Neuroendocrine tumors in Panama: A nationwide database analysis.

Neuroendocrine tumors (NETs) comprise a heterogenous group of rare malignancies, which are increasing in incidence worldwide. To further understand the epidemiology of NETs in the Republic of Panama, the present study used two study groups, which included patients from several hospitals and clinics throughout the country, who were referred to the three largest national reference centers: The Complejo Hospitalario Metropolitano, Hospital Santo Tomas and Instituto Oncologico Nacional. These two groups comprised a retrospective cohort, which included cases reported between 2016 and 2017, and a second cohort, which was retrospective, but data were continuously collected from patients diagnosed with NETs between 2018 and 2019. Data from 157 patients with NETs reported that 83% of patients were in the 40-80 years old age group. The majority of cases (46%) presented as grade G1 tumors, while 29% were G3. Computerized tomography scans with contrast, and analysis of the Ki-67 biomarker and immunohistology markers (chromogranin A and synaptophysin) was performed in the majority of the cases. The results revealed that the most frequent anatomical sites for the primary tumor were the colorectum (17.2%), pancreas (12.7%) and stomach (12.1%), and the most frequent organ with metastasis was the liver, accounting for 34% of all cases. In conclusion, the present study is the first comprehensive study of NET in Panama to the best of our knowledge, which provides evidence of the demographic characteristics of the population, clinical features and overall survival for the affected population in this Central American country.

Experiencia En El Manejo De Los Pacientes Con Melanoma En El Instituto Oncológico Nacional De Panamá En Los Años 2012 Al 2017 / Ex perienc e In The Management Of Patients With Melanoma In The National Oncology Ins titute Of Panama In The Years 2012 To 2017

Introducción: A nivel mundial hay un incremento de la incidencia de melanoma, Panamá no escapa a esta realidad. Para todas las etapas hay riesgo de recurrencia inclusive luego de una cirugía adecuada y elevadas probabilidades de fallecer a causa de metástasis. Este trabajo busca conocer la experiencia del ION en el tratamiento de estos pacientes, la cual no ha sido publicada a la fecha. Objetivos: Descri­ bir las características de los pacientes con melanoma y determinar la Supervivencia Global (OS) y la Su­ pervivencia Libre de Recurrencia (RFS). Metodología: Estudio retrospectivo de los pacientes con melanoma referidos al ION en los años 2012 a 2017 y el análisis de OS y RFS por el método de Kaplan­ Meier. Resultados: Un total de 247 pacientes de melanoma fueron atendidos en el ION en el periodo del estudio; 51.8% eran masculinos con mediana de edad de 65 años. El sitio más común fue acral (31%). En total 46% de nuestros pacientes están en etapas III­IV. Un 65% del total fueron operados, de éstos 80% con resección amplia, 27% con evaluaciones de ganglio centinela y 25% linfadenectomías. Encon­tramos 39% ulcerados y la histología más frecuente fue nodular con 31.6%. Hubo 31.4% de recurren­cias, de los cuales 63.8% era a distancia. La mOS: 55.8 meses en no metastásicos vs 13.1 meses en metastásicos (p<0.0001). La mRFS para los operados fue 53.6 meses y los factores pronósticos fueron ulceración (p=0.007) y realización de linfadenectomía (p=0.000). Conclusión: El diagnóstico de melano­ ma en la población panameña se hace en etapas avanzadas, lo que influye en su pronóstico. Su tasa de supervivencia está muy por debajo de otros países tanto desarrollados como en vías de desarrollo. Estos resultados deben tomarse con cuidado, ya que los factores clásicos descritos en múltiples estu­ dios, no parecen influenciar a nuestra población (edad, sexo, sitio anatómico, subtipo, mitosis). Siendo una enfermedad tan letal hace falta realizar estudios prospectivos a nivel nacional, así como fortalecer la red de prevención y atención primaria.

Introduction: Worldwide there is an increase in the incidence of melanoma, Panama does not escape this reality. For all stages there is a risk of recurrence even after adequate surgery and high chances of death due to metastasis. This work seeks to know the experience of ION in the treatment of these pa­ tients, which has not been published to date. Objectives: To describe the characteristics of patients with melanoma and determine the Global Survival (OS) and the Free Survival of Recurrence (RFS). Metho­ dology: Retrospective study of patients with melanoma referred to the ION in the years 2012 to 2017 and the analysis of OS and RFS by the Kaplan­Meier method. Results: A total of 247 melanoma patients we­ re treated at the ION during the study period; 51.8% were male with a median age of 65 years. The most common site was acral (31%). In total 46% of our patients are in stages III­IV. 65% of the total were ope­ rated, of these 80% with wide resection, 27% with sentinel lymph node evaluations and 25% lymphade­ nectomy. We found 39% ulcerated and the most frequent histology was nodular with 31.6%. There were 31.4% of recurrences, of which 63.8% were distant. The mOS: 55.8 months in non­metastatic vs 13.1 months in metastatic (p <0.0001). The mRFS for the operated patients was 53.6 months and the prog­ nostic factors were ulceration (p = 0.007) and lymphadenectomy (p = 0.000). Conclusion: The diagnosis of melanoma in the Panamanian population is made in advanced stages, which influences its prognosis. Its survival rate is well below other developed and developing countries. These results should be taken with care, since the classical factors described in multiple studies do not seem to influence our population (age, sex, anatomical site, subtype, mitosis). Being such a lethal disease, it is necessary to carry out prospective studies at the national level, as well as to strengthen the prevention and primary care network

Videotoracoscopia para el diagnóstico y tratamiento de los empalamientos por cuchillo en el tórax / Video-assisted thoracoscopy in the diagnosis and treatment of stab wounds in the chest

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