The importance of basic and translational research in caring for children with malignant solid tumors in Latin America.

Objective: Basic and translational research in pediatric cancer are essential to improve patient care. To critically assess the developments achieved in these areas in Latin America, we systematically reviewed information published between 2013 and 2023. Methods: Studies of basic and translational research performed by investigators in Latin America evaluating pediatric malignant solid and central nervous system tumors were retrieved from PubMed. Original articles published in English between 2013 and 2023 were included. Collaborations among Latin American authors or among Latin American authors working with researchers from other continents were also included. Studies were excluded if they focused only on adults or on basic research in tumor biology not specifically related to the tumor types analyzed in this review. Results: A total of 550 articles were retrieved, but after removal of duplicates, 514 articles were included in the analysis, the majority of which were authored by researchers affiliated with institutions in Argentina, Brazil and Mexico. These countries also had the highest number of collaborations on original articles published with authors from Europe and North America. Argentina had the highest number of collaborations on original publications, with coauthors from Brazil and Uruguay. The median impact factor of the 244 journals in which articles were published was 3.5. The most commonly studied tumors were osteosarcomas, neuroblastomas and medulloblastomas; the most commonly studied areas were molecular analysis, tumor cell biology and biomarkers. Conclusions: In Latin America, research in pediatric oncology is on the agenda, despite a notable disparity in publication rates and frequency of collaboration between countries. There is a need to strengthen scientific collaboration within Latin America and with countries from other continents to promote research and to develop novel treatment strategies that reflect the local needs of children in Latin America who have solid tumors and brain cancer.

The importance of basic and translational research in caring for children with malignant solid tumors in Latin America / La importancia de la investigación básica y aplicada para la atención de pacientes pediátricos con tumores sólidos malignos en América Latina / A importância da pesquisa básica e translacional no tratamento de crianças com tumores sólidos malignos na América Latina

ABSTRACT Objective. Basic and translational research in pediatric cancer are essential to improve patient care. To critically assess the developments achieved in these areas in Latin America, we systematically reviewed information published between 2013 and 2023. Methods. Studies of basic and translational research performed by investigators in Latin America evaluating pediatric malignant solid and central nervous system tumors were retrieved from PubMed. Original articles published in English between 2013 and 2023 were included. Collaborations among Latin American authors or among Latin American authors working with researchers from other continents were also included. Studies were excluded if they focused only on adults or on basic research in tumor biology not specifically related to the tumor types analyzed in this review. Results. A total of 550 articles were retrieved, but after removal of duplicates, 514 articles were included in the analysis, the majority of which were authored by researchers affiliated with institutions in Argentina, Brazil and Mexico. These countries also had the highest number of collaborations on original articles published with authors from Europe and North America. Argentina had the highest number of collaborations on original publications, with coauthors from Brazil and Uruguay. The median impact factor of the 244 journals in which articles were published was 3.5. The most commonly studied tumors were osteosarcomas, neuroblastomas and medulloblastomas; the most commonly studied areas were molecular analysis, tumor cell biology and biomarkers. Conclusions. In Latin America, research in pediatric oncology is on the agenda, despite a notable disparity in publication rates and frequency of collaboration between countries. There is a need to strengthen scientific collaboration within Latin America and with countries from other continents to promote research and to develop novel treatment strategies that reflect the local needs of children in Latin America who have solid tumors and brain cancer.

RESUMEN Objetivo. La investigación básica y aplicada en el campo de la oncología pediátrica es fundamental para mejorar la atención al paciente. Con el objetivo de realizar una evaluación crítica de los avances logrados en este campo en América Latina, hemos realizado una revisión sistemática de la información publicada entre el 2013 y el 2023. Metodología. Se recopilaron de PubMed los artículos de investigación básica y traslacional publicados por investigadores de América Latina en los que se evaluaron tumores malignos sólidos y del sistema nervioso central en la población infantil. Se incluyeron artículos originales publicados en inglés entre el 2013 y el 2023. También se incluyeron artículos fruto de la colaboración científica entre autores e investigadores de América Latina y otros continentes. Se excluyeron aquellos estudios que se centraron solo en personas adultas o en la investigación básica en biología tumoral no relacionada específicamente con los tipos de tumores analizados en esta revisión. Resultados. Se encontraron 550 artículos en total. Después de eliminar los artículos duplicados, se incluyeron 514 artículos en la revisión, la mayoría de los cuales fueron escritos por investigadores vinculados a centros de investigación de Argentina, Brasil y México. También procedieron de estos tres países la mayor parte de los artículos originales escritos en colaboración con autores de Europa y América del Norte. Argentina tuvo el mayor número de colaboraciones en publicaciones originales, con coautores de Brasil y Uruguay. La mediana del índice de impacto de las 244 revistas en las que se publicaron los artículos fue de 3,5. Los tumores más estudiados fueron osteosarcomas, neuroblastomas y meduloblastomas. Los temas más estudiados fueron el análisis molecular, la biología de las células tumorales y los biomarcadores. Conclusiones. La investigación en oncología pediátrica forma parte de la agenda de investigación de América Latina, si bien hay una disparidad notoria en las tasas de publicación y la frecuencia de la colaboración entre países. Es necesario fortalecer la colaboración científica dentro de América Latina y con los países de otros continentes para promover la investigación y desarrollar estrategias de tratamiento novedosas que respondan a las necesidades locales de los niños y niñas de América Latina que tienen tumores sólidos o cáncer del sistema nervioso central.

