Burden of focal cryoablation versus brachytherapy versus active surveillance in the treatment of very low-risk prostate cancer: a preliminary head-to-head comprehensive assessment.

Focal cryoablation (FC), brachytherapy (B) and active surveillance (AS) were offered to patients diagnosed with very low-risk prostate cancer (VLRPC) in an equal access protocol. Comprehensive validated self-report questionnaires accessed patients' erectile (IIEF-5) and voiding (IPSS) functions, Beck scales measured anxiety (BAI), hopelessness (BHS) and depression (BDI), SF-36 reflected patients' quality of life added to the emotional thermometers including five visual analogue scales (distress, anxiety, depression, anger and need for help). Kruskal-Wallis or ANOVA tests and Spearman's correlations were obtained among groups and studied variables. Thirty patients were included, median follow-up 18 months (15-21). Those on AS (n = 11) were older, presented higher hopelessness (BHS) and lower general health perceptions (SF-36) scores than patients opting for FC (n = 10) and B (n = 9), P = 0.0014, P = 0.0268 and P = 0.0168 respectively. Patients on B had higher IPSS scores compared to those under FC and AC, P = 0.0223. For all 30 included patients, Spearman's correlation (rs ) was very strong between BHS and general health perceptions (rs  = -0.800, P < 0.0001), and weak/moderate between age and BHS (rs  = 0.405, P = 0.026) and age and general health perceptions (rs  = -0.564, P = 0.001). The sample power was >60%. To be considered in patients' counselling and care, current study supports the hypothesis that even VLRPC when untreated undermines psychosocial domains.

Tratamento cirúrgico conservador do câncer de mama / Conservative surgical treatment of cancer of the breast

Os autores descrevem as variaçöes técnicas da quadrantectomia e a incisäo padräo axilar para o tratamento do carcinoma de mama estádios I e II. Salientam a importância do planejamento pré-cirúrgico, onde a presença do cirurgiäo plástico é indispensável a fim de se obter um bom resultado estético. Após o tratamento primário, as 77 pacientes foram tratadas com irradiaçäo e 36 delas receberam quimioterapia, devido ao envolvimento ganglionar axilar. As complicaçöes dos tratamentos foram mínimas. Após seguimento médio de 50 meses, näo se observou diferença quanto à recidiva local (2,5% x 3,89%) e metástases a distância, quando se comparou estas pacientes àquelas tratadas com mastectomia radical, mantendo-se equiparáveis o intervalo livre de doença e a sobrevida total