Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 263
Filtrar
1.
Radiología (Madr., Ed. impr.) ; 66(2): 132-154, Mar.- Abr. 2024. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-231515

RESUMO

El 80% de los carcinomas renales (CR) se diagnostican incidentalmente por imagen. Se aceptan un 2-4% de multifocalidad «esporádica» y un 5-8% de síndromes hereditarios, probablemente con infraestimación. Multifocalidad, edad joven, historia familiar, datos sindrómicos y ciertas histologías hacen sospechar un síndrome hereditario. Debe estudiarse individualmente cada tumor y multidisciplinarmente al paciente, con estrategias terapéuticas conservadoras de nefronas y un abordaje diagnóstico radioprotector. Se revisan los datos relevantes para el radiólogo en los síndromes de von Hippel-Lindau, translocación de cromosoma-3, mutación de proteína-1 asociada a BRCA, CR asociado a déficit en succinato-deshidrogenasa, PTEN, CR papilar hereditario, cáncer papilar tiroideo-CR papilar, leiomiomatosis hereditaria y CR, Birt-Hogg-Dubé, complejo esclerosis tuberosa, Lynch, translocación Xp11.2/fusión TFE3, rasgo de células falciformes, mutación DICER1, hiperparatoridismo y tumor mandibular hereditario, así como los principales síndromes de predisposición al tumor de Wilms.(AU)


80% of renal carcinomas (RC) are diagnosed incidentally by imaging. 2-4% of “sporadic” multifocality and 5-8% of hereditary syndromes are accepted, probably with underestimation. Multifocality, young age, familiar history, syndromic data, and certain histologies lead to suspicion of hereditary syndrome. Each tumor must be studied individually, with a multidisciplinary evaluation of the patient. Nephron-sparing therapeutic strategies and a radioprotective diagnostic approach are recommended. Relevant data for the radiologist in major RC hereditary syndromes are presented: von-Hippel-Lindau, Chromosome-3 translocation, BRCA-associated protein-1 mutation, RC associated with succinate dehydrogenase deficiency, PTEN, hereditary papillary RC, Papillary thyroid cancer- Papillary RC, Hereditary leiomyomatosis and RC, Birt-Hogg-Dubé, Tuberous sclerosis complex, Lynch, Xp11.2 translocation/TFE3 fusion, Sickle cell trait, DICER1 mutation, Hereditary hyperparathyroidism and jaw tumor, as well as the main syndromes of Wilms tumor predisposition. The concept of “non-hereditary” familial RC and other malignant and benign entities that can present as multiple renal lesions are discussed.(AU)


Assuntos
Humanos , Masculino , Feminino , Neoplasias Colorretais Hereditárias sem Polipose , Esclerose Tuberosa , Síndrome de Birt-Hogg-Dubé , Doença de von Hippel-Lindau , Neoplasias Renais , Metástase Neoplásica/diagnóstico por imagem , Radiologia/métodos , Diagnóstico por Imagem , Neoplasias Primárias Múltiplas , Nefropatias/diagnóstico por imagem , Carcinoma de Células Renais
3.
Rev. ORL (Salamanca) ; 14(2): 1-12, 20-06-2023. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-221992

RESUMO

Introducción y objetivo: El término de segundo tumor primario (STP) es utilizado para designar un nuevo cáncer primario que se presenta en una persona a la que se le ha diagnosticado un cáncer previamente. Se considera que los STP se producen de forma independiente y no como resultado de un resurgimiento o metástasis del tumor índice o primer tumor primario (PTP). El objetivo de este estudio es investigar la prevalencia, factores de riesgo, localización y tratamiento de los STP, así como el tiempo transcurrido entre la aparición de los tumores. Método: Se realiza un estudio retrospectivo descriptivo con pacientes con diagnóstico de STP entre enero del 2004 y diciembre de 2021 en el Hospital Universitario de Fuenlabrada. Se analizó la prevalencia y localización de los STP, los factores de riesgo relacionados, el tiempo entre la aparición del PTP y el STP, el tratamiento del PTP y STP y su resultado. Resultados: Del total de 360 casos del registro de tumores, 73 pacientes (20,2%) fueron incluidos en el estudio por padecer un STP. De los participantes, el 75% eran fumadores y el 46,6% bebedores. La mayor parte de estos pacientes fueron tratados quirúrgicamente. Se observó que el PTP con mayor desarrollo de STP fue el de cáncer de laringe, siendo la supraglotis la sublocalización más frecuente. El STP más frecuente fue el carcinoma epidermoide de pulmón. Conclusiones: En nuestra serie los STP aparecen en el 20% de los pacientes con tumores índice de cabeza y cuello. Son más frecuentes tras el cáncer de laringe, siendo la localización más frecuente el pulmón. Tanto el tabaco como el alcohol juegan un papel importante en su desarrollo, acortando el tiempo entre la aparición de los tumores, además de poder aparecer recidivas, persistencias y metástasis. (AU)


