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1.
Bol. méd. postgrado ; 36(2): 21-25, dic.2020. tab, graf
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1117893

RESUMO

El síndrome de lisis tumoral (SLT) es una complicación potencialmente letal provocada por la liberación masiva de ácidos nucleicos, potasio y fosfato hacia la circulación sistémica lo cual se asocia a graves trastornos del metabolismo hidroelectrolítico. Se realizó una revisión retrospectiva de historias clínicas con el objetivo de describir las características clínicas de los pacientes con sospecha de SLT que ingresaron al Servicio de Medicina Interna del Hospital General Universitario Dr. Luis Gómez López durante el lapso 2017-2018. El 50% de los pacientes tenían una edad comprendida entre 51 y 70 años, siendo el 65% de sexo femenino. Los canceres más frecuentemente encontrados fueron el cáncer de mama (29%), cáncer gástrico (15%) y el linfoma no Hodgkin (12%). Todos los pacientes presentaron al menos tres de las manifestaciones clínicas asociadas al SLT entre las cuales se encuentran náuseas, vómitos, anorexia, debilidad, calambres, hiperreflexia, oliguria, anuria, hematuria, hipotensión, convulsiones y deshidratación. El 46% de los pacientes presentaron hiperpotasemia, mientras que 36% mostraron hipocalcemia y 18% hiperfosfatemia. El 76% de los pacientes cursaron con una creatinina > 1,4 mg/dl. El diagnóstico definitivo de SLT no fue posible realizarlo en ninguno de los pacientes incluidos en este estudio debido a la falta de estudios paraclínicos necesarios para satisfacer los criterios según los lineamientos internacionales(AU)


Tumor lysis syndrome (TLS) is a potentially lethal complication due to massive release of nucleic acids, potassium and phosphate into the systemic circulation which is associated with severe hydroelectrolitic metabolic disorders. A retrospective review of clinical charts was performed in order to describe clinical characteristics of patients with possible TLS that were admitted to the Servicio de Medicina Interna of the Hospital General Universitario Dr. Luis Gómez López during the period 2017-2018. The results show that 50% of patients were between 51 and 70 years old and 65% were female. Breast cancer (29%), stomach cancer (15%) and Non-Hodgkin lymphoma (12%) were more frequent in patients with possible TLS. All patients showed at least three of the clinical features commonly associated with TLS such as nausea, vomiting, anorexia, weakness, cramps, hyperreflexia, oliguria, anuria, hematuria, hypotension, convulsion and dehydration. 46% of patients had hyperkalemia, 36% hypocalcemia and 18% hyperphosphatemia. Creatinine levels > 1,4 mg/dl were seen in 76% of patients. Definitive diagnosis of TLS was not possible in any of the patients included in this study due to the lack of laboratory studies required according to international guidelines(AU)


Assuntos
Humanos , Fosfatos , Potássio , Radioterapia , Neoplasias da Mama , Ácidos Nucleicos , Síndrome de Lise Tumoral/fisiopatologia , Tratamento Farmacológico , Prescrições de Medicamentos , Cuidados Críticos , Hematologia , Medicina Interna , Oncologia
2.
Rev. enferm. UERJ ; 28: e51821, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF | ID: biblio-1117686

RESUMO

Objetivo: compreender a vivência do enfrentamento e repercussões da COVID-19, na percepção de mulheres em tratamento oncológico. Método: estudo qualitativo, do tipo ação-participante, fundamentado no Itinerário de Pesquisa de Paulo Freire, que possui três fases: Investigação Temática; Codificação e Descodificação; Desvelamento Crítico. Foi realizado Círculo de Cultura virtual, com a participação de 12 mulheres em tratamento do câncer de mama, de diferentes localidades do Brasil. Resultados: no Círculo de Cultura virtual discutiram dois temas: desafios no enfrentamento do câncer e da COVID-19; aprendizados gerados nessa vivência, considerando um renascimento das próprias cinzas. Considerações finais: o momento pandêmico tem instigado reflexões sobre o viver. Assim, as mulheres em tratamento oncológico e também em restrição social puderam expressar seus sentimentos, descobrindo e redescobrindo fragilidades e fortalezas para ressignificar e crescer como seres, em uma sociedade, que pode e deve articular estratégias para promoção da saúde.


