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Introduction: different variables have been associated with a worse prognosis of patients with osteosarcoma (OS), highlighting tumor size, location in the axial skeleton and the presence of metastases. The objective of this study is to analyze the prognostic impact of diagnostic delay in osteosarcoma in adults in the Mexican population in a center specialized in sarcomas. Material and methods: retrospective cohort study from January 1, 2005, to December 31, 2016, 96 patients over 21 years of age with a diagnosis of osteosarcoma were analyzed. Results: the median time to diagnosis from the onset of symptoms was six months (range: 2-36). This variable was dichotomized by applying the operator-dependent curve (ROC) analysis and we determined a cut-off value greater than five months, with an area under the curve (AUC) = 0.93 [95% CI 0.86-0.97], sensitivity 93.2% and specificity 94.6%. Conclusion: time until diagnosis is a critical factor in the survival of adult patients with osteosarcoma, highlighting its influence on disease progression and the appearance of metastasis. The correlation between diagnostic delay and an unfavorable prognosis reinforces the need for rapid and efficient evaluation in suspected cases of osteosarcoma. [ABSTRACT FROM AUTHOR]

In non-small cell lung cancer (NSCLC) with classical EGFR mutation, EGFR tyrosine kinase inhibitors (TKIs) produce better results than platinum-based chemotherapy. However, therapeutic efficacy is quite different in patients with EGFR exon 20 insertion mutations (ex20ins) versus common mutations. Patients with ex20ins mutations are insensitive to EGFR-TKIs and have poor prognosis. It is important to know the demographic and clinical characteristics in this group of patients and the prevalence in our region. Methodology: retrospective, single institution, case series review of patients with non-small cell lung cancer with exon 20 insertion mutations from 2017-2023. Patients had received first-line therapy for advanced disease and had imaging studies to assess response. Demographics, characteristics, and treatment of each patient were recorded. Treatment response was assessed using RECIST v1.1 criteria and overall survival was calculated using the Kaplan Meier method. Results: Among the 15 patients identified with non-small cell lung cancer with exon 20 insertion mutations at our institution, the incidence for the mutation was 1.5%. The mean age was 60 years, 46.7% were women, and the incidence of the mutation was 1.5%. The average age was 60 years, 46.7% were women, 14 patients were Hispanic and 1 patient was Asian, only 3 patients had a history of smoking. Forty percent of the patients had an Eastern Cooperative Oncology Group (ECOG) functional score of 2. The histologic subtype was adenocarcinoma in all cases. Of the 13 (86.7%) patients who received first-line treatment had evaluable scans to determine response, 11 progressed, 1 patient had stable disease, and 1 patient had a partial response. The median overall survival (OS) was 5 months. Conclusions: Patients with exon 20 insertion mutations have resistance to tyrosine kinase inhibitors, which confers a worse prognosis. It is vital to know in our region the incidence of the mutation and patient characteristics to provide timely diagnosis and treatment. Our results provide an important context for the development of new therapies that can be approved in the first line of treatment and not in subsequent lines. [ABSTRACT FROM AUTHOR]

Copyright of Gaceta Médica de Caracas is the property of Academia Nacional de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Ciencias Médicas de Pinar del Río is the property of Editorial Ciencias Medicas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Heart surgical intervention is complex, but with satisfactory results for the patient, because it increases his survival and life quality. The low cardiac output syndrome in the postoperative period is one of the entities that darkens the prognosis of this operation and elevates the morbidity and mortality indexes in these patients. Objective: To estimate the survival of patients with low cardiac output syndrome in the postoperative period according to clinical and echocardiographyc variables. Methods: A cohort investigation of survival in 56 operated patients was carried out, who were diagnosed with postoperative low cardiac output syndrome and were assisted in the Cardiology and Cardiovascular Surgery Center of Santiago de Cuba, from January, 2019 to November, 2021. Results: There was prevalence of the 65 years and over age group (60.7%), the diabetes mellitus (44.6%) as personal pathological history and patients with ejection fraction of 45% or more who presented higher quantity of deaths (29.8%). The function of the affected right ventricle was found in 52.6% of deaths. The time of extracorporeal circulation of 90 minutes or more prevailed in 67.9% of those affected, of whom 42.1% died. Conclusions: It was observed that diabetes mellitus, the time of extracorporeal circulation and the long perioperative bleeding, as well as the biventricular systolic function was related to the prognosis of low cardiac output syndrome in the postoperative period. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The poor survival of patients with high-grade malignancy brain tumors, despite the existence of some treatment options, leads to the search for new therapeutic modalities. The cuban combination of alpha and gamma interferons is novel and there is evidence that it increases the survival of patients with solid tumors. Method: A clinical investigation was conducted to determine the efficiency of the combination in patients with highgrade brain tumors without therapeutic options. 40 patients treated at the “Arnaldo Milián Castro” Hospital in the period 2009-2020 were included, safety and efficacy were evaluated. Results: No serious adverse events occurred, events were mild or moderate, expected, and patients recovered. After one year, 8.7 % of the cases in the experimental group had died, compared to 70.6 % in the control group. Overall survival in stage III was similar in both scenarios and in stage IV it was higher for the experimental group. The chance of survival for the patients who were treated with the combination of interferons was 0.887 times higher than the control cases. There were significant differences in functional capacity between both groups of patients. Conclusions: It was evidenced that the Cuban combination of interferons is safe and effective for the treatment of high-grade malignancy brain tumors without therapeutic options, which makes it an efficient option in this clinical scenario. [ABSTRACT FROM AUTHOR]

