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Objetivos: determinar el rendimiento diagnóstico de la biopsia por punción aspiración con aguja fina (PAAF) para el diagnóstico de nódulos tiroideos malignos. Materiales y métodos: estudio retrospectivo que evaluó las PAAF de tiroides realizadas en el Hospital Nacional Guillermo Almenara Irigoyen en Lima, Perú, durante un período de tres años. Se categorizó el diagnóstico citopatológico de las biopsias usando el sistema de Bethesda, se consideró las categorías V y VI como malignas y la categoría II como benigna. Se obtuvo solo una biopsia por paciente y se consideró el resultado con la categoría de Bethesda más alta. Todos los pacientes fueron sometidos a tiroidectomía y los resultados histopatológicos se categorizaron como malignos o benignos. Resultados: se incluyó a 173 pacientes con resultados citopatológicos de Bethesda II al VI. El diagnóstico citológico mostró que el 47,4% de los pacientes tenían Bethesda VI. El 59,5% de los nódulos tiroideos fueron malignos en la histopatología, siendo el carcinoma papilar el tipo más frecuente. El rendimiento diagnóstico de la PAAF fue alta cuando considera Bethesda V y VI como malignos, con una sensibilidad 91,92%, especificidad 71,67%, valor predictivo positivo 84,26%, valor predictivo negativo 84,31% y precisión de 84,28%, razón de verosimilitud positiva 3,39; pero mejoró significativamente cuando se consideró solo Bethesda VI como maligno, con sensibilidad del 90,7%, especificidad del 89,58%, precisión 90,3% y razón de verosimilitud positiva 8,71. Conclusiones: la PAAF tiene buen rendimiento. Este estudio demostró ser de gran utilidad en nuestro centro de salud para detectar errores y promover mejoras, así también como modelo para próximas investigaciones en diferentes establecimientos de salud.

Introduction: A gastrectomy and lymph node dissection is the standard of management for patients with gastric cancer. Factors such as the identification of nodes by the pathologist can have a negative impact on staging and treatment. The objective of this study was to compare the lymph node count of a surgical specimen after a complete gastrectomy (group A) and of a specimen with lymph node by groups (group B). Methods: Study of a retrospective database of patients undergoing D2 gastrectomy in the Risaralda section of the Liga Contra el Cancer Gastrointestinal surgical service, Pereira, Colombia. The lymph node count was compared in surgical specimens with and without lymph node division by anatomical regions, prior to sending them to pathology. Results: Of the 94 patients who underwent surgery, 65 were from group A and 29 patients were from group B. The average number of nodes was 24.4±8.6 and 32.4±14.4, respectively (p=0.004). The percentage of patients with more than 15 and 25 nodes was lower in group A than in group B (27 vs 57, p=0.432 and 19 vs 24, p=0.014). The average number of patients with a nodal ratio less than 0.2 was higher in group B (72.4% vs 55.4%, p=0.119). Conclusions. The results of our study showed that a division by lymph node groups prior to the evaluation of the specimen by the pathology service increases the lymph node count and allows the prognosis of patients to be accurately established, having a positive impact on their staging, to avoid overtreatment. [ABSTRACT FROM AUTHOR]

Background. Melanoma is the malignant proliferation of melanocytes associated with aggressive behavior. The objective of this study was to determine the histological variables of cutaneous melanoma. Methods: Observational, cross-sectional, descriptive, retrospective study carried out with reports of pathologies with a diagnosis of cutaneous melanoma in a pathology laboratory in Cali between 2016-2021. The variables were age, sex, location, subtype, Breslow thickness, ulceration, margins, mitosis, lymphovascular invasion, neurotropism, tumoral regression, Clark level and tumor infiltration by lymphocytes. Results: One hundred and six reports were obtained and 54 were excluded due to duplication. A descriptive analysis was made on the 52 records that were included, the mean age was 61 years, with a higher frequency in women with 55.8%. Of the 33 cases where the histological subtype was specified, the most frequent was superficial extension with 66.6%, followed by acral lentiginous with 18.1% and nodular with 15.2%. The most frequent location was in the extremities (61.5%); the most common Breslow was IV (34.6%), and the most frequent Clark was IV (34.6%). Ulceration was in 40.4%. The nodular subtype was the most aggressive presentation where 100% presented Breslow IV. Conclusions. The most common subtype of melanoma was that of superficial extension. In our population, the second most frequent was the acral lentiginous subtype, which was always located on the extremities. More than 50% of the melanomas had Breslow greater than or equal to III, which affects the prognosis. [ABSTRACT FROM AUTHOR]

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La literatura sobre el câncer laríngeo es muy vasta y ha sido acumulada en um período relativamente reciente. Afección conocida vagamente en la antigüedad, es recién en el ano 1760 que Morgagni (18) refiere en su carta anatômica No. 28 dos observaciones de Valsalva con descripciones autópsicas bien precisas, acompanadas de Ias historias clinicas correspondientes. Se trataba en realidad de casos de câncer laringofaringeo.