Introduction and objective: The term second primary tumor (SPT) is used to designate a new primary cancer that occurs in a person previously diagnosed with cancer. SPT are considered to occur independently and not as a result of a resurgence or metastasis of the index tumor or first primary tumor (FPT). The aim of this study is to investigate the prevalence, risk factors, location and treatment of STP, as well as time elapsed between tumor occurrence. Method: A retrospective descriptive study was performed including patients diagnosed with SPT between January 2004 and December 2021 at Hospital Universitario de Fuenlabrada. The prevalence and location of SPT, related risk factors, time between the onset of FPT and SPT, treatment of FPT and SPT and their outcome were analyzed. Results: From a total of 360 cases, 73 patients were included in the study because of SPT. 75% were smokers and 46.6% were drinkers. Most of these patients were treated surgically. It was observed that the FPT with the highest development of SPT was the larynx, with supraglottis being the most frequent sublocalization. The most frequent SPT was epidermoid carcinoma of the lung. Conclusions: In our series SPT appear in 20% of head and neck tumors. They are more frequent after laryngeal cancer, the most frequent location being the lung. Both tobacco and alcohol play an important role in their development, shortening the time between the appearance of tumors, in addition to the possibility of recurrence, persistence and metastasis. (AU)


Assuntos
Humanos , Neoplasias de Cabeça e Pescoço , Neoplasias Primárias Múltiplas , Tabaco , Fatores de Risco , Estudos Retrospectivos , Epidemiologia Descritiva , Espanha
4.
Clin. transl. oncol. (Print) ; 23(9): 1915-1922, sept. 2021. ilus
Artigo em Inglês | IBECS | ID: ibc-222190

RESUMO

Background and purpose Synchronous bilateral breast cancer (SBBC) accounts for 1–3.5% of breast cancer patients. The aim of this study was to evaluate dosimetric issues, clinical outcomes, and acute toxicities for SBBC patients receiving synchronous bilateral hypofractionated radiotherapy (SBHRT) and to compare them with patients treated with synchronous bilateral normofractionated RT schedule (SBNRT). Materials and methods From April 2016 to March 2020, 39 SBBC patients were referred to our institution. Patients were divided according to their prescription dose: Group A: 50 Gy/25fx (fractions), B: 60–64 Gy/25fx, C: 40.05 Gy/15fx; D: 48 Gy/15fx. Toxicity was evaluated using Common Terminology Criteria for Adverse Events (CTCAE)v.5.0. Results 34 patients were finally evaluated. Median follow-up was 24 months for NF schedule and 9 months for HF schedule. In the HF schedule, no acute side-effects > G2 were observed and no dermatitis was reported in 6th month´s assessments. 95% of patients have no evidence of disease and only 1 patient presented local relapse in the first mammography after RT. No distant failures or deaths were observed. Regarding dosimetric issues, the inter-patient average Dmean for the heart was: Group A: 5.0 Gy (4.6–5.5), Group B: 4.4 Gy (4.1–5.4), Group C: 4.8 Gy (4.5–5.1) and Group D: 5.3 Gy (4.4–5.6). For the lungs, the inter-patient average Dmean was: Group A: 10.8 Gy (9.8–12.2), Group B: 11.5 Gy (11.3–12), Group C: 9.8 Gy (9.3–10.5) and Group D: 10.5 Gy (10–11.3). Conclusions This is the first study reporting the safety, feasibility, and tolerability of 40.05 Gy/15fx over 3 weeks for the treatment of SBBC patients. Further study with larger accrual is mandatory (AU)


