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Early stages are under-represented in studies on the molecular and immune features of high-grade serous ovarian carcinoma (HGSOC), and specific studies focused on early-stage HGSOC are required for a better prognostic stratification and to personalize chemotherapy. The aim of this study was to determine the prognostic significance of CD8+ and CD4+ tumor-infiltrating lymphocytes (TILs), tumoral cell PD-L1 expression, BRCA mutational status and tumor mutation burden (TMB) in early-stage HGSOC. A retrospective study was performed on stage I and II HGSOC from the Molecular Reclassification of Early Stages of Ovarian Cancer (RECLAMO) cohort from the Spanish Group of Ovarian Cancer Research (GEICO). Centralized histological typing was performed based on morphological and immunohistochemical features. Intraepithelial (i) and stromal (s) CD8+ and CD4+ T cells and PD-L1 were evaluated on tissue microarrays by immunohistochemistry. BRCA1 and BRCA2 mutation status and TMB were analyzed in tumor DNA using next-generation sequencing. The study included 124 tumors. High iCD8+ (>20 TILs/core), low/intermediate CD4+ (35/core) were associated with favorable outcomes. Tumor cell PD-L1 expression (TPS ≥ 1) was present in only 8% of tumors. In total, 11 (16%) and 6 (9%) out of 69 HGSOC tested carried pathogenic or likely pathogenic BRCA1 or BRCA2 mutations, respectively. Median TMB of 40 tumors analyzed was 5.04 mutations/Mb and only 6 tumors had 10 or more mutations/Mb. BRCA status and TMB were not associated with TILs or prognosis. When compared with studies on advanced HGSOC, our results suggested that prognostic variables differed according to stage and that more studies focused on early stages of HGSOC are needed to better stratify these tumors.

El sistema económico en la actualidad presenta limitaciones en términos de su sostenibilidad, así como: la sobreproducción, la definición de obsolescencia programada, la cultura del consumismo y la utilización, así como la ineficiencia en beneficio de los residuos en las diferentes etapas de producción, ocasionan tensiones en el sector arrocero que cada año va en aumento. Por tanto, se debe analizar la relación entre la economía circular y la perspectiva empresarial del sector arrocero del cantón Daule periodo 2021-2022. La metodología implementada en la investigación tiene un enfoque mixto con un diseño no experimental y un alcance descriptivo debido a que por medio de la realización de una encuesta dirigida a las empresas se evidencian los siguientes resultados, el 70 % considera que a veces los residuos en las diferentes etapas de producción ocasionan tensiones en el sector arrocero cada año. Así mismo, las diferencias fundamentales que se dan entre la economía lineal y la circular, la primera se centra en la rentabilidad sin tener ninguna preocupación por el ciclo de vida del producto y la segunda apuesta por la sostenibilidad.

The Figure Legend for the Supplemental Figure 1 describes the content of the 3 panels that make up this Supplemental Figure.

This Supplementary Figure contains the GOG 240 trial schema along with the survival curves from the interim analysis and second analysis.

Purpose: In the randomized phase III trial, Gynecologic Oncology Group (GOG) protocol 240, the incorporation of bevacizumab with chemotherapy significantly increased overall survival (OS) in women with advanced cervical cancer. A major objective of GOG-240 was to prospectively analyze previously identified pooled clinical prognostic factors known as the Moore criteria.Experimental Design: Potential negative factors included black race, performance status 1, pelvic disease, prior cisplatin, and progression-free interval Results: For the entire population (n = 452), high-risk patients had significantly worse OS (P < 0.0001). The HRs of death for treating with topotecan in low-risk, mid-risk, and high-risk subsets are 1.18 [95% confidence interval (CI), 0.63–2.24], 1.11 (95% CI, 0.82–1.5), and 0.84 (95% CI, 0.50–1.42), respectively. The HRs of death for treating with bevacizumab in low-risk, mid-risk, and high-risk subsets are 0.96 (95% CI, 0.51–1.83; P = 0.9087), 0.673 (95% CI, 0.5–0.91; P = 0.0094), and 0.536 (95% CI, 0.32–0.905; P = 0.0196), respectively.Conclusions: This is the first prospectively validated scoring system in cervical cancer. The Moore criteria have real-world clinical applicability. Toxicity concerns may justify omission of bevacizumab in some low-risk patients where survival benefit is small. The benefit to receiving bevacizumab appears to be greatest in the moderate- and high-risk subgroups (5.8-month increase in median OS). Clin Cancer Res; 21(24); 5480–7. ©2015 AACR.