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Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Depression stands out as the most prevalent psychiatric condition in the field of oncology. The diagnosis or potential diagnosis of cancer significantly affects the mental well-being of both patients and their family members, given the profound impact the disease attributes to the individual's new state of health. The article aims to provide and updated understanding of the current knowledge regarding the epidemiology, etiology, pathogenesis, diagnostic tools, and treatment concerning the intricate relationship between cancer and the development of depressive disorders. To achieve this objective, a comprehensive bibliographic search was carried out using the keywords depression, cancer, and the AND command for the term depression and cancer across PubMed, Scopus, SciELO, and Google Scholar databases. The search spanned multiple languages, including Spanish, English, and French, covering the period from 2010 to 2023. A total of 55 articles, selected by the authors for their relevance to the review's objective, were included. The review revealed a clear association between cancer and the development of major depressive disorder, was evidenced with a high prevalence rate of at least 40%. This association is attributed to a complex interplay of genetic, epigenetic, and environmental factors. Various validated tools, such as the Hospital Anxiety and Depression Scale (HADS), the Beck Depression Scale and the Montgomery-Åsberg Depression Rating Scale (MADRS) have been employed to assess depression in cancer patients. In conclusion, once a diagnosis of depressive disorder is confirmed within the oncology population, a combination of pharmacotherapy and/or psychotherapy is recommended. This approach, not only aims to enhance the quality of life for patients but also plays a crucial role in preventing treatment noncompliance and increasing overall survival rates. [ABSTRACT FROM AUTHOR]

As the world’s population lives longer and longer and has more cardiovascular risk factors, there is a greater prevalence of cardiovascular disease, including heart failure. Advances in medical knowledge, specifically in molecular, physiological and clinical fields, provide new and improved pharmacological treatments, cardiac devices and surgical procedures today which have optimized this condition’s prognosis. The available surgical procedures for treating heart disease include heart transplantation, which is useful for patients with advanced disease or disease which is refractory to the ordered and implemented interventions. The world’s first heart transplant was performed in 1967, and Colombia’s first in 1985. As of 2021, more than 1,400 heart transplants had been performed in this country. This procedure seeks to improve the quality of life and survival of patients who need it. The purpose of this article is to compile the historical events surrounding this surgical procedure around the world and in Colombia. [ABSTRACT FROM AUTHOR]

For a long time, the classification of central nervous system (CNS) tumors has been based on histological findings supported by complementary tests, such as immunohistochemistry, established in tissues. The fifth edition of the World Health Organization (WHO) Classification of Tumors of the Central Nervous System, published in 2021 (CNS-5), incorporates numerous molecular markers with clinical-pathological utility that are important for a more accurate classification of CNS neoplasms. These markers help to define adult diffuse gliomas, including IDH-mutant oligodendroglioma with 1p/19q codeletion (grades 2-3), IDH-mutant astrocytoma without 1p/19q codeletion (grades 2-4), and wild-type IDH glioblastoma (GBM). The median survival in patients with GBM is only 14.6 months, primarily due to resistance to the most widely used treatment protocol worldwide, which involves surgery, radiotherapy, and chemotherapy with temozolomide (TMZ), a potent genotoxic alkylating agent. The selection criteria for treatment and the estimation of prognosis in patients with this disease are predominantly based on clinical and pathological factors. In recent years, numerous molecular alterations have been reported, expanding our understanding on the biology of these tumors. However, only a few of these molecular alterations serve as biomarkers that influence clinical decision-making and treatment strategies. This article reviews the molecular alterations reported in peripheral blood for high-grade gliomas and emphasizes the importance of standardizing new biomarkers alongside histological findings to enhance our knowledge of these tumors. [ABSTRACT FROM AUTHOR]

