ABSTRACT
OBJETIVO: El cáncer de próstata (CP) avanzado es una entidad frecuente. Los objetivos de este trabajo son la presentación de una serie de pacientes con CP en tratamiento con Terapia de Deprivación Androgénica (TDA) en práctica clínica habitual y la determinación de parámetros asociados al desarrollo de resistencia a la castración (CPRC). MATERIAL Y MÉTODOS: Estudio multicéntrico, observacional, retrospectivo que analiza pacientes tratados con TDA desde enero 2016 hasta enero 2017. Análisis descriptivo de las variables clínicas más relevantes, análisis univariante y supervivencia libre de progresión mediante test Kaplan-Meier. RESULTADOS: Muestra 952 pacientes. Al diagnóstico del CP edad mediana 74 años. Mediana de PSA al diagnóstico de CP 23 ng/ml, al inicio TDA 20,2 ng/ml. El 80,2% de pacientes tenían biopsia al diagnóstico del CP: 28,2% grado pronóstico Gleason grupo 1, 38,7% grados 2 y 3 y 33,1% grados 4 y 5. Tratamiento inicial del CP: 75,9% TDA, prostatectomía radical 8,4% y radioterapia 15,1%. De los 952 pacientes, 281 (29,6%) cumplían criterios de CPRC. En este grupo el 21,7% alcanzó PSA indetectable (<0,1 ng/ml) con la TDA 20,2 frente al grupo no CPRC en el que lo alcanzaron el 59,9%. Encontramos mayor probabilidad de progresión a CPRC en pacientes con PSA al diagnóstico de CP > 30 ng/ml (p = 0,000, OR 2,78), grado pronóstico Gleason grupos 4-5 (p = 0,000, OR 2,33) y en aquellos que no alcanzan PSA indetectable tras TDA (p < 0,01, OR 3,32) variables que se relacionan con los tiempos de progresión a CPRC y especialmente al estadio metastásico. CONCLUSIONES: Se presenta una serie de pacientes CP avanzado en tratamiento con TDA que muestra heterogeneidad de características y de manejo según práctica clínica habitual. En nuestra serie el PSA elevado al diagnóstico, histología desfavorable y no alcanzar un PSA< 0,1 ng/ml tras la TDA se presentan como indicadores de progresión a estadio CPRC
OBJECTIVES: Advanced prostate cancer (PC) is a frequent entity. The objectives of this paper are the presentation of a sample of patients with PC undergoing treatment with androgen deprivation therapy (ADT) in usual clinical practice and the determination of parameters associated with the development of resistance to castration (CRPC). MATERIAL AND METHODS: Multicenter, observational, retrospective study that analyzes patients treated with ADT from January 2016 to January 2017. Descriptive analysis of the most relevant clinical variables and univariante analysis and progression times by Kaplan-Meier test. RESULTS: Sample of 952 patients. At PC diagnosis median age 74 years. Median PSA at PC diagnosis 23 ng/ml, when begining ADT 20.2 ng/ml. 80.2% of patients were biopsied at PC diagnosis: 28.2% Gleason score group 1, 38.7% groups 2 and 3 and 33.1% groups 4 and 5. Initial treatment of PC: 75.9% ADT, radical prostatectomy 8.4% and radiotherapy 15.1%. Of the 952 patients, 281 (29.6%) fulfilled CRPC criteria. In this group 21.7% achieved undetectable PSA (< 0.1 ng/ml) with ADT compared to the non-CRPC group in which it was 59.9%. Increased probability of progression to CRPC in: PSA >30ng/ml at PC diagnosis (p = 0.000, OR 2.78), Gleason score group 4-5 (p = 0.000, OR 2.33), and not to reach undetectable PSA after ADT (p < 0.001, OR 3.32). The initial ADT group presents progression to metastatic CRPC more rapidly in unfavourable histology and when not reached undetectable PSA after ADT. CONCLUSIONS: We present a sample of patients with advanced PC in treatment with ADT that shows heterogeneity in usual clinical practice. In our sample, elevated PSA at PC diagnosis, unfavorable histology and failure to achieve a PSA <0.1ng/ml after ADT is presented as an indicator of progression to the CRPC stage
Subject(s)