Contains fulltext : 241226.pdf (Publisher’s version ) (Closed access) BACKGROUND: Olaparib, a poly (ADP-ribose) polymerase (PARP) inhibitor, has previously been shown to extend progression-free survival versus placebo when given to patients with relapsed high-grade serous or endometrioid ovarian cancer who were platinum sensitive and who had a BRCA1 or BRCA2 (BRCA1/2) mutation, as part of the SOLO2/ENGOT-Ov21 trial. The aim of this final analysis is to investigate the effect of olaparib on overall survival. METHODS: This double-blind, randomised, placebo-controlled, phase 3 trial was done across 123 medical centres in 16 countries. Eligible patients were aged 18 years or older, had an Eastern Cooperative Oncology Group performance status at baseline of 0-1, had histologically confirmed, relapsed, high-grade serous or high-grade endometrioid ovarian cancer, including primary peritoneal or fallopian tube cancer, and had received two or more previous platinum regimens. Patients were randomly assigned (2:1) to receive olaparib tablets (300 mg in two 150 mg tablets twice daily) or matching placebo tablets using an interactive web or voice-response system. Stratification was by response to previous chemotherapy and length of platinum-free interval. Treatment assignment was masked to patients, treatment providers, and data assessors. The primary endpoint of progression-free survival has been reported previously. Overall survival was a key secondary endpoint and was analysed in all patients as randomly allocated. Safety was assessed in all patients who received at least one treatment dose. This trial is registered with ClinicalTrials.gov, NCT01874353, and is no longer recruiting patients. FINDINGS: Between Sept 3, 2013 and Nov 21, 2014, 295 patients were enrolled. Patients were randomly assigned to receive either olaparib (n=196 [66%]) or placebo (n=99 [34%]). One patient, randomised in error, did not receive olaparib. Median follow-up was 65·7 months (IQR 63·6-69·3) with olaparib and 64·5 months (63·4-68·7) with placebo. Median overall survival was 51·7 months (95% CI 41·5-59·1) with olaparib and 38·8 months (31·4-48·6) with placebo (hazard ratio 0·74 [95% CI 0·54-1·00]; p=0·054), unadjusted for the 38% of patients in the placebo group who received subsequent PARP inhibitor therapy. The most common grade 3 or worse treatment-emergent adverse event was anaemia (which occurred in 41 [21%] of 195 patients in the olaparib group and two [2%] of 99 patients in the placebo group). Serious treatment-emergent adverse events were reported in 50 (26%) of 195 patients receiving olaparib and eight (8%) of 99 patients receiving placebo. Treatment-emergent adverse events with a fatal outcome occurred in eight (4%) of the 195 patients receiving olaparib, six of which were judged to be treatment-related (attributed to myelodysplastic syndrome [n=3] and acute myeloid leukaemia [n=3]). INTERPRETATION: Olaparib provided a median overall survival benefit of 12·9 months compared with placebo in patients with platinum-sensitive, relapsed ovarian cancer and a BRCA1/2 mutation. Although statistical significance was not reached, these findings are arguably clinically meaningful and support the use of maintenance olaparib in these patients. FUNDING: AstraZeneca and Merck.

Background Ovarian clear cell carcinomas (OCCCs) are rare, aggressive and chemoresistant tumors. Geographical and ethnic differences in the incidence of OCCC have been reported with a higher incidence in Asiatic countries. There is a paucity of information regarding OCCC in Latin America (LA) and other countries. Methods Here, we characterized two cohorts of 33 patients with OCCC from LA (24 from Brazil and 9 from Costa Rica) and a cohort of 27 patients from Spain. Genomic analysis was performed for 26 OCCC using the OncoScan platform. Tumors were classified according to their genomic landscapes into the Simplex-like (Sxl), Firestorm-like (FSl) and Sawtooth-like (STl) subgroups. Results The median overall survival (OS) was not significantly different between the cohorts. Genomic landscapes were characterized by different homologous recombination deficiency (HRD) levels. OCCCs with MYC-amplified tumors bearing a concomitant loss of a region in chromosome 13q12-q13 that includes the BRCA2 gene (MB subgroup) had the longest OS. In contrast, non-MB patients carrying a high number (> 30) of total copy number (CN) aberrations presented the shortest OS (PS subgroup). Furthermore, amplification of the ASH1L gene was also associated with a shorter OS. No difference in the distribution of genomic landscapes or MB and PS profiles was detected between patients from the different cohorts. Initial-stage OCCCs with early progression were characterized by gains in the JNK1 and MKL1 genes. Conclusions Our results provide new data from understudied OCCC populations and reveal new potential markers and therapeutic targets for OCCCs.

