Evaluating the effects of preoperative treatment with 5-alpha reductase inhibitors in holmium laser enucleation of the prostate.

INTRODUCTION AND AIM: Patients treated with HoLEP are frequently treated with previous treatments, including 5-alpha-reductase inhibitors (5-ARIs). We investigated the impact of pretreatment with 5-ARIs on perioperative and immediate postoperative parameters in patients treated with HoLEP. MATERIAL AND METHODS: A retrospective study was performed using a prospectively collected database including all patients treated with HoLEP at our center between January 2017 and January 2023. The resected tissue weight, enucleation and morcellation efficiency (enucleation weight/time and morcellation weight/ time), postoperative complications, hospital stay and hemoglobin drop have been analyzed. RESULTS: A total of 327 patients were included. Of these, 173 (52.9%) were treated with 5-ARIs. No differences were found among the perioperative parameters investigated to determine efficiency. No differences were observed in peri- or postoperative complications, hospital stay or hemoglobin drop. CONCLUSIONS: Therapy with 5-ARIs had no impact on the immediate postoperative outcomes of patients treated with HoLEP. In our cohort, we observed that the use of 5-ARIs did not affect surgical efficiency, enucleation or morcellation. Further multicenter studies will be necessary to validate these findings.

Involvement of K-RAS mutations and amino acid substitutions in the survival of metastatic colorectal cancer patients.

The efficacy of epidermal growth factor-targeting therapies has been found to be limited in tumors with the wild-type K-RAS gene, suggesting a predictive value of K-RAS gene analysis in tumoral response. However, the prognostic value of K-RAS is controversial. This study included patients diagnosed with metastatic colorectal cancer. The presence of K-RAS mutations was analyzed, and the tumors positive for a K-RAS mutation were further analyzed to identify the mutation type. Similarly, the following clinical and pathological variables were also collected. The study was composed of 53.3 % of patients with wild-type K-RAS and 46.7 % of patients with mutated K-RAS (mutated codon 12 was the most frequent). With a mean follow-up of 15 months (range, 1-45), the median survival of patients with wild-type K-RAS was 31.6 months. The median survival was 24.8 months for patients with K-RAS mutated in codon 12 and 17.8 months for patients with mutated codon 13 (p = 0.37). In a univariate analysis, K-RAS was associated with stage IV at diagnosis (p < 0.005). When K-RAS was mutated, a lower overall survival was observed in cases of G → A transition compared with G → T transversion (19.5 vs. 24.2 months, respectively; p = 0.47). When the amino acid change resulted in an acidic substitution, survival was lower, but it increased when the substitution resulted in a polar or nonpolar amino acid (19.5 vs. 23.2 vs. 24.4 months, p = 0.79). The type of K-RAS mutation or amino acid changes may have prognostic implications in metastatic colon cancer patients. Further research is needed in patients treated in prospective controlled trials.

Bevacizumab for recurrent, persistent or advanced cervical cancer: reproducibility of GOG 240 study results in "real world" patients.

PURPOSE: Bevacizumab is the only therapeutic target approved for patients with persistent, recurrent or advanced cervical cancer from a phase III study that combined with chemotherapy; it proves a significant increase in overall survival. To retrospectively assess the efficacy and safety of bevacizumab as the first-line treatment in patients from usual clinical practice with recurrent/persistent or advanced cervical cancer. PATIENTS AND METHODS: Treatment consisted of cisplatin 50 mg/m2 or carboplatin AUC 5 plus paclitaxel 175 mg/m2 for 6-8 cycles and bevacizumab 15 mg/kg every 3 weeks up to progression or unacceptable toxicity. The endpoints were progression-free survival (PFS), overall survival (OS), response rates (RR) and toxicity. RESULTS: Twenty-seven patients were included from January 2014 to June 2017, with a median follow-up 10, 1 months. Eleven percent had recurrent/persistent disease and 89% had metastatic disease at diagnosis. The prior exposition to platinum was 70%. The median PFS and OS were 9, 6 and 21, 5 months, respectively. There was an increase of fistula formation (22%). All of them had pelvic and peritoneal disease at the beginning of treatment and previous treatment with chemoradiotherapy; non-incidence differences were found according to the type of platinum agent used. There were two treatment-related deaths, one from intestinal perforation and another from severe sepsis. CONCLUSION: Finally, although our study does have certain limitations, we believe that it can provide useful information and encouraging evidence that the routine use of bevacizumab as part of first-line treatment of patients with advanced cervical cancer may be associated with outcomes comparable with those obtained in GOG240 study.