Objective: to understand the experience of coping with COVID-19, as perceived by women undergoing cancer treatment. Method: qualitative, participatory action research based on the three phases of Paulo Freire's Research Itinerary: Thematic Investigation; Coding and Decoding; and Critical Unveiling. A Culture Circle was held online with 12 women from different places in Brazil undergoing breast cancer treatment. Results: in the virtual Culture Circle, they discussed two themes: challenges in coping with cancer and COVID-10; and learning generated in that experience, with a view to rebirth from their own ashes. Final considerations: the pandemic has prompted thinking about living. Accordingly, women undergoing cancer treatment and also under social restrictions were able to express their feelings, and in discovering and rediscovering weaknesses and strengths, to resignify themselves and to grow in a society that can and should deploy strategies for health promotion.


Objetivo: comprender la experiencia de afrontamiento del COVID-19, según la perciben las mujeres en tratamiento oncológico. Método: investigación-acción cualitativa y participativa basada en las tres fases del Itinerario de Investigación de Paulo Freire: Investigación Temática; Codificación y decodificación; y revelación crítica. Se realizó un Círculo Cultural en línea con 12 mujeres de diferentes lugares de Brazil sometidas a tratamiento contra el cáncer de mama. Resultados: en el Círculo de Cultura virtual se discutieron dos temas: desafíos en el afrontamiento del cáncer y COVID-10; y el aprendizaje generado en esa experiencia, con miras a renacer de sus propias cenizas. Consideraciones finales: la pandemia ha llevado a pensar en vivir. En consecuencia, las mujeres en tratamiento oncológico y también bajo restricciones sociales pudieron expresar sus sentimientos, y al descubrir y redescubrir debilidades y fortalezas, resignificarse y crecer en una sociedad que puede y debe desplegar estrategias de promoción de la salud.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Neoplasias da Mama/psicologia , Adaptação Psicológica , Quarentena/psicologia , Infecções por Coronavirus/epidemiologia , Promoção da Saúde , Aprendizagem , Brasil , Processo Saúde-Doença , Telemedicina , Pesquisa Qualitativa , Emoções , Acontecimentos que Mudam a Vida
3.
Med Ultrason ; 2020 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-32905569

RESUMO

AIMS: To revise the current literature about the usefulness of elastography in cervical cancer (CC) and cervical intraepithelial neoplasia (CIN), from methods and technical limitations, to diagnosis, staging and the ability of predicting the response to oncologic treatment. METHODS: An electronic database search was performed (PubMed, EMBASE, Web of Science) with the data range from January 2000 until May 2020. All studies, fully-available in English, assessing elastography of the uterine cervix in CC and CIN were selected. Studies were reviewed and discussed according to the elastographic technique and to the purpose of the research. RESULTS: Twenty-three articles were found: 11 articles regarding strain elastography, 4 articles assessing shear wave elastography and 8 papers with matter-related information. Elastography was used in the study of normal variants of the uterine cervix as well as: the positive diagnosis of CC and CIN, clinical staging and the prediction of therapeutic response in CC. Comparison of the elastographic techniques was also performed. CONCLUSIONS: Elastography has multiple applications in the gynecological pathology of the cervix. The methods used to assess the cervix are diverse, and none have become universally accepted. With regard to CC and CIN, elastography is still an ongoing research field.