Assuntos
Humanos , Feminino , Neoplasias da Mama/radioterapia , Neoplasias Primárias Múltiplas/radioterapia , Hipofracionamento da Dose de Radiação , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/cirurgia , Seguimentos , Coração/efeitos da radiação , Pulmão/efeitos da radiação , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Neoplasias Primárias Múltiplas/cirurgia , Órgãos em Risco/efeitos da radiação , Estudos Prospectivos , Radioterapia de Intensidade Modulada/efeitos adversos
6.
Clin. transl. oncol. (Print) ; 23(2): 335-343, feb. 2021.
Artigo em Inglês | IBECS | ID: ibc-220618

RESUMO

Purpose Multiple primary colorectal cancers (MPCCs) are different from solitary colorectal cancers in many aspects, which are not well studied. The aim of this study was to clarify the clinicopathological features and prognosis of MPCCs. Methods The data of 64 patients with MPCCs out of 2300 patients with colorectal cancers (CRCs) from January 2009 to December 2017 were retrospectively analyzed. Stratified analysis was conducted based on subtypes and microsatellite status. Results The overall incidence of MPCC was 2.8% and the median follow-up duration was 51.5 (range 1–120) months. Metachronous CRCs (MCRCs) are more likely to appear in the right colon (p < 0.05). However, no significant differences regarding age, sex, BMI, tumor size, smoking/drinking history, TNM stage, family history of cancer, and 5-year survival rate were observed between synchronous CRC (SCRC) and MCRC. Advanced TNM stage (III) and the presence of polyps were found to be independent poor prognostic factors for MPCCs. The prevalence of mismatch repair deficiency (dMMR) in MPCCs was 28.1%. Deficient MMR is more likely to appear in younger, lighter MPCC patients with polyps (p < 0.05). Of four mismatch repair proteins, MLH-1, MSH-2, MSH-6, and PMS-2 were negative in nine, nine, five, and nine patients, respectively. The 5-year survival rate did not differ significantly between MMR-proficient (pMMR) and dMMR groups (p = 0.752). Conclusions Synchronous CRC (SCRC) and MCRC might represent similar disease entities with different courses. Deficient MMR is more likely to appear in younger, lighter MPCC patients with polyps and it is an essential indicator for screening Lynch syndrome (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais , Instabilidade de Microssatélites , Neoplasias Primárias Múltiplas , Estudos Retrospectivos , Fatores Sexuais , Taxa de Sobrevida , Prognóstico , Neoplasias Colorretais/genética , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/patologia , Neoplasias Primárias Múltiplas/genética , Neoplasias Primárias Múltiplas/mortalidade , Neoplasias Primárias Múltiplas/patologia
8.
Actas dermo-sifiliogr. (Ed. impr.) ; 112(1): 52-58, ene. 2021. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-200043