RESUMO Objetivo. A pesquisa básica e translacional em câncer pediátrico é essencial para melhorar o atendimento dos pacientes. No intuito de realizar uma avaliação crítica dos avanços alcançados nessa área na América Latina, fez-se uma revisão sistemática de informações publicadas entre 2013 e 2023. Métodos. Pesquisas básicas e translacionais realizadas por pesquisadores da América Latina que avaliaram tumores sólidos malignos e tumores do sistema nervoso central em crianças foram obtidas da base de dados PubMed. Foram incluídos artigos originais publicados em inglês entre 2013 e 2023. Também foram incluídas colaborações entre autores latino-americanos ou entre autores latino-americanos que trabalham com pesquisadores de outros continentes. Estudos que tratavam apenas de adultos ou pesquisas básicas sobre biologia tumoral não especificamente relacionadas aos tipos de tumor analisados nesta revisão foram excluídos. Resultados. No total, a busca recuperou 550 artigos da base de dados. Após a remoção dos artigos duplicados, foram incluídos 514 artigos na análise, a maioria de autoria de pesquisadores de instituições da Argentina, do Brasil e do México. Esses países também tiveram o maior número de colaborações em artigos originais publicados com autores da Europa e da América do Norte. A Argentina teve o maior número de colaborações em publicações originais, com coautores do Brasil e do Uruguai. O fator de impacto mediano dos 244 periódicos nos quais os artigos foram publicados era de 3,5. Os tumores mais estudados foram osteossarcomas, neuroblastomas e meduloblastomas; as áreas mais estudadas foram análise molecular, biologia de células tumorais e biomarcadores. Conclusões. Na América Latina, a pesquisa em oncologia pediátrica está na ordem do dia, apesar de uma evidente disparidade nos índices de publicação e na frequência de colaboração entre os países. É necessário fortalecer a colaboração científica dentro da América Latina e com países de outros continentes a fim de promover a pesquisa e desenvolver novas estratégias de tratamento que reflitam as necessidades locais das crianças latino-americanas com tumores sólidos e câncer cerebral.

Myxoid Endometriosis: An Entity That Can Cause Confusion with Malignant Entities.

Myxoid endometriosis, a rare entity, is part of the histological changes that can occur in endometriosis. Pathologists must know the histological guidelines for the morphological recognition of this entity, as well as the histochemical and immunohistochemical techniques that support diagnosis, and define the morphological characteristics of myxoid endometriosis. In the present work, we propose diagnostic guidelines and primary differential diagnoses using special histochemical techniques and immunohistochemical reactions to recognize this entity.

Socioeconomic status and cancer survival in Brazil: Analysis of population data from the municipalities of Aracaju and Curitiba, 1996-2012.

INTRODUCTION: The association between socioeconomic status and cancer prognosis has been demonstrated in several countries. Despite the existence of indirect evidence of this phenomenon in Brazil, few studies in this regard are available. OBJECTIVES: The objective of the present study is to analyse socioeconomic related survival gaps for patients diagnosed with breast, cervical, lung, prostate, and colorectal cancer in the cities of Aracaju (SE) and Curitiba (PR). METHODS: Using population-based data, we estimated net survival by tumour site, year of diagnosis, socioeconomic status and local of residence. Net survival estimation was done with multilevel parametric model allowing flexible spline functions do estimate excess mortality hazards. RESULTS: 28,005 cases were included in survival analysis. Five-year net survival showed positive association with SES. Intermunicipal survival gaps favouring Aracaju where prominent for breast (reaching 16,1% in 5 years) OBJECTIVES: Study the impact of socioeconomic factors on cancer survival in two Brazilian capitals. METHODS: Survival analysis using population-based cancer data including patients diagnosed with breast, lung, prostate, cervical and colorectal cancer between 1996 and 2012 in Aracaju and Curitiba. Outcomes were excessive mortality hazard (EMH) and 5- and 8-years net survival (NS). The association of race/skin color and socioeconomic level (SES) with EMH and net survival were analyzed using a multilevel regression model with flexible splines. RESULTS: 28,005 cases were included, 6636 from Aracaju and 21,369 from Curitiba. NS for all diseases studied increased more prominently for Curitiba population. We observed NS gap between the populations of Aracaju and Curitiba that increased or remained stable during the study period, with emphasis on the growth of the difference in NS of lung and colon cancer (among men). Only for cervical cancer and prostate cancer there was a reduction in the intermunicipal gaps. 5-year NS for breast cancer in Aracaju ranged from 55.2% to 73.4% according to SES. In Curitiba this variation was from 66.5% to 83.8%. CONCLUSION: The results of the present study suggests widening of socioeconomic and regional inequalities in the survival of patients with colorectal, breast, cervical, lung and prostate cancers in Brazil during the 1990 s and 2000 s.

What is the Role of SNORA42 in Carcinogenesis? A Systematic Review.

OBJECTIVE: Perform a systematic literature review on SNORA42 in carcinogenesis in order to elucidate its importance, its potential use as a biomarker and as a therapeutic target. METHODS: Using PubMed, SciELO and Science Direct databases as search means, articles that are in line with the scope of the study, written in English, that were published between 2012 and 2022, were selected using the following keywords: "small nucleolar RNA 42", "snoRNA 42" and "SNORA42", as well as searches for the synonyms of this snoRNA (SNORA80E, box H/ACA 42 and ACA42). RESULT: From a total of 131 studies, seven were selected, in which it was possible to identify that SNORA42 interferes in several biological processes, such as proliferation, migration, invasion, metastasis, apoptosis, and signaling pathways. Among the signaling pathways, the p53 and NF-KappaB pathways stand out. Moreover, it is a potential biomarker for diagnosis, prognosis, and treatment of cancer. CONCLUSION: The summary of the main information about SNORA42 in the process of carcinogenesis and cancer progression shows that the use of this snoRNA is ideal for future applications in the field of oncology, in which it can be used as a biomarker and therapeutic target. Thus, it is of fundamental importance to carry out new studies to consolidate the applicability of this molecule.

Cancer in the head and neck region and its face under the perspective of users of a public reference hospital in Recife, state of Pernambuco, Brazil

Introduction: In Brazil, cancer is a public health problem because of its epidemiological, social, and economic amplitude. Objective: This study aimed to identify and analyze the difficulties experienced by head and neck (H&N) cancer patients, who are users of the Brazilian public health system (SUS), from their perspective of diagnosis to post-treatment. Methods: Qualitative case series carried out using individual semistructured interviews. Data were collected from October 2019 to March 2020 and interpreted by content analysis. Results: Three categories emerged from the analysis: "difficulties in the diagnosis phase", "conflicts experienced during treatment" and "post-treatment difficulties/sequelae". Corroborating the literature, it was found that the difficulties faced by cancer patients are present in all stages of the disease: from access to prevention health services and diagnosis to post-treatment, influenced by late diagnosis, treatment side effects, and disease comorbidities. Conclusion: It is essential to carry out studies addressing changes in the family, professional and personal scope of cancer patients, aiming to provide them with comprehensive care and health professionals with understanding about what this disease represents in the life of these individuals.