4.
Am J Surg Pathol ; 2020 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-32910021

RESUMO

Secondary involvement of the uterine cervix by nongynecologic neoplasms is rare accounting for <2% of metastases to the gynecologic tract. This study aimed to analyze the clinicopathologic features of cervical involvement by nongynecologic malignancies. A total of 47 cases were identified including 39 (83%) carcinomas, 6 lymphomas (12.8%), and 2 (4.2%) cutaneous malignant melanomas. The most common primary site of origin among carcinomas was the gastrointestinal tract (27, 69.2%), followed by breast and urothelium (5 each, 12.8%), gallbladder, and lung (1 each, 2.6%). The gynecologic tract was involved at the presentation in 16 patients (34%), including 5 (10.6%) with the cervix being the first site, 7 (14.9%) with synchronous involvement of the cervix and other gynecologic sites, and 4 (8.5%) with the involvement of other gynecologic sites before the cervical presentation. Patients with lymphoma were younger compared with those with carcinoma (43.7 vs. >50.5) (P=0.01). Mean time to identification of cervical metastases was <1 year for gallbladder carcinoma, melanomas, and gastrointestinal signet ring cell carcinomas (P=0.03). Features that varied with different types of metastatic tumor included lymphovascular space invasion, depth of stromal invasion, growth pattern (glands lacking architectural complexity, cribriforming, solid), presence of goblet cells, and signet ring cells, degree of cytologic atypia, and overall findings mimicking a benign/noninvasive process (P≤0.027). Six tumors (12.8%) were initially misdiagnosed as cervical primary. Metastatic nongynecologic tumors can mimic primary in situ or invasive neoplasms in both ectocervix and endocervix. In patients with a known prior malignancy, the clinical history with ancillary studies and a high level of suspicion are crucial to ensure accurate diagnosis.

5.
Artigo em Inglês | MEDLINE | ID: mdl-32911575

RESUMO

We here describe a case of the prolapse of pedunculated submucosal leiomyoma through the cervix during the treatment of a gonadotropin-releasing hormone (GnRH) antagonist relugolix. We also present the literature review of the cases of leiomyoma prolapse during GnRH modulators. A 55-year-old woman with atypical vaginal bleeding diagnosed submucosal uterine fibroid 6 cm in diameter, and daily oral administration of relugolix was conducted. On the 35th day of the administration, heavy vaginal bleeding suddenly occurred due to leiomyoma prolapse. Finally, she underwent abdominal hysterectomy to treat heavy bleeding. To date, six cases of leiomyoma prolapse during GnRH modulators have been reported, in which all the previous cases were treated with GnRH agonists. This is the first case report of leiomyoma prolapse during GnRH antagonist treatment. Notably, leiomyoma prolapse is a possible common adverse effect of GnRH modulators for the treatment of submucosal leiomyoma, which is caused by rapid decrease in its volume.

6.
Cancer Imaging ; 20(1): 63, 2020 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-32912310

RESUMO

BACKGROUND: Postoperative pathologic risk factors (PRFs) could increase the recurrence rate in early-stage uterine cervical squamous cancer (ECSC). Our study intended to explore the efficiency of 18F-FDG PET/CT for assessing the pathologic risk status (PRS) in ECSC patients. METHODS: This retrospective study was performed in 240 ECSC patients with stage IA2-IIA2 (FIGO 2009), who underwent preoperative PET/CT scans and subsequent radical surgery between January 2010 and July 2015. Intermediate-risk (tumour diameter ≥ 4 cm, stromal invasion depth ≥ 1/2, lymphovascular space invasion (LVSI)), and high-risk factors (parametria involvement, positive surgery margin, pelvic lymph node metastasis) were confirmed by postoperative pathology. Patients with none of these PRFs were at a low risk for relapse. One of these PRFs was defined as positive risk. The relationship between each PRF and 18F-FDG uptake was analysed by t-test. Chi-square tests and logistic regression analyses were used to determine the efficiency of PET/CT parameters for assessing the PRS. The area under the curve (AUC) was used as an indicator for predictive efficiency. RESULTS: Patients with higher SUVmax (p < 0.001), MTV (p < 0.001) and TLG (p < 0.001) had larger tumour sizes and deeper stromal invasion. Further multivariate analyses showed SUVmax and TLG were independent predictors for positive- and intermediate-risk status. In high-risk group, MTV and TLG were associated with pelvic lymph node metastasis and parametria involvement. However, only MTV was a significant indicator. CONCLUSIONS: Preoperative 18F-FDG PET/CT had an independent predictive value for PRS in ECSC.