RESUMO

INTRODUCCIÓN: Realizamos una revisión de los melanomas múltiples primarios que se han diagnosticado en nuestro servicio a lo largo de los últimos 32 años (1987-2019) con el objetivo de tener mejor caracterizada nuestra población de pacientes con melanoma y poder ofrecerles un seguimiento más estrecho mediante la elaboración de un protocolo de seguimiento personalizado. METODOLOGÍA: Estudio observacional, descriptivo y retrospectivo de los melanomas primarios múltiples diagnosticados en un hospital de tercer nivel entre enero de 1987 y marzo de 2019. Se recogieron las características clínicas, epidemiológicas e histológicas de los melanomas primarios, así como de los subsecuentes melanomas, y se realizó un análisis descriptivo de las mismas. RESULTADOS: Se incluyeron 31 pacientes (15 hombres y 16 mujeres), con una media de edad de 67 años (intervalo: 36-85 años). La mediana de tiempo transcurrido desde el diagnóstico del primer melanoma primario y el del segundo melanoma fue de 2 años (intervalo 0-4 años). La mediana del número de melanomas por paciente fue de 2 (entre 2 y 6). Del total de 31 pacientes, 25 padecieron 2 melanomas (80%), 4 de ellos 3 melanomas (13%), y 2 pacientes presentaron 5 y 6 melanomas primarios, respectivamente. Los segundos melanomas primarios o subsecuentes eran menos invasivos comparados con los primeros. La mediana de índices de Breslow fue de 1mm en los primeros (entre 0,67 y 4 mm) y de 0,5 mm (0,32-2,42 mm) en los segundos. CONCLUSIONES: Los melanomas subsecuentes son más finos que los primeros melanomas diagnosticados. Se encontró un aumento de la frecuencia en los dos últimos años de melanomas múltiples primarios. Estos datos resaltan la importancia del seguimiento estrecho y a largo plazo de estos pacientes


BACKGROUND: We reviewed all cases of multiple primary melanoma diagnosed at our department over a 32-year period (1987-2019) to better characterize this subgroup of patients and develop a tailored protocol to offer them closer follow-up. METHODS: Retrospective, observational, descriptive study of patients diagnosed with multiple primary melanoma at a tertiary care hospital between January 1987 and March 2019. We collected clinical, epidemiologic, and histologic characteristics of primary and subsequent melanomas and performed a descriptive analysis. RESULTS: Thirty-one patients (15 men and 16 women) with a median age of 67 years (range, 36-85 years) were included. Second primary melanomas were diagnosed after a median of 2 years (range, 0-4 years). The median number of melanomas per patient was 2 (range, 2-6). Twenty-three of the 31 patients, 25 had 2 primary melanomas (80%), 4 had 3 melanomas (13%), and 2 patients each had 5 and 6 primary melanomas. Subsequent melanomas were less invasive than the initial primary melanomas. Median Breslow thickness was 1mm (range, 0.67-4 mm) for the first primary melanoma and 0.5mm (range, 0.32-2.42 mm) for subsequent melanomas. CONCLUSIONS: Subsequent melanomas are thinner than primary melanomas. We observed an increase in the number of cases of multiple primary melanoma diagnosed in the last 2 years of our study. Our findings highlight the importance of close, long-term follow-up of patients


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias Primárias Múltiplas/patologia , Melanoma/patologia , Neoplasias Cutâneas/patologia , Estudos Retrospectivos , Neoplasias de Cabeça e Pescoço/patologia , Extremidade Superior/patologia , Extremidade Inferior/patologia , Centros de Atenção Terciária , Prognóstico , Espanha
9.
Rev. senol. patol. mamar. (Ed. impr.) ; 33(4): 157-161, oct.-dic. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-201069

RESUMO

OBJETIVO: Revisión bibliográfica del diagnóstico, tratamiento y supervivencia del carcinoma de mama metastásico que cursa con carcinomatosis peritoneal. PACIENTES Y MÉTODOS: Presentamos el caso de una paciente en tratamiento en nuestro hospital comentándose los aspectos clínicos, diagnósticos y terapéuticos de interés. CONCLUSIÓN: Las metástasis del tracto gastrointestinal extra-hepáticas secundarias a tumor de mama son poco comunes (8-10%). La carcinomatosis peritoneal presenta una baja incidencia, habiéndose descrito pocos casos en la literatura, siendo la mayoría de tipo lobulillar infiltrante. Nuestro caso tratado de carcinomatosis peritoneal de origen mamario ductal infiltrante lo hace aún más infrecuente


AIM: We provide a literature review of the diagnosis, treatment and survival of metastatic breast cancer with peritoneal carcinomatosis. PATIENTS AND METHODS: We present a case treated in our institution and discuss relevant clinical, diagnostic, and therapeutic features. CONCLUSION: Extra-hepatic gastrointestinal metastasis from breast cancer is infrequent (8%-10%). The incidence of peritoneal carcinomatosis is low, with few cases reported in the literature, mostly from invasive lobular carcinoma. Our case of invasive ductal carcinoma is even less frequent