Humans , Male , Aged , Prostatic Neoplasms/therapy , Androgen Antagonists/therapeutic use , Prostatic Neoplasms/pathology , Orchiectomy , Prostatectomy , Retrospective Studies , Kaplan-Meier Estimate , Disease Progression , Prostatic Neoplasms, Castration-Resistant , Treatment Outcome , Prostate-Specific Antigen/bloodABSTRACT
OBJECTIVES: Advanced prostate cancer (PC) is a frequent entity. The objectives of this paper are the presentation of a sample of patients with PC undergoing treatment with androgen deprivation therapy (ADT) in usual clinical practice and the determination of parameters associated with the development of resistance to castration (CRPC). MATERIAL AND METHODS: Multicenter, observational, retrospective study that analyzes patients treated with ADT from January 2016 to January 2017. Descriptive analysis of the most relevant clinical variables and univariante analysis and progression times by Kaplan-Meier test. RESULTS: Sample of 952 patients. At PC diagnosis median age 74 years. Median PSA at PC diagnosis 23 ng/ml, when begining ADT 20.2 ng/ml. 80.2% of patients were biopsied at PC diagnosis: 28.2% Gleason score group 1, 38.7% groups 2 and 3 and 33.1% groups 4 and 5. Initial treatment of PC: 75.9% ADT, radical prostatectomy 8.4% and radiotherapy 15.1%. Of the 952 patients, 281 (29.6%) fulfilled CRPC criteria.In this group 21.7% achieved undetectable PSA (group in which it was 59.9%. Increased probability of progression to CRPC in: PSA >30ng/ml at PC diagnosis (p=0.000, OR 2.78), Gleason score group 4-5 (p=0.000, OR 2.33), and not to reach undetectable PSA after ADT (p <0.001, OR 3.32). The initial ADT group presents progression to metastatic CRPC more rapidly in unfavourable histology and when not reached undetectable PSA after ADT. CONCLUSIONS: We present a sample of patients with advanced PC in treatment with ADT that shows heterogeneity in usual clinical practice. In our sample, elevated PSA at PC diagnosis, unfavorable histology and failure to achieve a PSA<0.1 ng/ml after ADT is presented as an indicator of progression to the CRPC stage.
OBJETIVO: El cáncer de próstata (CP) avanzado es una entidad frecuente. Los objetivos de este trabajo son la presentación de una serie de pacientes con CP en tratamiento con Terapia de Deprivación Androgénica (TDA) en práctica clínica habitual y la determinación de parámetros asociados al desarrollo de resistencia a la castración (CPRC).MATERIAL Y MÉTODOS: Estudio multicéntrico, observacional, retrospectivo que analiza pacientes tratados con TDA desde enero 2016 hasta enero 2017. Análisis descriptivo de las variables clínicas más relevantes, análisis univariante y supervivencia libre de progresión mediante test Kaplan-Meier. RESULTADOS: Muestra 952 pacientes. Al diagnóstico del CP edad mediana 74 años. Mediana de PSA al diagnóstico de CP 23 ng/ml, al inicio TDA 20,2 ng/ml. El 80,2% de pacientes tenían biopsia al diagnóstico del CP: 28,2% grado pronóstico Gleason grupo 1, 38,7% grados 2 y 3 y 33,1% grados 4 y 5. Tratamiento inicial del CP: 75,9% TDA, prostatectomía radical 8,4% y radioterapia 15,1%.De los 952 pacientes, 281 (29,6%) cumplían criterios de CPRC. En este grupo el 21,7% alcanzó PSA indetectable (<0,1 ng/ml) con la TDA 20,2 frente al grupo no CPRC en el que lo alcanzaron el 59,9%. Encontramos mayor probabilidad de progresión a CPRC en pacientes con PSA al diagnóstico de CP >30 ng/ml (p=0,000, OR 2,78), grado pronóstico Gleason grupos 4-5 (p=0,000, OR 2,33) y en aquellos que no alcanzan PSA indetectable tras TDA (p<0,01, OR 3,32) variables que se relacionan con los tiempos de progresión a CPRC y especialmente al estadio metastásico. CONCLUSIONES: Se presenta una serie de pacientes CP avanzado en tratamiento con TDA que muestra heterogeneidad de características y de manejo según práctica clínica habitual. En nuestra serie el PSA elevado al diagnóstico, histología desfavorable y no alcanzar un PSA<0,1 ng/ml tras la TDA se presentan como indicadores de progresión a estadio CPRC.