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Introducción. La laparoscopía de estadificación permite identificar con gran precisión el compromiso locorregional avanzado y metastásico a peritoneo en los pacientes con cáncer gástrico. Las guías internacionales aún difieren en las indicaciones para incluir este procedimiento como parte del proceso de estadificación. Métodos. Se diseñó una encuesta dirigida a cirujanos residentes en Colombia, sobre el uso de la laparoscopía de estadificación en los pacientes con cáncer gástrico. Se analizaron los resultados y con base en la evidencia disponible se proponen algunas pautas en las indicaciones y técnica del procedimiento. Resultados. Respondieron la encuesta 74 cirujanos; el 43,8 % considera que el objetivo de la laparoscopía de estadificación es descartar la carcinomatosis peritoneal. El 54,1 % realiza el procedimiento en estadios tempranos, sin embargo, el 48,6 % considera realizarla solo en pacientes con sospecha de carcinomatosis por imágenes. Las áreas evaluadas con mayor frecuencia por los cirujanos (más del 85 %) son la superficie hepática, las cúpulas diafragmáticas, los recesos parietocólicos y la pelvis. Las zonas evaluadas en menor frecuencia son la válvula ileocecal (40,5 %) y el ligamento de Treitz (39 %). El 33 % de los cirujanos no toma rutinariamente citología peritoneal. Conclusión. Este trabajo muestra la tendencia de los cirujanos en el uso de la laparoscopía de estadificación en pacientes con cáncer gástrico. A pesar de encontrar resultados muy positivos en relación con las indicaciones y técnica del procedimiento, es necesario analizar la evidencia disponible para su uso según cada escenario y mejorar la sistematización del procedimiento.

Introduction: Folliculotropic mycosis fungoides is a variant that has poor prognosis and a variable clinical presentation. Concerns have been expressed that the current TNMB staging of this tumor may not be useful. A recently developed classification system based on clinical and histologic variables classifies this tumor as early or advanced, a distinction found to correlate with prognosis. The aim of this study was to compare survival in FMF in Colombia between patients with early versus advanced tumors. Material and methods: Retrospective, observational study of clinical course and outcomes in patients with FMF treated at the National Cancer Institute of Colombia between 2008 and 2020. Survival was compared between early and advanced disease. Results: Twenty-one patients (11 with early FMF and 10 with advanced FMF) were studied. Seven patients, all with advanced disease, died. Survival at 5 years was 62% overall and 40% for patients with advanced FMF. No differences were observed when survival was analyzed according to TNMB stage. Conclusions: TNMB staging is not useful in FMF. The new classification system based on clinicopathologic features appears to provide reliable information for assessing prognosis and guiding treatment decisions. Resumen: Introducción: La micosis fungoide foliculotropa es una variante de mal pronóstico y presentación clínica variada. Se ha planteado que la estadificación TNMB usada para esta neoplasia no es útil. En una propuesta reciente basada en aspectos clínicos e histológicos, se clasifica en enfermedad temprana y avanzada, encontrando diferencias pronósticas entre las dos categorías. El objetivo de este estudio fue comparar la supervivencia de estos dos grupos en nuestra población. Materiales y métodos: Se realizó un estudio observacional retrospectivo de serie de casos donde se evaluó la evolución clínica de los pacientes con micosis fungoide foliculotropa tratados en el Instituto Nacional de Cancerología entre el 2008 y el 2020, realizando un análisis comparativo de supervivencia entre aquellos que tienen enfermedad temprana y enfermedad avanzada. Resultados: Se incluyó a un total de 21 pacientes, 11 de los cuales presentaban enfermedad temprana y 10 enfermedad avanzada. Se identificaron siete decesos, todos ellos en los pacientes con enfermedad avanzada. La supervivencia global de la población total a cinco años fue del 62%, mientras que para la población con enfermedad avanzada fue del 40%. No hubo diferencias en la supervivencia según la estadificación TNMB. Conclusión: La estadificación TNMB no es útil para los pacientes con una micosis fungoide foliculotropa. Por el contrario, la nueva clasificación clínico-patológica parece brindar información pronóstica fiable y permite tomar medidas terapéuticas acordes.