Impacto da pandemia de COVID-19 no atendimento do serviço de radioterapia em um hospital público de Salvador/BA / Impact of the COVID-19 pandemic on the service of radiotherapy in a public hospital in Salvador/BA

Introdução: o câncer é uma das principais causas de morte no mundo e o seu tratamento, associado com o processo da doença, acaba tornando esses pacientes mais vulneráveis. A pandemia de COVID-19 foi declarada no Brasil em março de 2020 e se estende até o presente momento, com centenas de milhares de infectados e de óbitos. No seu início, algumas medidas de prevenção foram adotadas, principalmente para populações de risco como os pacientes oncológicos, mediante o fechamento de centros de diagnósticos e de serviços eletivos, além da aderência ao distanciamento social. Objetivo: este estudo teve como objetivo determinar o impacto quantitativo gerado no atendimento de pacientes em um serviço de radioterapia, no perfil sociodemográfico dos pacientes oncológicos e no estadiamento tumoral desses pacientes. Metodologia: Tratou-se de estudo observacional descritivo, onde foram coletados dados dos prontuários dos pacientes, a partir do relatório mensal de atendimentos iniciais do serviço de radioterapia de uma Unidade de Alta Complexidade em Oncologia, em hospital público de Salvador, referentes às terapias iniciadas no período entre março e agosto dos anos de 2019 e 2020. Resultados: avaliaram-se 259 prontuários no ano de 2019 e 227 em 2020. A maioria dos pacientes foi do sexo feminino (78%) nos dois anos e residentes da cidade de Salvador. Segundo os resultados obtidos, percebeu-se uma diminuição de 12% no número de atendimentos realizados em 2020, com uma piora no estadiamento tumoral desses pacientes, chegando a um aumento de 115% nos casos de presença de metástase. As principais neoplasias encontradas foram câncer de mama, cabeça e pescoço, próstata e colo do útero. Conclusões: houve uma redução no número de atendimentos na referida unidade, não existindo grande mudança no perfil desses pacientes, que apresentam uma amostra predominantemente do sexo feminino, sendo sua maioria residente da cidade de Salvador-BA. Porém foi possível notar uma diminuição da população acima de 60 anos e também um agravamento do estadiamento tumoral.

Introduction: Cancer is one of the main causes of death in the world and its treatment, associated with the disease process, ends up making these patients more vulnerable. The COVID-19 pandemic was declared in Brazil in March 2020 and has continued to date, with hundreds of thousands of infected people and deaths. At its beginning, some prevention measures were adopted, mainly for populations at risk such as cancer patients, through the closing of diagnostic centers and elective services, in addition to adherence to social distance. Objective: this study aimed to determine the quantitative impact generated on the care of patients in a radiotherapy service, on the sociodemographic profile of cancer patients and on the tumor staging of these patients. Methods: this was a descriptive observational study, where data were collected from the patients' medical records, from the monthly report of initial care at the radiotherapy service of a High Complexity Oncology Unit, in a public hospital in Salvador, regarding the therapies started in the period between March and August in the years 2019 and 2020. Results: two hundred and fifty nine (259) medical records were evaluated in 2019 and 227 in 2020. Most patients were female (78%) in both years and residents in the city of Salvador. According to the results obtained, there was a 12% decrease in the number of consultations performed in 2020, with a worsening in the tumor staging of these patients, reaching an increase of 115% in cases of metastasis. The main neoplasms found were breast, head and neck, prostate and cervical cancer. Conclusions: there was a reduction in the number of consultations in that unit, with no major change in the profile of these patients, who have a predominantly female sample, most of them residing in the city of Salvador-BA. However, it was possible to notice a decrease in the population over 60 years of age and also an aggravation of tumor staging.

Clear cell renal carcinoma synchronous with dedifferentiated liposarcoma: a case report and review of the literature.

BACKGROUND: Multiple primary malignant neoplasms are not frequent but are increasing in incidence. Some of them are associated with genetic syndromes such as von Hippel-Lindau syndrome and Li-Fraumeni syndrome. Dedifferentiated liposarcoma is one of the rarest soft tissue tumors, and clear cell renal carcinoma is the most frequent kidney cancer. The concomitant presence of these tumors is extremely rare; however, some cases have been reported, none of them presenting with liposarcoma of the limbs. We report an interesting case of a patient with synchronous multiple primary tumors presenting with a very rare liposarcoma associated with renal cell carcinoma (a very rare association). A review of the literature and a collection of similar cases published previously are also provided. CASE PRESENTATION: We report a case of a 62-year-old Hispanic man who presented to our institution with a left thigh mass compatible with dedifferentiated liposarcoma synchronous with metastatic clear cell renal carcinoma. Multiple treatment lines were provided with no response, with a further metastatic transformation. Genetic analysis by liquid biopsy showed some mutations that were not susceptible to targeted therapy. At the time of this report, the patient is undergoing palliative care because his nonresponsive metastatic disease persists. CONCLUSIONS: We present the first reported case of clear cell renal carcinoma synchronous with dedifferentiated liposarcoma of a limb. The association between renal cell carcinoma and dedifferentiated liposarcoma is unusual, and there are few reports of this presentation in the literature. More research about these tumors along with genetic tests needs to be performed to seek a better understanding of the fundamental basis of this rare association.

