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Objectives: To compare the oncological outcomes between two open surgical techniques and two endoscopic approaches for the management of the distal ureter during laparoscopic radical nephroureterectomy (LRNU)., Material and Methods: Retrospective review of 152 patients submitted to LRNU for the management of upper urinary tract tumors between 2007-2014. We analyzed the potential impact of two different open surgical (extravesical vs intravesical) and two endoscopic (resection of ureteral orifice and fragment removal vs endoscopic bladder cuff) techniques on the development of bladder recurrence, distant/local recurrence and cancer-specific survival (CSS)., Results: A total of 152 patients with a mean age of 69.9 years (±10.1) underwent LRNU. We reported 62 pTa-T1 (41%), 35 pT2 (23%) and 55 pT3-4 (36%). Thirty-two were low grade (21.1%) and 120 high grade (78.9%). An endoscopic approach was performed in 89 cases (58.5%), 32 with resection (36%) and 57 with bladder cuff (64%), and open approach in 63 (41.5%), 42 intravesical (66.7%) and 21 extravesical (33.3%). Within a median follow-up of 32 months (3-120), 38 patients (25%) developed bladder recurrence, 42 distant/local recurrence (27.6%) and 34 died of tumor (22.4%). In the univariate analysis, the type of endoscopic technique was not related to bladder recurrence (P=.961), distant/local recurrence (P=.955) nor CSS (P=.802). The open extravesical approach was not related to bladder recurrence (P=.12) but increased distant/local recurrence (P=.045) and decreased CSS (P=.034) compared to intravesical approach., Conclusions: LRNU outcomes are not dependant on the type of endoscopic approach performed. The open extravesical approach is a more difficult technique and could worsen the oncological outcomes when compared to the intravesical., (Copyright © 2019 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)

Eradication of the hepatitis C virus (HCV) with interferon-free therapies (DAAs) has modified the course of the disease, as the rate of patients with compensated cirrhosis who achieve a sustained virological response exceeds 95%. However, the impact on development of hepatocellular carcinoma (HCC) is currently in dispute. This argument could be divided into different key points: the impact of DAA on rate of HCC recurrence, the temporal link between starting DAAs and HCC recurrence, and finally, the aggressive pattern of HCC. Therefore, the aim of this review is to analyse the available results in this population of patients from a clinical perspective where the risks and benefits of HCV eradication with DAA therapies are evaluated in patients with complete response of HCC., (Copyright © 2019. Publicado por Elsevier España, S.L.U.)

Turcot syndrome is an association of primary neuroepithelial tumors of the central nervous system with adenomatous polyposis coli. It is a genetic disorder, with two forms; In type I, glioblastomas are usually associated with hereditary nonpolyposis colorectal cancer (HNPC or Lynch). In Type II, medulloblastomas are often associated with familial adenomatous polyposis coli (classical or attenuated). This patient had a medulloblastoma at seven years of age, then 20 years later developed a meningioma which recurred several times. At 36 years old he presented with anemia after digestive bleeding, and an adenomatous polyposis coli with high grade dysplasia was found at colonoscopy. As far as we know, this is the first case of Turcot syndrome described in our country.

Objective: To evaluate the clinical, radiological and histological factors that can predict local recurrence of fibromatosis., Methods: A retrospective study was conducted on 51 patients diagnosed with fibromatosis in this hospital from 1983 to 2014. The mean follow-up was 83 months. A study was made of the clinical parameters, location, depth, size, surgical margins, and proliferation index (Ki-67). An evaluation was also made of the risk of recurrence depending on the adjuvant treatment and the relationship between treatment and patient functionality., Results: Tumour location and depth were identified as risk factors for local recurrence, showing statistically significant differences (P<.001 and P=.003, respectively). There were no statistically significant differences in age, gender, size, surgical margins, or adjuvant treatments, or in the Musculoskeletal Tumour Society Score according to the treatment received. The mean Ki-67 was 1.9% (range 1-4), and its value was not associated with the risk of recurrence., Discussion: Deep fibromatosis fascia tumours, and those located in extremities are more aggressive than superficial tumours and those located in trunk. The Ki-67 has no predictive value in local recurrence of fibromatosis. Radiotherapy, chemotherapy, or other adjuvant treatments such as tamoxifen have not been effective in local control of the disease. Given the high recurrence rate, even with adequate margins, a wait and see attitude should be considered in asymptomatic patients and/or stable disease., (Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: After pneumonectomy, the development of a new lung cancer or a recurrence in the residual lung is a challenge. Surgery often is considered contraindicated. The goal of our study is to assess the morbidity and mortality of lung resection on a single lung., Methods: All patients who underwent lung resection after pneumonectomy from January 1996 through December 2012 were reviewed., Results: There were 12 patients (10 men and 2 women). Mean age was 71 years (range, 54-81 years). Mean preoperative FEV1 was 1,470 ml (52%) and preoperative FVC 2,153 ml (61,5%). Subsequent pulmonary resection was performed after a median follow-up of 34,5 months. Wedge resection was performed in all patients. Diagnosis was pulmonary mestastatic lung cancer in 2 patients, metachronous lung cancer in 6, metastatic extrathoracic cancer in 3 and benign nodule in one. Complications occurred in 4 patients (33,4%) while operative mortality was nil., Conclusions: Lung resection on a single lung is a safe procedure associated with acceptable morbidity and mortality. Careful patient selection is very important., (Copyright © 2014 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objectives: Retrospectively to analyse the influence of clinical and histo-pathological characteristics in the local recurrence after non-small cell lung cancer surgery., Method: 146 patients were included and studied during a minimum of two years. The free survival of disease function (FSD) was constructed according to the Kaplan-Meier method. The univariant comparison of the FSD by Mantel-Haenszel means of logarithmic ranks test and the multivariant analysis by Cox regression model., Results: In the univariant analysis 20 months of FSD and the following predicting factors of a smaller FSD: Radiological contact of the tumour with the pleura (p=0.005), peritumoral margin affectation (p=0.001), pleural affectation (p=0.006), T stratification factor (p=0.04) and N factor (p=0.002). Other factors like age, initial symptoms, second neoplasias, radiological spiculations or cavitations, transtoracic puncion, type of surgery, peribronquial affectation, so large margin tumorlike and histological type, did not show statistically significant differences in the FSD. In the multivariant study they maintain its value prognosis the pleural affectation (p=0.0014), ganglionary affectation (p=0.02) and degree of differentiation (p=0.03)., Conclusions: The most important prognosis factor of local recurrence after surgery in these patients were the infiltration of the pleura, followed of the hilio-mediastinic ganglionary affectation and the degree of histological differentiation.