Introduction: Cervical cancer is the second most common malignant neoplasm affecting women in the Republic of Panama. Although it can be detected in early stages, patients in advanced stages associated with renal failure still arrive for care at the Institute. The objective of our work consists of reviewing the clinical evolution of patients with renal failure secondary to cervical cancer at the National Oncology Institute (ION) of Panama in a period from 2015 to 2020 in order to be able to make recommendations in the management of these. Material and Methods This is a retrospective and descriptive study. For the purposes of the study, creatinine levels greater than 2 mg/dL were considered. Quality of life was assessed by applying specific questionnaires that are not part of the Institute's patient care. In order to identify the cases, a cross-checking of data of patients with a diagnosis of cervical cancer and creatinine greater than 2 mg/dL was performed. Results. The total number of cases that could be reviewed was 65. 94% of the cases corresponded to the histological type of squamous cell carcinoma. The most frequent stage was IIIB (44%). The ECOG index 0/1 (72%). Arterial hypertension was present in 35% of cases and diabetes in 5%. There were patients in all creatinine ranges used. Of the 65 cases received some type of oncologic treatment. 36 of the 55 were treated with radiotherapy or radiochemotherapy. 10 patients could not receive any treatment due to poor general condition. The average overall survival was 7 months. The group aged 20-29 years had a better initial survival, but at 10 months this difference was lost. Conclusions The median overall survival of patients with renal failure secondary to cervical cancer in our study was 10 months and did not vary significantly according to the type of renal shunt used. [ABSTRACT FROM AUTHOR]

Copyright of Revista Habanera de Ciencias Médicas is the property of Universidad de Ciencias Medicas de La Habana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To determine the clinical, epidemiological and therapeutic characteristics of malignant ovarian germ cell tumors. Materials and Methods: Retrospective cross-sectional observational descriptive study where the characteristics of 67 patients with a diagnosis of malignant ovarian germ cell tumors attended at the National Oncologic Institute from January 2012 to December 2021 were evaluated by electronic file. Results: The prevalence of malignant ovarian germ cell tumors in the study population was 8.6%. The predominant age group was in the second and third decade of life in 80.59%. Almost 40% of the patients were of native ethnicity. The most frequent histologic type was dysgerminoma followed by immature teratoma, mixed tumor and endodermal breast tumor. 52% were nulligestosis. 96% of the patients had some symptoms at diagnosis and the main symptom was abdominal pain. There was no association between a specific tumor marker and histologic type. 95% received surgical treatment. 95.52% were able to undergo surgery, of which 89% had their fertility preserved. 60% required chemotherapy and the most commonly used scheme was Bleomycin, Etoposide and Platinum. 6% recurred, 13% died, an overall survival of 86% was obtained. Conclusion: Malignant germinal tumors in our population have a prevalence of 8.6%, they predominate in the third decade of life and in mixed race and native patients. The cause of the high prevalence in the native ethnic group is unknown. The most frequent histological type is dysgerminoma. There was no specific correlation between histologic type and associated tumor marker. 6% of patients with malignant germ cell tumors recur, 13% die, obtaining an overall survival of 87%. [ABSTRACT FROM AUTHOR]