Meduloblastoma cerebeloso durante el embarazo: Reporte de caso / Cerebellar meduloblastoma during pregnancy: A case report

Maternal malignancies complicate approximately one of every 1 000 pregnancies. These neoplasms arise more frequently from the breasts, cervix and hematopoietic system. Brain tumors in pregnancy are extremely rare. Cerebellar medulloblastomas are the most common malignant brain tumors in childhood. They are considered as embryonic tumors and represent 4% of all intracranial neoplasms; they are extremely rare during pregnancy. We present the case of a 21-year-old patient with a 16-week pregnancy who suffered of intense headache in the occipital region, accompanied by photophobia, slight alteration of coordination, unstable gaits and vomiting. Neurological evaluation was normal but for positive Romberg sign and ataxic gait. Cerebral magnetic resonance imaging showed a complex, ill-defined tumor occupying the cerebellar space. The patient underwent surgical reduction of the tumor. Histopathological analysis revealed grade IV cerebellar medulloblastoma. Adjuvant radiotherapy was administered. Cesarean section was performed at 34 weeks of gestation with live newborn. Following delivery, treatment was completed with external radiation therapy to the craniospinal axis.

Las neoplasias malignas maternas complican aproximadamente uno de cada 1 000 embarazos. Estas neoplasias surgen con mayor frecuencia de las mamas, cuello uterino o sistema hematopoyético. Los tumores cerebrales en el embarazo son extremadamente raros. Los meduloblastomas cerebelosos son los tumores cerebrales malignos más comunes de la infancia. Se les clasifica como tumor embrionario y representan el 4% de todas las neoplasias intracraneales; es extremadamente raro que aparezcan durante el embarazo. Se presenta un caso de una paciente de 21 años con embarazo de 16 semanas quien consultó por presentar cefalea intensa en la región occipital, acompañada de fotofobia, alteración ligera de la coordinación, marcha inestable y vómitos. El examen neurológico fue normal, aparte del signo de Romberg positivo y marcha atáxica. La resonancia magnética cerebral mostró tumoración compleja, mal definida, que ocupaba el espacio cerebeloso. La paciente fue sometida a reducción quirúrgica. El análisis histopatológico reveló meduloblastoma cerebeloso de grado IV. Se administró radioterapia adyuvante. La cesárea fue realizada a las 34 semanas de gestación, obteniendo un recién nacido vivo. Después del parto, la radioterapia externa hacia el eje craneoespinal completó el tratamiento.

Caracterización epidemiológica y clínico-terapéutica de las neoplasias malignas de glándulas salivales / Epidemiological and Clinical-therapeutic Characterization of Malignant Neoplasm in the Salivary Glands

RESUMEN Introducción: Las neoplasias malignas de glándulas salivales se ubican entre las primeras diez localizaciones de incidencia oncológica. Objetivo: Describir el comportamiento epidemiológico-clínico-terapéutico de los tumores malignos de glándulas salivales en pacientes mayores de 15 años en la provincia de Sancti Spiritus entre 2012 y 2015. Métodos: Se realizó un estudio observacional, descriptivo, transversal. La muestra estuvo constituida por 39 pacientes mayores de 15 años, con neoplasias en glándulas salivales que acudieron al servicio de Cirugía Maxilofacial entre el 1 de enero de 2012 y el 31 de diciembre de 2015. Resultados: Predominó el sexo masculino y el rango de edad comprendido entre 45-64 años. Los municipios con mayor número de pacientes fueron Sancti Spiritus y Cabaiguán. El 23,1 por ciento de los obreros están expuestos a los rayos solares y sustancias químicas. Los parámetros clínicos más frecuentes fueron el aumento de volumen, las molestias, el dolor en la región. La glándula parótida fue el sitio anatómico de aparición más frecuente y el carcinoma mucoepidermoide la más recurrente de las neoplasias malignas de glándulas salivales. La supervivencia global a los dos años fue de 84,1 por ciento. Conclusiones: Las neoplasias malignas de glándulas salivales constituyen un problema de salud en el centro del país. Más de la mitad de los casos se diagnostican en etapas avanzadas debido, en parte, a la procedencia rural (zonas de difícil acceso) de gran parte de la muestra. Las cifras de supervivencia se encuentran acorde a parámetros internacionales(AU)

ABSTRACT Introduction: Malignant neoplasms in the salivary glands are among the first ten locations of cancer incidence. Objective: To describe the epidemiological, clinical and therapeutic behavior of malignant salivary gland tumors in patients older than 15 years in Sancti Spiritus Province between 2012 and 2105. Methods: An observational, descriptive, cross-sectional study was carried out. The sample consisted of 39 patients older than 15 years, with salivary gland neoplasms and who attended the maxillofacial surgery service between January 1st, 2012 and December 31st, 2015. Results: The male sex and the age range between 45-64 years predominated. The municipalities with the highest number of patients were Sancti Spiritus and Cabaiguán. 23.1 percent of workers are exposed to sunlight and chemicals. The most frequent clinical parameters were volume increase, discomfort, localized pain. The parotid gland was the most frequent anatomical onset site and the mucoepidermoid carcinoma was the most recurrent of the malignant neoplasms in the salivary glands. The two-year overall survival was 84.1 percent. Conclusions: Malignant neoplasms of salivary glands constitute a health concern in the central region of the country. More than half of the cases are diagnosed in advanced stages due, in part, to the rural origin (hard-to-reach areas) of much of the sample. Survival rates are coincident with international parameters(AU)

Health inequities and cancer survival in Manizales, Colombia: a population-based study.

OBJECTIVE: To analyze differences in survival of breast, cervical, lung, prostate and stomach cancer by health insurance regime (HIR) and socioeconomic position (SEP) in an intermediate city in a middle-income country. METHODS: All patients with breast, cervix uteri, lung, prostate and stomach cancer diagnosed between 2003 and 2007 and characterized by the Manizales population-based Cancer Registry (MCR) were included and followed up to a maximum of 5 years for identifying deaths. Survival probabilities estimated by HIR were defined according to the type of affiliation at the date of diagnosis, and by socioeconomic stratification of residence (SS) as indicator of SEP, stratifying for other prognostic factors using Kaplan-Meier methods. Cox proportional hazard models were fitted for multivariate analysis. RESULTS: A total of 1,384 cases and 700 deaths were analyzed. Five-year observed survival was 71.0% (95% IC: 66.1-75.3) for breast, 51.4% (95% IC: 44.6-57.9) for cervix, 15.4% (95% IC: 10.7-20.8) for lung, 71.1% (95% IC: 65.3-76.1) for prostate and 23.8% (95% IC: 19.3-28.6) for stomach. Statistically significant differences in survival by HIR were observed for breast, lung, prostate, and stomach - with poorer survival for the subsidized and uninsured patients. Differences by SS were observed for lung and prostate. Differences in survival by HIR were independent of SS, and viceversa. CONCLUSIONS: Important inequities in cancer survival exist related to HIR and SEP. Possible explanations include underlying comorbidities, late stage at diagnosis, or barriers to timely and effective treatment.

