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1.
BMC Cancer ; 20(1): 759, 2020 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-32795358

RESUMEN

BACKGROUND: Few studies have examined gender differences in the clinical management of rectal cancer. We examine differences in stage at diagnosis and preoperative radiotherapy in rectal cancer patients. METHODS: A prospective cohort study was conducted in 22 hospitals in Spain including 770 patients undergoing surgery for rectal cancer. Study outcomes were disseminated disease at diagnosis and receiving preoperative radiotherapy. Age, comorbidity, referral from a screening program, diagnostic delay, distance from the anal verge, and tumor depth were considered as factors that might explain gender differences in these outcomes. RESULTS: Women were more likely to be diagnosed with disseminated disease among those referred from screening (odds ratio, confidence interval 95% (OR, CI = 7.2, 0.9-55.8) and among those with a diagnostic delay greater than 3 months (OR, CI = 5.1, 1.2-21.6). Women were less likely to receive preoperative radiotherapy if they were younger than 65 years of age (OR, CI = 0.6, 0.3-1.0) and if their tumors were cT3 or cT4 (OR, CI = 0.5, 0.4-0.7). CONCLUSIONS: The gender-specific sensitivity of rectal cancer screening tests, gender differences in referrals and clinical reasons for not prescribing preoperative radiotherapy in women should be further examined. If these gender differences are not clinically justifiable, their elimination might enhance survival.


Asunto(s)
Detección Precoz del Cáncer/estadística & datos numéricos , Disparidades en Atención de Salud/estadística & datos numéricos , Terapia Neoadyuvante/estadística & datos numéricos , Proctectomía/estadística & datos numéricos , Neoplasias del Recto/terapia , Anciano , Anciano de 80 o más Años , Estudios Transversales , Diagnóstico Tardío/estadística & datos numéricos , Femenino , Humanos , Masculino , Estadificación de Neoplasias , Estudios Prospectivos , Radioterapia Adyuvante/estadística & datos numéricos , Neoplasias del Recto/diagnóstico , Neoplasias del Recto/mortalidad , Neoplasias del Recto/patología , Recto/patología , Recto/cirugía , Derivación y Consulta/estadística & datos numéricos , España/epidemiología
2.
Rep Pract Oncol Radiother ; 20(1): 1-11, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25535578

RESUMEN

Short-course preoperative radiotherapy (RT) is widely used in northern Europe for locally advanced resectable rectal cancer, but its role in the era of advanced imaging techniques is uncertain. Here, we reviewed articles and abstracts on SCRT published from 1974 through 2013 with the goal of identifying patients who might be best suited for short-course RT. We included relevant articles comparing surgery with or without preoperative radiation published before and after the advent of total mesorectal excision. We also analyzed two randomized trials directly comparing short-course RT with conventionally fractionated chemoradiation (the Polish Colorectal Study Group and the Trans-Tasman Radiation Oncology Group) that compared short-course RT with conventional chemoradiotherapy. We conclude from our review that short-course RT can be generally applied for operable rectal cancer and produces high rates of pelvic control with acceptable toxicity; it reduces local recurrence rates but does not increase overall survival. SCRT seems to be best used for tumors considered "low risk," i.e., those that are >5 cm from the anal margin, without circumferential margin involvement, and involvement of fewer than 4 lymph nodes. Whether sequential chemotherapy can further improve outcomes remains to be seen, as does the best time for surgery (immediately or 6-8 weeks after RT). We further recommend that selection of patients for short-course RT should be based on findings from magnetic resonance imaging or transrectal ultrasonography.

3.
Neurocirugia (Astur) ; 23(4): 151-6, 2012 Jul.
Artículo en Español | MEDLINE | ID: mdl-22796295

RESUMEN

The Neuro-Oncology Study Group (NOSG) at SENEC has commissioned the elaboration of the present document to the Neuro-Oncology Committee at Donostia University Hospital. It is intended to serve as a NOSG Consensus Guide and a proposed recommendation for the management of this pathological condition at all Spanish Hospitals, both public and private. Neuro-Oncology Committees must be established and active at all centres with a Neurosurgery Service, taking into account the specific diagnostic and therapeutic capacity available. The work presents an example of the constitution, functioning and experience of such a Committee, drawing on 8 years of multidisciplinary work with brain tumour patients.


