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1.
Clin. transl. oncol. (Print) ; 25(9): 2732-2748, sept. 2023. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-224137

RESUMO

Renal cancer is the seventh most common cancer in men and the tenth in women. The aim of this article is to review the diagnosis, treatment, and follow-up of renal carcinoma accompanied by recommendations with new evidence and treatment algorithms. A new pathologic classification of RCC by the World Health Organization (WHO) was published in 2022 and this classification would be considered a “bridge” to a future molecular classification. For patients with localized disease, surgery is the treatment of choice with nephron-sparing surgery recommended when feasible. Adjuvant treatment with pembrolizumab is an option for intermediate-or high-risk cases, as well as patients after complete resection of metastatic disease. More data are needed in the future, including positive overall survival data. Clinical prognostic classification, preferably IMDC, should be used for treatment decision making in mRCC. Cytoreductive nephrectomy should not be deemed mandatory in individuals with intermediate-poor IMDC/MSKCC risk who require systemic therapy. Metastasectomy can be contemplated in selected subjects with a limited number of metastases or long metachronous disease-free interval. For the population of patients with metastatic ccRCC as a whole, the combination of pembrolizumab–axitinib, nivolumab–cabozantinib, or pembrolizumab–lenvatinib can be considered as the first option based on the benefit obtained in OS versus sunitinib. In cases that have an intermediate IMDC and poor prognosis, the combination of ipilimumab and nivolumab has demonstrated superior OS compared to sunitinib. As for individuals with advanced RCC previously treated with one or two antiangiogenic tyrosine-kinase inhibitors, nivolumab and cabozantinib are the options of choice. When there is progression following initial immunotherapy-based treatment, we recommend treatment with an antiangiogenic tyrosine-kinase inhibitor (AU)


Assuntos
Humanos , Carcinoma de Células Renais/diagnóstico , Carcinoma de Células Renais/terapia , Neoplasias Renais/diagnóstico , Neoplasias Renais/terapia , Sociedades Médicas , Espanha
2.
Clin Transl Oncol ; 25(9): 2732-2748, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37556095

RESUMO

Renal cancer is the seventh most common cancer in men and the tenth in women. The aim of this article is to review the diagnosis, treatment, and follow-up of renal carcinoma accompanied by recommendations with new evidence and treatment algorithms. A new pathologic classification of RCC by the World Health Organization (WHO) was published in 2022 and this classification would be considered a "bridge" to a future molecular classification. For patients with localized disease, surgery is the treatment of choice with nephron-sparing surgery recommended when feasible. Adjuvant treatment with pembrolizumab is an option for intermediate-or high-risk cases, as well as patients after complete resection of metastatic disease. More data are needed in the future, including positive overall survival data. Clinical prognostic classification, preferably IMDC, should be used for treatment decision making in mRCC. Cytoreductive nephrectomy should not be deemed mandatory in individuals with intermediate-poor IMDC/MSKCC risk who require systemic therapy. Metastasectomy can be contemplated in selected subjects with a limited number of metastases or long metachronous disease-free interval. For the population of patients with metastatic ccRCC as a whole, the combination of pembrolizumab-axitinib, nivolumab-cabozantinib, or pembrolizumab-lenvatinib can be considered as the first option based on the benefit obtained in OS versus sunitinib. In cases that have an intermediate IMDC and poor prognosis, the combination of ipilimumab and nivolumab has demonstrated superior OS compared to sunitinib. As for individuals with advanced RCC previously treated with one or two antiangiogenic tyrosine-kinase inhibitors, nivolumab and cabozantinib are the options of choice. When there is progression following initial immunotherapy-based treatment, we recommend treatment with an antiangiogenic tyrosine-kinase inhibitor. While no clear sequence can be advocated, medical oncologists and patients should be aware of the recent advances and new strategies that improve survival and quality of life in the setting of metastatic RC.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Masculino , Humanos , Feminino , Carcinoma de Células Renais/terapia , Carcinoma de Células Renais/tratamento farmacológico , Sunitinibe/efeitos adversos , Nivolumabe/uso terapêutico , Qualidade de Vida , Neoplasias Renais/terapia , Neoplasias Renais/tratamento farmacológico , Tirosina/uso terapêutico
3.
Arch Esp Urol ; 61(8): 949-54, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19040169