Background and objectives: 720,000 new cases of rectal cancer are reported each year. In the locally advanced stage (LARC), multimodal therapy followed by surgery with total mesorectal excision (TME) is the standard of care with potential benefits in acute toxicity, response assessment and resectability. The objective is to describe the clinicopathological characteristics and oncological results in patients treated with neoadjuvant chemoradiation therapy followed by radical surgery. Methods: A descriptive, non-experimental, cross-sectional and retrospective study in which the clinical records of 141 patients diagnosed with LARC defined as cT3T4N0 or cTXN+M0 scheduled for treatment with neoadjuvant chemoradiation therapy at the National Oncology Institute during the period from January 2014 to December 2019 were analyzed. Results: A total of 119 patients completed neoadjuvant chemoradiotherapy followed by radical surgery, resulting in a resectability of 90.1%. The overall rate of postoperative complications was 17.4%. The pCR and downstaging rate was 19.6% and 70.6%, respectively. Preoperative N category was the only variable with a statistically significant impact regarding pCR vs no pCR (p = 0.04). The median follow-up was 39 months, obtaining a 5-year overall survival of 69% and a 5-year disease-free survival of 74.4%. Conclusion: At the National Oncology Institute of Panama, the treatment of LARC with a long course of chemoradiation therapy followed by surgery with curative intent demonstrated high adherence to treatment with a rate of complete pathological response and local control in accordance with international reports. [ABSTRACT FROM AUTHOR]

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Habanera de Ciencias Médicas is the property of Universidad de Ciencias Medicas de La Habana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: thyroid cancer (CT) is the most common endocrine cancer in the world, with an increasing incidence. According to figures from the World Health Organization, it is the eighteenth most common cancer pathology in men and women. This increase presented in much of the world is occurring markedly at the expense of papillary type CT, which represents 85 % of CT, but has also noticed an increase of follicular type. The use of radioactive iodine for the treatment of thyroid cancer after initial thyroidectomy is discussed. Methodology: a narrative review of the literature published in Colombia and abroad in the last two decades was carried out. Elsevier and Medline databases were consulted through portals such as Clinicalkey and Ovid, using the terms Thyroid cancer, Thyroidectomy, Endocrinology, Thyroid nodule and their equivalents in Spanish. The unit of analysis was differentiated thyroid cancer and its post-surgical management with iodotherapy, according to its stratification. Results: the available literature contains numerous scientific evidences to support the influence of post-surgical therapy with iodine in the prognosis of patients with this condition, which will depend on risk stratification of recurrence. Conclusion: post-surgical iodotherapy is not recommended in low-risk ATA Differentiated Thyroid Cancer (DTC); intermediate-risk patients with aggressive tumor characteristics present benefits in overall survival; for high-risk patients it is recommended routinely. [ABSTRACT FROM AUTHOR]

We present the recent report of a 22-year-old patient with primary central nervous system (CNS) germinoma, cured with chemotherapy and radiotherapy. The authors commented on the rarity of this neoplasm which is usually located in the midline near the pineal gland, the alpha-fetoprotein and chorionic gonadotropin markers, the indication for neoadjuvant chemotherapy and reduced dose radiotherapy, and the favorable prognosis, with an overall survival of up to 70%. They emphasized the current limitations in terms of dose and extent of radiation to the CNS, as well as the use of chemotherapy alone or neoadjuvant chemotherapy. The additional comments that we are about to present seek to highlight the importance of the initial report, increasing interest in primary CNS tumors. [ABSTRACT FROM AUTHOR]

Introduction: Peritoneal mesotheliomas originate from the cells lining the serosa of the body cavities, 15% originate from the peritoneum. Their incidence is 0.2 to 3 cases per million personnel per year. They are rare tumors and their overall survival is limited to 12 months. The aim of this case report is to describe an atypical presentation of this entity and to review the literature. Materials and methods: A description of a case was made in the oncology outpatient clinic diagnosed with well-differentiated papillary mesothelioma of primary peritoneum diagnosed in 2012 who in 2022 maintains 10 years of overall survival and a review of the literature was performed based on the clinical case. Results: We define the types of peritoneal mesothelioma, its clinical features, the management of peritoneal mesothelioma according to the Chicago Consensus, the principles in supportive care such as peritoneal ascites, pain, nausea and vomiting, psychosocial distress, as well as the discussion of the case. Conclusion: Peritoneal mesothelioma is a rare disease that can be rapidly progressive with a significant disease burden and limited prognosis. The early establishment of palliative care in patients with incurable neoplasm such as peritoneal mesothelioma allows the approach to a better quality of life of the patient, as well as to meet objectives according to the clinical situation of each patient. [ABSTRACT FROM AUTHOR]

Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective. Estimate five-year survival from cervical cancer and associated factors in Mexican patients financed by Seguro Popular during the period 2006-2014. Materials and methods. We analyzed the database of patients financed by the Catastrophic Expenses Protection Fund and linked it to the Statistical and Epidemiological System of mortality. We performed a five-year survival analysis by clinical stage and associated factors, using the Kaplan-Meier method and Cox proportional hazards models. Results. Overall survival for cervical cancer at five years was 68.5%. The associated factors were the clinical stage: locoregional (HR=2.8 CI95% HR: 2.6,3.0) and metastatic (HR=5.4 CI95% HR: 4.9,5.9) compared to early stage and age (HR=1.003 CI95% HR:1.001,1.004). Conclusions. Women who gained access to Catastrophic Expenses Protection Fund cervical cancer care had similar survival than that reported in other studies. [ABSTRACT FROM AUTHOR]

Copyright of Acta Médica Peruana is the property of Colegio Medico del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Chilena de Urologia is the property of Sociedad Chilena de Urologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Habanera de Ciencias Médicas is the property of Universidad de Ciencias Medicas de La Habana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: the prognosis of patients with metastatic cancer of unknown origin is precarious, only 25% of patients are alive at one year. Objective: to determine the influence of histopathological diagnosis on one-year survival in patients with cancer metastases of unknown origin. Methods: an observational cohort study was conducted with patients admitted to the "Arnaldo Milián Castro" Hospital in the period from January 2011 to December 2017. Results: 57 patients were studied, 10 were alive and 47 died. Arterial hypertension (47.4%) and smoking (45.6%) were the most frequent personal pathologic antecedents. Asthenia, anorexia and weight loss, among others, were the clinical manifestations at admission most significantly associated with mortality. In the group of deceased patients the mean values of hemoglobin, serum albumin and triglycerides were significantly lower, while lactate dehydrogenase was higher. Patients with unknown primary tumor did not survive to one year and approximately 20% survive to six months, those with a diagnosis of poorly differentiated adenocarcinoma approximately 10% survived to 11 months and patients with lung primary survived approximately 10% to one year. Having unknown primary tumor increased the risk of dying approximately 3.6-fold, poorly differentiated adenocarcinoma 2.0-fold and primary lung tumor 1.9-fold. Conclusions: histopathological diagnosis of primary tumor, poorly differentiated adenocarcinoma and primary lung tumor influence mortality in patients with metastases of cancer of unknown origin. [ABSTRACT FROM AUTHOR]

Introduction. Medical Intelligence contributes significantly to the improvement of clinical practice and training of military health personnel, such as through health information analysis and application of the results of this analysis to the improvement of patient severe trauma care. Trauma registries collect data that are useful for further analysis by collaborating in the development, improvement, updating and implementation of education programmes for health personnel where clinical simulation plays a key role. Material and methods. An unsystematic review has been carried out on different databases such as Medline, Military Medicine Magazine or Google Scholar. Results and discusión. In Europe there are different trauma registries, both civilian and military, which collect data on different aspects of the care of the trauma patient. Analysis by the Medical Intelligence of the registered data and effective training, including clinical simulation, will contribute to the improvement of the training of health personnel, both civilian and military, and therefore to increase the patient survival with severe trauma. [ABSTRACT FROM AUTHOR]

Prostate cancer is currently one of the main pathologies that affects men. The objective of this article was to estimate the survival of patients with intermediate and high risk prostate cancer belonging to the special health regimen. A cohort study was conducted that estimates the survival function with the Kaplan-Meier method, the Hazard ratio (HR) as a function of explanatory variables using a Cox regression model. The patients included were diagnosed by urology and / or confirmed with diagnostic support, patients treated for prostate cancer in another institution, primary tumors other than the prostate, and those who consulted for a second medical opinion were not included. Intermediate-risk patients survive 90% to both 5 and 7 years, and high-risk patients survive 35% and 30% to 5 and 7 years, respectively, with a median of 28 months. This study allowed us to conclude that survival in patients classified as intermediate risk is similar to national and international ones, however, in high-risk patients, survival is lower than in other countries. [ABSTRACT FROM AUTHOR]

