The Presence of Mutations in the K-RAS Gene Does Not Affect Survival after Resection of Pulmonary Metastases from Colorectal Cancer.

Introduction. Our objective was to identify mutations in the K-RAS gene in cases of pulmonary metastases from colorectal cancer (CRC) and determine whether their presence was a prognostic factor for survival. Methods. We included all patients with pulmonary metastases from CRC operated on between 1998 and 2010. K-RAS mutations were investigated by direct sequencing of DNA. Differences in survival were explored with the Kaplan-Meier method log-rank tests and multivariate Cox regression analysis. Results. 110 surgical interventions were performed on 90 patients. Factors significantly associated with survival were disease-free interval (P = 0.002), age (P = 0.007), number of metastases (P = 0.001), lymph node involvement (P = 0.007), size of the metastases (P = 0.013), and previous liver metastasis (P = 0.003). Searching in 79 patients, K-RAS mutations were found in 30 cases. We did not find statistically significant differences in survival (P = 0.913) comparing native and mutated K-RAS. We found a higher rate of lung recurrence (P = 0.040) and shorter time to recurrence (P = 0.015) in patients with K-RAS mutations. Gly12Asp mutation was associated with higher recurrence (P = 0.022) and lower survival (P = 0.389). Conclusions. The presence of K-RAS mutations in pulmonary metastases does not affect overall survival but is associated with higher rates of pulmonary recurrence.

Extracción segura de cuerpo extraño intrapulmonar después de traumatismo torácico penetrante: control vascular y sutura primaria es el tratamiento de elección / Safe extraction of an intrapulmonary foreign body after a penetrating thoracic trauma: vascular control and primary suture is the treatment of choice

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Percutaneous aspiration versus tube drainage for spontaneous pneumothorax: systematic review and meta-analysis.

Spontaneous pneumothorax is an extremely frequent pathology. Despite this, there is still no clear consensus on managing these patients. Therefore, we perform a systematic review and meta-analysis of the effectiveness of percutaneous aspiration compared with tube drainage for treating idiopathic spontaneous pneumothorax. Controlled, randomised clinical trials were selected, in which the effectiveness of percutaneous aspiration is compared with that of chest tube drainage, in terms of resolution of the pneumothorax and rates of relapse and hospital admission. Relevant articles were identified by searching electronic databases (e.g., Medline, EMBASE, CENTRAL, mRCT and Pascal), as well as the references of the papers found in this manner, with a cut-off date of April 2009. Quality was assessed by two independent evaluators, using the CASPe appraisal tool. Effectiveness of percutaneous aspiration is compared with that of chest tube drainage, in terms of resolution of the pneumothorax and rates of relapse and hospital admission.