Molecular subtypes in early colorectal cancer associated with clinical features and patient prognosis

Purpose: After surgical resection, an ample prognosis variability among stages is observed. Multiple prognostic factors are individually studied and some CRC classifiers have been proposed. Not one have been implemented into clinical practice. Methods/patients: We classified 105 patients with resected CRC (stage I-III) into five molecular subtypes using BRAFV600E and RAS (KRAS; NRAS) status, and the expression of DNA mismatch repair (MMR) proteins (MLH1 and MSH2). Clinicopathological features and DFS) of distincts groups were evaluated. Results and conclusions: RAS and BRAFV600E mutations were detected in 43.8 and 11.4% of patients, respectively. 19% of tumours had lack of expression of any MMR proteins reflecting a system deficiency (dMMR). Patients with any RAS mutation had lower DFS that patients with RAS wild type (wt) (40.23 vs 45.26 months; p value = 0.035). Of a total of five molecular subtypes, three were MMR proficient (pMMR): RAS mutated (39%), BRAFV600E mutated (6.7%) and RAS/BRAFV600E wt (35.2%); and two were dMMR: BRAFV600E mutated (4.8%) and BRAFV600E wt (14.3%). Left side tumours were more frequently observed in pMMR/RAS and BRAFV600E wt subtype, and right side tumours in dMMR subtypes. Among the three pMMR subtypes, a benefit survival was observed for patients without any mutation in BRAFv600E or RAS oncogenes (median of DFS = 45.5 vs 40.98 months in RAS mutated group; p = 0.084 and vs 34.13 in BRAFv600E mutated group; p = 0.031). Molecular classification using these biomarkers can be useful to identify groups with differences in prognosis

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Necrosis ósea avascular (NOA) de cabeza femoral en paciente con enfermedad de Hodgkin (EH) tratado con quimioterapia / Femoral head avascular osteonecrosis,(AON) in patient with Hodgkin disease (HD) treated with chemotherapy

Propósito: Descripción de un caso de NOA bilateral de cabeza femoral como complicación del tratamiento con quimioterapia de la EH. Valoramos la necesidad de un diagnóstico precoz de esta complicación. Material y métodos: Varón de 28 años diagnosticado de EH tratado con quimioterapia. Presenta NOA bilateral de cabeza femoral a los 10 meses de finalizado el tratamiento. Conclusiones: El seguimiento en pacientes con EH tratados con quimioterapia mediante radiografía simple de las articulaciones coxofemorales, puede ser útil en el diagnóstico precoz de la NOA (AU)