First-line mFOLFOX plus cetuximab followed by mFOLFOX plus cetuximab or single-agent cetuximab as maintenance therapy in patients with metastatic colorectal cancer: Phase II randomised MACRO2 TTD study.

BACKGROUND: This multicentre, randomised, and phase II study evaluated mFOLFOX+cetuximab followed by maintenance mFOLFOX+cetuximab or single-agent cetuximab in metastatic colorectal cancer (mCRC) patients (NCT01161316). PATIENTS AND METHODS: Previously, untreated mCRC patients (wild-type KRAS) were randomised to receive cetuximab+mFOLFOX-6 (8 cycles for 2 weeks) followed by maintenance therapy: single-agent cetuximab (Arm-A) or mFOLFOX-6 + cetuximab (Arm-B) until progression. Primary endpoint was progression-free survival (PFS) at 9 months. RESULTS: One hundred ninety-three patients (median [range] age 60 [33-74] years) were randomised (2:1): 129 Arm-A versus 64 Arm-B. PFS at 9 months (95% confidence interval) showed non-inferiority between arms (Arm-A/Arm-B: 60 [52, 69]%/72 [61, 83]%, p [non-inferiority]<0.1). There were no statistically significant differences in the PFS (Arm-A/Arm-B: 9 [95% CI 7, 10] months/10 [7,13] months, hazard ratio [HR] = 1.19 [0.80, 1.79]) or overall survival (23 [19, 28] months/27 [18, 36] months, HR = 1.24 [0.85, 1.79]) between arms. The objective response rate was also similar (48 [39, 57]%/39 [27, 52]%). The safety profile was similar between arms, and all patients experienced at least one adverse event (AE) (Arm-A/Arm-B grade ≥III AEs: 70%/68%). The most common grade ≥III AEs were as follows: neutropenia (Arm-A/Arm-B: 28%/26%), rash acneiform (15%/24%) and sensory neuropathy (2%/15%) in any group. Arm-A was associated with less grade ≥III rash and sensory neuropathy and a lower rate of serious AEs (20%/27%). CONCLUSION(S): This phase II exploratory trial with a non-inferiority design suggests that maintenance therapy with single-agent cetuximab following mFOLFOX+cetuximab induction could be a valuable option compared with mFOLFOX+cetuximab treatment continuation. We await phase III trials to confirm single-agent cetuximab as maintenance therapy in mCRC patients.

Effectiveness and safety of aflibercept for metastatic colorectal cancer: retrospective review within an early access program in Spain.

PURPOSE: In the VELOUR study, aflibercept + FOLFIRI regimen resulted in improved survival in metastatic colorectal cancer (mCRC) patients who progressed after oxaliplatin. The use of aflibercept outside the clinical trial framework needs to be further assessed in terms of effectiveness and tolerability. METHODS: Early access to aflibercept through a named patient programme (NPP) was provided to mCRC patients receiving FOLFIRI as second-line treatment in Spain. The effectiveness of aflibercept was assessed as progression-free survival (PFS) achieved within the NPP population. Post hoc analyses on PFS were done according to certain baseline characteristics (K-RAS mutation, prior targeted therapy) or prognostic factors. RESULTS: Registries from 71 mCRC patients included in the NPP were reviewed retrospectively. The median age for the NPP population was 64 years (19.7 % aged ≥70 years) and 63.4 % patients had ≥2 metastases. A median PFS of 5.3 months (95 % CI, 3.6-8.5 months) was achieved, which did not depend on K-RAS mutation status or prior targeted therapy received. The risk of progression or death increased in patients with a poor prognosis as per the GERCOR score (performance status [PS] 1-2 and increased baseline lactate dehydrogenase [LDH] level) compared with patients with a good prognosis (PS 0 and normal LDH level) (median PFS: 2.6 vs. 8.3 months, respectively; p = 0.0124). Aflibercept was well tolerated, with a manageable toxicity profile. CONCLUSIONS: Bearing in mind the differences in sample size, the PFS achieved with the aflibercept + FOLFIRI regimen in the real-life practice setting is comparable to that observed in the clinical trial setting.

[Development of a laparoscopic radical prostatectomy program in an university center]. / Implantación de un programa de prostatectomía radical laparoscópica.

The aim of this article is to report our experience in setting up a laparoscopic radical prostatectomy programme. We believe that knowledge of the difficulties we faced at the start will be useful for those who wish to implement a programme like ours. We hope that by explaining the steps we took as well as our conclusions and recommendations this difficult task can be made easier.