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El cáncer de recto es el tercer cáncer en frecuencia en Colombia, y constituye un reto diagnóstico y terapéutico para gastroenterólogos, cirujanos y oncólogos. La evaluación diagnóstica y el estudio de su extensión locorregional y sistémica se han modificado por nuevos métodos de imagen, que permiten una visualización precisa de estructuras anatómicas que antes no se podían evaluar fácilmente. La disponibilidad de estas nuevas herramientas en la estadificación de la enfermedad ha tenido un gran impacto en las decisiones terapéuticas y en la escogencia de una ruta de tratamiento específica para cada paciente, lo que ha racionalizado el uso de terapias neoadyuvantes y la realización de cirugía con criterios anatómicos correctos. Esto ha sido fundamental en el objetivo de lograr los mejores desenlaces con la menor morbilidad posoperatoria asociada. En este artículo se revisarán y explicarán en detalle cuáles han sido los cambios más recientes y las recomendaciones más actualizadas para el manejo del cáncer de recto.

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Introduction: In the patients with lung cancer it is vital the surgical treatment, because it facilitates a meticulous pathological staging, as well as a prognosis and treatment according to each patient tumoral charge. Objective: To determine the influence of the mediastinal limphadenectomy type in the survival of patients operated due to non-small cells lung cancer. Methods: A descriptive and longitudinal study was carried out in the General Surgery Service of Saturnino Lora Teaching Clinical-Surgical Provincial Hospital in Santiago de Cuba, during 10 years (from 2009 to 2019), in 55 patients selected at random who received some type of mediastinum lymphadenectomy besides lung resection. In the statistical processing, the absolute number, percentage and the mean were used, as summary measures; also the chi-squared test to identify the possible association among variables, and the Kaplan-Meier method, to specify survival. Results: The most used medistinic lymphadenectomy technique was the ganglionar sampling (47.3 %), with which a higher percentage of negative results was also obtained (84.6) as regards neoplastic invasion, contrary to that is observed with the systematic ganglionar dissection that revealed metastasis positivity in a high number of the patients that received it (52.9 %). Likewise, patients operated by means of systematic ganglionar dissection showed a better survival 6 months later (100 %) and a year later (87.5 %); after 5 years the survival number with this technique was superior to all the types of ganglionar excisions practiced. Conclusions: There was a higher probability of the mediastinic lymphatic infiltration diagnosis and better survival in the patients treated with systematic ganglionar dissection. Reason why, it is recommended to protocolize this surgical treatment, which could be endorsed by a clinical trial that allows to compare homogeneous groups that receive each type of lymphadenectomy, respectively, in order to obtain an outstanding and conclusive scientific evidence.

Introduction: In the patients with lung cancer it is vital the surgical treatment, because it facilitates a meticulous pathological staging, as well as a prognosis and treatment according to each patient tumoral charge. Objective: To determine the influence of the mediastinal limphadenectomy type in the survival of patients operated due to non-small cells lung cancer. Methods: A descriptive and longitudinal study was carried out in the General Surgery Service of Saturnino Lora Teaching Clinical-Surgical Provincial Hospital in Santiago de Cuba, during 10 years (from 2009 to 2019), in 55 patients selected at random who received some type of mediastinum lymphadenectomy besides lung resection. In the statistical processing, the absolute number, percentage and the mean were used, as summary measures; also the chi-squared test to identify the possible association among variables, and the Kaplan-Meier method, to specify survival. Results: The most used medistinic lymphadenectomy technique was the ganglionar sampling (47.3 %), with which a higher percentage of negative results was also obtained (84.6) as regards neoplastic invasion, contrary to that is observed with the systematic ganglionar dissection that revealed metastasis positivity in a high number of the patients that received it (52.9 %). Likewise, patients operated by means of systematic ganglionar dissection showed a better survival 6 months later (100 %) and a year later (87.5 %); after 5 years the survival number with this technique was superior to all the types of ganglionar excisions practiced. Conclusions: There was a higher probability of the mediastinic lymphatic infiltration diagnosis and better survival in the patients treated with systematic ganglionar dissection. Reason why, it is recommended to protocolize this surgical treatment, which could be endorsed by a clinical trial that allows to compare homogeneous groups that receive each type of lymphadenectomy, respectively, in order to obtain an outstanding and conclusive scientific evidence. [ABSTRACT FROM AUTHOR]

La endosonografía es un método diagnóstico que viene revolucionando el abordaje de los pacientes con tumores del tracto gastrointestinal y de otros órganos y estructuras extradigestivas. En la actualidad, se viene posicionando como un método de elección en la evaluación de lesiones subepiteliales gastrointestinales, además en la estadificación de muchos tumores gastrointestinales como esófago, estomago, recto, páncreas. Por lo cual pretendemos hacer una revisión de tema mostrando la evidencia de la endosonografía en indicaciones clásicas y aplicaciones actuales en tumores gastrointestinales.