La tecnología se ha convertido en una herramienta fundamental en nuestras actividades diarias. Por ejemplo, usamos teléfonos inteligentes para comunicarnos con nuestros familiares y amigos, realizar actividades laborales, operaciones financieras y entretenernos con aplicaciones y redes sociales. Sin embargo, debido a su poco conocimiento en el tema, los usuarios regulares no son conscientes de los riesgos asociados al usarla, por lo que están expuestos a tomar decisiones equivocadas que los podrían convertir en víctimas de cibercriminales. Adicionalmente, la coyuntura global de salubridad que ha generado el virus COVID-19 ha incrementado el uso de dispositivos electrónicos, aplicaciones e Internet, que agudizan la exposición de los usuarios regulares a riesgos cibernéticos.

A presente tese concentra-se no estudo de estimativas de erro das soluções aproximadas da discretização do Laplaciano pelo Método clássico de Volumes Finitos na esfera unitária \\S. Inicialmente e conforme a literatura, estabelecemos a boa colocação do problema de Poisson em \\S. Em seguida, apresentamos a construção recursiva usual das malhas esféricas geodésicas icosaédricas (NOPT) e esboçamos propriedades geométricas essenciais como o principio de dualidade Voronoï-Delaunay e as otimizações SCVT e HR95, sendo que a precisão da soluções aproximadas depende da qualidade da malha. Definida a estrutura, introduzimos uma discretização do Laplaciano via um Método clássico de Volumes Finitos (MVF). De forma geral, ao usar este método, frequentemente aparece uma perda da consistência causada pela não uniformidade da malha; mas isso não implica necessariamente em perda de convergência. Esse fato foi a motivação principal para o desenvolvimento deste trabalho. Nesse sentido, analisamos taxas de convergência através de uma abordagem mais tradicional, que consiste em reescrever o MVF como um Método de Elementos Finitos Lineares (MEFL) e usar a teoria de aproximação disponível dos MEFL. Aqui, mostramos estimativas clássicas \\emph{a priori} de primeira ordem nas normas H^ e L^ de forma direta. O principal resultado deste trabalho são estimativas nas normas W^{1,\\infty} e L^{\\infty} com ordem sub-linear em relação ao tamanho de malha. Tais estimativas são obtidas através do uso de funções de Green regularizadas em \\S, combinadas com a relação entre o método de volumes finitos com elementos finitos. No caso de uso de uma malha SCVT a convergência nestas normas é super-linear (quase quadrática). Apresentamos exemplos numéricos confirmando as estimativas do erro, evidenciando que ao menos tais ordens de convergência são atingidas. In this work, we focus on the study of error estimates of the approximate solutions of a Poisson equation on the unit sphere \\S, discretized by a classical Finite Volume Method (FVM). Initially and according to the literature, we establish the well-posedness of the problem. Next, we present the usual recursive construction of the spherical icosahedral geodesic grids (NOPT). We sketch essential geometric properties as the duality principle of Voronoï-Delaunay and SCVT and HR95 optimizations, since the precision of approximate solutions depends on the quality of the grid. The usual finite volume discretization of the Laplacian on icosahedral spherical grids presents a loss of consistency, caused by non-uniformity of the grids. However, this does not necessarily imply in a degradation of convergence. This fact was the main motivation for the development of this work. In this sense, we analyse convergence rates through a more traditional approach, which consists on rewriting the FVM as a Linear Finite Element Method (LFEM) and use the available LFEM approximation theory. Here we present some classical \\emph{a priori} first order estimates in H^ and L^-norms. The main contribution of this work are estimates in the W^{1,\\infty} and L^{\\infty} -norms with sub-linear order concerning the mesh size. The proofs employ regularized Green\'s functions on \\S, combined with the finite element formulation for the finite volume method. In the case of the SCVT grid we obtain super-linear (almost quadratic) convergence estimates. Numerical examples evidence that the convergence is at least as good as predicted.