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Transarterial radioembolization (TARE) is an alternative therapy for the treatment of unresectable liver tumors. Method: Retrospective and descriptive study in 27 patients undergoing TARE with Ytrio-90-loaded resin microspheres. Baseline, demographic and clinical characteristics were studied, and overall survival at 18 months was analyzed using the Kaplan-Meier method. Results: Age ranged between 52-85 years, and 81% of patients were men. 78% presented primary liver tumors, highlighting hepatocellular carcinoma BCLC (Barcelona Clinic Liver Cancer) stage B (HCC BCLC B) (44%). The origin of the most frequent secondary liver tumor was colorectal adenocarcinoma. The ECOG (Eastern Cooperative Oncology Group) was 0 for 78% of the patients and the antecedents were alcoholism (41%) and hepatitis C (56%). The average administered activity was 1.8 GBq. 34% received more than one previous treatment: surgical resection (11%), transarterial embolization or chemoembolization (48%), radiofrequency ablation (22%) or multi-kinase inhibitors (15%). 33% received subsequent treatment with multi-kinase inhibitors. The overall survival at 18 months was 58.9%. In patients with HCC BCLC B, the median survival was 15.6 months. Conclusion: The survival results are in line with those of other studies, although there are differences in some of the variables. It is necessary to have more patients and follow-up time to analyze its influence on survival. [ABSTRACT FROM AUTHOR]

Pulmonary lymphangitic carcinomatosis (PLC) is associated with a poor prognosis in patients with non-small cell lung cancer (NSCLC). We sought to determine prognostic value of pretherapeutic fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in NSCLC with radiologically diagnosed PLC. We retrospectively reviewed 50 NSCLC patients with radiologically diagnosed PLC. Among eight clinical variables and five imaging parameters, metabolic PLC burden, which represents the overall tumor burden of PLC, and PLC, which represents the location and extent of PLC in a three-grade system, were used. In multivariate analyses for progression-free survival, metabolic PLC burden (P = 0.0181), PLC (P = 0.0401), and clinical stage (P = 0.0284) were identified as independent prognostic factors. High metabolic PLC burden had a worse prognosis, and the prognosis of cPLC3 was significantly worse than that of cPLC1 or cPLC2. In univariate analyses for overall survival, only age (P = 0.0073) was identified a prognostic factor. In conclusion, FDG PET/CT parameters were identified as independent prognostic factors in NSCLC with radiologically diagnosed PLC. Furthermore, a combination of anatomical and metabolic information about PLC obtained using FDG PET/CT provides insight into the overall tumor burden of PLC and is useful in predicting prognosis. [ABSTRACT FROM AUTHOR]

Lung cancer continues to be the leading cause of cancer death worldwide, with two main types: small cell and non-small cell. In addition to smoking, other risk factors have been identified, such as exposure to radon and wood smoke. Early diagnosis is difficult due to the lack of screening strategies, limited access to tomographic studies, and lack of medical knowledge. However, it has been shown that low-dose computed tomography screening can reduce lung cancer mortality by 20%. In Mexico, the National Institute of Respiratory Diseases is the main center for diagnosis and treatment of lung cancer. Strategies are being implemented to improve early diagnosis, expedite clinical management, use precision medicine, and adopt multidisciplinary approaches to improve prognosis and patient survival. [Extracted from the article]

Introduction: Worldwide there is an increase in the incidence of melanoma, Panama does not escape this reality. For all stages there is a risk of recurrence even after adequate surgery and high chances of death due to metastasis. This work seeks to know the experience of ION in the treatment of these patients, which has not been published to date. Objectives: To describe the characteristics of patients with melanoma and determine the Global Survival (OS) and the Free Survival of Recurrence (RFS). Methodology: Retrospective study of patients with melanoma referred to the ION in the years 2012 to 2017 and the analysis of OS and RFS by the Kaplan-Meier method. Results: A total of 247 melanoma patients were treated at the ION during the study period; 51.8% were male with a median age of 65 years. The most common site was acral (31%). In total 46% of our patients are in stages III-IV. 65% of the total were operated, of these 80% with wide resection, 27% with sentinel lymph node evaluations and 25% lymphadenectomy. We found 39% ulcerated and the most frequent histology was nodular with 31.6%. There were 31.4% of recurrences, of which 63.8% were distant. The mOS: 55.8 months in non-metastatic vs 13.1 months in metastatic (p <0.0001). The mRFS for the operated patients was 53.6 months and the prognostic factors were ulceration (p = 0.007) and lymphadenectomy (p = 0.000). Conclusion: The diagnosis of melanoma in the Panamanian population is made in advanced stages, which influences its prognosis. Its survival rate is well below other developed and developing countries. These results should be taken with care, since the classical factors described in multiple studies do not seem to influence our population (age, sex, anatomical site, subtype, mitosis). Being such a lethal disease, it is necessary to carry out prospective studies at the national level, as well as to strengthen the prevention and primary care network. [ABSTRACT FROM AUTHOR]