El compromiso ganglionar es crítico en la estadificación del cáncer de colon como factor pronóstico y como determinante de tratamiento adyuvante. Se sigue discutiendo el número de ganglios adecuados a resecar, cuáles son los factores que inciden en la cosecha ganglionar y el significado biológico de ésta. Se revisan las variables clínicas y de la propia biología tumoral que hacen que la definición de un número determinado de ganglios, como gold standard de cosecha ganglionar adecuada, sea controversial. El número 12 no necesariamente es un número “mágico” marcador de calidad. Extender la resección para aumentar la cosecha ganglionar no mejora la estadificación, expone al paciente a riesgos innecesarios, sin efecto terapéutico comprobado. La “magia” sigue siendo realizar resecciones regladas, que incluyan el pedículo vascular y el meso satélite al tumor, ajustando la resección a las características del paciente. Menos no es más, pero más no es necesariamente mejor.

Copyright of Jornal Brasileiro de Patologia e Medicina Laboratorial is the property of Sociedade Brasileira de Patologia Clinica 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 Colombiana de Gastroenterología is the property of Asociacion Colombiana de Gastroenterologia 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.)

Introducción. El cáncer colorrectal es el tercer cáncer más diagnosticado a nivel mundial en hombres y el segundo en mujeres. En Colombia, es la cuarta causa de muerte por cáncer en ambos sexos. Es importante conocer las características de su presentación clínica en nuestro medio y la experiencia en el manejo de esta neoplasia en instituciones hospitalarias de Colombia que sirvan como referencia para analizar tendencias y resultados. Materiales y métodos. Se llevó a cabo un estudio de corte transversal de la población con diagnóstico de cáncer colorrectal atendida entre agosto de 2012 y diciembre de 2014, que corresponde al periodo de funcionamiento del Servicio de Coloproctología de Méderi-Hospital Universitario Mayor. Resultados. Se atendieron 152 pacientes, 57 % (n=87) eran mujeres. La edad promedio fue de 67 años. Se intervino quirúrgicamente el 91 % (n=138), el 61 % (n=93) por vía laparoscópica y el 25 % (n=38) se encontraron en estadio IV. Solo el 4,6 % (n=7) presentó dehiscencia de la anastomosis. El subtipo histológico más frecuente fue el adenocarcinoma moderadamente diferenciado. Discusión. Las características demográficas de la serie coinciden con las reportadas en la literatura científica. Como sucede en países similares al nuestro, esta neoplasia se diagnostica en los estadios avanzados, lo que sugiere deficiencia del sistema de tamización y diagnóstico precoz. Los resultados del manejo son similares a los reportados por otros grupos de excelencia.

En la última década han surgido los tratamientos guiados por el perfil molecular del tumor, con beneficio clínico para los pacientes con cáncer colorrectal avanzado o metastásico. Esta estratificación molecular permite agrupar o individualizar a los pacientes para un óptimo tratamiento de su enfermedad. Basada en información relevante y actualizada, se presenta una revisión de genes y biomoléculas de las vías de señalización intracelular del receptor del factor de crecimiento epidérmico, involucradas en la carcinogénesis del cáncer colorrectal. Además, se pretende identificar evidencia que soporte el beneficio de utilizar biomarcadores en pacientes con cáncer colorrectal, como factores pronósticos o predictivos para tratamientos biológicos. Se concluye que existe evidencia científica y, además, aceptación por parte de asociaciones internacionales de oncología clínica, para utilizar la evaluación del estado de los genes KRAS y BRAF en la práctica clínica, por su valor predictivo en el tratamiento del cáncer colorrectal avanzado; mientras que, para los genes NRAS, PIK3CA, PETEN y HER2, la aceptación por consenso de expertos de Europa y Estados Unidos aún no es unánime, para recomendar la evaluación rutinaria de estos biomarcadores predictivos en el cáncer colorrectal avanzado.

Copyright of Enfermagem Brasil is the property of Atlantica Editora 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.)

