulation of HSC activity affects T ce...