RESUMEN
Cutaneous squamous cell carcinoma (cSCC) is the second most common form of skin cancer, the incidence of which has risen over the last years. Although cSCC rarely metastasizes, early detection and treatment of primary tumours are critical to limit progression and local invasion. Several prognostic factors related to patients' clinicopathologic profile and tumour features have been identified as high-risk markers and included in the stratification scales, but their association with regional control or survival is uncertain. Therefore, decision-making on the diagnosis and management of cSCC should be made based on each individual patient's characteristics. Recent advances in non-invasive imaging techniques and molecular testing have enhanced clinical diagnostic accuracy. Surgical excision is the mainstay of local treatment, whereas radiotherapy (RT) is recommended for patients with inoperable disease or in specific circumstances. Novel systemic treatments including immunotherapies and targeted therapies have changed the therapeutic landscape for cSCC. The anti-PD-1 agent cemiplimab is currently the only FDA/EMA-approved first-line therapy for patients with locally advanced or metastatic cSCC who are not candidates for curative surgery or RT. Given the likelihood of recurrence and the increased risk of developing multiple cSCC, close follow-up should be performed during the first years of treatment and continued long-term surveillance is warranted.
RESUMEN
Objetivo: El objetivo del presente trabajo es describir de forma retrospectiva la técnica, eficacia y seguridad de la colposacropexia laparoscópica con malla en Y de macroporo y anclajes helicoidales de titanio para el tratamiento del prolapso de cúpula vaginal. Método: Catorce pacientes, desde enero de 2011 a enero de 2013, fueron intervenidas en el Servicio de Ginecología del Hospital General Universitario de Castellón. La técnica consistía en la fijación de la vagina al sacro con la ayuda de una malla de polipropileno y anclajes helicoidales de titanio. La paridad de las pacientes fue entre 1 y 3 partos vaginales con un rango de edad entre 49 y 78 años. Resultados: La técnica quirúrgica logró la corrección del defecto en las 14 pacientes. No se reportaron complicaciones intraoperatorias, ni postoperatorias, con rápida recuperación e incorporación a las actividades diarias. Conclusiones: La colposacropexia laparoscópica con malla de polipropileno es una técnica segura, efectiva y reproducible con excelentes resultados (AU)
Objective: To retrospectively analyze the technical feasibility, effectiveness and safety of laparoscopic sacrocolpopexy with Y wide-pore mesh and helical titanium anchorages for the treatment of vaginal vault prolapse. Method: Between January 2011 and January 2013, 14 laparoscopic colposacropexies were performed in the Gynecology Service of the General University Hospital of Castellón. The technique consisted of mesh joined to the sacropromontory with helical titanium anchorages. Parity was between one and three births. The age of the patients was between 49 and 78 years. Results: The surgical technique successfully corrected the defect in 14 patients. There were no interoperative or postoperative complications, with prompt recovery and reintegration to usual activities. Conclusions: Laparoscopic colposacropexy with polypropylene mesh is a safe, effective and reproducible technique with excellent results (AU)