Whether age is an independent prognostic factor in breast cancer is a matter of debate. This is a retrospective cohort study of 767 breast cancer patients, stages I-III, treated at the Hospital das Clínicas, Minas Gerais Federal University, Belo Horizonte, Minas Gerais State, Brazil, from 2001 to 2008, aiming to study the relationship between age and survival. We included variables related to patients, tumors, and types of treatment. Different sets of Cox models were used for survival analysis. Hazard ratios (HR) and 95%CI were calculated. The relationship between age and breast cancer survival did not change substantially in any of them. In the model that accounted for all variables, women aged 70 and older (HR = 1.51, 95%CI: 1.04-2.18), and 35 or younger (HR = 1.78, 95%CI: 1.05-3.01) had shorter cancer specific survival than patients aged between 36 and 69. In addition, older age, having at least one comorbidity, and being white were associated with a higher risk of dying from other causes. In conclusion, shorter breast cancer survival is expected among the youngest and oldest patients.

OBJECTIVE: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive diagnostic test with a high diagnostic yield for suspicious central pulmonary lesions and for mediastinal lymph node staging. The main objective of this study was to describe the diagnostic yield of EBUS-TBNA for mediastinal lymph node staging in patients with suspected lung cancer. METHODS: Prospective study of patients undergoing EBUS-TBNA for diagnosis. Patients ≥ 18 years of age were recruited between July of 2010 and August of 2013. We recorded demographic variables, radiological characteristics provided by axial CT of the chest, location of the lesion in the mediastinum as per the International Association for the Study of Lung Cancer classification, and definitive diagnostic result (EBUS with a diagnostic biopsy or a definitive diagnostic method). RESULTS: Our analysis included 354 biopsies, from 145 patients. Of those 145 patients, 54.48% were male. The mean age was 63.75 years. The mean lymph node size was 15.03 mm, and 90 lymph nodes were smaller than 10.0 mm. The EBUS-TBNA method showed a sensitivity of 91.17%, a specificity of 100.0%, and a negative predictive value of 92.9%. The most common histological diagnosis was adenocarcinoma. CONCLUSIONS: EBUS-TBNA is a diagnostic tool that yields satisfactory results in the staging of neoplastic mediastinal lesions.

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El cáncer colorrectal es la cuarta causa de muerte a nivel mundial y la quinta causa de muerte por cáncer en Colombia. La resonancia magnética es la modalidad ideal para la valoración del cáncer colorrectal, ya que permite la estadificación mediante la determinación de la invasión más allá de la muscular propia, la extensión hacia órganos adyacentes, la identificación de pacientes candidatos a quimioterapia o radioterapia prequirúrgica y la planeación del procedimiento quirúrgico. El punto clave se basa en la diferenciación entre los estadios T2 y T3 mediante el uso de secuencias con información T2 de alta resolución. Además de esto, permite la valoración del tamaño y la morfología de los ganglios linfáticos, y aumenta considerablemente la especificidad para la detección de compromiso ganglionar. La resonancia magnética es una técnica con una alta especificidad y una alta reproducibilidad.

Objective: To identify the nutritional status of patients with gastrointestinal cancer and verify its association with demographic and clinical characteristics. Methods: This was a cross-sectional study with a nonprobability sampling design. The participants were 143 adult patients with gastrointestinal cancer, receiving care in the Amaral Carvalho Hospital (Jau-SP, Brazil) from November 2010 to October 2011. A survey was conducted to collect information for the purpose of demographic and clinical characterization. In order to identify nutritional status, the Scored Pati2) test were used. The prevalence ratio (PR) was estimated. The level of significance adopted was 5%. Results: The mean age of patients was 57.45 (SD = 9.62) years, with Stages III and IV of the disease being the most prevalent (39.2% and 35.0%). There was 44.8% prevalence of malnutrition. The undernourished individual more frequently reported having problems with eating (pcent-Generated Subjective Global Assessment (Scored PG-SGA) was applied. Descriptive statistics and the Chi-square (< 0.001), presented less desire to eat (p < 0.001), more nausea (p = 0.001), vomiting (p = 0.006), constipation (p < 0.001) and pain (p < 0.001) than eutrophic patients, and more frequently related feeling nauseated by the smell of food (p = 0.012), difficulty with swallowing (p = 0,002) and early satiety (p = 0.020). As regards the prevalence ratio, greater chance was observed of malnourished individuals being exposed to a larger portion of the symptoms related in the Scored PG-SGA. Conclusion: High prevalence of malnutrition was observed among patients with gastrointestinal cancer, with significant association with clinical symptoms directly related to the eating process.

