Incidencia, prevalencia y patrones de tratamiento del cáncer de próstata metastásico hormonosensible en España: Estudio ECHOS / Incidence, prevalence, and treatment patterns in metastatic hormone-sensitive prostate cancer in Spain: ECHOS study

Introducción y objetivo: El manejo de los pacientes con cáncer de próstata hormonosensible metastásico (CPHSm) ha cambiado en los últimos años debido a la autorización de nuevos medicamentos. El objetivo fue caracterizar la prevalencia, incidencia y patrones de tratamiento para el CPHSm en España.Pacientes y métodos: Estudio multicéntrico, observacional, longitudinal, retrospectivo en condiciones de práctica clínica habitual con pacientes con CPHSm atendidos en hospitales españoles entre 2015 y 2019 (estudio ECHOS). Las historias clínicas se extrajeron de la base de datos BIG-PAC (geográficamente representativa).Resultados: Se incluyeron los datos de 379 hombres con CPHSm. La prevalencia varió entre 12,2-14,6%. Hubo de 671 a 824 nuevos casos anualmente, con una tendencia creciente. La incidencia media en el periodo del estudio fue de 2,5%, con valores anuales en el rango 2,2-3%. Los nuevos casos anuales de pacientes de novo y recurrentes osciló en el rango 7-11 y 77-104, respectivamente, sin tendencia observada. Mayoritariamente eran pacientes recurrentes (91%) y de alto volumen tumoral (68,6%). La primera línea de tratamiento fue la combinación de docetaxel y terapia de deprivación de andrógenos (TDA) (53%), seguida por TDA sola (23,8%), combinación de TDA y abiraterona (11,1%) y radioterapia (8,6%). En los 12 meses anteriores al diagnóstico de metástasis, la mayoría se sometieron a una prostatectomía (84,9%). El resto había recibido radioterapia (12%) o no recibieron tratamiento (3,8%).Conclusiones: El estudio ECHOS proporciona datos epidemiológicos y patrones de tratamiento actuales en la práctica clínica en pacientes con CPHSm en España. Los resultados obtenidos destacan la necesidad médica de terapias dirigidas. (AU)

Introduction and objective: The management of patients with metastatic hormone-sensitive prostate cancer (mHSPC) has changed in recent years due to the approval of new drugs. The aim of this study was to evaluate the prevalence, incidence, and treatment patterns in mHSPC in Spain.Patients and methods: Multicenter, observational, longitudinal, retrospective study in routine clinical practice of patients diagnosed with mHSPC treated in Spanish hospitals between 2015 and 2019 (ECHOS study). Electronic medical records were extracted from BIG-PAC database, which contains geographically representative Spanish centers.Results: Data from 379 men with mHSPC were included. The prevalence of mHSPC ranged between 12.2-14.6% per year, representing from 671 to 824 annual cases with an increasing trend. The mean incidence along the 4-year period was 2.5%, with annual incidence ranging 2.2-3.0%. New annual cases of de novo and recurrent disease ranged between 7-11 and 77-104, respectively, with no trend being observed. These patients were mostly recurrent (91%) with high-volume disease (68.6%). The most common first-line therapy was ADT combined with docetaxel (53%), followed by ADT alone (23.8%), combination of ADT and abiraterone (11.2%), and radiotherapy (8.6%). In the last 12 months before diagnosis of metastasis, most men had been submitted to radical prostatectomy (84.9%). The remaining patients had received radiotherapy (12%) or no treatment at all (3.8%).Conclusions: The ECHOS study provides epidemiologic data and current patterns of treatment in clinical practice of patients with mHSPC in Spain. These results emphasize the medical need of targeted treatments in these clinical settings. (AU)

Incidence, prevalence, and treatment patterns in metastatic hormone-sensitive prostate cancer in Spain: ECHOS study.