Ovarian epithelial cancer (OEC) is the most lethal gynecologic malignancy. Despite current chemotherapeutic and surgical options, this high lethality can be attributed to multiple factors, including late-stage presentation. In order to optimize OEC treatment, it is important to highlight that it is composed of five main subtypes: high-grade serous ovarian carcinoma (HGSOC), low-grade serous ovarian carcinoma (LGSOC), endometrioid ovarian carcinoma (EOC), ovarian clear cell carcinoma (CCOC), and mucinous ovarian carcinoma (MOC). These subtypes differ in their precursor lesions, as well as in epidemiological, morphological, molecular and clinical features. OEC is one of the tumours in which most pathogenic germline mutations have been identified. Accordingly, up to 20% OC show alterations in BRCA1/2 genes, and also, although with a lower frequency, in other low penetrance genes associated with homologous recombination deficiency (HRD), mismatch repair genes (Lynch syndrome) and TP53. The most important prognostic factor is the 2014 FIGO staging, while older age is also associated with worse survival. HGSOC in all stages and CCC and MOC in advanced stages have the worse prognosis among histological types. Molecular markers have emerged as prognostic factors, particularly mutations in BRCA1/2, which are associated with a better outcome. Regarding treatment, whereas a proportion of HGSOC is sensible to platinum-based treatment and PARP inhibitors due to HRD, the rest of the histological types are relatively chemoresistant. New treatments based in specific molecular alterations are being tested in different histological types. In addition, immunotherapy could be an option, especially for EOC carrying mismatch repair deficiency or POLE mutations., Highlights • The five different histological types have different precursor lesions and epidemiological, morphological, genetic, epigenetic and clinical features. • Histological type is an important prognostic factor. • Drugs targeting homologous recombination deficiency have been approved for treatment. • The use of immunotherapy is limited due to lack of predictive biomarkers

Background Olaparib, a poly(ADP-ribose) polymerase (PARP) inhibitor, has previously shown efficacy in a phase 2 study when given in capsule formulation to all-comer patients with platinum-sensitive, relapsed high-grade serous ovarian cancer. We aimed to confirm these findings in patients with a BRCA1 or BRCA2 (BRCA1/2) mutation using a tablet formulation of olaparib. Methods This international, multicentre, double-blind, randomised, placebo-controlled, phase 3 trial evaluated olaparib tablet maintenance treatment in platinum-sensitive, relapsed ovarian cancer patients with a BRCA1/2 mutation who had received at least two lines of previous chemotherapy. Eligible patients were aged 18 years or older with an Eastern Cooperative Oncology Group performance status at baseline of 0–1 and histologically confirmed, relapsed, high-grade serous ovarian cancer or high-grade endometrioid cancer, including primary peritoneal or fallopian tube cancer. Patients were randomly assigned 2:1 to olaparib (300 mg in two 150 mg tablets, twice daily) or matching placebo tablets using an interactive voice and web response system. Randomisation was stratified by response to previous platinum chemotherapy (complete vs partial) and length of platinum-free interval (6–12 months vs ≥12 months) and treatment assignment was masked for patients, those giving the interventions, data collectors, and data analysers. The primary endpoint was investigator-assessed progression-free survival and we report the primary analysis from this ongoing study. The efficacy analyses were done on the intention-to-treat population; safety analyses included patients who received at least one dose of study treatment. This trial is registered with ClinicalTrials.gov, number NCT01874353, and is ongoing and no longer recruiting patients. Findings Between Sept 3, 2013, and Nov 21, 2014, we enrolled 295 eligible patients who were randomly assigned to receive olaparib (n=196) or placebo (n=99). One patient in the olaparib group was randomised in error and did not receive study treatment. Investigator-assessed median progression-free survival was significantly longer with olaparib (19·1 months [95% CI 16·3–25·7]) than with placebo (5·5 months [5·2–5·8]; hazard ratio [HR] 0·30 [95% CI 0·22–0·41], p

En esta propuesta se busca relacionar la acción de los colorantes utilizados en la fabricación de alimentos con la salud humana. La propuesta, basada en el modelo de enseñanza por investigación dirigida, está orientada a estudiantes de grado 11º, para fomentar las habilidades investigativas y generar motivación para el estudio de las ciencias, en especial de la química. La metodología empleada aquí refleja el papel del docente en la investigación dirigida, en la que se plantea una pregunta de investigación relacionada con los posibles efectos negativos de los colorantes en los alimentos y una alternativa de colorante natural no perjudicial para la salud humana. Así mismo, esta propuesta incentiva el estudio de las propiedades físicas y químicas de las sustancias abordadas y el estudio de química orgánica. Además, el artículo incluye la metodología y las actividades a implementar durante su desarrollo.