La cirugía oncológica se desarrolló como una rama de la cirugía general, que busca facilitar la interacción entre la radioterapia, la oncología médica y las demás especialidades, para concertar un plan terapéutico integral y multidisciplinario del paciente con cáncer. En este artículo se presenta una revisión narrativa de los principios básicos del abordaje diagnóstico y terapéutico del paciente oncológico, bien sea con un diagnóstico inicial o recurrente. Se hace particular énfasis en la necesidad de plantear un tratamiento curativo de ser posible, con márgenes claros y con una aproximación quirúrgica que tenga en cuenta el comportamiento y la diseminación tumoral. Cuando la curación no sea posible, en el contexto de un tratamiento multimodal, la cirugía paliativa es una opción válida y acertada. Los principios de la cirugía oncológica deben ser interiorizados y respetados por todos los cirujanos que enfrentan y tratan pacientes con cáncer. La observancia de estos principios garantizará mejores resultados para los pacientes. “En el mundo de la cirugía oncológica, la biología es rey, la selección de casos, la reina, las técnicas quirúrgicas y maniobras son los príncipes y princesas. Ocasionalmente, el príncipe y la princesa tratan de usurpar el trono; casi siempre fallan en derrocar las poderosas fuerzas del rey y la reina”. Blake Cady

Realizou-se um estudo de coorte retrospectivo para avaliar a sobrevida de 655 mulheres com câncer de mama, atendidas no Sistema Único de Saúde, em Joinville, Santa Catarina, Brasil. Para a análise de sobrevivência aplicou-se o método estatístico de Kaplan-Meier e o modelo de Cox. A sobrevivência das mulheres segundo o estadiamento resultou ser significativamente diferente de acordo com os resultados do Teste Log-rank. A razão de risco instantâneo de morte entre os estádios I/II, I/III e I/IV foi de 3,26, 15,40 e 25,51, respectivamente. Tais achados encontram-se em consonância com os dados da literatura, e apontam que o estadiamento é uma variável que explica as disparidades na sobrevivência entre as mulheres com câncer de mama.

OBJETIVO: Estimar a sobrevida e os fatores prognósticos clínicos (pré-tratamento) de pacientes com adenocarcinoma de próstata localizado. MÉTODOS: Coorte hospitalar composta por 258 pacientes do Instituto Nacional de Câncer, Rio de Janeiro, RJ, de 1990 a 1999. As funções de sobrevida em cinco e dez anos foram calculadas empregando-se o estimador de Kaplan-Meier, tomando-se como início da observação a data do diagnóstico histológico e como eventos os óbitos por câncer de próstata. Para avaliação dos fatores prognósticos pré-tratamento foram calculadas hazard ratios (HR) e intervalos com 95% de confiança, seguindo-se o modelo de riscos proporcionais de Cox. O pressuposto desses riscos foi avaliado pela análise dos resíduos de Schoenfeld e a influência de valores aberrantes pelos resíduos martingale e escore. RESULTADOS: Dos 258 pacientes estudados, 46 foram a óbito durante o período de seguimento.A sobrevida específica por câncer de próstata foi de 88% em cinco anos e de 71% em dez. A classificação de Gleason maior que 6, PSA maior que 40ng/ml, estádio B2 e cor da pele branca foram marcadores independentes de pior prognóstico. CONCLUSÕES: A classificação de Gleason, o toque retal e o valor do PSA possuem grande poder preditivo e devem ser utilizados na estratificação de risco pré-tratamento dos pacientes com câncer de próstata localizado.OBJETIVO: Estimar la sobrevida y los factores pronósticos clínicos (pre-tratamiento) de pacientes con adenocarcinoma de próstata localizado. MÉTODOS: Cohorte hospitalaria compuesta por 258 pacientes del Instituto Nacional de Cáncer, Rio de Janeiro, Sureste de Brasil, de 1990 a 1999. Las funciones de sobrevida en cinco y diez años fueron calculadas empleándose el estimador de Kaplan-Meier, tomándose como inicio de la observación la data del diagnóstico histológico y como eventos los óbitos por cáncer de próstata. Para evaluación de los factores pronósticos pre-tratamiento fueron calculados hazard ratios (HR) e intervalos con 95% de confianza, siguiéndose el modelo de riesgos proporcionales de Cox. El presupuesto de esos riesgos fue evaluado por el análisis de los residuos de Schoenfeld y la influencia de valores aberrantes por los residuos martingala y escore. RESULTADOS: De los 258 pacientes estudiados, 46 fueron a óbito durante el período de seguimiento. La sobrevida global fue de 88% en cinco años y de 71% en diez. La clasificación de Gleason mayor que 6, PSA mayor que 40ng/mL, estadio B2 y color de la piel blanca fueron marcadores independientes de peor pronóstico. CONCLUSIONES: La clasificación de Gleason, el toque rectal y el valor del PSA poseen gran poder predictivo y deben ser utilizados en la estratificación del riesgo pre-tratamiento de los pacientes con cáncer de próstata localizado.OBJECTIVE: To assess survival rates and clinical (pretreatment) prognostic factors in patients with clinically localized adenocarcinoma of the prostate. METHODS: Hospital cohort including 258 patients registered in the National Cancer Institute, in the city of Rio de Janeiro, southeastern Brazil, from 1990 to 1999. Five- and ten-year survival functions were estimated using the Kaplan-Meier estimator from the histological diagnosis (initial time of follow-up) to death due to prostate cancer (events). Prognostic factors were assessed using hazard ratios (HR) with confidence intervals of 95%, following the Cox's proportional hazards model. The assumption of proportionality of risks was tested using Schoenfeld residuals and the impact of outliers in the model fitness was analyzed using martingale and score residuals. RESULTS: Of 258 patients studied, 46 died during follow-up. The overall five-year and ten-year survival rates were 88% and 71%, respectively. A Gleason score higher than 6, PSA levels higher than 40 ng/mL, B2 stage, and white skin color were independent markers of poor prognosis. CONCLUSIONS: Gleason score, digital rectal examination and PSA levels have great predictive power and must be used in pretreatment risk stratification of patients with localized prostate cancer.