[Analysis of a laparoscopic radical prostatectomy program with 544 cases]. / Prostatectomía radical laparoscópica. Revisión de la literatura. Nuestra experiencia.

INTRODUCTION: This article reviews the latest publications that refer to Laparoscopic Radical Prostatectomy (LRP) up to 2005, and describes our series of patients for this type of surgery. MATERIALS AND METHODS: After a search of the Internet and consulting journals of renowned prestige, we selected articles that refer to this technique and we summarise the latest developments in LRP. We also present our series of patients. RESULTS: In view of the good oncologic and functional results obtained with LRP, and the possibility of performing hernioplasty as in open surgery, this technique provides a high quality service for patients. CONCLUSIONS: Due to the advances in the safety and quality of this technique, such as the use of robots, 3 CCD cameras, and the surgeon's experience, LRP should be offered to our patients, if it is within our means.

Clinical and epidemiological aspects of smoking and tuberculosis: a study of 13,038 cases.

SETTING AND OBJECTIVE: Smoking habit and tuberculosis (TB) appear to have common epidemiological and clinical links. The present study was to evaluate risk factors in TB patients with and without a smoking habit. DESIGN: A cross-sectional observational study of cases (TB with smoking) and controls (TB without smoking) from the same registry. Data were retrieved from case notes and interviews of patients registered in the Tuberculosis Control Programme in Cataluuña, Spain, between 1 January 1996 and 31 December 2002. Statistical analyses included univariate and stepwise multiple logistic regression analyses. RESULTS: There were 13,038 recorded patients. Social factors associated with TB in smokers were male sex (adjusted odds ratio [aOR] 2.2), age <64 years, alcohol use >30 g/day (aOR 7.4) and intravenous drug use (aOR 1.5). Smokers developed more pulmonary disease (aOR 1.5) and more cavitary lesions (aOR 1.9), and were more likely to require hospitalisation (aOR 1.8) which was more protracted. Differences in mortality and delay in diagnosis did not reach statistical significance. CONCLUSIONS: Smoking leads to faster and more severe progression of TB. The cost of TB-related hospitalisation for smokers increases by approximately one million euros per year.

[Solitary fibrous tumor of the prostate]. / Tumor fibroso solitario de la próstata.

We report a new case of a solitary fibrous tumor. It is a tumor which involve to genitourinary system unusual time, and it is exceptional in the prostate. Our patient began with bladder compression symptoms. Radiological studies showed polilobed mass that moved out the bladder although the could not show the pelvic organ was involved. The definitive diagnosis was made by histology and inmunohistochemestry of the surgical piece.

The spread of AIDS and the re-emergence of tuberculosis in Catalonia, Spain.

OBJECTIVE: To assess the impact of HIV/AIDS on the incidence of tuberculosis (TB) and to analyse the determinants of TB presenting as the first indicative disease of AIDS. DESIGN: Analysis of TB and AIDS surveillance data. SETTING: Catalonia, north-east Spain. PATIENTS: Two separate sources were used: (i) TB cases reported to the Catalan TB registry diagnosed between January 1982 and December 1993; (ii) AIDS cases reported to the AIDS Catalan registry diagnosed between January 1982 and December 1994. MAIN OUTCOME MEASURES: Expected and observed TB cases, and number and characteristics of AIDS cases presenting with TB. RESULTS: From 1987 to 1993 the annual TB crude incidence rate increased by 50% to a rate of 49.7 per 100,000, with a least 60% of the increase directly due to AIDS. During that period specific rates among children aged 0-4 years remained high at around 40 per 100,000. A total of 7,010 AIDS cases were diagnosed between 1988 and 1994, of whom 24.3% had TB. Multivariate analysis from those AIDS cases showed that besides male sex, young age, and urban residence, the strongest predictors of TB among AIDS cases were history of imprisonment (odds ratio, 2.16; P < 0.001) and intravenous drug use (odds ratio, 1.65; P < 0.001). CONCLUSIONS: The high rates of TB among children and young adults suggest that TB transmission has increased during this period, especially among people at high risk of AIDS. The determinants of individual risk of TB among AIDS patients act together, especially in prisons. The HIV/TB coepidemic is an emerging threat potentially for all and requires expanding targeted measures to prevent and control both disease in our setting.

Evaluation of a new serodiagnostic tuberculosis test based on immunoglobulin A detection against Kp-90 antigen.