Introduction: Pilocytic astrocytoma is a slow-growing tumor that has been considered by the World Health Organization (WHO) as a grade I glioma. The most common location is the cerebellum and usually occurs during the first two decades of life. This neoplasm is associated with an excellent prognosis, with 5-year survival greater than 95%. Objective: To describe the clinicopathological characteristics associated with the survival of patients with pilocytic astrocytoma. Methods: A descriptive and retrospective observational study in patients with histopathological confirmation of pilocytic astrocytoma treated at the Instituto Nacional de Enfermedades Neoplásicas (INEN) during the period 1996 - 2010. Results: During the study period, 27 patients with pilocytic astrocytoma were identified. The characteristics associated with overall survival (OS) were age greater than 11 years (p = 0.028), the Karnofsky index greater than 80% (p = 0.006) and the cerebellar/parietal/suprasellar location (p = 0.004); while the characteristics associated with progression free survival (PFS) was age (p = 0.049) and the presence of Rosenthal fibers (p = 0.020). Conclusions: Pilocytic astrocytoma is a favorable prognosis tumor, which presents clinicopathological characteristics such as age over eleven years old, a Karnofsky index greater than 80%, cerebellar/parietal/suprasellar localization, and whose total tumor resection is associated to a better survival. [ABSTRACT FROM AUTHOR]

Background: We investigated the correlation between genetic mutations and clinical-pathological features in young patients with NSCLC. Methods: Clinicopathologic information of 102 young NSCLC patients was collected. Direct ctDNA sequencing of a portion of these patients was performed. The correlation between EGFR mutation and ALK fusions with clinicopathologic parameters was analyzed. Results: In young NSCLC patients, adenocarcinoma is the major histology (86.9%), and the misdiagnosis rate was as high as 45.7%. EGFR gene mutation was found in 13 patients (31.7%) and common mutations were with EGFR19del mutation (7 cases, 17.1%) and EGFR21L858R mutation (4 patients, 9.7%). EGFR mutation was constantly found in adenocarcinoma and male gender, and ever smokers (100%, P < 0.05). Furthermore, ALK fusions were found in 7 patients (31.8%), which include EML-4-ALK fusions; there was a trend that ALK fusions were associated with adenocarcinoma and female gender. However, there was no significant difference in overall survival between patients with or without gene mutations. Conclusions: EGFR mutation and ALK fusions are related to histology, gender, and smoke exposure in young NSCLC patients, and may be effective predictive factors. [ABSTRACT FROM AUTHOR]

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Background: The phyllodes tumor of the breast is a rare neoplasm that represent less than 1% of all breast tumors and between 2.5% of fibroepithelial tumors. The aim of this study was to describe clinical pathological characteristics and identify prognostics factors in terms of local recurrence free survival (LRFS), distant metastasis-free survival (DMFS) and overall survival (OS) in patients with phyllodes tumors of the breast. Methods: We retrospectively analyzed 157 patients diagnosed and treated at the Instituto Nacional de Enfermedades Neoplasicas between January 2005 to December 2010. In order to evaluate the relationship between clinical features and histology of the tumors, the Pearson X2 test was used. Kaplan-Meier method was used to identify prognostic factors in terms of LRFS, DMFS and OS. Results: The median age was 42 years (range: 13-81 years), 98 cases ≤ 45 years (62.4%) and 59 cases > 45 years (37.6%). In the univariate analysis, histological subtype (p=0.006) and pleomorphism (p<0.001) were identified as prognostic factors of LRFS, while the surgical approach (p=0.008), histological type (p<0.001) and some histological features such as stromal cellularity (P<0.001), pleomorphism (p<0.001), heterologous elements (p<0.001) and tumor necrosis (p=0.004) were identified as prognostic factors for DMFS. In regard to the OS, we found as prognosis factors, histology (p= 0.044), pleomorphism (p<0.001) and tumor necrosis (p=0.001). Conclusions: In our institution we have a low frequency (2.3%) of phyllodes tumors of the breast and the majority of our patients had benign tumors and good prognosis. We found that histological type and degree of pleomorphism are prognostic factors related to LRFS and OS. Surgical approach, histological type and some histological characteristics were predictors for DMFS. [ABSTRACT FROM AUTHOR]