Introducción. El cáncer de seno es un problema de salud pública en Colombia que amerita atención por su incidencia y crecientes tasas de mortalidad. Las características de su presentación inicial son importantes, puesto que determinan el estadio clínico y, por consiguiente, el pronóstico de la enfermedad; por lo tanto, es importante conocer cómo llegan las pacientes con cáncer de seno a su primera consulta en nuestra institución. Objetivo. Describir las características demográficas y clínicas de las mujeres con diagnóstico de cáncer de seno en el Centro Javeriano de Oncología, Hospital Universitario San Ignacio. Materiales y métodos. Estudio observacional descriptivo-retrospectivo de 232 casos consecutivos, de pacientes diagnósticados por primera vez con cáncer de seno, de los cuales se obtuvieron los siguientes datos: edad, motivo de consulta, enfermedad actual, antecedentes relevantes, examen clínico de seno, diagnóstico histológico y estadificación clínica. Resultados. Se encontró una tendencia hacia una población mayor de 50 años (63,4%), que consultó más frecuentemente por presencia de masa (77%) y predominio de tumores ductales (91%). Los estadios clínicos más frecuentes fueron IIIB (25%), IIA (17%), IIB (16%) y I (16%). Conclusión. En el periodo de estudio, los nuevos casos de carcinoma mamario se presentaron en su mayoría en estadios temprano y localmente avanzado, distribución semejante a la reportada por otros grupos en Bogotá, Colombia.Introduction. Breast cancer is a public health issue in Colombia that deserves awareness due to its increasing incidence and mortality rates. Initial presentation characteristics are important because these determine the clinical stage, and consequently the prognosis. It is important to understand how women with breast cancer are presenting at our center. Objective. To describe the demographic and clinical characteristics of women with breast cancer diagnosed at Centro Javeriano de Oncología, Hospital Universitario San Ignacio (HUSI). Methods. Retrospective, descriptive observational study of 232 consecutive, newly diagnosed breast cancer cases of which the following data was obtained from clinical charts: age, chief complaint, medical history, clinical breast exam, histologic diagnosis, and clinical staging. Results. The population tended to be over 50 years (63.4%), generally referred because of the presence of a lump (77%); tumors were predominantly ductal, in 91% of the cases. The most frequent clinical stages were IIIB (25%), IIA (17%), IIB (16%), and y I (16%). Conclusion. In this study, newly diagnosed breast cancer cases mainly presented in early and locally advanced stages, a distribution similar to that reported by other research groups in Bogotá, Colombia.

