Validation of the International Metastatic Renal-Cell Carcinoma Database Consortium (IMDC) prognostic model for first-line pazopanib in metastatic renal carcinoma: the Spanish Oncologic Genitourinary Group (SOGUG) SPAZO study.

BACKGROUND: Patients with metastatic renal carcinoma (mRCC) treated with first-line pazopanib were not included in the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) prognostic model. SPAZO (NCT02282579) was a nation-wide retrospective observational study designed to assess the effectiveness and validate the IMDC prognostic model in patients treated with first-line pazopanib in clinical practice. PATIENTS AND METHODS: Data of 278 patients, treated with first-line pazopanib for mRCC in 34 centres in Spain, were locally recorded and externally validated. Mean age was 66 years, there were 68.3% male, 93.5% clear-cell type, 74.8% nephrectomized, and 81.3% had ECOG 0-1. Metastatic sites were: lung 70.9%, lymph node 43.9%, bone 26.3%, soft tissue/skin 20.1%, liver 15.1%, CNS 7.2%, adrenal gland 6.5%, pleura/peritoneum 5.8%, pancreas 5%, and kidney 2.2%. After median follow-up of 23 months, 76.4% had discontinued pazopanib (57.2% due to progression), 47.9% had received second-line targeted therapy, and 48.9% had died. RESULTS: According to IMDC prognostic model, 19.4% had favourable risk (FR), 57.2% intermediate risk (IR), and 23.4% poor risk (PR). No unexpected toxicities were recorded. Response rate was 30.3% (FR: 44%, IR: 30% PR: 17.3%). Median progression-free survival (whole population) was 11 months (32 in FR, 11 in IR, 4 in PR). Median and 2-year overall survival (whole population) were 22 months and 48.1%, respectively (FR: not reached and 81.6%, IR: 22 and 48.7%, PR: 7 and 18.8%). These estimations and their 95% confidence intervals are fully consistent with the outcomes predicted by the IMDC prognostic model. CONCLUSION: Our results validate the IMDC model for first-line pazopanib in mRCC and confirm the effectiveness and safety of this treatment.

Prognostic value of the detection of lymph node micrometastases in colon cancer

INTRODUCTION AND OBJECTIVES: A study is made of the clinical repercussions of occult metastases-micrometastases (MMs+)-or isolated tumour cells (ITCs+) in the lymph nodes of patients with stage IIA and IIB colon adenocarcinoma initially considered as corresponding to N0. MATERIAL AND METHODS: A retrospective study of 39 patients with stage IIA and IIB (T3-T4 N0 M0) colon adenocarcinoma, subjected to similar surgical and adjuvant chemotherapy treatment, with long and careful follow-up (minimum: 5 years, mean: 81.7 months) was performed on their previously resected lymph nodes, with the aid of new histological and immunohistochemical (cytokeratin) sections, in order to detect MMs or ITCs. Disease-free survival (DFS) and global survival (GS) in the two groups (patients with MMs+ or ITCs+ vs. patients without MMs or ITCs) were compared at 5 years based on the corresponding Kaplan-Meier survival curves, with the Breslow test. RESULTS: A total of 382 lymph nodes from the 39 patients (mean: 9.8; standard deviation: 6.09) were revised. MMs+ were detected in 2 cases and ITCs+ in 2 more cases on the Cytokeratin study. GS of the whole series at 5 years was 89.74% (35 patients alive) with a DFS at 5 years of 79.49% (31 patients free of disease), but the 2 cases with MMs+ were dead at 5 years, with high statistical differences between both groups (MMs+/MMs-) (p<0.0001). When comparing the group of MMs+/ITCs+ patients and the group of MM-/ITCs- patients, the DFS and GS times at 5 years were higher in the MMs-/ITCs- group (p=0.0692 and p=0.006 respectively). CONCLUSIONS: Although the incidence of MMs+ or ITCs+ in the examined lymph nodes was low, the presence of MMs is related to a dramatic reduction in GS and DFS at 5 years. We encourage a detailed histological study of lymph nodes resected in patients with deep penetrating colon tumours in order to assure a pN0 status (AU)

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Carcinomatosis peritoneal mucinosa tratada con cisplatino (CDDP) intraperitoneal y 5-FU endovenoso / Mucinous peritoneal carcinomatosis treated with intraperitoneal cisplatin (CDDP) and intravenous 5-FU

• Propósito: describir el tratamiento de una entidad clínica poco frecuente de curso clínico variable.• Material y método: se presenta el caso de un paciente con carcinomatosis peritoneal mucinosa, varianteintermedia.• Resultados y conclusiones: una cirugía de citoreducción adecuada, seguida de quimioterapia conCDDP Intraperitoneal (IP) y 5FU ev, puede lograr una larga supervivencia en pacientes afectos de carcinomatosisperitoneal, con buena tolerancia al tratamiento

• Purpose: To describe the treatment of a slightly frequent clinical entity of variable clinical course.• Material and methods: We present the case of a patient with mucinous peritoneal carcinomatosis,intermediate variant.• Results and conclusion: A suitable cytoreductive surgery, followed by chemotherapy withintraperitoneal CDDP and intravenous 5-FU, can achieve a long survival of patients with peritonealcarcinomatosis, with good tolerance for the treatment

Adenocarcinoma colorrectal: factores pronósticos de supervivencia en el tratamiento adyuvante con 5-Fluorouracilo-Levamisol (5FU-Lev) / Colorectal adenocarcinoma: survical prognostic factors of the adjuvant treatment with 5-fluorouracil-levamisole (5FU-LEV)

- Propósito: Valoración de la supervivencia global (SG) y libre de enfermedad (SLE) a 5 años y estudio de los factores pronósticos de los pacientes operados, con finalidad curativa, de adenocarcinoma colorrectal estadios II y III, que recibieron tratamiento adyuvante con 5FU-LEV.- Material y métodos: ciento veintiséis pacientes tratados con esquema 5FU-LEV durante 12 meses, entre septiembre de 1990 y noviembre de 1997.- Resultados: La SG a los 5 años es de 68.3 por ciento y la SLE de 54 por ciento. El número de ganglios afectos por el tumor y la afectación vásculo-linfática y perineural, han resultado factores pronósticos significativos tanto en la SLE como en SG a los 5 años. La existencia de obstrucción intestinal tan sólo resulta factor pronóstico significativo en la SLE a los 5 años.- Conclusiones: los resultados que presentamos son semejantes a otras grandes series conocidas, tanto en supervivencia global y libre de enfermedad como en el estudio univariante de los factores pronósticos. La afectación ganglionar continúa presentando significación pronóstica con el análisis multivariante (AU)