Diffuse low-grade glioma: a review on the new molecular classification, natural history and current management strategies

The management of diffuse supratentorial WHO grade II glioma remains a challenge because of the infiltrative nature of the tumor, which precludes curative therapy after total or even supratotal resection. When possible, functional-guided resection is the preferred initial treatment. Total and subtotal resections correlate with increased overall survival. High-risk patients (age >40, partial resection), especially IDH-mutated and 1p19q-codeleted oligodendroglial lesions, benefit from surgery plus adjuvant chemoradiation. Under the new 2016 WHO brain tumor classification, which now incorporates molecular parameters, all diffusely infiltrating gliomas are grouped together since they share specific genetic mutations and prognostic factors. Although low-grade gliomas cannot be regarded as benign tumors, large observational studies have shown that median survival can actually be doubled if an early, aggressive, multi-stage and personalized therapy is applied, as compared to prior wait-and-see policy series. Patients need an honest long-term therapeutic strategy that should ideally anticipate neurological, cognitive and histopathologic worsening (AU)

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Diffuse low-grade glioma: a review on the new molecular classification, natural history and current management strategies.

The management of diffuse supratentorial WHO grade II glioma remains a challenge because of the infiltrative nature of the tumor, which precludes curative therapy after total or even supratotal resection. When possible, functional-guided resection is the preferred initial treatment. Total and subtotal resections correlate with increased overall survival. High-risk patients (age >40, partial resection), especially IDH-mutated and 1p19q-codeleted oligodendroglial lesions, benefit from surgery plus adjuvant chemoradiation. Under the new 2016 WHO brain tumor classification, which now incorporates molecular parameters, all diffusely infiltrating gliomas are grouped together since they share specific genetic mutations and prognostic factors. Although low-grade gliomas cannot be regarded as benign tumors, large observational studies have shown that median survival can actually be doubled if an early, aggressive, multi-stage and personalized therapy is applied, as compared to prior wait-and-see policy series. Patients need an honest long-term therapeutic strategy that should ideally anticipate neurological, cognitive and histopathologic worsening.

SEOM recommendations on the structure and operation of hereditary cancer genetic counseling units (HCGCUs)

INTRODUCTION: Approximately 5 % of all cancer cases are hereditary. Cancer genetic counseling assesses individual and family risks of cancer, conducts genetic studies, interprets results, and advises patients regarding strategies for prevention and risk reduction. Currently, many networks of hereditary cancer genetic counseling units (HCGCUs) are integrated in the medical oncology services of most Spanish hospitals, which are comprised of multidisciplinary teams and offer high-quality care for the treatment of hereditary cancer. MATERIALS AND METHODS: The Spanish Society of Medical Oncology (SEOM) analyzed key issues involving the integration of HCGCUs into the National Health Service. These included basic compliance issues by these units regarding their operation and organization, as well as prerequisites in quality control thereof. RESULTS: This document describes the specific roles and clinical processes performed in HCGCUs in addition to basic services provided by molecular diagnostic laboratories. It also provides a summary on the coordination of care across different levels for patients and families with hereditary cancers. Finally, this document describes the human and material resources needed for the organization of HCGCUs. CONCLUSIONS: SEOM has been a pioneer in the creation and development of HCGCUs. This paper seeks to ensure high-quality care to individuals and families with inherited susceptibility to cancer in Spain (AU)

Hemangioendotelioma epitelioide. Presentación de un caso diagnosticado a partir de lesión cutánea / Epithelioid haemangioendothelioma. Report of a case diagnosed from a dermal lesion

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Tratamiento del carcinoma diseminado de estómago: ¿pauta estándar? / No disponible

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[Capecitabine: an oral chemotherapeutic agent against metastatic breast and colorectal cancer]. / Capecitabina: un quimioterápico oral en la lucha contra el cáncer de mama y colorrectal metastásico.

Capecitabine is the first drug in a new fluoropyrimidine class that offers distinct characteristics. On one hand its oral administration mimics continuous fluorouracil infusion while remaining convenient with higher patient acceptance and compliance rates and avoiding intravenous administration-associated complications and financial costs. On other hand it provides intra-tumour selective activation, thus potentially facilitating local management and therefore improved anti-tumour activity as well as reduced systemic toxicity. The concentration of thymidine phosphorylase an enzyme essential for capecitabine activation in tumour cells increases after exposure to cytotoxics such as taxanes, cyclophosphamide, gemcitabine or vinorelbine, which results in synergistic activity. It has been tried both as monotherapy and in combination with other chemotherapy agentsâboth in first-line regimes and in previously treated patients against metastatic colorectal and breast cancer, results being very good in terms of efficacy and tolerability.

Ancianos con cáncer: cómo son y cómo los tratamos / Cancer in the old: what they are like and how they are treated

Propósito: La esperanza de vida aumenta progresivamente en los países occidentales y en igual medida la población envejece. Al ser la edad el mayor factor de riesgo de cáncer, el número de pacientes ancianos aumenta rápidamente y pronto constituirán el grupo más numeroso en la práctica clínica habitual. los objetivos del estudio han sido conocer las característicos básicas de la población anciana diagnosticada de cáncer en nuestra unidad, conocer la comorbilidad presente y cuáles fueron las decisiones terapéuticas y sus condicionantes. Material y métodos: Se han revisado las historias de los 384 pacientes diagnosticados de cáncer en nuestra unidad durante el año 1997. La edad de corte que determina la población anciana ha sido fijada arbitrariamente en los 70 años. Se recogieron datos básicos de todos los pacientes y en mayores de 70 años, datos acerca de la extensión de la enfermedad, tratamiento realizado y comorbilidad. Se ha realizado análisis estadístico descriptivo simple para evaluar las diferentes variables y comparaciones de frecuencia de diferentes variables entre grupos de edad, y entre grupos con diferente número de comorbilidades. Resultados: Los resultados muestran que un elevado número de pacientes ancianos llegó a nuestra consulta en su primera visita con mal estado funcional y enfermedad avanzada. La prevalencia de comorbilidad asociada fue alta. Los pacientes con peor estado funcional presentaban mayor número de comorbilidades. Con elevada frecuencia se realizó exclusivamente tratamiento sintomático. Conclusiones: La adecuada valoración y comprensión de las interacciones entre comorbilidad, cáncer y su tratamiento es un reto para la oncología geriátrica. El paso siguiente será revisar un nuevo grupo de pacientes en los años venideros y determinar si se confirman las previsiones poblacionales y se objetivan modificaciones en cuanto a la presentación de la enfermedad y a las decisiones de tratamiento adoptadas por el médico especialista (AU)