RESUMO

OBJECTIVE: The EORTC Quality of Life Group has developed a questionnaire for evaluating Quality of Life in international clinical trials: EORTC QLQ-C30, which is widely used in many countries. The purpose of this study was to assess the psychometric properties of the third version of this questionnaire, EORTC QLQ-C30 (version 3.0), when applied to Spanish prostate cancer patients. METHODS: A sample of 137 prostate cancer patients prospectively filled in the questionnaire three times: on the first and last day of the treatment, and in the followup period. Psychometric evaluation of the structure, reliability and validity was made. RESULTS: Multitrait scaling analysis showed that most item-scale correlation coefficients met the standards of convergent and discriminant validity. Few exceptions appeared mainly in CF Most scales had low to moderate inter-correlations. Cronbach's coefficients of the scales were above 0.7, except for the CF and NV values. Group comparison analyses showed better QL in patients with higher Performance Status. Changes in functioning and symptom areas appeared throughout the different measurements, which were in line with the treatment process. CONCLUSIONS: The EORTC QLQC30 (version 3.0) appeared as a reliable and valid instrument when applied to a sample of Spanish prostrate cancer patients. The results are in line with previous studies.


Assuntos
Neoplasias da Próstata , Qualidade de Vida , Inquéritos e Questionários , Idoso , Humanos , Masculino , Neoplasias da Próstata/diagnóstico , Espanha
4.
Arch. esp. urol. (Ed. impr.) ; 61(8): 949-954, oct. 2008. tab
Artigo em En | IBECS | ID: ibc-67677

RESUMO

Objective: The EORTC Quality of Life Group has developed a questionnaire for evaluating Quality of Life in international clinical trials: EORTC QLQ-C30, which is widely used in many countries. The purpose of this study was to assess the psychometric properties of the third version of this questionnaire, EORTC QLQ-C30 (version 3.0), when applied to Spanish prostate cancer patients. Methods: A sample of 137 prostate cancer patients prospectively filled in the questionnaire three times: on the first and last day of the treatment, and in the follow-up period. Psychometric evaluation of the structure, reliability and validity was made. Results: Multitrait scaling analysis showed that most item-scale correlation coefficients met the standards of convergent and discriminant validity. Few exceptions appeared mainly in CF. Most scales had low to moderate inter-correlations. Cronbach's coefficients of the scales were above 0.7, except for the CF and NV values. Group comparison analyses showed better QL in patients with higher Performance Status. Changes in functioning and symptom areas appeared throughout the different measurements, which were in line with the treatment process. Conclusions: The EORTC QLQ-C30 (version 3.0) appeared as a reliable and valid instrument when applied to a sample of Spanish prostrate cancer patients. The results are in line with previous studies (AU)


Objetivo: El Grupo de Calidad de Vida de la EORTC ha desarrollado un cuestionario para evaluar la Calidad de Vida en ensayos clínicos internacionales: EORTC QLQ-C30, el cual es ampliamente utilizado en muchos países. El objetivo de este trabajo es evaluar las propiedades psicométricas de la tercera versión de este cuestionario, EORTC QLQ-C30 (versión 3.0), al ser administrado a pacientes españoles con cáncer de próstata. Métodos: Una muestra de 137 pacientes con cáncer de próstata han contestado el cuestionario de forma prospectiva tres veces: el primer y último día de tratamiento, y durante el período de seguimiento. Se ha realizado una evaluación psicométrica de su estructura, fiabilidad y validez. Resultados: los análisis multirasgo-multimétodo han mostrado que la mayoría de las correlaciones ítem-escala satisfacían los criterios de validez convergente y divergente. Se han dado pocas excepciones, principalmente en la escala CF. La mayoría de las correlaciones entre escalas eran bajas o moderadas. Los coeficientes Alpha de Cronbach de las escalas eran superiores a 0,7, excepto en las escalas CF y NV. Los análisis de comparación entre grupos han indicado que se da una mejor Calidad de Vida en pacientes con mayor performance status. Se han dado cambios en áreas de funcionamiento y de síntomas a lo largo de las diferentes medidas, que han ido en línea con el proceso de tratamiento. Conclusiones: el EORTC QLQ-C30 (versión 3.0) se ha mostrado como un instrumento fiable y válido al ser aplicado a una muestra de pacientes españoles con cáncer de próstata. Los resultados van en línea con los estudios de validación previos (AU)


Assuntos
Humanos , Masculino , Adulto , Qualidade de Vida , Inquéritos e Questionários , Indicadores de Serviços , Indicadores de Qualidade de Vida , Neoplasias da Próstata/epidemiologia , Psicometria/métodos , Inquéritos e Questionários/classificação , Inquéritos e Questionários/normas , Perfil de Impacto da Doença
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