Medical oncology future plan of the Spanish Society of Medical Oncology: challenges and future needs of the Spanish oncologists.

PURPOSE: The SEOM Future Plan is aimed at identifying the main challenges, trends and needs of the medical oncology speciality over the next years, including potential oncologist workforce shortages, and proposing recommendations to overcome them. METHODS: The estimations of the required medical oncologists workforce are based on an updated Medical Oncologist Register in Spain, Medical Oncology Departments activity data, dedication times and projected cancer incidence. Challenges, needs and future recommendations were drawn from an opinion survey and an advisory board. RESULTS: A shortage of 211 FTE medical oncologist specialists has been established. To maintain an optimal ratio of 158 new cases/FTE, medical oncology workforce should reach 1881 FTE by 2035. CONCLUSIONS: Main recommendations to face the growing demand and complexity of oncology services include a yearly growth of 2.5% of medical oncologist's workforce until 2035, and development and application of more accurate quality indicators for cancer care and health outcomes measure.

[Recommendations for radiological diagnosis and assessment of treatment response in lung cancer: a national consensus statement by the Spanish Society of Medical Radiology and the Spanish Society of Medical Oncology]. / Recomendaciones para el diagnóstico radiológico y la valoración de la respuesta terapéutica en el cáncer de pulmón. Consenso nacional de la Sociedad Española de Radiología Médica y la Sociedad Española de Oncología Médica.

The last decade has seen substantial progress in the diagnostic and therapeutic approach to lung cancer, thus meaning that its prognosis has improved. The Spanish Society of Medical Radiology (SERAM) and the Spanish Society of Medical Oncology (SEOM) have therefore produced a national consensus statement in order to make recommendations for radiological diagnosis and assessment of treatment response in patients with lung cancer. This expert group recommends multi-detector computed tomography (MDCT) as the technique of choice for investigating this disease. The radiology report should include a full assessment by the TNM staging system. Lastly, when the patient is on immunotherapy, response evaluation should employ not only Response Evaluation Criteria in Solid Tumours (RECIST 1.1) but also Immune-Related Response Criteria (irRC).

Recommendations for radiological diagnosis and assessment of treatment response in lung cancer: a national consensus statement by the Spanish Society of Medical Radiology and the Spanish Society of Medical Oncology.

The last decade has seen substantial progress in the diagnostic and therapeutic approach to lung cancer, thus meaning that its prognosis has improved. The Spanish Society of Medical Radiology and the Spanish Society of Medical Oncology have therefore produced a national consensus statement to make recommendations for radiological diagnosis and assessment of treatment response in patients with lung cancer. This expert group recommends multi-detector computed tomography as the technique of choice for investigating this disease. The radiology report should include a full assessment by the TNM staging system. Lastly, when the patient is on immunotherapy, response evaluation should employ not only response evaluation criteria in solid tumours, but also immune-related response criteria.

Improved cardiac function in patients with obstructive jaundice after internal biliary drainage: hemodynamic and hormonal assessment.

OBJECTIVE: To investigate myocardial function in patients with obstructive jaundice before and after internal biliary drainage. SUMMARY BACKGROUND DATA: Increased plasma levels of atrial natriuretic peptide (ANP) have been found in patients with biliary obstruction. METHODS: Thirteen patients with newly diagnosed obstructive jaundice and no previous heart, lung, or renal disease were studied using a Swan-Ganz catheter. Hemodynamic measurements were taken before and 4 days after internal biliary drainage. Levels of ANP and brain natriuretic peptide (BNP) were obtained and liver function tests were also determined. RESULTS: Plasma levels of ANP and BNP were increased twofold to fourfold in the basal state and declined after biliary drainage. Independent variables predicting left ventricular systolic work were total bilirubin concentrations, duration of jaundice, and BNP. In addition, bilirubin concentrations correlated with pulmonary vascular resistance, mean arterial pulmonary pressure, and right ventricular systolic work. Internal biliary drainage resulted in an improvement in left ventricular systolic work. A correlation was found between decreasing ANP concentrations and increasing cardiac output. CONCLUSIONS: Increased plasma levels of natriuretic peptides in patients with obstructive jaundice may reflect a subclinical myocardial dysfunction correlating with the degree of jaundice. After internal biliary drainage, there is a measurable improvement of cardiac function.

[Cardiotocography in intrauterine growth retardation]. / Cardiotocografía en retardo en el crecimiento intrauterino.

Fifty seven cases of intrauterine growth retardation were analyzed at the Department of Perinatal Medicine, "Luis Castelazo Ayala" Hospital, IMSS. The main purpose of the study was to establish the usefulness of cardiotocography in the decision of pregnancy interruption. The patients were divided in three groups in relation to the last non stress test made before delivery (reactive, non reactive, non reactive, non reactive with declarations). It is concluded that cardiotocography is a useful procedure for the surveillance of these fetuses and it was found a good correlation between progressively ominous traces and fetal condition at birth.

PIP: Early diagnosis, adequate follow-up, and determination of the ideal moment for delivery are fundamental aspects of management of intrauterine growth retardation. This study evaluates the usefulness of cardiotocography in follow-up such cases and in the identification of the best moment for delivery. 57 cases of intrauterine growth retardation were studied at the Department of Perinatal Medicine of a Mexican Institute of Social Security hospital in Mexico City between July 1986-June 1987. The 57 cases were divided into 3 groups based on the results of the most recent nonstress test made 72 hours or less before delivery. Group 1 consisted of 15 cases with reactive tests, group 2 of 17 cases with nonreactive tests, and group 3 of 25 cases of nonreactive tests with decelerations. In group 1 there were no histories of previous complicated pregnancies. In group 2 there were 3 cases of low birth weight and 7 of preterm birth in previous pregnancies. In group 3 there were 3 cases of low birth weight, 2 of preterm birth in previous pregnancies. In group 3 there were 3 cases of low birth weight, 1 of preterm birth, 5 of stillbirth and 1 neonatal death. 77.1% of the 57 mothers were hypertensive, 5.2% had cardiopathies, and 1.7% each had lupus erythematosus, prolonged pregnancy, and hyperparathyroidism. There was no associated pathology in 12.2% of cases. There were 13 caesareans and 2 vaginal deliveries in group 1, with a fetal indication for cesarean in 3 cases. In group 2 there were 13 caesareans and 4 vaginal deliveries, with 9 maternal and 4 fetal indications for cesarean. 24 of 25 deliveries in group 3 were cesarean, with fetal indications in 22 cases and both fetal and maternal indications in 2 cases. The nonstress test was the basic criterion for the indication in group 3. The average birth weight and gestational age respectively were 1798 g and 37.2 weeks for group 1, 1681 g and 36.5 weeks for group 2, and 1551 g and 37 weeks for group 3. The average Apgar score at the minute of birth was 6.8 for group 1, 6.6 for group 2l, and 5.1 for group 3. There were 3 fetal deaths, 2 in group 2 including 1 case of anencephaly and 1 which occurred 48 hours after a recommendation for cesarean following a deterioration in the nonstress test. 1 death in group 3 followed a misinterpreted nonstress test. 4 neonatal deaths included 1 in group 1 from septicemia probably acquired in the nursery and 3 in group 3 attributed to cerebral hemorrhage. The results indicate that the presence of spontaneous decelerations in the fetal heart beat strongly suggest fetal compromise, and are an alarm signal in case of intrauterine growth retardation. The nonstress test is a useful tool in such cases.