ABSTRACT
INTRODUCTION: Gallbladder cancer (GBC) is one of the most important causes of cancer death in Chile. MATERIALS AND METHODS: A retrospective review of 103 patients with a diagnosis of GBC who were treated with surgery and adjuvant radiochemotherapy (RT-CT) was carried out at the Oncological Institute of Viña del Mar, Chile. Of these, 56 underwent surgery with oncological criteria, in which the impact of lymph node involvement and prognostic factors for survival were analysed. RESULTS: The median follow-up was 47.5 months. The 5-year survival of the patients operated on with oncological surgery was 55%, and for those resected without oncological criteria, it was 32% (p = 0.02). Regarding the impact of lymph node involvement, 5-year overall survival (OS) in patients with compromised lymph nodes was 32% versus 68% for patients without compromised lymph nodes (p = 0.006). Five-year OS in patients without involved nodes, with 1 involved node or with>1 involved node was 68%, 44% and 12%, respectively (p = 0.0002). The N ratio was grouped in 0, <10% and ≥10%. Five-year OS was 71%, 0% and 24%, respectively (p = 0.003). There was no evidence of differences in survival with respect to the number of lymph nodes studied. CONCLUSION: Our data provide information regarding the importance of lymph node involvement in patients with GBC undergoing surgery with oncological criteria and adjuvant RT-CT. In the absence of randomised studies, it is suggested to have a more aggressive therapeutic approach in those patients with two or more involved nodes or with a lymph node ratio >10%.
ABSTRACT
BACKGROUND: Gastric cancer is one of the main important causes of cancer death in Chile. OBJECTIVE: To report the results of adjuvant radiochemotherapy in advanced gastric cancer. MATERIAL AND METHODS: Between 2000 and 2018, 214 subjects aged 23-85 (median, 62) years with lymph node and/or serosa involvement were treated with adjuvant chemoradiotherapy after curative resection. RESULTS: With a median follow-up of 41 months, overall 3- and 5-year survival was 54.9% and 40.85%, respectively. On multivariate analysis, the factors associated with lower survival were aged >65 years, stage group and number of lymph nodes involved. CONCLUSION: In patients with locoregionally advanced gastric cancer treated with curative intent with surgery and adjuvant radiochemotherapy, the overall 5-year survival reported from local clinical practice is similar to that reported in randomised series and supports its use as an effective treatment for this type of patients in our country.
ABSTRACT
Gallbladder cancer is now considered a distinct clinical entity, allowing for a separate analysis from that of other malignancies of the biliary tree. Symptoms related to a malignant tumor of the gallbladder include jaundice and abdominal pain, or a palpable abdominal mass that occurs in a late stage of the disease. The majority of patients with operable gallbladder cancer are diagnosed by cholecystectomy performed for presumed benign disease, mostly cholelithiasis, a clinical entity known as incidental gallbladder cancer. Given the poor prognosis if tumor invasion beyond the muscular layer and/or nodal metastasis is found, adjuvant treatments have been implemented, but few data are available to guide treatment decisions in this setting. For advanced disease, a multidisciplinary treatment approach including biliary drainage procedures and palliative support is needed in the management of this aggressive disease. Palliative chemotherapy with a combination of gemcitabine and cisplatin or oxaliplatin is the standard treatment based on the findings of two phase III trials that showed improved overall survival compared to single-agent chemotherapy and best supportive care. Several phase II studies have been reported investigating the role of targeted agents against EGFR, VEGF, HER2, and MEK. International collaboration to enhance our knowledge of gallbladder cancer should be encouraged.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Combined Modality Therapy/methods , Gallbladder Neoplasms/therapy , Antineoplastic Combined Chemotherapy Protocols/pharmacology , Clinical Trials as Topic , Gallbladder Neoplasms/pathology , Humans , Molecular Targeted Therapy , PrognosisABSTRACT
Penile cancer is a radiocurable disease. The different types of radiotherapy (RT)-brachytherapy, plesiotherapy, external beam radiation therapy-have proven valid in the treatment of the primary tumor allowing preservation of the penis and sexual function. RT is even an option in candidates for surgery who reject surgery for clinical or personal reasons. A high nodal recurrence rate has been observed after inguinal lymphadenectomy, specially in patients at high risk of relapse. Technological advances in the field of RT, new imaging techniques, and more modern equipment enable RT to enhance local control and improve survival in patients with this condition. Palliative RT can exercise a decompressive effect that makes possible tumor size reduction in cases of inguinal-pelvic recurrence in patients with lymphedema and thus improve quality of life. In this article, we review the current role of RT in the treatment of penile cancer. We also present two cases that illustrate the main indications.
Subject(s)
Penile Neoplasms/radiotherapy , Aged , Humans , Lymphatic Metastasis/radiotherapy , Male , Palliative Care , Penile Neoplasms/pathologyABSTRACT
El cáncer de pene es una enfermedad radiocurable. El papel de la Radioterapia (RT), en sus distintas formas (braquiterapia, plesioterapia, radioterapia externa) en el tratamiento del tumor primario es una alternativa válida, permitiendo preservar el pene y su función sexual. Aún en pacientes con indicación quirúrgica, que por motivos clínicos o personales rechacen la cirugía, la RT es una opción de tratamiento. Existe una alta tasa de recidivas inguinales tras una linfadenectomía inguinal especialmente en pacientes de alto riesgo de recidiva regional. El avance tecnológico en el campo de la RT, las nuevas técnicas de imagen, y los equipos modernos hacen que la RT administrada de manera adyuvante sea una opción para mejorar el control local y la supervivencia en este grupo de pacientes.Por último, la RT paliativa, de manera específica, tiene un efecto descompresivo al reducir el tamaño tumoral en caso de recidivas inguino-pélvicas, permitiendo reducir el linfedema y mejorar la calidad de vida.En el presente artículo, se realiza una revisión del papel actual de la RT en el tratamiento del cáncer de pene, con la exposición breve de dos casos clínicos que introducen sus principales indicaciones(AU)
Penile cancer is a radiocurable disease. The different types of radiotherapy (RT)-brachytherapy, plesiotherapy, external beam radiation therapy-have proven valid in the treatment of the primary tumor allowing preservation of the penis and sexual function. RT is even an option in candidates for surgery who reject surgery for clinical or personal reasons. A high nodal recurrence rate has been observed after inguinal lymphadenectomy, specially in patients at high risk of relapse. Technological advances in the field of RT, new imaging techniques, and more modern equipment enable RT to enhance local control and improve survival in patients with this condition.Palliative RT can exercise a decompressive effect that makes possible tumor size reduction in cases of inguinal-pelvic recurrence in patients with lymphedema and thus improve quality of life. In this article, we review the current role of RT in the treatment of penile cancer. We also present two cases that illustrate the main indications(AU)
