Lymph node ratio as a predictor of survival in gastric carcinoma.

According to the American Joint Committee on Cancer (AJCC), the number of metastatic lymph nodes is the main prognostic factor in gastric cancer. Lymph node ratio (LNR) has been proposed as a better predictor of survival. We included patients resected for gastric cancer in a referral center in Mexico City. Number of metastatic nodes was analyzed according to AJCC 2002 and 2010. We divided LNR into four stages. Survival was calculated with the Kaplan-Meier method and curves compared with the log-rank test. P < 0.05 was significant. Two hundred patients were included. Median number of retrieved and metastatic nodes were 18 and 2.5, respectively. Median survival was 44 months. AJCC 2010 was a better predictor of survival than the 2002 version (P < 0.001). Median survival for LNR 0, 1, 2, and 3 was 117, 68, 44, and 14 months, respectively (P < 0.001). In patients with less than 15 nodes removed, AJCC was not a predictor of survival (P = 0.09) but LNR was (P = 0.04). Nodal staging in AJCC 2010 is a better predictor of survival than the 2002 edition. LNR is useful in the group of patients with suboptimal node dissection.

Factors associated with breast symmetry after breast conserving surgery for cancer.

INTRODUCTION: Breast-conserving surgery (BCS) is the standard of care for treatment of early breast cancer. Factors associated with poor cosmetic results are not well described. The aim of the present study was to evaluate factors associated with breast asymmetry after BCS for invasive breast cancer. MATERIAL AND METHODS: Patients who underwent unilateral BCS for invasive breast cancer and completed at least six months after radiation therapy were included. After informed consent, patients answered a validated questionnaire for breast symmetry. Demographic, clinical-pathological and surgical variables were recorded. Bilateral breast volume was measured in office and volume difference > 20% was considered objective asymmetry. Variables were analyzed with χ(2) test and significance was considered at p < 0.05. RESULTS: One-hundred and thirtythree patients were included. Mean patient age was 56 ± 9 years. Most patients were married (78%) with educational level of high school or greater (50.8%). Mean body mass index (BMI) was 25 ± 8. Twelve percent of patients underwent ≥ 2 surgical procedures. Eighty-one percent of patients had tumors > 1 cm. Twenty-two percent of patients had objective breast asymmetry and 27% perceived themselves with asymmetry. There were no significant relationship between objective and subjective asymmetry. The only variable significantly associated with perception of breast asymmetry was educational level ≥ high school. CONCLUSIONS: There was no relationship between subjective and objective breast asymmetry after BCS, suggesting that cosmetic results are mainly related to patient subjective perception. The only variable associated with subjective breast asymmetry was high educational level, possibly because higher cosmetic expectations in this group of patients.

Glisson's capsule blistering after hyperthermic intraperitoneal chemotherapy.

Hypertermic intraperitoneal chemotherapy is a treatment option after cytorreduction of certain types of malignancies with peritoneal spread. Blistering of the Glisson's capsule has not been previously reported as a consequence of this treatment modality. Patient do not experiment any associated morbidity.