7.
Jpn J Radiol ; 2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32894410

RESUMO

PURPOSE: Fractures are known to shorten life expectancy and worsen the quality of life. The risk of fractures after radiation therapy in cervical cancer patients is known to be multifactorial. In this study, we examined risk factors for fractures in cervical cancer patients, especially by evaluating bone densities and DVH parameters for fractured bones. MATERIALS AND METHODS: For 42 patients, clinical characteristics, pretreatment CT bone densities, and radiation dose were compared between patients with and without fractures. RESULTS: Posttreatment fractures occurred in 25 bones among ten patients. Pretreatment CT bone densities were significantly lower in patients with fractures (P < 0.05-0.01 across sites, except for the ilium and the ischium). Although DVH parameters were also significantly associated with fractures in univariate analysis, only CT densities were significantly associated with fractures in multivariate analysis. CONCLUSION: Pretreatment CT densities of spinal and pelvic bones, which may reflect osteoporosis, have a significant impact on the risk for posttreatment fractures.

8.
FP Essent ; 496: 21-25, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32902243

RESUMO

Breast cancer is a leading cause of cancer mortality among women in the United States. Screening has been shown to increase early detection rates and decrease mortality rates. Evidence-based guidelines have been updated as knowledge has advanced. Screening recommendations from various organizations vary significantly. These variations-from screening modality, age to initiate and discontinue screening, and screening intervals-have led to confusion among patients and clinicians alike. Clinicians should be aware of the current screening recommendations so they can address questions patients may have about recommendation differences and to optimize early detection. Management of breast cancer is highly individualized and dependent on the subtype of cancer, the stage at diagnosis, patient preferences, and physician recommendations. Management may involve surgery, chemotherapy, radiation, and/or hormone therapy. Family physicians can help facilitate patient care throughout the screening, diagnosis, and treatment processes. Multiple factors contribute to disparities in breast cancer screening, management, and outcomes. Clinician knowledge of these factors can help reduce disparities in care and patient outcomes.


Assuntos
Neoplasias da Mama , Detecção Precoce de Câncer , Feminino , Humanos , Programas de Rastreamento , Estados Unidos
10.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 42(4): 535-539, 2020 Aug 30.
Artigo em Chinês | MEDLINE | ID: mdl-32895107

RESUMO

Cervical cancer is the second most common malignant tumor in women worldwide.The burden of cervical cancer is particularly heavy in less developed countries as the malignancy brings huge pain to the patients and their family members and causes huge losses to social development and global health.However,cervical cancer is a preventable and curable disease.While screening and human papillomavirus vaccination in developed countries have remarkably lowered the incidence and mortality of cervical cancer,there is still a far way to go to achieve the prevention and treatment of this disease.The multidisciplinary prevention and control programs slightly differ in different countries due to diverse economic and health conditions.The general principle is to vaccinate the young females and to implement a comprehensive strategy including human papillomavirus vaccine vaccination,screening,early diagnosis,and early treatment in adults.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Detecção Precoce de Câncer , Feminino , Humanos , Neoplasias do Colo do Útero/prevenção & controle , Vacinação
11.
BMC Infect Dis ; 20(1): 642, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32873233

RESUMO

BACKGROUND: Evidence suggested that vaginal microbiome played a functional role in the progression of cervical lesions in female infected by HPV. This study aimed at evaluating the influence of common vaginal infection on the carcinogenicity of high risk HPV (hr-HPV). METHODS: From January 15, 2017 to December 31, 2017, 310,545 female aged at least 30 years old had been recruited for cervical cancer screening from 9 clinical research centers in Central China. All the recruited participants received hr-HPV genotyping for cervical cancer screening and vaginal microenvironment test by a high vaginal swab. Colposcopy-directed biopsy was recommended for female who were infected with HPV 16 and HPV 18, and other positive hr-HPV types through test had undertaken triage using liquid-based cytology, cases with the results ≥ ASCUS among them were referred to colposcopy directly, and cervical tissues were taken for pathology examination to make clear the presence or absence of other cervical lesions. RESULTS: Among 310,545 female, 6067 (1.95%) were tested with positive HPV 16 and HPV 18, 18,297 (5.89%) were tested with other positive hr-HPV genotypes, cervical intraepithelial neoplasia (CIN) 1, CIN 2, CIN 3 and invasive cervical cancer (ICC) were detected in 861 cases, 377 cases, 423 cases, and 77 cases, respectively. Candida albicans and Gardnerella were not associated with the detection of cervical lesions. Positive trichomonas vaginitis (TV) was correlated with hr-HPV infection (p < 0.0001). Co-infection with TV increased the risk of CIN 1 among female infected with hr-HPV (OR 1.18, 95% CI: 1.42-2.31). Co-infection with TV increased the risk of CIN 2-3 among female infected with HPV 16 (OR 1.71, 95% CI: 1.16-2.53). CONCLUSIONS: Co-infection of TV and HPV 16 is a significant factor for the detection of cervical lesions.