Asunto(s)
Neoplasias Encefálicas , Neurocirugia , Hospitales Universitarios , Humanos
4.
Sci Rep ; 10(1): 18445, 2020 10 28.
Artículo en Inglés | MEDLINE | ID: mdl-33116181

RESUMEN

O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation status has been considered a prognostic factor in newly diagnosed glioblastoma (GBM). In this study, we evaluated the prognostic and predictive value of MGMT promoter methylation in patients with glioblastoma in Donostia Hospital. Surprisingly, methylation of MGMT promoter did not predict response to temozolomide in patients with glioblastoma in Donostia Hospital. Specifically, overall survival (OS) and progression-free survival (PFS) did not differ significantly by MGMT methylation status in our cohort. In contrast, both were longer in patients who received treatment, received more TMZ cycles, had a better general status and perform at least a partial resection. No association was detected between methylation of MGMT promoter and molecular markers such as ATRX, IDH, p53 and Ki67. These results indicate that MGMT methylation did not influence in patient survival in our cohort.


Asunto(s)
Metilación de ADN/efectos de los fármacos , Metilasas de Modificación del ADN/metabolismo , Enzimas Reparadoras del ADN/metabolismo , ADN de Neoplasias/metabolismo , Glioblastoma , Regiones Promotoras Genéticas , Temozolomida/administración & dosificación , Proteínas Supresoras de Tumor/metabolismo , Anciano , Supervivencia sin Enfermedad , Femenino , Glioblastoma/tratamiento farmacológico , Glioblastoma/enzimología , Glioblastoma/mortalidad , Glioblastoma/patología , Hospitales , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Tasa de Supervivencia
5.
Sci Rep ; 8(1): 12746, 2018 08 24.
Artículo en Inglés | MEDLINE | ID: mdl-30143669

RESUMEN

Long non-coding RNAs (LncRNAs) have emerged as a relevant class of genome regulators involved in a broad range of biological processes and with important roles in tumor initiation and malignant progression. We have previously identified a p53-regulated tumor suppressor signature of LncRNAs (PR-LncRNAs) in colorectal cancer. Our aim was to identify the expression and function of this signature in gliomas. We found that the expression of the four PR-LncRNAs tested was high in human low-grade glioma samples and diminished with increasing grade of disease, being the lowest in glioblastoma samples. Functional assays demonstrated that PR-LncRNA silencing increased glioma cell proliferation and oncosphere formation. Mechanistically, we found an inverse correlation between PR-LncRNA expression and SOX1, SOX2 and SOX9 stem cell factors in human glioma biopsies and in glioma cells in vitro. Moreover, knock-down of SOX activity abolished the effect of PR-LncRNA silencing in glioma cell activity. In conclusion, our results demonstrate that the expression and function of PR-LncRNAs are significantly altered in gliomagenesis and that their activity is mediated by SOX factors. These results may provide important insights into the mechanisms responsible for glioblastoma pathogenesis.


Asunto(s)
Neoplasias Encefálicas/genética , Regulación Neoplásica de la Expresión Génica , Glioma/genética , ARN Largo no Codificante/genética , Factores de Transcripción SOX/metabolismo , Anciano , Neoplasias Encefálicas/patología , Proliferación Celular/genética , Femenino , Silenciador del Gen , Glioma/patología , Humanos , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Células Madre Neoplásicas/metabolismo , Células Madre Neoplásicas/patología , ARN Largo no Codificante/metabolismo
7.
Neurocir. - Soc. Luso-Esp. Neurocir ; 23(4): 151-156, jul.-ago. 2012. ilus
Artículo en Español | IBECS (España) | ID: ibc-111338

RESUMEN

El Grupo de Trabajo de Neurooncología (GTNO) de la SENEC ha encargado a los miembros del comité de neurooncología del Hospital Universitario Donostia de San Sebastián (España) la elaboración del presente documento, para que sirva como Guía del consenso establecido en el seno del GTNO y recomendación propuesta en todos los hospitales, públicos o privados, que manejan esta patología. Es obligado la constitución y funcionamiento normalizado de comités de neurooncología en todos los centros con servicio de neurocirugía, y lo expuesto a continuación debe contemplarse a la luz de las condiciones particulares de los mismos, con las variaciones pertinentes según los recursos diagnósticos y terapéuticos. Nos presentan a continuación el ejemplo de la constitución, funcionamiento y experiencia que han contraído en más de 8 años de trabajo multidisciplinar en pacientes con tumores cerebrales (AU)


The Neuro-Oncology Study Group (NOSG) at SENEC has commissioned the elaboration of the present document to the Neuro-Oncology Committee at Donostia University Hospital. It is intended to serve as a NOSG Consensus Guide and a proposed recommendation for the management of his pathological conditionatallSpanishHospitals,bothpublicandprivate.Neuro-Oncology Committees must be established and active at all centres with a Neurosurgery Service, taking into account the specific diagnostic and therapeutic capacity available. The work presents an example of the constitution, functioning and experience of such a Committee, drawing on 8 years of multidisciplinary work with brain tumour patients (AU)


Asunto(s)
Humanos , Comité de Profesionales/organización & administración , Neurocirugia/organización & administración , Neoplasias Encefálicas/cirugía , Neoplasias del Sistema Nervioso
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