RESUMEN
BACKGROUND/AIM: Totally implanted venous access devices (TIVAD) are increasingly used in the treatment of cancer patients. The aim of this study was to assess the incidence of early and late complications resulting from subcutaneous TIVADs in patients with breast cancer. MATERIALS AND METHODS: Between 2004 and 2009, we reviewed patients with breast cancer who had a TIVAD placed. Early and late complications, as well as risk factors for TIVAD-associated thrombosis were retrospectively assessed. RESULTS: A total of 281 patients were included. Complications occurred in 26% of patients, the majority of which were late complications (21.4%.) The development of TIVAD associated thrombosis was the most frequent late complication (16.4%). In the univariate analysis followed by a multivariate model, risk factors for TIVAD associated thrombosis were not identified. Only within the subgroup of metastatic breast cancer patients an increased risk of TIVAD-associated thrombosis of left compared to right venous access was detected (p=0.015). CONCLUSION: TIVAD implantation done in a gynecological outpatient setting is feasible and safe.
Asunto(s)
Neoplasias de la Mama/complicaciones , Dispositivos de Acceso Vascular/efectos adversos , Trombosis de la Vena/epidemiología , Trombosis de la Vena/etiología , Adulto , Anciano , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/epidemiología , Femenino , Humanos , Estimación de Kaplan-Meier , Persona de Mediana Edad , Clasificación del Tumor , Estadificación de Neoplasias , Pronóstico , Modelos de Riesgos Proporcionales , Medición de Riesgo , Factores de Riesgo , Trombosis de la Vena/diagnóstico , Trombosis de la Vena/mortalidadRESUMEN
Recently it has been shown that the genome organizer SATB1 plays an important role in breast cancer progression and predicts a poor prognosis. However its prognostic value compared to markers as the estrogen receptor is currently unclear. The expression levels of SATB1 mRNA from Affymetrix microarray in a cohort of 2058 breast cancer samples and its prognostic impact were analyzed. There was no significant difference in disease-free survival among ER negative cancers but instead a benefit for high SATB1 expression among ER positive tumors (p = 0.042). However, even in ER positive cancer no independent prognostic value in multivariate analysis with standard parameters was observed. Thus the use of SATB1 as target or prognostic marker for breast cancer should be viewed with caution and a possible confounding effect of the estrogen receptor status of the tumor should be taken into account when analysing new markers as SATB1.
Asunto(s)
Neoplasias de la Mama/genética , Regulación Neoplásica de la Expresión Génica/genética , Expresión Génica , Proteínas de Unión a la Región de Fijación a la Matriz/genética , Receptores de Estrógenos/metabolismo , Neoplasias de la Mama/metabolismo , Línea Celular , Línea Celular Tumoral , Femenino , Amplificación de Genes , Humanos , Pronóstico , Análisis de SupervivenciaRESUMEN
Urinary incontinence, defined as a leakage of small amounts of urine during physical movement (coughing, sneezing, exercising) is rather a common problem. The treatment of this disorder is even more non-uniformed: there have been roundly 100 operations proposed for it. The Burch procedure has become probably the most popular. As traumatic and invasive as it is, this procedure is performed under general anaesthetic, the abdomen is opened, the bladder neck suspended and fixed with clips or sutures to the back of the pubic bone. Some of the advantages with this procedure include safety and reproducibility, direct access to internal organs and possibility of performing this procedure in laparoscopic settings. A recent study by the same group, employing 150 patients treated with this type of procedure showed that the SERASIS TO transobturator sling seems to be very effective, less traumatic, less dangerous and does not require cystoscopy or urethral deviation devices. Although long-term follow-up data are not available for the transobturator approach, short-term results are encouraging. Large comparative studies with other anti-incontinent procedures are needed.