ABSTRACT
ABSTRACT Prostate cancer is the second most common cancer and the fifth leading cause of cancer deaths. In Brazil, it is likewise the second most common cancer among men, second only to non-melanoma skin cancers. The aim of this consensus is to align different opinions and interpretations of the medical literature in a practical and patient-oriented approach. The first Brazilian Consensus on the Treatment of Advanced Prostate Cancer was published in 2017, with the goal of reducing the heterogeneity of therapeutic conduct in Brazilian patients with metastatic prostate cancer. We acknowledge that in Brazil the incorporation of different technologies is a big challenge, especially in the Sistema Único de Saúde (SUS), which allows for the disparity in the options available to patients treated in different institutions. In order to update the recommendations and to make them objective and easily accessible, once more a panel of specialists was formed in order to discuss and elaborate a new Brazilian Consensus on Advanced Prostate Cancer. This Consensus was written through a joint initiative of the Brazilian Society of Clinical Oncology (SBOC) and the Brazilian Society of Urology (SBU) to support the clinical decisions of physicians and other health professionals involved in the care of patients with prostate cancer.
Subject(s)
Humans , Male , Prostatic Neoplasms/therapy , Practice Guidelines as Topic , Consensus , Prostatic Neoplasms/pathology , Societies, Medical , Brazil , Clinical Decision-Making , Neoplasm Metastasis , Antineoplastic Agents/therapeutic useABSTRACT
ABSTRACT Introduction Prostate cancer still represents a major cause of morbidity, and still about 20% of men with the disease are diagnosed or will progress to the advanced stage without the possibility of curative treatment. Despite the recent advances in scientific and technological knowledge and the availability of new therapies, there is still considerable heterogeneity in the therapeutic approaches for metastatic prostate cancer. Objectives This article presents a summary of the I Brazilian Consensus on Advanced Prostate Cancer, conducted by the Brazilian Society of Urology and Brazilian Society of Clinical Oncology. Materials and Methods Experts were selected by the medical societies involved. Forty issues regarding controversial issues in advanced disease were previously elaborated. The panel met for consensus, with a threshold established for 2/3 of the participants. Results and Conclusions The treatment of advanced prostate cancer is complex, due to the existence of a large number of therapies, with different response profiles and toxicities. The panel addressed recommendations on preferred choice of therapies, indicators that would justify their change, and indicated some strategies for better sequencing of treatment in order to maximize the potential for disease control with the available therapeutic arsenal. The lack of consensus on some topics clearly indicates the absence of strong evidence for some decisions.
Subject(s)
Humans , Male , Prostate/pathology , Consensus , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/therapy , Brazil , Practice Guidelines as TopicABSTRACT
Este estudo incluiu 59 pacientes em que foram avaliadas as expressões das proteínas dos genes mdm-2, p53, e da família do gene bcl-2 por meio de método imunohistoquímico em carcinoma de células transicionais músculo-invasivo tratados com M-VAC, seguido do tratamento loco-regional. Este estudo procurou explorar a associação entre a expressão alterada destas proteínas com a sobrevida global. A expressão mínima ou ausente da proteína do gene p53 (p = 0.006) foi o único marcador que apresentou associação significativa, com taxas de sobrevida global mais favoráveis. /This study of 59 patients evaluated mdm-2, p53, and bcl-2 family gene protein expression by immunohistochemistry in muscle-invasive transitional cell carcinoma of urinary bladder treated with M-VAC, followed by locoregional treatment. This study explored the relationship between altered expression and long-term survival in this patient population. Absence or minimal p53 gene protein expression (p = 0.006) was the only molecular marker that statistically correlated with prolonged survival. However, the cooperative effects of mdm-2, p53, and bcl-2 genes represented a more robust prognostic model to delineate overall survival (p = 0.01) compared to isolated gene proteins...
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Carcinoma, Transitional Cell/genetics , Urinary Bladder Neoplasms/genetics , Tumor Suppressor Protein p53 , Immunohistochemistry , PrognosisABSTRACT
Paciente adulto, natural de regiao endemica para esquistossomose e portador cronico da doenca, apresenta queixa de febre ha sete dias, associada a ictericia e dor lombar em regiao direita. Os exames radiologicos mostraram abscessos hepaticos piogenicos multiplos, cuja causa predisponente e conhecida, segundo trabalhos da literatura, em 100 por cento dos casos. Atraves de parametros clinicos, laboratoriais e radiologicos todas as etiologias classicas foram afastadas. Sabe-se que a esquistossomose pode provocar, como complicacao, a pileflebite, alem de depressao imunologica e reacao granulomatosa com necrose lobular central e maior risco de infeccao. Os autores deste relato de caso sugerem ser a esquistossomose, na sua forma cronica, causa predisponente para formacao de abscessos hepaticos piogenicos multiplos, principalmente em regioes endemicas.
Subject(s)
Humans , Male , Middle Aged , Liver Abscess/etiology , Schistosomiasis mansoni/diagnosis , Schistosomiasis mansoni/complicationsABSTRACT
Com o intuito de investigar o potencial neoplasico dos polipos juvenis foram analisados polipos de 45 pacientes, quatro deles portadores de polipos juvenil (tres do sexo feminino e um do masculino), sendo o restante dos pacientes portadores de polipos unicos (20 do sexo masculino e 21 do sexo feminino). A idade variou desde meses ate 32 anos. O exame microscopico de rotina revelou processos proliferativos epiteliasi, incluindo fenomenos regenerativos (51,5 por cento ), hiperplasia adenomatoide (6,7 por cento ) e adenomas (5 por cento ) alem de alteraçoes displasicas (5 por cento ), nao ocorrendo neoplasias maligna. Estes achados indicam que em nosso meio houve presença de potencial neoplasico em 2,3 por cento dos polipos unicos e em 13,6 por cento dos multiplos, o que sugere maior chance de degeneraçao carcinomatosa a partir destes ultimos, tanto pelo maior comprometimento da mucosa colica quanto pelo comportamento biologico mais agressivo
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Colonic Neoplasms , Colonic Polyps , PolypsABSTRACT
O objetivo deste trabalho foi o estudo anatômico da artéria cística. Para tal, estudamos 50 artérias císticas, por dissecaçao a olho nu, em blocos de vísceras humanas, formolizados. Em 80 por cento dos casos, a artéria cística originou-se da artéria hepática direita; nos 20 por cento restantes, a origem anatômica foi variada. Foram também estudadas as dimensoes e as relaçoes topográficas das artérias císticas, principalmente no que se refere aos elementos do pedículo hepático.