Purpose To assess the progression-free survival (PFS) and antitumor response to standard-dose doxorubicin compared with sequential dose-dense doxorubicin and ifosfamide in first-line treatment of advanced soft tissue sarcoma. Patients and Methods Patients with measurable advanced soft tissue sarcoma, Eastern Cooperative Oncology Group (ECOG) performance status (PS) < 2, between the ages 18 and 65 years, and with adequate bone marrow, liver, and renal function were entered in the study. The stratifications were: ECOG PS (0 v 1), location of metastases, and potentially resectable disease. Patients were randomly assigned to either doxorubicin 75 mg/m2 given as a bolus injection every 3 weeks for 6 cycles (arm A) or doxorubicin at 30 mg/m2 per day for 3 consecutive days once every 2 weeks for 3 cycles followed by ifosfamide at 12.5 g/m2 delivered by continuous infusion over 5 days once every 3 weeks for 3 cycles with filgastrim or pegfilgastrim support (arm B). Results Between December 2003 and September 2007, 132 patients were entered onto the study. Febrile neutropenia, asthenia, and mucositis were more frequent in the arm B. The interim preplanned analysis for futility allowed the premature closure. Objective responses were observed in 23.4% of assessable patients in arm A and 24.1% in arm B. PFS was 26 weeks in the arm A and 24 weeks in arm B (P = .88). Overall survival did not differ between the two therapeutic arms (P = .14). Conclusion Single-agent doxorubicin remains the standard treatment in fit patients with advanced soft tissue sarcoma.

The majority of patients with recurrent ovarian cancer receive palliative chemotherapy. Several factors have been identified as predictors of response, but the main factor related to second-line treatment response is platinum-free interval (PFI). Patients with a PFI of 6 months are described as platinum sensitive. In platinum-sensitive patients the goal is to prolong survival, whereas in platinum-resistant patients treatment can only produce palliative benefits. An alternative classification of ovarian cancer has been proposed relating to platinum-refractory disease. Patients with refractory disease are those who have progressive disease during treatment or those with a treatmentfree interval (TFI) of 4 months or less, intermediate group patients have a TFI of 4-12 months, while patients with sensitive-recurrent disease have a TFI of 12 months or more. Trial data have confirmed the superiority of platinum-based combination chemotherapy versus platinum monotherapy in platinum-sensitive patients. In patients pre-treated with paclitaxel plus carboplatin, a gemcitabine plus carboplatin combination is promising, avoiding alopecia, neurotoxicity and other toxicities, and may also benefit platinum-sensitive patients who have suffered early recurrence. Trials are currently under way for various compounds, including bevacizumab, erlotinib, pertuzumab, imatinib, enzastaurin, epothilones, topotecan and trabectedin. Clinical trials are also ongoing for combinations of molecular-targeting agents and conventional chemotherapeutics.

Purpose The prognosis for women with recurrent and metastatic endometrial cancer is poor, and improved therapies are needed. The mammalian target of rapamycin (mTOR) pathway is an important target, and mTOR inhibitors show clinical activity in endometrial cancer. Patients and Methods An open-label, multicenter, randomized, phase II trial of oral ridaforolimus compared with progestin or investigator choice chemotherapy (comparator) was undertaken in women with metastatic or recurrent endometrial cancer who had progressive disease following one or two lines of chemotherapy and no hormonal therapy. The primary end point was progression-free survival (PFS) assessed by independent radiologic review. Results One hundred thirty patients were enrolled (64 received ridaforolimus and 66 received the comparator), and median age was 66 years. Treatment discontinuation as a result of adverse events was 33% with ridaforolimus versus 6% with the comparator, with common (> 10%) grade 3 toxicities being hyperglycemia, anemia, and diarrhea. Thirty-eight percent (ridaforolimus) versus 71% (comparator) of patients discontinued treatment as a result of disease progression. Median PFS at the protocol prespecified interim analysis with 58 PFS events (primary end point) was 3.6 months (95% CI, 2.7 to 7.3 months) for ridaforolimus and 1.9 months (95% CI, 1.9 to 2.3 months) for the comparator (hazard ratio, 0.53; 95% CI, 0.31 to 0.90; P = .008). PFS rate for ridaforolimus versus comparator was 48% versus 18% at 16 weeks and 38% versus 15% at 24 weeks. Objective response rate for ridaforolimus versus comparator was 0% versus 4% (P = .925), and stable disease was achieved in 35% versus 17% of patients (P = .021). Conclusion Oral ridaforolimus shows encouraging activity in advanced endometrial cancer but is associated with significant toxicity. Inhibition of the PI3K/Akt/mTOR pathway may be a viable therapeutic target.