We evaluated a new serological test for tuberculosis (TB) diagnosis, an enzyme-linked immunosorbent assay which detects the presence of immunoglobulin A (IgA) antibodies in human serum, the Kreatech TB IgA EIA test. The study was performed using 166 serum samples collected in the city of Barcelona, Spain. Fifty-six serum samples were from TB patients and 111 from controls, 40 of which were non-TB pneumonia patients. The test sensitivity was 70.58% in the adult group with pulmonary TB and 50% in the group with extra-pulmonary TB. These sensitivities were similar to those previously reported by others. However, we found that the test had a low specificity of only 68.68%, while specificities of 90% and 95% have been reported. This discrepancy may be attributable to differences in the respective study populations. In our control group we included 40 non-TB pneumonia patients (36% of the entire control group), in whom test specificity dropped to 47.22%. In those studies in which specificities of 90% and above were achieved, very few serum samples from non-TB pneumonia patients were tested (6-12% of the entire control group).

Tuberculosis screening among immigrants holding a hunger strike in churches.

SETTING: In January 2001, approximately 600 immigrants held a sit-down and hunger strike in several churches in Barcelona to force the Spanish government to comply with demands to regulate their immigration status. Following the diagnosis of a case of smear-positive pulmonary tuberculosis (TB) in one of the immigrants, we performed a large contact investigation. OBJECTIVES: To describe contact investigation procedures used in this setting and to evaluate contact investigation results. METHODS: Demographic variables were collected, and tuberculin skin tests (TST) and chest radiograph examinations were performed. Odds ratios (OR) with 95% confidence intervals (CI) were calculated and logistic regression was used for multivariate analyses. RESULTS: A total of 541 TSTs were performed. Of these, 86% were read and 40.5% yielded a positive reaction with an induration >14 mm. In a multivariate analysis, the risk of presenting a TST induration >14 mm was found to be three times higher among those aged >35 years compared to those <24 years (OR 3.40; 95%CI 1.76-6.59), and for immigrants from Bangladesh (OR 3.14; 95%CI 1.16-6.10) and Pakistan (OR 2.04; 95%CI 1.11-3.73) compared to those from India. A total of 314 chest radiographs examinations were performed and three additional cases of TB were identified, yielding a TB prevalence of 0.7%. CONCLUSIONS: By focusing efforts and conducting targeted TB screening in this high-risk population, it was possible to complete the intervention in only 3 days. A high prevalence of TB infection and TB disease was found.

Procedures for developing a simple scoring method based on unsophisticated criteria for screening children for tuberculosis.

OBJECTIVE: To develop a scoring system for screening children for tuberculosis (TB) and for selecting suspects for further investigation in tuberculosis control programmes. Application of the score model, which would not require sophisticated or expensive technology, would be directed towards resource-poor countries with high prevalences of tuberculosis, where health care workers have to deal with diagnostic problems away from district hospitals or diagnostic facilities. DESIGN: Based on contributions from members of an IUATLD task group from 10 countries on the use of diagnostic criteria in childhood tuberculosis, criteria were selected to be used as elements in a score model. Data were collected by standardised questionnaire on 879 subjects aged under 15 years. Of these, 794 were considered probable or confirmed cases of tuberculosis by the diagnosing doctors. From each record, the criteria/procedures used in the diagnosis of probable/confirmed TB and regarded by the doctors as relevant criteria were selected. Bacteriology, histology and chest radiography were used either singly or collectively as the definitive reference (gold standard) against which the more subjective criteria (symptoms, clinical signs, skin test) would be evaluated. The latter criteria cited as relevant were then ranked and further explored for inclusion in the score model. The relative importance of each criterion to every other criterion on the list was expressed as weights, determined by employing a logarithmic least squares method to solve the ratio scale estimation problem which underlies decision-making involving more than one criterion. The resultant values were then assigned to each criterion in the final score model. RESULTS: The five clinical criteria thought to be most relevant as predictors of disease in children were history of contact with a case of tuberculosis, positive skin test, persistent cough, low weight for age, and unexplained/prolonged fever. In selecting the optimal cut-off points for the model at which tuberculosis would be suspected, low sensitivity and specificity (below 70%) but reasonably good positive predictive values (60%-77%) were obtained, depending on age group and epidemiological setting. In low tuberculosis prevalence settings, heavy reliance is placed by the model on a history of contact with a household case of tuberculosis and on a positive skin test, both of which have to be true. For high prevalence settings, more or less equal weighting is assigned to all five elements. Case contact and skin tests are less important, with low body weight, prolonged fever and cough being more indicative of tuberculosis. CONCLUSION: The model provides for epidemiological differences between target populations and should prove successful as a screening tool to select children for further investigation by radiography and bacteriology.