OBJETIVO: Analizar la supervivencia de pacientes con cáncer de mama, cuello uterino, pulmón, próstata y estómago según régimen de aseguramiento en salud (RAS) y posición socioeconómica (PSE) en una ciudad intermedia de un país de medianos ingresos. MÉTODOS: Se incluyeron todos los pacientes con cáncer de mama, cuello uterino, pulmón, próstata y estómago diagnosticados entre 2003 y 2007 y caracterizados por el Registro Poblacional de Cáncer de Manizales, quienes fueron seguidos hasta un máximo de cinco años para identificar los fallecimientos. Las probabilidades de supervivencia estimada según RAS fueron definidas de acuerdo con el tipo de afiliación al momento del diagnóstico, y según el estrato socioeconómico de la residencia como indicador de PSE, estratificando por otros factores pronósticos y utilizando el método de Kaplan-Meier. Para el análisis multivariado se ajustaron modelos de riesgos proporcionales de Cox. RESULTADOS: Se analizaron en total 1.384 casos y 700 muertes. La supervivencia observada a cinco años fue 71.0% (IC 95%: 66.1-75.3) para cáncer de mama, 51.4% (44.6-57.9) para cuello uterino, 15.4% (10.7-20.8) para pulmón, 71.1% (65.3-76.1) para próstata, y 23.8% (19.3-28.6) para estómago. Se observaron diferencias estadísticamente significativas en la supervivencia según RAS para mama, pulmón, próstata y estómago, con supervivencia más pobre en los pacientes del régimen subsidiado y no asegurados. Se observaron diferencias por estrato socioeconómico en los cánceres de pulmón y próstata. Las diferencias por RAS fueron independientes del estrato socioeconómico y viceversa. CONCLUSIONES: Existen importantes inequidades en la supervivencia de pacientes con cáncer relacionadas con el RAS y con la PSE. Las posibles explicaciones incluyen comorbilidades subyacentes, diagnóstico tardío y barreras para el acceso al tratamiento oportuno y efectivo.

Health inequities and cancer survival in Manizales, Colombia: a population-based study / Inequidades en salud y supervivencia al cáncer en Manizales, Colombia: un estudio de base poblacional

Abstract Objective: To analyze differences in survival of breast, cervical, lung, prostate and stomach cancer by health insurance regime (HIR) and socioeconomic position (SEP) in an intermediate city in a middle-income country. Methods: All patients with breast, cervix uteri, lung, prostate and stomach cancer diagnosed between 2003 and 2007 and characterized by the Manizales population-based Cancer Registry (MCR) were included and followed up to a maximum of 5 years for identifying deaths. Survival probabilities estimated by HIR were defined according to the type of affiliation at the date of diagnosis, and by socioeconomic stratification of residence (SS) as indicator of SEP, stratifying for other prognostic factors using Kaplan-Meier methods. Cox proportional hazard models were fitted for multivariate analysis. Results: A total of 1,384 cases and 700 deaths were analyzed. Five-year observed survival was 71.0% (95% IC: 66.1-75.3) for breast, 51.4% (95% IC: 44.6-57.9) for cervix, 15.4% (95% IC: 10.7-20.8) for lung, 71.1% (95% IC: 65.3-76.1) for prostate and 23.8% (95% IC: 19.3-28.6) for stomach. Statistically significant differences in survival by HIR were observed for breast, lung, prostate, and stomach - with poorer survival for the subsidized and uninsured patients. Differences by SS were observed for lung and prostate. Differences in survival by HIR were independent of SS, and viceversa. Conclusions: Important inequities in cancer survival exist related to HIR and SEP. Possible explanations include underlying comorbidities, late stage at diagnosis, or barriers to timely and effective treatment.

Resumen Objetivo: Analizar la supervivencia de pacientes con cáncer de mama, cuello uterino, pulmón, próstata y estómago según régimen de aseguramiento en salud (RAS) y posición socioeconómica (PSE) en una ciudad intermedia de un país de medianos ingresos. Métodos: Se incluyeron todos los pacientes con cáncer de mama, cuello uterino, pulmón, próstata y estómago diagnosticados entre 2003 y 2007 y caracterizados por el Registro Poblacional de Cáncer de Manizales, quienes fueron seguidos hasta un máximo de cinco años para identificar los fallecimientos. Las probabilidades de supervivencia estimada según RAS fueron definidas de acuerdo con el tipo de afiliación al momento del diagnóstico, y según el estrato socioeconómico de la residencia como indicador de PSE, estratificando por otros factores pronósticos y utilizando el método de Kaplan-Meier. Para el análisis multivariado se ajustaron modelos de riesgos proporcionales de Cox. Resultados: Se analizaron en total 1.384 casos y 700 muertes. La supervivencia observada a cinco años fue 71.0% (IC 95%: 66.1-75.3) para cáncer de mama, 51.4% (44.6-57.9) para cuello uterino, 15.4% (10.7-20.8) para pulmón, 71.1% (65.3-76.1) para próstata, y 23.8% (19.3-28.6) para estómago. Se observaron diferencias estadísticamente significativas en la supervivencia según RAS para mama, pulmón, próstata y estómago, con supervivencia más pobre en los pacientes del régimen subsidiado y no asegurados. Se observaron diferencias por estrato socioeconómico en los cánceres de pulmón y próstata. Las diferencias por RAS fueron independientes del estrato socioeconómico y viceversa. Conclusiones: Existen importantes inequidades en la supervivencia de pacientes con cáncer relacionadas con el RAS y con la PSE. Las posibles explicaciones incluyen comorbilidades subyacentes, diagnóstico tardío y barreras para el acceso al tratamiento oportuno y efectivo.