INTRODUCTION AND OBJECTIVE: The management of patients with metastatic hormone-sensitive prostate cancer (mHSPC) has changed in recent years due to the approval of new drugs. The aim of this study was to evaluate the prevalence, incidence, and treatment patterns in mHSPC in Spain. PATIENTS AND METHODS: Multicenter, observational, longitudinal, retrospective study in routine clinical practice of patients diagnosed with mHSPC treated in Spanish hospitals between 2015 and 2019 (ECHOS study). Electronic medical records were extracted from BIG-PAC database, which contains geographically representative Spanish centers. RESULTS: Data from 379 men with mHSPC were included. The prevalence of mHSPC ranged between 12.2-14.6% per year, representing from 671 to 824 annual cases with an increasing trend. The mean incidence along the 4-year period was 2.5%, with annual incidence ranging 2.2-3.0%. New annual cases of de novo and recurrent disease ranged between 7-11 and 77-104, respectively, with no trend being observed. These patients were mostly recurrent (91%) with high-volume disease (68.6%). The most common first-line therapy was ADT combined with docetaxel (53%), followed by ADT alone (23.8%), combination of ADT and abiraterone (11.2%), and radiotherapy (8.6%). In the last 12 months before diagnosis of metastasis, most men had been submitted to radical prostatectomy (84.9%). The remaining patients had received radiotherapy (12%) or no treatment at all (3.8%). CONCLUSIONS: The ECHOS study provides epidemiologic data and current patterns of treatment in clinical practice of patients with mHSPC in Spain. These results emphasize the medical need of targeted treatments in these clinical settings.

Pleomorphic malignant fibrous histiocytoma in bladder diverticulum.

The Malignant Fibrous Histiocytoma is a very rare cancer and rather exceptional when located in bladder diverticulum. it occurs in men in their sixties, manifests itself through haematuria and/or irritative micturition. There is not a causal association. An immunohistochemical analysis is necessary to establish a differential diagnosis. It is aggressive, with a high rate of local recurrence and remote progression, thereby requiring early treatment that consists of radical cystectomy with pelvic lymph node dissection followed by adjuvant therapy, predominantly radiotherapy on the surgical wound. Close follow-up is crucially important. Poor survival rate even when patients undergo multimodal therapy.

Multimodal therapy in urachal carcinoma with oligometastatic bone disease.

A 35-year-old male patient was admitted to our hospital for urachal carcinoma with oligometastatic bone disease. He received a surgical resection through the umbilical area, urachal ligament and bladder dome (partial cystectomy) and adjuvant chemotherapy based on cisplatin-gemcitabine regimens together zoledronic acid with a good tolerance, no toxicity. Nine months after surgery, our patient presented no symptoms and the metastasis had been brought under control with no apparent signs of recurrence as assessed in a follow-up CT. To our knowledge, is the first case report of a urachal carcinoma with oligometastatic bone disease who received multimodal therapy, including surgery resection.

Bladder Fetal Rhabdomyoma Intermediate Type.

INTRODUCTION: Rhabdomyomas are benign tumors of striated muscle, the bladder localization is very rare. CLINICAL CASE: We present an 87-year-old male consulting for gross hematuria. Cystoscopy was done with evidence of bulged bladder mucosa in right side wall and dome. Post-transurethral resection of the bladder (TURB) pathological anatomy was negative for malignancy. As extension study abdominopelvic computed tomography was performed identifying a bladder thickening of right posterior sidewall and an increased density of the adjacent fat. Second TURB was performed and a fetal bladder rhabdomyoma intermediate type was obtained. We performed another biopsy to confirm this rare pathology, with the same diagnosis. Subsequently, the patient continues with hematuria deciding on hemostatic radiotherapy (not candidate for cystectomy or arterial embolization). Currently, the patient is asymptomatic. DISCUSSION: Bladder rhabdomyomas are rare tumors, and, in fact, there have been only 5 papers published. Some cases are only isolation cited in the bladder mesenchymal tumors, and other polemic cases in which clinical and macroscopic characteristics remembered a rhabdomyosarcoma. The importance of this publication case is the macro- and microscopic images that can corroborate the final diagnosis, helping us to differentiate between rhabdomyoma, rhabdomyofibroma, or the malignant rhabdomyosarcoma, and shows the treatment possibilities of these tumors.

Avaliação de parâmetros clínicos e hematológicos de eqüinos submetidos a um programa de controle estratégico de Amblyomma cajennense (Fabricius, 1787) (Acari: Ixodidae) / Evaluation of clinical and hematological parameters of equines submitted to a strategic control program of Amblyomma cajennense (Fabricius, 1787) (Acari: Ixodidae)