Purpose To explore the prognostic value of mutations in c-KIT and PDGFR-α genes with respect to relapse-free survival (RFS) in patients with gastrointestinal stromal tumors (GIST). We have investigated the prognostic relevance of the type and position of the mutations, in addition to other clinicopathologic factors, in a large series of patients with GIST. Methods For this study, 162 patients were selected according to the following criteria: completely resected tumors with negative margins attended between 1994 and 2001; no metastasis at diagnosis; tumor larger than 2 cm, c-KIT–positive immunostaining; and no other primary tumors. Results The median follow-up was 42 months for patients free of recurrence. Mutations were detected in 96 tumors (60%): 82 cases involving c-KIT and 14 cases involving PDFGR-α. Univariate analysis demonstrated the following as poor prognostic factors for RFS: tumors larger than 10 cm (P < .0001); mitotic count higher than 10 mitoses per 50 high-power fields (P < .0001); high risk index (P < .0001); intestinal GIST location (P = .0041); high cellularity (P < .0001); tumor necrosis (P < .0001); deletions affecting exon 11 (P = .0007); and deletions affecting codons 557 to 558 (P < .0001). After the multivariate analysis, only the high risk index (relative risk [RR], 12.36), high cellularity (RR, 3.97), and deletions affecting codons 557 to 558 of c-KIT (RR, 2.57) corresponded to independent prognostic factors for RFS in GIST patients. Conclusion Deletions affecting codons 557 to 558 are relevant for the prognosis of RFS in GIST patients. This critical genetic alteration should be considered to be a new prognostic stratification variable for randomized trials exploring imatinib mesylate in the adjuvant setting in GIST patients.

Background: Angiogenesis is a valid target in the treatment of epithelial ovarian cancer. Trebananib inhibits the binding of angiopoietins 1 and 2 to the Tie2 receptor, and thereby inhibits angiogenesis. We aimed to assess whether the addition of trebananib to single-agent weekly paclitaxel in patients with recurrent epithelial ovarian cancer improved progression-free survival. Methods: For this randomised, double-blind phase 3 study undertaken between Nov 10, 2010, and Nov 19, 2012, we enrolled women with recurrent epithelial ovarian cancer from 32 countries. Patient eligibility criteria included having been treated with three or fewer previous regimens, and a platinum-free interval of less than 12 months. We enrolled patients with a computerised interactive voice response system, and patients were randomly assigned using a permuted block method (block size of four) in a 1:1 ratio to receive weekly intravenous paclitaxel (80 mg/m2) plus either weekly masked intravenous placebo or trebananib (15 mg/kg). Patients were stratified on the basis of platinum-free interval (≥0 and ≤6 months vs >6 and ≤12 months), presence or absence of measurable disease, and region (North America, western Europe and Australia, or rest of world). The sponsor, investigators, site staff, and patients were masked to the treatment assignment. The primary endpoint was progression-free survival assessed in the intention-to-treat population. The trial is registered with ClinicalTrials.gov, NCT01204749, and is no longer accruing patients. Findings: 919 patients were enrolled, of whom 461 were randomly assigned to the trebananib group and 458 to the placebo group. Median progression-free survival was significantly longer in the trebananib group than in the placebo group (7·2 months [5·8-7·4] vs 5·4 months [95% CI 4·3-5·5], respectively, hazard ratio 0·66, 95% CI 0·57-0·77, p