Parotid gland adenocarcinoma in a cow: case report / Adenocarcinoma de glândula parótida em vaca: relato de caso

A 9-year-old Girolando dairy cow, weighing 400kg, with a history of increased volume in the right parotid region, which extended to the submandibular region, was assisted. Fine needle aspiration cytology was performed, and the cytological findings were consistent with malignant neoplasm of epithelial origin (carcinoma). Because of the unfavorable prognosis, the animal was euthanized and submitted to an anatomopathological examination. Samples of the increased parotid and affected lymph nodes were collected for histopathological evaluation. The microscopic changes were accentuated features of anaplasia, moderate cell proliferation, atypical mitotic figures, and necrosis. Stroma ranged from delicate to scirrhous, and the tumor boundaries were not distinct. These findings substantiated the preliminary histomorphological diagnosis of undifferentiated carcinoma with metastasis in lymph nodes. Immunohistochemical tests were performed with anti-CK Pan (clone AE1AE3), anti-CK HMW (clone 34ßE12), anti-CK19 (clone RCK108), anti-vimentin (clone V9), anti-S100 (polyclonal), and anti-androgen (polyclonal) antibodies. The immunophenotype favored the diagnosis of salivary gland adenocarcinoma. Despite the rareness in cattle, salivary gland adenocarcinoma should be considered in the differential diagnosis of diseases that occur with increased volume in the head, lymphadenopathy, drooling, dysphagia, and progressive weight loss.(AU)

Foi atendida uma vaca da raça Girolando, de nove anos de idade, de aptidão leiteira, pesando aproximadamente 400kg e com histórico de aumento de volume na região parotídea e submandibular direita. Diante do prognóstico desfavorável, o animal foi submetido à eutanásia e encaminhado para exame anatomopatológico. Fragmentos da glândula parótida e dos linfonodos alterados foram colhidos e encaminhados para exame histopatológico. À avaliação microscópica, observaram-se acentuada anaplasia, moderada proliferação celular, figuras de mitose atípicas e focos de necrose. O estroma variava de delicado a esquirroso e os limites do tumor eram imprecisos. Esses achados fundamentaram o diagnóstico de carcinoma indiferenciado com metástase em linfonodos. No exame imuno-histoquímico, foram utilizados anticorpos primários monoclonais anti-CK Pan (clone AE1AE3), anti-CK alto peso molecular (clone 34ßE12), anti-CK19 (clone RCK108), antivimentina (clone V9), anti-S100 (policlonal) e antirreceptor de andrógenos (policlonal). As células neoplásicas apresentaram imunomarcação para todos os anticorpos testados, resultado que favorece o diagnóstico de adenocarcinoma de glândula salivar. Embora raro em bovinos, o adenocarcinoma de glândula salivar deve ser considerado no diagnóstico diferencial de doenças que cursam com aumento de volume na cabeça, linfadenopatia salivação, disfagia e emagrecimento progressivo.(AU)

Parotid gland adenocarcinoma in a cow: case report / Adenocarcinoma de glândula parótida em vaca: relato de caso

A 9-year-old Girolando dairy cow, weighing 400kg, with a history of increased volume in the right parotid region, which extended to the submandibular region, was assisted. Fine needle aspiration cytology was performed, and the cytological findings were consistent with malignant neoplasm of epithelial origin (carcinoma). Because of the unfavorable prognosis, the animal was euthanized and submitted to an anatomopathological examination. Samples of the increased parotid and affected lymph nodes were collected for histopathological evaluation. The microscopic changes were accentuated features of anaplasia, moderate cell proliferation, atypical mitotic figures, and necrosis. Stroma ranged from delicate to scirrhous, and the tumor boundaries were not distinct. These findings substantiated the preliminary histomorphological diagnosis of undifferentiated carcinoma with metastasis in lymph nodes. Immunohistochemical tests were performed with anti-CK Pan (clone AE1AE3), anti-CK HMW (clone 34ßE12), anti-CK19 (clone RCK108), anti-vimentin (clone V9), anti-S100 (polyclonal), and anti-androgen (polyclonal) antibodies. The immunophenotype favored the diagnosis of salivary gland adenocarcinoma. Despite the rareness in cattle, salivary gland adenocarcinoma should be considered in the differential diagnosis of diseases that occur with increased volume in the head, lymphadenopathy, drooling, dysphagia, and progressive weight loss.(AU)

Foi atendida uma vaca da raça Girolando, de nove anos de idade, de aptidão leiteira, pesando aproximadamente 400kg e com histórico de aumento de volume na região parotídea e submandibular direita. Diante do prognóstico desfavorável, o animal foi submetido à eutanásia e encaminhado para exame anatomopatológico. Fragmentos da glândula parótida e dos linfonodos alterados foram colhidos e encaminhados para exame histopatológico. À avaliação microscópica, observaram-se acentuada anaplasia, moderada proliferação celular, figuras de mitose atípicas e focos de necrose. O estroma variava de delicado a esquirroso e os limites do tumor eram imprecisos. Esses achados fundamentaram o diagnóstico de carcinoma indiferenciado com metástase em linfonodos. No exame imuno-histoquímico, foram utilizados anticorpos primários monoclonais anti-CK Pan (clone AE1AE3), anti-CK alto peso molecular (clone 34ßE12), anti-CK19 (clone RCK108), antivimentina (clone V9), anti-S100 (policlonal) e antirreceptor de andrógenos (policlonal). As células neoplásicas apresentaram imunomarcação para todos os anticorpos testados, resultado que favorece o diagnóstico de adenocarcinoma de glândula salivar. Embora raro em bovinos, o adenocarcinoma de glândula salivar deve ser considerado no diagnóstico diferencial de doenças que cursam com aumento de volume na cabeça, linfadenopatia salivação, disfagia e emagrecimento progressivo.(AU)

Leiomiosarcoma cutáneo ulcerado: Reporte de un caso clínico y revisión de la literatura / Ulcerated cutaneous leiomyosarcoma: A case report and literature review

Los leiomiosarcomas cutáneos son neoplasias malignas, originadas en el músculo liso, infrecuentes, tanto en las formas primarias como en el caso de las secundarias o metastásicas. Existen pocos casos publicados en la literatura. Presentamos el caso de un leiomiosarcoma cutáneo primario, en un hombre de 76 años de edad y realizamos una revisión de sus características clínicas y diagnóstico, así como, de las diferencias pronóstico-evolutivas según las distintas localizaciones de esta afección. Por último, debe señalarse que el tratamiento es fundamentalmente quirúrgico, con escisión y márgenes de seguridad, ya que, no existe una respuesta satisfactoria o significativa al tratamiento radiante y/o quimioterápico, siendo imprescindible efectuar un control evolutivo periódico de los pacientes, debido a la tasa de recurrencia local y la posibilidad de ocasionar metástasis, según la localización histológica del tumor.