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Neoplasias Peritoneais/secundário , Neoplasias do Colo Sigmoide/patologia , Neoplasias Primárias Múltiplas/patologia , Adenocarcinoma/patologia , Neoplasias Peritoneais/patologia , Neoplasias do Colo Sigmoide/secundário
10.
Actas urol. esp ; 43(9): 467-473, nov. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-185247

RESUMO

Introducción y objetivos: El objetivo de este estudio fue analizar el impacto del grado histológico del tumor en la predicción de supervivencia de los tumores primarios T1 G2 y G3 OMS 1973, que han sido clasificados como HG (alto grado) en el sistema de clasificación OMS 2004. Materiales y métodos: Se revisaron retrospectivamente los datos de 481 pacientes con cáncer de vejiga T1HG primario, tratados entre 1986 y 2016 en 2 centros universitarios. Para comparar los grupos se realizaron pruebas de log-rank y análisis de regresión de Cox. Resultados: Noventa y cinco (19,8%) tumores fueron clasificados como G2 y 386 (80,2%) como G3. La mediana de seguimiento fue de 68 meses. Las tasas de recurrencia y progresión fueron 228 (47,5%) y 109 (22,7%) pacientes, respectivamente. Se realizó cistectomía radical en 114 pacientes (23,7%) y hubo 64 (13,3%) casos de muerte cáncer-específica. La tasa de supervivencia libre de recurrencia para G2, G3 y el total de los pacientes fue del 68,7, el 51,2 y el 56,3%, respectivamente, y la para tasa libre de progresión, se obtuvieron unos valores del 89,3, el 73,2 y el 78,1%. Durante todo el período de seguimiento, los pacientes con tumores G3 obtuvieron peores tasas de supervivencia libre de progresión y de recurrencia que los pacientes con tumores G2. En el análisis multivariante, después del ajuste de las características clínicas, el riesgo de recurrencia y progresión para los tumores G3 fue 1,65 y 2,42 veces mayor que para los tumores G2. Conclusiones: Se demostró que los tumores T1G3 se caracterizan por peores tasas de supervivencia libre de progresión y recurrencia en comparación con los cánceres G2


Introduction and objectives: The aim of this study was to analyse prognostic impact of tumour histological grade on survival differences between primary G2 and G3 WHO1973 stage T1 tumours which were graded as HG according to WHO2004 grading system. Materials and methods: Data from 481 patients with primary T1HG bladder cancer who were treated between 1986 and 2016 in 2 university centres were retrospectively reviewed. Log-rank test and Cox regression analysis was performed to compare the groups. Results: 95 (19,8%) tumours were classified as G2 and 386 (80,2%) were G3. Median follow-up was 68 months. The recurrence was observed in 228 (47,5%), and progression in 109 patients (22,7%). Radical cystectomy was performed in 114 pts (23,7%) and there were 64 (13,3%) cancer specific deaths. Recurrence-free rates at 5-years follow-up for G2, G3 and all patients were 68,7%, 51,2% and 56,3% and progression-free rates were 89,3%, 73,2% and 78,1% respectively. For total observation period patients with G3 tumours presented also worse recurrence-free, and progression-free survival levels than patients with G2 tumours. In multivariate analysis, after adjustment for clinical features, the risk of recurrence and progression for G3 tumours was 1,65 and 2,42 fold higher than for G2 tumours. Conclusions: It was shown that G3 T1 tumours are characterized by worse recurrence free and progression free survivals when compared to G2 cancers


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Classificações em Saúde , Neoplasias da Bexiga Urinária/classificação , Neoplasias da Bexiga Urinária/epidemiologia , Estadiamento de Neoplasias/classificação , Taxa de Sobrevida , Neoplasias Primárias Múltiplas/classificação , Estudos Retrospectivos , Ligante RANK , Neoplasias da Bexiga Urinária/cirurgia , Estadiamento de Neoplasias/métodos , Cistoscopia/métodos , 28599 , Análise Multivariada
13.
Med. paliat ; 26(3): 250-253, jul.-sept. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-190249