Tuberculosis in Spain: epidemiological pattern and clinical practice.

SETTING: Thirteen Autonomous Regions in Spain. OBJECTIVE: To study the incidence of all forms of tuberculosis (TB) and investigate clinical practice in TB. DESIGN: Cases of all forms of tuberculosis diagnosed in the study setting from May 1986 to April 1997 were identified though active search of different databases. Clinical and epidemiological information on cases was collected from clinical records or by interview with physicians. RESULTS: The overall incidence of all forms of tuberculosis was 38.5/100,000 and the incidence of smear-positive disease was 13.83/100,000. Most cases (97.1%) were Spanish nationals, with rates higher in men than in women (52.7/100,000 vs. 24.87/100,000) and in groups aged 25-34 and 75 years and over (61.35/100,000 and 59.35/100,000, respectively). Disseminated forms were frequent (6.6%), and the most common risk factor was human immunodeficiency virus (HIV) infection (17.7% of cases). Hospitalisation was common (71.6%). Microbiological confirmation of diagnosis was sought for 87.7% of the cases (91.8% of pulmonary vs. 75.5% of extra-pulmonary cases), and 65.2% were culture-positive (73.8% of pulmonary vs. 39.7% of extra-pulmonary cases). HIV-infected patients were treated in almost equal proportions with three or four drugs (49.7% and 48.2%, respectively), while HIV-negative cases or those whose HIV status was unknown were usually treated with three drugs. CONCLUSION: The epidemiological pattern of TB in Spain is different to other industrialised countries in the age distribution of cases and the proportions of foreigners and cases with HIV infection. Microbiological confirmation of diagnosis is more common in pulmonary than in extra-pulmonary disease, and treatment with four drugs more frequent in HIV-positive cases.

[Tuberculin test responses of tuberculosis patients]. / La respuesta a la prueba de la tuberculina en enfermos tuberculosos.

OBJECTIVE: To determine the response of tuberculosis patients to tuberculin skin tests. METHOD: The results of skin tests used for initial assessment of tuberculosis patients in Catalonia were reviewed (Multicenter Tuberculosis Research Project). Negative skin tests were those with indurations < 5 mm; positive tests were those with indurations measuring > or = 5 mm. Individuals were classed as having or not having risk factors for developing tuberculosis and those without risk factors were classified by age, location and extension of tuberculosis. RESULTS: Negative skin tests were seen in 1,566 patients (23%). Negative tests were more common in patients with risk factors, significantly so in those undergoing immunosuppressant therapy (50%) or with HIV infection (61%). Negative tests were less prevalent in patients with no risk factors (13%) and, among them, in children (1%), in patients between 15 and 29 years of age (10%) or in those with non-pulmonary forms (10%). Negative tests were significantly more prevalent among patients 60 to 74 years of age (27%), those over 74 (44%), and those whose disease was pulmonary and extrapulmonary (26%) or disseminated (64%). No significant differences in induration size of positive skin tests were observed for patients with and without risk factors (including HIV infection or non-infection). A normal distribution of induration size was observed in all groups. CONCLUSIONS: A negative tuberculin skin test for initial assessment should be interpreted in function of the presence or absence of risk factors, age, location or extension of tuberculosis. When a skin test is positive, the response will be similar whether or not an immunodepressant factor is present.

[Retrospective evaluation of the effectiveness of the BCG vaccine campaign in newborns of Barcelona]. / Evaluación retrospectiva de la eficacia de la campaña de vacunación BCG de los recién nacidos de Barcelona.

BACKGROUND: The aim of this study was to know the efficacy of the BCG vaccination campaign of the newborns of Barcelona carried out during the period from 1966-1974. METHODS: To achieve this aim an epidemiologic investigation was undertaken by an observational analytical study of paired cases and controls. Two hundred and fifty randomly selected cases were studied between 1978-1988 from between 4-21 years of age during the study period. The cases were paired with 750 controls (1:3) with identical conditions and age, sex and place of residence. Statistical analysis of data was performed by the specific methods for this type of study. RESULTS: The estimated gross odds ratio was 0.68; the interval of confidence 95% and 0.51-0.91 (p < 0.025). The efficacy of this vaccination campaign was estimated as weak at 32%, in the age group and investigation time being greater in males and diminished with time. The percentage of new cases of tuberculosis potentially prevented by this campaign was calculated at 13%. CONCLUSIONS: The weak efficacy of the BCG vaccination campaign may be attributed not only to the unforeseen effects of this vaccine but also to the deficient operative aspects of the campaign itself.