Ovarian cancer (OC) is the third most common gynecologic malignancy worldwide. Most of cases it is of epithelial origin. At the present time there is not a standardized screening method, which makes difficult the early diagnosis. The 5-year survival is 90% for early stages, however most cases present at advanced stages, which have a 5-year survival of only 5-20%. GICOM collaborative group, under the auspice of different institutions, have made the following consensus in order to make recommendations for the diagnosis and management regarding to this neoplasia.The following recommendations were made by independent professionals in the field of Gynecologic Oncology, questions and statements were based on a comprehensive and systematic review of literature. It took place in the context of a meeting of two days in which a debate was held. These statements are the conclusions reached by agreement of the participant members.No screening method is recommended at the time for the detection of early lesions of ovarian cancer in general population. Staging is surgical, according to FIGO. In regards to the pre-surgery evaluation of the patient, it is recommended to perform chest radiography and CT scan of abdomen and pelvis with IV contrast. According to the histopathology of the tumor, in order to consider it as borderline, the minimum percentage of proliferative component must be 10% of tumor's surface. The recommended standardized treatment includes primary surgery for diagnosis, staging and cytoreduction, followed by adjuvant chemotherapy Surgery must be performed by an Oncologist Gynecologist or an Oncologist Surgeon because inadequate surgery performed by another specialist has been reported in 75% of cases. In regards to surgery it is recommended to perform total omentectomy since subclinic metastasis have been documented in 10-30% of all cases, and systematic limphadenectomy, necessary to be able to obtain an adequate surgical staging. Fertility-sparing surgery will be performed in certain cases, the procedure should include a detailed inspection of the contralateral ovary and also negative for malignancy omentum and ovary biopsy. Until now, laparoscopy for diagnostic-staging surgery is not well known as a recommended method. The recommended chemotherapy is based on platin and taxanes for 6 cycles, except in Stage IA, IB and grade 1, which have a good prognosis. In advanced stages, primary cytoreduction is recommended as initial treatment. Minimal invasion surgery is not a recommended procedure for the treatment of advanced ovarian cancer. Radiotherapy can be used to palliate symptoms. Follow up of the patients every 2-4 months for 2 years, every 3-6 months for 3 years and anually after the 5th year is recommended. Evaluation of quality of life of the patient must be done periodically.In the present, there is not a standardized screening method. Diagnosis in early stages means a better survival. Standardized treatment includes primary surgery with the objective to perform an optimal cytoreduction followed by chemotherapy Treatment must be individualized according to each patient. Radiotherapy can be indicated to palliate symptoms.

Gastrointestinal stromal sarcomas (GISTs) are the most common mesenchymal tumours originating in the digestive tract. These tumours have become a model of multidisciplinary work in oncology: the participation of several specialities (oncologists, pathologists, surgeons, molecular biologists, radiologists and others) has allowed advances in the understanding of this tumour and the consolidation of a targeted therapy, imatinib, as the first molecular treatment that is efficacious in solid tumours. Following the introduction of this drug, median survival of patients with advanced stage GIST has gone from 18 to more than 60 months. Therapy planning of GIST must be considered within a multidisciplinary context, and it is advisable that it takes place in reference centres for the care of sarcomas and GIST participating in clinical trials.

Ovarian cancer is the second most common gynecological cancer, representing 5% of all cancers in women. It has the highest case-fatality rate of all gynecological malignancies. In the European Union, there are approximately 48,000 new cases of ovarian cancer and 31,000 deaths per year. Similarly, in the United States, there are approximately 25,500 new cases per year, with 16,000 deaths associated.