Assuntos
Neoplasia Intraepitelial Cervical/epidemiologia , Coinfecção/complicações , Papillomavirus Humano 16/genética , Papillomavirus Humano 18/genética , Infecções por Papillomavirus/complicações , Vaginite por Trichomonas/complicações , Trichomonas vaginalis/isolamento & purificação , Neoplasias do Colo do Útero/epidemiologia , Adulto , Neoplasia Intraepitelial Cervical/diagnóstico , Neoplasia Intraepitelial Cervical/virologia , China/epidemiologia , Coinfecção/diagnóstico , Colposcopia , Estudos Transversais , Citodiagnóstico , Detecção Precoce de Câncer/métodos , Feminino , Genótipo , Humanos , Pessoa de Meia-Idade , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/patologia , Infecções por Papillomavirus/virologia , Fatores de Risco , Vaginite por Trichomonas/diagnóstico , Vaginite por Trichomonas/parasitologia , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/virologia
13.
Medicine (Baltimore) ; 99(33): e21667, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32872031

RESUMO

BACKGROUND: This study will explore the association between tumor necrosis factor α (TNF-α) and uterine fibroids (UFs). METHODS: We will retrieve electronic databases in Cochrane Library, PUBMED, EMBASE, Web of Science, WANGFANG, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure from inception to the present. All potential case-controlled studies investigating the association between TNF-α and UFs will be included in this study. Two researchers will independently select literature, appraise study quality, and extract outcome data. We will utilize a fixed-effects model or a random-effects model to synthesize outcome data. All data analysis will be performed by RevMan 5.3 software. RESULTS: The present study will supply high-quality synthesis and/or descriptive analysis of the recent evidence to explore the association between TNF-α and UFs. CONCLUSION: This study will exert evidence to determine whether or not TNF-α is associated with UFs. STUDY REGISTRATION NUMBER: INPLASY202070010.


Assuntos
Leiomioma/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Neoplasias Uterinas/metabolismo , Biomarcadores Tumorais , Estudos de Casos e Controles , Feminino , Humanos , Revisões Sistemáticas como Assunto
14.
J Med Case Rep ; 14(1): 138, 2020 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-32873335

RESUMO

BACKGROUND: Mantle cell lymphoma is one of several subtypes of non-Hodgkin lymphoma. Cervical relapse of non-Hodgkin lymphoma is a very rare condition that has a variable and nonspecific presentation and may resemble other neoplastic or inflammatory conditions. CASE PRESENTATION: Our patient was a 58-year-old Caucasian woman who experienced relapse of mantle cell lymphoma with cervical localization. She complained of postmenopausal vaginal bleeding, bladder pressure, and rapid growth of a cervical lesion. An irregular tumor mass of the cervix was visualized during gynecological examination, with findings highly suggestive of locally advanced cervical cancer. Surprisingly, the biopsies showed an extra nodal relapse of mantle cell lymphoma in the cervix. The rarity of this presentation and the scarcity of clinical studies make this type of recurrence very aggressive and difficult to treat. CONCLUSIONS: Obtaining a definitive histological diagnosis by biopsy or surgical resection and starting appropriate therapy are essential for recovery and treatment of these patients, even if the prognosis is poor.