RESUMO

El término neoplasia primaria múltiple define a la presencia de dos o más procesos neoplásicos de distinto origen simultáneamente. Existe poca información de los pacientes en cuidados paliativos con esta patología. Presentamos una serie de 10 casos seguidos en nuestra unidad


The term multiple primary neoplasm is defined as the occurrence of two or more neoplastic processes of different origin that develop simultaneously. Information is sparse regarding patients with this condition in the palliative care setting. We report herein a series of 10 consecutive cases seen in our unit


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias Primárias Múltiplas , Cuidados Paliativos/métodos , Sobrevivência , Fatores de Risco , Fatores de Tempo
15.
Cir. plást. ibero-latinoam ; 45(1): 67-72, ene.-mar. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-182680

RESUMO

Introducción y Objetivo: La patología tumoral primaria de pared torácica es una entidad poco frecuente en niños. El tratamiento quirúrgico comúnmente involucra la resección de la pared torácica, pudiendo dejar grandes defectos que requieren reconstrucción compleja. Estos pueden incluir la reconstrucción de tejidos blandos y esqueléticos con materiales aloplásticos y colgajos regionales. Presentamos nuestra experiencia en reconstrucción torácica secundaria a tumores primarios de pared torácica en población pediátrica. Material y Método: Describimos 2 casos clínicos de pacientes pediátricos con tumores de pared torácica manejados multidisciplinariamente con resección amplia, cobertura con malla y colgajo miocutáneo de latissimus dorsi. Resultados: El colgajo de latissimus dorsi fue una buena alternativa en estos 2 casos para la cobertura de la reconstrucción esquelética en niños. Conclusiones: El abordaje multidisciplinario de estas patologías es fundamental dada la necesidad de realizar grandes ablaciones torácicas


Background and Objective: Primary tumor of the thoracic wall is a rare entity in children. Surgical treatment commonly involves resection of the chest wall, potentially leaving large defects that can require complex reconstruction. These may include skeletal and soft tissue reconstruction with alloplastic materials and regional flaps. We report our experience in thoracic wall reconstruction after extensive resection due to primary wall tumors resection in children. Methods: We present 2 cases of pediatric patients with thoracic wall tumor who were managed multidisciplinary with wide resection and reconstructed with mesh coverage and latissimus dorsi myocutaneous flap. Results: The latissimus dorsi flap was a good alternative for coverage of skeletal reconstruction in the presented cases. Conclusions: Multidisciplinary management of these pathologies is fundamental given the need to perform large thoracic ablations


Assuntos
Humanos , Masculino , Recém-Nascido , Parede Torácica/cirurgia , Retalhos Cirúrgicos/cirurgia , Neoplasias Primárias Múltiplas/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Neoplasias Primárias Múltiplas/secundário , Fibrossarcoma/diagnóstico , Biópsia , Sarcoma de Ewing/diagnóstico por imagem , Sarcoma de Ewing/cirurgia
16.
Rev. esp. enferm. dig ; 111(3): 245-247, mar. 2019. ilus
Artigo em Inglês | IBECS | ID: ibc-189834

RESUMO

Endoscopic full-thickness resection (EFTR) is a new technique for the resection of colonic lesions with limitations for other techniques such as endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) due to fibrosis, the location of the lesion or invasion depth. In addition, techniques such as ESD require a long learning curve and unfortunately they are not fully implemented in Western countries. EFTR has numerous indications, which are expanding daily. The Full-Thickness Resection Device(R) (FTRD) is a promising tool, although it has many limitations and is associated with some risks. One of the main limitations of this resection device is the size of the lesion and it is not recommended for the resection of lesions > 30 mm. Furthermore, tumor size is directly related to the "en bloc" resection rate. On the one hand, this case report suggests that neoadjuvant chemotherapy can modify the lesion size and larger lesions become candidates for EFTR in a second attempt. On the other hand, the concomitant use of systemic anticancer therapy could be a contraindication for the use of FTRD(R) as it may be associated with late perforations. It is necessary to establish the time between the use of chemotherapy and the use of FTRD(R) in order to avoid complications. These considerations must be analyzed in future prospective studies