Leiomyosarcomas located in superficial soft tissue are very rare or uncommon malignant neoplasms, both as primary tumors and as secondary or metastatic lesions. We present the case of a primary cutaneous leiomyosarcoma in a 76-year-old man, reviewing the clinical and diagnostic features, as well as the different prognoses depending on the site at this level. Treatment is basically surgical, involving excision with wide margins since the response to radiotherapy and/or chemotherapy is not satisfactory or significant. Given the high rate of local recurrence and the possibility of metastasis, depending on the histological location of the tumor, periodic follow-up of the patients is essential and indispensable.

A relação entre doença periodontal e o câncer oral / The relationship between periodontal disease and oral cancer

Objetivo: O objetivo deste artigo foi revisar os dados na literatura sobre possíveis mecanismos que estabeleçam uma relação entre o câncer oral e a doença periodontal. Material e Métodos: Foi realizada uma busca nas bases de dados Pubmed, Scopus e Web of Science por publicações até abril de 2016. Resultados: Os artigos analisados apontaram evidências que corroboram com o papel da doença periodontal na carcinogênese. Esta atuação baseia-se na liberação de mediadores inflamatórios e de periodontopatógenos das bolsas periodontais até sítios sadios através do sangue e da saliva, sendo capaz alterar o padrão epigenético do hospedeiro. Em consequência, esta alteração na expressão gênica pode inibir regiões relacionadas à supressão tumoral, crescimento celular, reparo do DNA, ligação intracelular, inibição de metástase, entre outros. Conclusão: É possível concluir que há bases biológicas para sustentar uma relação entre doença periodontal e o câncer oral, porém mais estudos são necessários para avaliar seu real impacto

Objective: The aim of this article was to review the extant literature about possible mechanisms for a relationship between periodontal disease and oral cancer. Material and Methods: A search was performed using PubMed, Scopus, and Web of Science for articles published through April 2016. The articles showed evidence supporting the role of periodontal disease in carcinogenesis. Results: The relationship between periodontal disease and oral cancer is based on the release of inflammatory mediators and periodontopathogens from periodontal pockets to healthy sites via the blood and saliva, thereby changing the host's epigenetic patterns. Consequently, these changes in gene expression can inhibit genetic regions related to tumor suppression, cell growth, DNA repair, intracellular binding, and inhibition of metastasis, among other processes. Conclusion: There is sufficient biological evidence to support the relationship between periodontal disease and oral cancer; however, more studies are needed to evaluate the impact of this relationship on patients

Modos de vida entre pessoas que tiveram câncer no Brasil em 2013 / Lifestyle among former cancer patients in Brazil in 2013

Resumo Pessoas que tiveram diagnóstico de câncer tendem a adotar modos de vida mais saudáveis. Este estudo analisa a prevalência de tabagismo, consumo de frutas e hortaliças, atividade física e uso de bebidas alcoólicas entre adultos que relataram ter tido diagnóstico de câncer na Pesquisa Nacional de Saúde (PNS). Foram calculadas as prevalências e respectivos intervalos de 95% de confiança referentes ao consumo de frutas e hortaliças, inatividade física, uso de bebidas alcoólicas, excesso de peso e tabagismo. A associação entre ter tido diagnóstico de câncer e fatores de risco e proteção foi avaliada por regressão de Poisson e ajustada por variáveis sociodemográficas e por outras comorbidades crônicas. As análises foram estratificas pelo tempo de diagnóstico e por tipos de câncer relacionados aos fatores analisados. Os cânceres mais frequentes informados entre as mulheres foram os de mama e colo de útero, e entre os homens próstata e estômago. Entre os que tiveram diagnósticos de câncer, observou-se maior consumo de frutas e hortaliças, maior proporção de ex-fumantes, porém, maior uso de álcool. Não houve diferença entre a frequência e a atividade física e excesso de peso entre os dois grupos. Ações de promoção de saúde e de prevenção de doenças crônicas devem ser implementadas no acompanhamento de pessoas que tiveram câncer na perspectiva de assegurar o cuidado integral de saúde.

Abstract People who have been diagnosed with cancer tend to adopt healthier lifestyles. This study analyzes the prevalence of smoking, eating fruits and vegetables, exercise and the use of alcoholic beverages among individuals who reported to have been diagnosed with cancer in the PNS (Pesquisa Nacional de Saúde or National Health Survey). The prevalence and corresponding 95% confidence intervals were calculated for consuming fruits and vegetables, sedentary lifestyle (no exercise), use of alcoholic beverages, being overweight and tobacco use. The associa-tion between having received a diagnosis of cancer and the risk and protection factors was analyzed using a Poisson regression, adjusted by sociodemographic variables and other chronic comorbidities. The analyses were stratified by time since the diagnosis and the type of cancer related to the factors analyzed. The types of cancer most often reported were breast and cervix in women, and prostate and stomach in men. Among those who had cancer diagnoses, there was a higher consumption of fruits and vegetables, higher proportion of ex-smokers, however, increased use of alcohol. There was no difference in the frequency of exercise or incidence of being overweight between the two groups. Measures to promote health and prevent chronic diseases should be implemented in the follow-up of people who have had cancer, in an effort to ensure integrated healthcare.