Objective: To determine the clinical characteristic of brain metastases. Methods: It was done a retrospective longitudinal descriptive study from January 1 of 2006 at December 31 the 2008 according to demographic variables and other related with the primary cancer. All the death certificates were revising in bigger than 18 years with brain metastases in anyone of the causes of death. This information was paired with the databases of the National Registration of Cancer to look for information of the moment of the diagnosis. They were 359 cases reported, of which information was obtained in 245 clinical histories. The distributions of frequencies were analyzed to describe the qualitative variables, and average with range for quantitative variables. Results: 945 died by brain metastases were identified. The medium age was 65 years. The most frequent localizations were lung (41 %), breast (12 %) and prostate (11.3 %). Single brain metastases occurred in 50.6 % of the sample. The applied treatments were whole brain radiotherapy (48.2 %), single steroids (38.4 %), surgery (11 %) and chemotherapy (2.4 %). The halftime among the diagnosis of them brain metastases and the death was of 5.6 months. Death cause confirmation by autopsy was done in 29.4 % of the cases. Conclusions: The brain metastases presented from a similar way to that reported in other studies with the particularity of being presented a bigger number of these in the cases with diagnosis of head cancer and neck. [ABSTRACT FROM AUTHOR]

Breast cancer is the leading cause of cancer death in Peruvian women and while the cancer control programs focus on increasing the diagnosis of early stages, it is important to know prognostic factors in this subgroup of patients. The aim of this study was to identify prognostic factors in patients with breast cancer in early clinical stages patients (I-IIA) with surgery as first treatment. We conducted a descriptive study of retrospective case series of patients diagnosed with breast cancer stages I-IIA is from January 2000 to December 2005 in the Instituto Nacional de Enfermedades Neoplásicas. During the study period 952 patients met eligibility criteria and were included in the study. The tumor size, number of involved nodes, pathological stage, estrogen receptor, the type of surgery and hormone therapy were identified predictors of recurrence-free survival at a distance, while for overall survival, variables were age at diagnostic, the pathological T stage, tumor size, number of involved nodes, pathological stage, estrogen receptor and progesterone status and the hormone phenotype. Multivariate analysis showed that independent prognostic factors for recurrence-free survival were pathological T stage (HR = 1.51, for T2, compared to T1), and pathologic N stage (HR = 1.82, for N2, compared to N1), whereas for overall survival were age at diagnosis (HR = 4.14, for = 70 years, compared to <50), pathological T stage (HR = 1.74, for T2, compared to T1), pathologic N stage (HR = 1.93 for N1, compared to N0). In conclusion, age, pathologic T and N stages were the most important prognostic factors. [ABSTRACT FROM AUTHOR]

There are 600 new cases of bladder cancer per year in our country, of which half dies, however the inclusion of adjuvant chemotherapy has improved survival. The aim of this study was to describe the results of bladder cancer treatment in a cohort of patients treated with chemotherapy at the INEN. Six hundred and thirty patients diagnosed with bladder cancer between 2005 to 2010 were included, of which 30 received adjuvant chemotherapy. The median age was 59.2 years and 83.3% were > 50 years. More than the fifty six percent (56.7%)of patients were male and 37.3% female; 63.3% had cancer of transitional cell high grade/ moderately differentiated, 10% had low grade transitional cell carcinoma and 13.3% had micrometastases. All patients received first-line chemotherapy, the most common was platinum salts plus gemcitabine (50%). The 33.3% of patients received radiotherapy. The most common site of metastasis was nodal (46.7%) followed by bone (23.3%). Median follow-up and overall survival were 28 and 14.7 months, respectively (5-year OS 12.5%). Factors associated with overall survival were nodal involvement (involved, OS 28.2 months vs not involved, OS 5.5 months; 5-year rate 23.2% vs 16.7%, P = 0.031) and the type of chemotherapy, median OS of 29.4 months for gemcitabine - cisplatin (5-year rate 17.5%). In conclusion, the survival times observed in this study were similar to previously reported, nodal involvement was predictive for overall survival and the best treatment factor was the combination of gemcitabine plus cisplatin. [ABSTRACT FROM AUTHOR]