No disponible


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Adenocarcinoma/cirurgia , Neoplasias do Colo/cirurgia , Ressecção Endoscópica de Mucosa/métodos , Quimioterapia Adjuvante , Adenocarcinoma/patologia , Neoplasias do Colo/patologia , Colonoscopia/métodos , Neoplasias Pulmonares/patologia , Neoplasias Primárias Múltiplas/patologia , Carga Tumoral
18.
Clin. transl. oncol. (Print) ; 20(10): 1274-1279, oct. 2018. tab, graf
Artigo em Inglês | IBECS | ID: ibc-173715

RESUMO

Background: Multimodal strategy including chemotherapy and hepatectomy is advocated for the management of colorectal liver metastases (CRLM). The aim of this study was to evaluate the impact of neoadjuvant Bevacizumab-based chemotherapy on survival in patients with resected stage IVA colorectal cancer and liver metastases. Methods: Data from 120 consecutive patients who received neoadjuvant chemotherapy and underwent curative-intent hepatectomy for synchronous CRLM were retrospectively reviewed. Overall survival (OS) was stratified according to administration of Bevacizumab before liver resection and surgical strategy, i.e., classical strategy (primary tumor resection first) versus reverse strategy (liver metastases resection first). Results: Patients who received Bevacizumab (n = 37; 30%) had a higher number of CRLM (p = 0.003) and underwent more often reverse strategy (p = 0.005), as compared to those who did not (n = 83; 70%). Bevacizumab was associated with an improved OS compared with conventional chemotherapy (p = 0.04). After stratifying by the surgical strategy, Bevacizumab was associated with improved OS in patients who had classical strategy (p = 0.03). In contrast, Bevacizumab had no impact on OS among patients who had liver metastases resection first (p = 0.89). Conclusions: Neoadjuvant Bevacizumab-based chemotherapy was associated with improved OS in patients who underwent liver resection of synchronous CRLM, especially in those who underwent primary tumor resection first


No disponible


Assuntos
Humanos , Bevacizumab/farmacocinética , Neoplasias Colorretais/patologia , Neoplasias Hepáticas/patologia , Taxa de Sobrevida , Neoplasias Hepáticas/secundário , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/cirurgia
19.
Clin. transl. oncol. (Print) ; 20(8): 1018-1025, ago. 2018. tab
Artigo em Inglês | IBECS | ID: ibc-173685

RESUMO

Background: The goal of treatment for patients with synchronous liver metastases (SLM) from rectal cancer is to achieve a complete resection of both tumor locations. For patients with symptomatic locally advanced rectal cancer with resectable SLM at diagnosis, our usual strategy has been the rectum first approach (RF). However, since 2014, we advocate for the interval approach (IS) that involves the administration of chemo-radiotherapy followed by the resection of the SLM in the interval of time between rectal cancer radiation and rectal surgery. Methods: From 2010 to 2016, 16 patients were treated according to this new strategy and 19 were treated according RF strategy. Data were collected prospectively and analyzed with an intention-to-treat perspective. Complete resection rate, duration of the treatment and morbi-mortality were the main outcomes. Results: The complete resection rate in the IS was higher (100%, n = 16) compared to the RF (74%, n = 14, p = 0.049) and the duration of the strategy was shorter (6 vs. 9 months, respectively, p = 0.006). The incidence of severe complications after liver surgery was 14% (n = 2) in the RF and 0% in the IS (p = 1.000), and after rectal surgery was 24% (n = 4) and 12% (n = 2), respectively (p = 1.000). Conclusion: The IS is a feasible and safe strategy that procures higher level of complete resection rate in a shorter period of time compared to RF strategy


No disponible


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias Retais/patologia , Neoplasias Hepáticas/patologia , Hepatectomia , Neoplasias Retais/cirurgia , Neoplasias Hepáticas/cirurgia , Metástase Neoplásica/patologia , Recidiva Local de Neoplasia/patologia , Neoplasias Primárias Múltiplas/patologia , Estudos Prospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...