15.
Wiad Lek ; 73(7): 1420-1426, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32759431

RESUMO

OBJECTIVE: Introduction: Ovarian tumours are an actual problem of present-day medicine, being one of the most difficult sections of modern oncology. The majority of ovarian tumours are of epithelial origin. The ovarian Brenner tumour represents a rare epithelial ovarian neoplasm and accounts for 1-2% of all ovarian neoplasms. The aim of the study is to identify clinical and morphological features of ovarian Brenner tumour. PATIENTS AND METHODS: Materials and methods: The material was 5 cases of Brenner ovarian tumour, diagnosed in the study of 4 cases of operational material and 1 case of autopsy observation for the period from 2007 to 2019. Histological and immunohistochemical staining methods were used. The microspecimens were examined on an Olympus BX-41 microscope (Japan). RESULTS: Results: Ovarian Brenner tumour is a rather rare pathology, the histogenesis of which is debatable. Morphological examination is the main method for its diagnosing. Ovarian Brenner tumours developed in women of middle and old age (the average age was 51.8 years). Women with a malignant ovarian Brenner tumour were older than women with a benign variant (the average age in women with a malignant variant was 55.8 years, with a benign variant - 49.3 years). Benign ovarian Brenner tumour occurred more frequently compared with a malignant one. Malignant and benign variants of ovarian Brenner tumour were characterized by a one-sided nature of the lesion with frequent involvement in the pathological process of the left ovary. Clinically, in patients with a benign variant of the Brenner tumour in all cases an abdominal pain syndrome was determined, combined in one case with metrorrhagia. A malignant ovarian Brenner tumour was clinically manifested by severe abdominal pain syndrome, combined in one case with complaints of an increase in the size of the abdomen, and in another case with intoxication syndrome and a clinic of small bowel obstruction. In all cases a malignant ovarian Brenner tumour metastasized to the omentum and in one case also to the small intestine wall. Macroscopically the ovarian Brenner tumour had the form of a node, the dimensions of which were significantly larger for the malignant variant compared with a benign, dense or soft consistency, on the cross section of a whitish-gray or brown color with cysts. A damaged ovary with a malignant variant of Brenner tumour significantly increased in size, while with a benign one, its size did not change or increased slightly. In all cases the malignant and benign variants of ovarian Brenner tumour were combined with various reproductive system organs pathologies (mucinous papillary cystadenoma of the ovary, serous ovarian cyst, ovarian endometriosis, endometrial hyperplasia, cervical nabothian cysts, uterine leiomyoma). CONCLUSION: Conclusions: A study conducted by the authors revealed clinical and morphological features of a rare ovarian tumour - Brenner tumour, which will contribute to a better understanding of this pathology by the doctors of various specialties, and improve the treatment and diagnostic process.


Assuntos
Neoplasias Ovarianas , Tumor de Brenner , Endometriose , Feminino , Humanos , Pessoa de Meia-Idade , Lesões Pré-Cancerosas
16.
J Res Med Sci ; 25: 47, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32765617

RESUMO

Background: Serous adenocarcinoma of the uterine cervix is an extremely rare variant of cervical adenocarcinoma. This study aimed to evaluate the clinicopathological and molecular features and outcomes of serous adenocarcinoma of the uterine cervix (SACC). Materials and Methods: This was a retrospective study conducted based on the clinical and pathological data of seven patients diagnosed with SACC after hysterectomy, who were evaluated at the gynecologic oncologic centers between 2010 and 2019. Results: Five cases were diagnosed at Stage IB and two at Stage IV. All patients underwent radical hysterectomy with bilateral salpingo-oophorectomy and subsequently received postoperative radiotherapy or chemotherapy. One patient showed persistent disease, and two patients suffered recurrence. Immunohistochemical study showed that three (43%) of the seven patients were positive for p53, and among these three patients, two with diffuse strong p53 expression experienced an aggressive course with recurrences at pelvic lymph nodes, lung, and brain. Conclusion: High p53 expression and advanced stage may be associated with poorer clinical outcomes in SACC, which suggest that immunohistochemistry may contribute to the prediction of prognosis.