Identificación molecular de helicobacter pylori en tejidos gástricos con neoplasias malignas embebidos en parafina / Molecular identification of helicobacter pylori in paraffin embedded gastric tissues with malignant neoplasm

Introducción: Helicobacter pylori es considerado uno de los principales agentes causales de gastritis crónica, úlcera péptica y neoplasias gástricas malignas en humanos. Objetivo: evaluar el uso de la reacción en cadena de la polimerasa para la identificación de H. pylori y sus genotipos en tejidos gástricos con neoplasias malignas embebidos en parafina. Material y Métodos: se estudiaron secciones de 5 bloques de parafina procedentes de 5 pacientes mexicanos con neoplasias gástricas malignas. Se realizaron coloraciones de rutina y especiales de anatomía patológica, así como la técnica de la reacción en cadena de la polimerasa para la detección del microorganismo y sus genotipos. Resultados: la técnica de la reacción en cadena de la polimerasa identificó a este agente infeccioso en todos los bloques analizados en correspondencia con su detección a través de las técnicas histológicas. Esta metodología permitió demostrar una variabilidad genética del patógeno en las muestras analizadas según los genotipos vacA y cagA. Conclusiones: la reacción en cadena de la polimerasa podría ser un método eficaz en la identificación del H. pylori en tejidos gástricos con neoplasias malignas embebidos en parafina. Esta se perfila como una estrategia atractiva para realizar estudios de epidemiología molecular y permitirá establecer posibles asociaciones de genotipos/subtipos del microorganismo con variables clínicas, epidemiológicas y de manejo del paciente.

Introduction: Helicobacter pylori is considered one of the main causal agents of chronic gastritis, peptic ulcer and gastric malignant neoplasms in humans. Objective: to evaluate polymerase chain reaction for identification of Helicobacter pylori and its genotypes in paraffin embedded gastric tissues with malignant neoplasms. Material and Methods: sections of five paraffin blocks from five patients with gastric malignant neoplasms were studied. They were analyzed through routine and special stains of pathological anatomy, as well as the polymerase chain reaction technic for microorganism and genotypes detection. Results: the infectious agent was identified in all of the analyzed blocks through the polymerase chain reaction technic in correspondence with its detection through histologic techniques. This methodology showed a genetic variability of the pathogen in the analyzed samples in respect to vacA and cagA genotypes. Conclusions: the polymerase chain reaction could be an efficacious method for the identification of H. pylori in paraffin embedded gastric tissues with malignant neoplasms. It is projected as an attractive strategy for performing studies of molecular epidemiology and the establishment of possible associations between genotypes/subtypes of the microorganism and clinic or epidemiologic variables, and patient handling.

Cáncer de senos paranasales y sus manifestaciones orales: reporte de dos casos clínicos / Paranasal sinus cancer and oral manifestations: report of two cases

Los carcinomas de senos paranasales son entidades poco frecuentes y cuando se diagnostican, generalmente ya se encuentran en estados avanzados de la enfermedad, dado que el proceso neoplásico en las etapas iniciales crece invadiendo las cavidades paranasales, para luego en etapas avanzadas producir la deformación de las corticales. Dentro de las manifestaciones clínicas se pueden presentar epistaxis, obstrucción nasal, dolor en zona maxilar, dolor o movilidad dentaria. Se presentan dos casos clínicos que dentro de las primeras manifestaciones cursaron con dolor de la zona maxilar y movilidad anormal de un diente. Al momento de realizar el diagnóstico definitivo los procesos tumorales se encontraban muy avanzados, comprometiendo diversas estructuras como seno maxilar, etmoidal, esfenoidal, y piso de órbita, lo que obliga a realizar grandes resecciones de la zona maxilofacial. El rol del odontólogo en el diagnóstico de la enfermedad podría ser de gran importancia, al sospechar que un aumento de volumen del reborde, la movilidad dentaria anormal o un dolor de la zona maxilar no siempre corresponden a causas odontogénicas.

Paranasal sinus cancer are rare entities, but when diagnosed, often already in advanced stages of the disease, because the neoplastic process in the initial stages grows invading the paranasal sinuses and then in advanced stages, produces deformation of cortical bone. Among the clinical manifestations epistaxis, nasal obstruction, pain in maxillary area, pain or tooth mobility may occur. We present two clinical cases in which within the first manifestations are the maxillary pain and abnormal tooth mobility. When making the final diagnosis, tumor processes were well advanced, engaging various structures as maxillary sinus, ethmoid, sphenoid, and orbital floor, forcing large resections perform maxillofacial area. The role of the dentist in the diagnosis of the disease could be of great importance, suspecting that an increase maxillary volume, abnormal tooth mobility or pain of the maxillary not always correspond with odontogenic causes.

Diagnóstico tardío de carcinoma escamo celular en boca: reporte de caso / Delayed diagnosis of squamous cell carcinoma in the mouth: case report

Es de gran importancia que el odontólogo esté entrenado en la detección temprana de cualquier lesión de la cavidad bucal, más aun cuando se trata de una lesión pre-maligna o maligna. El odontólogo es el primer profesional de la salud que entra en contacto con la cavidad bucal del paciente y por lo tanto el encargado de preservar la salud de la misma, no solo de los órganos dentarios si no de todos los tejidos que componen el aparato estomatognático. En el presente caso se muestra un paciente masculino de 72 años de edad que acude al Instituto Dermatológico de Jalisco “Dr. José Barba Rubio” con una lesión exofítica ulcerada de aproximadamente cinco años de evolución localizada en piel de mejilla, se realiza excisión quirúrgica, el estudio histopatológico diagnostica carcinoma de células escamosas bien diferenciado originado en cavidad bucal que posteriormente invade tejido blando y piel. Se remite al Instituto Jalisciense de Cancerología para continuar el tratamiento.

It is important, the dentist should be prepared in early detection of any lesion of the oral cavity, specially, if there is a premalignant lesion. The dentist is the health professional that first has contact with the mouth of the patient. Therefore preserving the health of dental organs and all tissues of the mouth. The case we report, is a 72 year old male who presented at the dermatological institute of Jalisco, “Dr. Jose Barba Rubio, with an ulcerated exophytic lesion of approximately five years of development, surgical excision is performed, the histopathological diagnosis of squamous cell carcinoma, well differentiated originated in the oral cavity, the latter invading soft tissue and skin. The patient was referred to the Instituto Jalisciense de Cancerología, to continue treatment.