The endoscopical resection of the urether in the radical nephroureterectomy is an easy way to treat transitional cell carcinoma of the upper urinary tract. We want to present a complication derived from this surgical technique: the tumor implantation in the resected ureteral meatus zone.

We report a case of a 18-year-old male patient with his fourth relapse of a desmoid tumour of the left popliteal hollow after a traumatism in this area. Arterial displacement and extrinsic compression were showed by arteriography. Tumoration was extirpated including popliteal artery, in this way a terminal by-pass from distal femoral to peroneo-tibial trunks with contralateral great saphena was made. Diagnosis of intestinal polyposis and of the little osseous malformations, was discarded these pathologies frequently are related with these tumours. The research for 8 years and 4 months doesn't show any relapse, nor local neither multicentral. Furthermore, some considerations about this theme are reported.

Report of a retrospective study on 303 patients operated from colorectal carcinoma to whom colonic resection was done in B and C stages of Astler-Coller's classification. The aim was to try to find a relation between blood transfusion and colorectal carcinoma recurrence. The statistical study is made with the program LOGIT, studying the surgical incision, evolutive stage and blood transfusion variables. The significant contribution of each variable in the occurrence of recurrence is studied with the Wald Test. As a result it can be deduced that the prognosis of colorectal cancer is influenced by three factors: the evolutive stage, the surgical incision (1.87 times more frequent for the abdomino-perineal) and the transfusion of more of three units of blood in the perioperative period which multiplies by 2.85 the risk of recurrence of colorectal carcinoma. In our hospital almost exclusively red cell concentrates (including red cells, white cells and minimal fraction of plasma), are transfused; possibly the white cells are responsible for the recurrence.

More effective therapy of high-risk patients and less toxic CNS prophylaxis are two goals in present acute lymphoblastic leukemia treatment research. Protocol LA A 7/78 was based on: 1) Distribution of patients in 2 therapy groups: standard (SR) and high-risk (HR) according to presence of clinical and hematological prognostic factors. 2) Remission induction in SR with PRED, VCR and ASPAR, and as maintenance, combination of MP and MTX. HR patients were given 4 drugs, with addition of DAUNO; reinductions with PRED, VCR and DAUNO every 3 months were given as well. 3) CNS prophylaxis in both groups was given according two modalities, on a randomized base. "A": cranial irradiation (24Gy) plus i.t. MTX, 6 doses. "B": i.t. MTX and ARA-C, 10 doses (6 weekly and 4 monthly). From 1978 to 1983, 76 patients under 14 years old were entered in study: 22 in HR and 54 in SR groups. All attained remission. After a median follow-up of 49 months estimated disease-free survival rate is 65.6% corresponding to 70% in SR and 56% in HR. Modality "B" of SNC prophylaxis (without irradiation) was, at least, as effective as modality "A" in SR and HR groups; estimated disease free survival is 60.5% +/- 9% in "A" and 71 +/- 8.5% in "B" therapy. Mortality by infections in patients in remission was less than 4%. This low proportion can be attributed in part to continuous use of cotromoxazol. Main conclusions of this study are: 1. Need for more intensive induction and consolidation therapy, especially in high-risk patients, and 2. That prolonged (5 months) intrathecal chemotherapy can substitute cranial irradiation in CNS prophylaxis.

An evaluation is made of the clinical and histological parameters of 650 cases of spinocellular epithelioma. The statistical analysis shows tumor relapse to be related to tumor size, evolution time, relapse following previous treatments, earlier cutaneous lesions, Broders' grading, acantholysis, inflammatory infiltrate and type of treatment applied.

The AA. evaluate the incidence of peristomal recurrences among 349 total laryngectomies operated between 1975 and 1985, at ENT Service, Hospital Dr. Peset, Valencia. As possible etiologies they emphasize: first of all the infraglottic spreading of the tumor, the emergency tracheostomy done prior to the surgery of the larynx, and the lacking of irradiation of the tracheostoma.