Estudaram-se aspectos clínicos e hematológicos em eqüinos submetidos a um programa de controle estratégico de A. cajennense. Os tratamentos carrapaticidas foram realizados a cada sete dias e divididos em dois módulos, o primeiro com início em abril de 2004, e o segundo com início em julho do mesmo ano, utilizando-se a base química piretróide - cipermetrina na concentração de 0,015 por cento. Além do acompanhamento clínico dos animais, foram realizados hemogramas completos antes e após o programa. As dosagens bioquímicas de bilirrubinas, gama-glutamiltransferase (GGT), aspartato aminotransferase (AST), creatina kinase (CK), proteína total, albumina e globulinas, foram realizadas antes, durante e ao final do programa. Os resultados demonstraram que houve uma melhora no quadro hematológico dos animais após o programa de controle. Os tratamentos carrapaticidas, na forma em foram aplicados, não provocaram alterações desfavoráveis nos parâmetros clínicos e hematológicos dos eqüinos. Tais informações podem ser consideradas na busca de alternativas viáveis e seguras para o controle dessa espécie de carrapato.

Clinical and hematological parameters were studied in equines submitted to a strategic control program of Amblyomma cajennense. The acaricide treatments were carried to each seven days and divided in two batteries, the first one began in April 2004 and the second in July 2004. A pyrethroid chemical base - 0.015 percent cypermethrin was used. Clinical examinations of the animals and complete hemograms were carried before and after the control program of the tick. Seric dosages of bilirrubins, gamma-glutamiltransferase (GGT), aspartate aminotransferase (AST), creatin kinase (CK), total protein, albumin, and globulins, were carried before and throughout the experiment. The results showed an improvement in the hematological parameters of the animals after the end of control program. The acaricide treatments did not cause undesirable alterations of the clinical and hematological parameters studied. Such information can be considered as viable and safe alternatives for the control of this tick.

Frequency of equine viral arteritis in Minas Gerais State, Brazil

Verificou-se a freqüência e a distribuição de eqüídeos soropositivos para arterite viral eqüina (AVE) em 10 Delegacias Regionais do IMA no estado de Minas Gerais, por meio da técnica soroneutralização. A taxa de animais reagentes foi 0,85 por cento (7/826) e em cada Delegacia Regional: Almenara (0,77 por cento), Montes Claros (1,09 por cento), Oliveira (2,12 por cento), São Gonçalo do Sapucaí (2,22 por cento), Teófilo Otoni (1,36 por cento) e Viçosa (1,72 por cento). O presente estudo indica a presença de animais soropositivos para AVE em diferentes regiões do estado de Minas Gerais

Liquid chromatographic determination of morphine sulfate and some contaminants in injections and bulk drug material: collaborative study.

A liquid chromatographic method for the assay of morphine sulfate and some preservatives and impurities in the bulk drug and in injections has been developed and collaboratively studied in 8 laboratories. Each collaborator analyzed 5 samples: 1 bulk drug, 3 different concentrations of injectable dosages, and 1 prepared mixture containing, in addition to morphine sulfate, phenol, 2-mercaptobenzothiazole, and pseudomorphine. The proposed method quantitates morphine sulfate and resolves the other components for identification using a C18 reverse-phase column with a mobile solvent containing 240 mL methanol, 720 mL 0.005 M 1-heptanesulfonic acid Na salt, and 10 mL acetic acid. Samples are prepared by direct dilution with mobile solvent minus 1-heptanesulfonic acid. All collaborators met system suitability requirements and performed the analysis without difficulty. No outliers were found when data were analyzed by the Dixon, Grubbs, double Grubbs, and Cochran tests. Relative standard deviations between laboratories (RSDR) for duplicate determinations of morphine sulfate ranged from 1.4 to 2.1%. Mean morphine sulfate recoveries for the bulk drug and the prepared mixture were 100.8 and 100.4%, respectively. The method has been approved interim official first action.

Liquid chromatographic determination of morphine sulfate and some contaminants in injections and bulk drug material.

A liquid chromatographic (LC) procedure is described for the assay of morphine sulfate in bulk drug material and injection solutions. The bulk drug and injection samples are prepared by direct dilution with LC mobile solvent. The average bulk drug purity (5 manufacturers) determined by the LC method was 99.9% with a difference of 0.1% from the average purity (anhydrous) found by the official USP XX procedure. The average LC recovery (19 studies) of morphine sulfate added to injection samples was 99.4% with a coefficient of variation (CV) of 1.14%. Morphine sulfate content was determined in triplicate for 53 injection samples (1-15 mg morphine sulfate/mL) formulated by 6 manufacturers, using the proposed LC procedure. Individual sample CV (n = 3) averaged 1.14%. The LC method is simple and specific for morphine sulfate. Major degradation products, preservatives, and some contaminants and related compounds are separated during LC.