El sarco made Kaposies un tumor vascular de bajo grado, que manifesta típicamente cuatro formas diferentes, siendo la epidémica (o relacionada con el SIDA) la más conocida de ellas. El compromiso pulmonar de esta enfermedad está bien descrito y se manifiesta principalmente por nódulos parenquimatosos bilateral es de morfología característica ; sin embargo, esta neoplasia produce un compromiso multisistémico que no es ampliamente conocido. Debido a la creciente incidencia y sobrevida de los pacientes con VIH y el hecho de que el sarcoma de Kaposi es una de sus complicaciones frecuentes, decidimos describir su estadificación y los principales hallazgos imaginológicos en tomografía computada, por la importancia de su conocimiento para el adecuado pronóstico y manejo de esta enfermedad.Kaposi's sarcoma is a low-grade vascular neoplasm that typically manifests as one of four variants, being the epidemic (or AIDS-related) the best known of them. The pulmonary involvement of this disease is well described and is expressed mainly by bilateral parenchymal nodules of characteristic morphology; however, this tumor produces a multisystemic compromise that is not widely known. Due to the increasing incidence and survival rates of patients with HIV, and the fact that Kaposi's sarcoma is one of its frequent complications, we sought to describe its staging and major imaging findings in computed tomography, given the importance of timely recognition of this neoplasm for a proper prognosis and management of the disease.

Objective: To compare quality-of-life levels (QoL) among patients who received or did not receive palliative care (PC) and had a diagnosis of breast cancer or other types of gynaecological cancers. Materials and methods: Cross-sectional study conducted in a referral institution for the diagnosis and treatment of cancer (National Cancer Institute in Bogota, Colombia). Bivariate analyses to measure the association between PC and demographic and clinical variables were performed in a nonprobabilistic sample of 114 female patients with a hystopathological diagnosis of breast cancer or some form of gynaecological cancer who agreed to participate in the study. Scores for QoL dimensions were compared between the two groups using range tests with sign. Logistic regression models were usted to assess the association between receiving PC and QoL domains. Results: There were 49 cases of cervical cancer (42,98 %), 30 cases (26,32 %) of breast cancer, 24 cases (21,05 %) of ovarian cancer, 10 cases (8,77 %) of endometrial cancer and 1 case (0.88 %) of vulvar cancer. Of the total number of patients, 13 % (n = 15) received PC (95 % CI: 8 % - 20 %). Among those that received PC there was a higher proportion of patients with advanced stages. QoL scores were lower in patients referred to PC, especially for the physical wellness and functional domains. The estimators for QoL/PC association were: physical (OR = 0.97; 95 % CI 0.83-1.12); social/family (OR = 1.02; 95 % CI 0.82-1.27); emotional (OR = 1.10; 95 % CI 0.91-1.33); functional (OR = 0.72; 95 % CI 0.60-0.87). Conclusion: The frequency with which PC was provided in this sample is low. The indication for PC appears to be related more to QoL compromise (specifically in the functionality domain) than to the clinical stage of the disease. PC is more frequent among patients with a higher level of education, which may be related to their greater participation in decision-making. [ABSTRACT FROM AUTHOR]

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Colorectal cancer is the fourth leading cause of death worldwide and the fifth leading cause of cancer death in Colombia. MRIs are ideal for evaluating colorectal cancer, especially for screening, because they allow staging by determining the extent of any invasion beyond the muscularis and into adjacent organs. This is key for identifying candidates for chemotherapy and/or preoperative radiation therapy and for planning surgical procedures. The key is differentiation between stages T2 and T3 by using T2 sequences with high resolution information. In addition, MRIs allow assessment of the size and morphology of the lymph nodes and greatly increases the specificity of detection of nodal involvement. Magnetic resonance imaging has high specificity and reproducibility. [ABSTRACT FROM AUTHOR]

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The lung cancer is an aggressive disease and early diagnosis guides its treatment to a greater chance of cure. Literature data indicates that a minority of patients, about 30%, with non-small cell lung cancer, benefits from curative surgical treatment, so every effort for early diagnosis should be made. As discussed here, sophisticated tests may be used for earlier detection in medical practice, and more advanced surgical techniques and innovations in chemotherapy/radiation therapy may allow for an extended survival. [ABSTRACT FROM AUTHOR]

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Gastric cancer is the fifth most common cancer in the world. The most common histologic subtype is adenocarcinoma. Gastric adenocarcinomas are staged using the American Joint Committee on Cancer's 8th TNM classification. The perigastric ligaments, mesentery, omentum, and potential spaces between the parietal and visceral peritoneal linings play are important structures for staging. The spread of disease is influenced by the location of the tumor within the stomach, as well as by the anatomy related to the ligaments and lymph vessels. CT is the imaging modality of choice for the preoperative clinical staging of gastric cancer, and it is essential for planning treatment. To be able to do an adequate imaging workup, radiologists need to know the different pathways through which gastric cancer can spread: lymphatic, subperitoneal, direct invasion, transperitoneal, hematogenous, and extramural venous invasion., (Copyright © 2022 SERAM. Published by Elsevier España, S.L.U. All rights reserved.)