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ABSTRACT Objective: Sorafenib significantly prolonged progression-free survival in patients with iodine-refractory advanced thyroid cancer. The present study was initiated before sorafenib was approved in Colombia and therefore represents an effort by an oncology institution to evaluate its efficacy and safety in this population. Subjects and methods: This phase II clinical trial had a single treatment arm. We included adult patients with progressive metastatic iodine-refractory thyroid cancer who received treatment with sorafenib 800 mg/day (400 mg every 12 hours) up to a maximum of 24 months or until the occurrence of limiting related toxicity, the progression of the disease, or voluntary withdrawal. Results: Nineteen patients received the treatment and were included in the safety analysis. However, for the efficacy analysis, 6 patients were excluded because they received only one month of therapy. Thirteen (68%) patients were women, and the mean age at diagnosis was 61.8 years. No complete responses were observed; 5 patients had a partial response (35.7%), 6 patients had stable disease, and 3 showed progression. Mean progression-free survival was calculated at 18 months (95% CI 10.7-20.3). Overall survival was estimated at 21.3 months (95% CI 17.8-24.8). Conclusion: For the first time in Colombia, the efficacy of sorafenib was evaluated in patients with advanced and progressive thyroid carcinoma refractory to radioactive iodine, with an efficacy and a safety profile similar to those previously reported.
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Objetivos: Describir las principales características del melanoma cutáneo en el Instituto Nacional de Cancerología, centro de referencia del cáncer, en Bogotá, Colombia. Materiales y métodos: Estudio descriptivo, retrospectivo, de las características demográficas, clínicas e histológicas de los pacientes con diagnóstico de melanoma cutáneo primario, en el Instituto Nacional de Cancerología entre 2006 y 2010. Resultados: Se incluyeron un total de 599 pacientes, de los cuales el 57,4% eran mujeres (n = 344) y el 42,6% hombres (n = 255). La edad media de diagnóstico fue de 60,8 años. La mayoría de los casos fueron procedentes de Bogotá, con el 56,3% (n = 329). Fue más frecuente el área urbana como sitio de residencia habitual (n = 500). La media de frecuencia anual fue de 115 casos nuevos por año. La localización más frecuente fue acral, con el 42,2% (n = 253), seguido de cabeza y cuello (n = 186). Concordando con la localización, el subtipo más frecuente fue el melanoma lentiginoso acral, con el 43,7% (n = 262), seguido por el lentigo maligno, con el 24% (n = 144). En cuanto a la profundidad, se observó una frecuencia igual de melanomas in situ y melanomas con Breslow > 4 mm, ambos con el 19% de los casos. Se encontró que la mayoría de los lentigos malignos, el 75% (n = 108), fueron in situ o con un Breslow ≤ 1 mm; por el contrario, los lentiginosos acrales y los nodulares tuvieron un Breslow > 4 mm con mayor frecuencia (con el 26,3%, n = 69, y el 45,4%, n = 10, respectivamente). El estadio más frecuente fue el III, con el 26,2% de los casos (n = 157). Conclusiones: Se evidenció un mayor porcentaje de melanomas en mujeres y mayor frecuencia de melanomas acrales. Un número importante de pacientes se ubicaron en estado avanzado, por lo que se requieren mayores acciones para la detección temprana del melanoma.
Objectives: To describe the main characteristics of cutaneous melanoma in the National Cancerology Institute, a cancer reference center in Bogota, Colombia. Materials and methods: A descriptive, retrospective study was conducted on the demographic, clinical and histological characteristics of patients diagnosed with primary cutaneous melanoma in the National Cancerology Institute between 2006 and 2010. Results: A total of 599 patients were included, of whom 57.4% were females (n= 344) and 42.6% males (n=255). The mean age at diagnosis was 60.8 years. The majority of cases, 56.3% (n=329), were from Bogota. It was also the most common urban area where the patients had their usual residence (n=500). The mean annual frequency was 115 new cases per year. The most frequent location was acral, with 42.2% (n=253), followed by head and neck (n=186). In accordance with the location, the most common sub-type was acral lentiginous melanoma, with con 43.7% (n=262), followed by lentigo maligna, with 24% (n=144). As regards the depth, a similar frequency was observed for melanomas in situ and melanomas with Breslow >4 mm, both with 19% of the cases. It was found that the large majority of the lentigo maligna, 75% (n=108) were in situ or with a Breslow ≤1 mm. On the other hand, acral lentiginous and nodular melanomas had a higher frequency of Breslow >4 mm (with 26.3% n=69 and 45.4% n=10, respectively). Stage III was the most common stage, with 26.2% (n=157) of the cases. Conclusions: A higher percentage of melanomas were observed in women, as well as a higher frequency of acral melanomas. A signifi cant number of patients were in an advanced stage, thus greater action is required for the early detection of melanoma.