Endometrial cancer (EC) is the second most common gynecologic malignancy worldwide in the peri and postmenopausal period. Most often for the endometrioid variety. In early clinical stages long-term survival is greater than 80%, while in advanced stages it is less than 50%. In our country there is not a standard management between institutions. GICOM collaborative group under the auspice of different institutions have made the following consensus in order to make recommendations for the management of patients with this type of neoplasm.The following recommendations were made by independent professionals in the field of Gynecologic Oncology, questions and statements were based on a comprehensive and systematic review of literature. It took place in the context of a meeting of four days in which a debate was held. These statements are the conclusions reached by agreement of the participant members.Screening should be performed women at high risk (diabetics, family history of inherited colon cancer, Lynch S. type II). Endometrial thickness in postmenopausal patients is best evaluated by transvaginal US, a thickness greater than or equal to 5 mm must be evaluated. Women taking tamoxifen should be monitored using this method. Abnormal bleeding in the usual main symptom, all post menopausal women with vaginal bleeding should be evaluated. Diagnosis is made by histerescopy-guided biopsy. Magnetic resonance is the best image method as preoperative evaluation. Frozen section evaluates histologic grade, myometrial invasion, cervical and adnexal involvement. Total abdominal hysterectomy, bilateral salpingo oophorectomy, pelvic and para-aortic lymphadenectomy should be performed except in endometrial histology grades 1 and 2, less than 50% invasion of the myometrium without evidence of disease out of the uterus. Omentectomy should be done in histologies other than endometriod. Surgery should be always performed by a Gynecologic Oncologist or Surgical Oncologist, laparoscopy is an alternative, especially in patients with hypertension and diabetes for being less morbid. Adjuvant treatment after surgery includes radiation therapy to the pelvis, brachytherapy, and chemotherapy. Patients with Stages III and IV should have surgery with intention to achieve optimal cytoreduction because of the impact on survival (51 m vs. 14 m), the treatment of recurrence can be with surgery depending on the pattern of relapse, systemic chemotherapy or hormonal therapy. Follow-up of patients is basically clinical in a regular basis.Screening programme is only for high risk patients. Multidisciplinary treatment impacts on survival and local control of the disease, including surgery, radiation therapy and chemotherapy, hormonal treatment is reserved to selected cases of recurrence. This is the first attempt of a Mexican Collaborative Group in Gynecology to give recommendations is a special type of neoplasm.

Soft tissue sarcomas (STS) constitute a rare heterogeneous group of tumours that include a wide variety of histological subtypes, which require a multidisciplinary and, frequently specialized and complex management. Despite advances in our understanding of the pathophysiology of the disease, there are no consensus multidisciplinary recommendations about its diagnosis and treatment in our country. The objective of these guidelines is to provide practical therapeutic recommendations that may contribute to improve the therapeutic results of this disease in our environment. With this purpose, the Spanish Group for Research in Sarcomas (GEIS) held a meeting with a multidisciplinary group of experts for the study and management of sarcomas. The results of this meeting are compiled in this document, in which recommendations on diagnosis, treatment and monitoring of soft tissue sarcomas are included. In summary, these guidelines aim to facilitate the identification and management of STS for clinical practice in Spain.

Resumen: Actualmente se han desarrollado diferentes estudios para lograr un aprovechamiento de agregados no convencionales en la preparación de mezclas de concreto debido a que la producción masiva de concreto ha generado un sobreconsumo de agregados naturales (grava y arena). Estudios previos han analizado el efecto en mezclas de concreto de agregados como: fibras de polipropileno, viruta de acero, escoria de fundición, bagazo de caña, estopa de coco y escombros; aprovechando materiales que anteriormente eran desechados y a su vez mejorando las propiedades del concreto. El presente proyecto estudia la influencia del uso de vidrio molido como agregado sobre la resistencia al desgaste en adoquines de hormigón tipo A. Se utiliza las normas EN 1338 e INEN 1488 para caracterizar a los adoquines fabricados. El vidrio es empleado en reemplazo parcial de los agregados tradicionales del hormigón, para conferir propiedades superiores de resistencia al desgaste, empleando diferentes granulometrías y dosificaciones. La principal motivación de este proyecto es brindar una alternativa diferente para el reciclaje de vidrio de fácil aplicación e implementación en las pequeñas y medianas industrias de producción artesanal de adoquines.Abstract: Nowadays, different studies to achieve the utilization of unconventional aggregates in the preparation of concrete have been developed, because mass production of concrete has generated an overconsumption of natural aggregates (gravel and sand). Previous studies have analyzed the effect on concrete mixtures of aggregates such as: polypropylene fibers, steel wool, slag, coconut and sugar cane bagasse and debris, using materials that were previously discarded and at the same time improving the properties of concrete . This work studies the influence of crushed glass as aggregate in concrete paving blocks on their abrasion resistance. Standards EN 1338 and INEN 1488 are used to characterize the obtained blocks. The glass is used as partial substitute of traditional aggregates, to confer superior abrasion resistance properties, using different grain distributions and percentages. The main motivation of this project is to provide an alternative for glass recycling of easy application and implementation in small and medium scale artisanal industries of paving block production.