17.
Semin Radiat Oncol ; 30(4): 281-290, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32828384

RESUMO

The clinical, molecular, and genetic heterogeneity of uterine cervix cancers makes the discovery of effective therapies a challenge. Optimal evaluation of effective radiotherapy-agent combinations requires sophisticated trial strategies from the United States National Cancer Institute and its pharmaceutical collaborators. One strategy involves the phase 0 trial, which falls under the United States Food and Drug Administration Exploratory Investigational New Drug Guidance, or xIND. As currently envisioned for radiotherapy-based trials, the phase 0 trial provides a platform for study of pharmacodynamic effects linked to pharmacokinetic exposures, designed to screen a new experimental agent's dose or schedule, in combination with standard radiotherapy regimens, in a very small number (10-15) of subjects. In the phase 0 trial, radiotherapy-agent combinations are intended to be biologically active, but a new experimental agent's low dose or infrequent schedule is considered nontoxic and nonbeneficial. The phase 0 trial primary endpoint is an individual subject's pharmacodynamic response. Regimens move on from phase 0 trial development if and when a predetermined all-subject pharmacodynamic response rate is crossed. An initial safety experience during and after the radiotherapy-agent combination determines future feasibility. For this article, the clinical example of women with abdominopelvic lymph node-positive uterine cervix cancer is used to elaborate the phase 0 trial approach to the discovery of novel radiosensitizing oncological agents. It is expected that phase 0 radiotherapy-agent trials will become more prevalent in near-term clinical development.

18.
Eur J Obstet Gynecol Reprod Biol ; 253: 35-41, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32768799

RESUMO

OBJECTIVE: Small cell carcinoma of the cervix uteri (SCCC) is an uncommon cancer associated with unsatisfactory survival outcomes. We aimed to investigate the incidence and prognostic factors of survival in SCCC patients using the Surveillance, Epidemiology, and End Results database. METHODS: Eligible patients with histopathologic diagnoses of SCCC were identified between 2004 and 2015. Overall survival (OS) and cause-specific survival (CSS) for the included patients were calculated using the Kaplan-Meier method. Univariate and multivariate analyses of clinical factors were performed using Cox proportional hazard regression models. RESULTS: We identified 272 SCCC patients based on predefined criteria. The average incidence of SCCC was 1.01 % per year between 2004 and 2015. The median OS and CSS were 17.0 and 19.0 months, respectively, accompanying with 5-year OS rate was 26.3 % and 5-year CSS rate was 30.1 %. In the multivariate analysis, advanced age (age ≥ 65 years old), late FIGO stage, surgery at the primary site, radiotherapy (RT) and chemotherapy (CT) were strong prognostic factors for OS. The corresponding variables for CSS were: advanced age, late FIGO stage, RT and CT. In the subgroup analysis for nonsurgical management of SCCC, the combination of RT and CT provided the best survival outcomes when compared with other therapeutic modalities. Again, advanced age was interrelated to worse survival outcomes for both OS and CSS. CONCLUSIONS: SCCC is an infrequent disease with aggressive nature, which lead to poor survival outcomes. In addition to other known parameters, advanced age is a strong predictive factor for OS and CSS. The combination of RT and CT was the best therapeutic strategy for patients who received nonsurgical management.

19.
Adv Exp Med Biol ; 1252: 189-193, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32816281

RESUMO

Breast cancer is one of the most commonly diagnosed malignancies in women of childbearing age. One of the surgeries performed in the management of the disease is mastectomy , which might negatively affect body image and quality of life, and breast reconstruction is seen as a remedy to this problem. However, for the women who are interested in having children after treatment of breast cancer, the debate is whether they can have a successful pregnancy and delivery after breast reconstruction.


Assuntos
Neoplasias da Mama/cirurgia , Mamoplastia , Gravidez/fisiologia , Criança , Feminino , Humanos , Mastectomia , Resultado da Gravidez , Qualidade de Vida
20.
Adv Exp Med Biol ; 1252: 199-207, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32816283

RESUMO

Young breast cancer patients face numerous challenges during the cancer trajectory. As in the last decade, women tend to delay pregnancies to a later time in life, and clinicians are often faced with young breast cancer patients who want to start a family or complete it. Becoming a mother is a delicate developmental process in which the woman redefines and restructures her identity as she gets prepared for her new role and responsibilities. When there is a history of cancer or cancer diagnosis is communicated during the pregnancy, fears, worries, and concerns emerge and specific support may be necessary. Follow-ups during the post-partum period are also recommended as lactation issues should not be overlooked. In this chapter, we analyze the psychological aspects of cancer survivors and women with pregnancy-associated breast cancer, and the management of these issues.


Assuntos
Neoplasias da Mama/psicologia , Lactação/psicologia , Complicações Neoplásicas na Gravidez/psicologia , Ansiedade , Aleitamento Materno , Feminino , Humanos , Período Pós-Parto/psicologia , Gravidez
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