[Comparative study of human cutaneous sensitivity to 2 and 5 international units of the PPD RT 23 tuberculin with Tween 80]. / Estudio comparativo de la sensibilidad cutánea humana a 2 y 5 unidades internacionales de la tuberculina PPD RT 23 con Tween 80.

BACKGROUND: The aim of this study was to know whether the human reaction to the Mantoux test with 5 UT of PPD RT 23 is similar to that achieved with the same test but with 2 UT of the same substance. METHODS: A simultaneous double Mantoux test was used at doses of 2 UT and another of 5 UT of the same trade mark of tuberculin PPD RT 23 with Tween 80 in 2,575 individuals. The subjects were distributed into two different groups of different ages, taking into consideration the possible presence of BCG vaccination. RESULTS: The doses of 5 UT produced a greater number of tuberculin positive individuals and a greater diameter of induration of reaction than that of the doses of 2 UT in both groups and with significant statistical differences. One hundred ninety-six (7%) subjects were tuberculin positive with 5 UT and negative with 2 UT. CONCLUSIONS: The reactions produced by the Mantoux test with 5 and 5 UT PPD RT were different since the two doses are not bioequivalent.

[Cost-benefit analysis of the active screening of pulmonary tuberculosis in a recluse population entering prison]. / Análisis coste-beneficio de la búsqueda activa de tuberculosis pulmonar en población reclusa a su ingreso en prisión.

BACKGROUND: In spanish prisons, tuberculosis is a serious problem of public health and health authorities don't take it seriously. OBJECTIVE: To prove the efficiency of pulmonary tuberculosis case-finding on arrival at prison in order to get location resources in this activity. METHODS: Cost-benefit analysis of a case-finding program compared with to wait for diagnostic to illness. The sensitivity of test was fixed in 80% and the specificity in 99.99%. The cost was based on market prices. Sensitivity analysis was done in every variables as well as tridimensional analysis in those one of more influence. RESULTS: The case-finding was efficient on prevalences of tuberculosis over 5 per mil. Its efficiency was hardly affected by discount social rates or the sensitivity of diagnostic tests. The prevalence of illness, the cost of diagnostic activities as well as the success of treatment and the specificity of diagnostic tests used had as influence on the efficiency model. The tridimensional analysis proved that the case-finding of pulmonary tuberculosis has efficiency on low prevalences (1 per thousand), provided the number of people cured is a 5% higher than the alternative one and the costs of case-finding less than 1,000 pesetas per subject. CONCLUSIONS: The case-finding pulmonary tuberculosis on arrival at prisons is of high efficiency. In a cost-opportunity situation (location of available resources, penitentiary and extrapenitentiary) the program is very efficacious taking into account the fact of higher prevalence of pulmonary tuberculosis in this people.

The influence of host fruit and temperature on the body size of adult Ceratitis capitata (Diptera: Tephritidae) under laboratory and field conditions.

The adult body size of the Mediterranean fruit fly, Ceratitis capitata (Wiedemann) (Diptera: Tephritidae), varies in natural conditions. Body size is an important fitness indicator in the Mediterranean fruit fly; larger individuals are more competitive at mating and have a greater dispersion capacity and fertility. Both temperature during larval development and host fruit quality have been cited as possible causes for this variation. We studied the influence of host fruit and temperature during larval development on adult body size (wing area) in the laboratory, and determined body size variation in field populations of the Mediterannean fruit fly in eastern Spain. Field flies measured had two origins: 1) flies periodically collected throughout the year in field traps from 32 citrus groves, during the period 2003-2007; and 2) flies evolved from different fruit species collected between June and December in 2003 and 2004. In the lab, wing area of male and female adults varied significantly with temperature during larval development, being larger at the lowest temperature. Adult size also was significantly different depending on the host fruit in which larvae developed. The size of the flies captured at the field, either from traps or from fruits, varied seasonally showing a gradual pattern of change along the year. The largest individuals were obtained during winter and early spring and the smallest during late summer. In field conditions, the size of the adult Mediterannean fruit fly seems apparently more related with air temperature than with host fruit. The implications of this adult size pattern on the biology of C. capitata and on the application of the sterile insect technique are discussed.