RESUMEN
Statins seem to positively influence the inflammatory, anti-angiogenic milieu of pregnancies with underlying placental ischemia by their pleiotropic effects. This might prevent, ameliorate and delay preeclampsia. To confirm the benefits of pravastatin on gestational age at birth as well as clinic and angiogenic markers in pregnancies at high-risk for preeclampsia, the Department of Obstetrics at the University Hospital Leipzig plans a randomized, double-blinded, placebo-controlled feasibility study.
Asunto(s)
Anticolesterolemiantes/uso terapéutico , Pravastatina/uso terapéutico , Preeclampsia/prevención & control , Embarazo de Alto Riesgo/efectos de los fármacos , Anticolesterolemiantes/efectos adversos , Método Doble Ciego , Estudios de Factibilidad , Femenino , Desarrollo Fetal/efectos de los fármacos , Edad Gestacional , Humanos , Recién Nacido , Neovascularización Fisiológica/efectos de los fármacos , Pravastatina/efectos adversos , Embarazo , Resultado del Embarazo , Segundo Trimestre del Embarazo , Flujo Sanguíneo Regional/efectos de los fármacos , Ultrasonografía Prenatal , Útero/irrigación sanguíneaRESUMEN
INTRODUCTION: Colorectal carcinoma (CRC) is the second most common adult cancer in Germany, however, it is extremely rare in children and adolescents. In these patients, previous literature describes aggressive behavior and diagnosis at advanced stage. METHOD: Thirty-one patients with CRC age ≤ 18 years and treated between 1990 and 2012 have been identified through the structures and registries of the German Society for Pediatric Oncology and Hematology. RESULTS: The age range was 9-18 years (median 13.5 years); the median follow-up time was 43.9 months (range 1-124 months). Twenty-six patients (84%) were tested for a genetic tumor syndrome (GTS); of these, 11 patients (35% of all patients) tested positive (eight cases of Lynch syndrome, one patient with familial adenomatous polyposis, two patients with constitutional mismatch repair deficiency). An unfavorable histology was reported in 55% of the records (n = 17), a poor differentiation (grade III) in 68% of carcinoma (n = 21). Overall survival (OS) and event-free survival at 5 years was 52.0% and 65.6%, respectively. Five-year survival according to stage was 100% in stage II (n = 2), 100% in stage III (n = 13), and 12.9% in stage IV (n = 15; P < 0.001). Five-year OS in patients with and without a defined GTS was 100% and 36.5% (P = 0.019), respectively. CONCLUSION: Children and adolescents with CRC are frequently diagnosed in advanced stages and have an unfavorable prognosis. In this study, a high percentage of pediatric CRC patients presented with a tumor predisposition syndrome and showed an especially favorable OS.