Subject(s)
Prostatic Neoplasms/therapy , Aged , Androgen Antagonists/therapeutic use , Humans , Male , Orchiectomy , Prostate-Specific Antigen , Prostatectomy , Retrospective StudiesABSTRACT
Chemical composition of commercial Origanum compactum and Cinnamomum zeylanicum essential oils and the antifungal activity against pathogenic fungi isolated from Mediterranean rice grains have been investigated. Sixty-one compounds accounting for more than 99.5% of the total essential oil were identified by using gas chromatography (GC) and gas chromatography-mass spectrometry (GC-MS). Carvacrol (43.26%), thymol (21.64%) and their biogenetic precursors p-cymene (13.95%) and γ-terpinene (11.28%) were the main compounds in oregano essential oil, while the phenylpropanoids, eugenol (62.75%), eugenol acetate (16.36%) and (E)-cinnamyl acetate (6.65%) were found in cinnamon essential oil. Both essential oils at 300 µg/mL showed antifungal activity against all tested strains. O. compactum essential oil showed the best antifungal activity towards Fusarium species and Bipolaris oryzae with a total inhibition of the mycelial growth. In inoculated rice grains at lower doses (100 and 200 µg/mL) significantly reduced the fungal infection, so O. compactum essential oil could be used as ecofriendly preservative for field and stored Valencia rice.
Subject(s)
Antifungal Agents/chemistry , Cinnamomum zeylanicum/chemistry , Oils, Volatile/chemistry , Origanum/chemistry , Oryza/microbiology , Plant Oils/chemistry , Alternaria/drug effects , Antifungal Agents/isolation & purification , Ascomycota/drug effects , Cinnamates , Cyclohexane Monoterpenes , Cymenes , Eugenol , Fusarium/drug effects , Gas Chromatography-Mass Spectrometry , Microbial Sensitivity Tests , MonoterpenesABSTRACT
OBJECTIVES: To retrospectively review all cases of epididymal cysts registered over the last five years; 15 cases have been included. Simple epididymal cysts are a rare pathology in childhood, being most of them diagnosed in puberty. Currently, due to the scarce case series, there is not consensus about the most adequate therapy. METHODS/RESULTS: Mean age at presentation was 11.5 yr. (1-16). 50% were diagnosed incidentally and 29% presented increased scrotal size. 46% of the cases had associated left varicocele (n = 6) and 26% had history of orchiepididymitis. Diagnosis was based on physical examination and confirmed by ultrasound. 40% of the patients underwent surgery and the remainder received conservative treatment without evidence of complications on follow-up. CONCLUSIONS: Due to the benign character and good evolution of all cases of epididymal cysts treated conservatively and the absence of benefit after surgical treatment, we believe that management should be conservative with clinical and ultrasound controls, leaving surgery for cysts with complications. The frequent association between epididymal cysts and varicocele is related to coincidence of both pathologies in the prepuberal age.
Subject(s)
Cysts , Epididymis , Genital Diseases, Male , Adolescent , Child , Child, Preschool , Cysts/diagnosis , Cysts/therapy , Genital Diseases, Male/diagnosis , Genital Diseases, Male/therapy , Humans , Infant , Male , Retrospective StudiesABSTRACT
OBJETIVO: Hemos realizado una revisiónretrospectiva de los casos atendidos en los últimos 5años; se han recogido un total de 15 casos. Los quistessimples de epidídimo son patología poco frecuenteen la infancia diagnosticándose la mayoría en la pubertad.Actualmente y debido a la escasa casuística noexiste consenso en la terapéutica más adecuada.METODOS/RESULTADOS: La edad media de presentaciónfue de 11,5 años (1-16).El 50% fueron diagnosticadosde forma incidental y un 29% cursó conaumento de tamaño escrotal. El 46% de los casos presentabanvaricocele izquierdo asociado (n=6) y un26% presentaba antecedentes de orquiepididimitis. Eldiagnóstico se basó en la exploración física con con-firmación ecográfica. Un 40 % fue tratado quirúrgicamentey el resto fue subsidiario de tratamiento conservadorsin constatarse la presencia de complicacionesen estos en los controles posteriores.CONCLUSIONES: Dada la benignidad y la buenaevolución de todos los casos de quistes de epidídimotratados de forma conservadora, y la ausencia debeneficio con el tratamiento quirúrgico, creemos que eltratamiento debe ser conservador con controles clínicosy ecográficos reservando el tratamiento quirúrgico paraaquellos quistes que presenten complicaciones. La frecuenteasociación encontrada entre el quiste epididimarioy el varicocele responde a una coincidencia deambas patologías en la edad peripuberal
OBJECTIVES: To retrospectively review all cases of epididymal cysts registered over the last five years; 15 cases have been included. Simple epididymal cysts are a rare pathology in childhood, being most of them diagnosed in puberty. Currently, due to the scarce case series, there is not consensus about the most adequate therapy. METHODS/RESULTS: Mean age at presentation was 11.5 yr. (1-16). 50% were diagnosed incidentally and 29% presented increased scrotal size. 46% of the cases had associated left varicocele (n = 6) and 26% had history of orchiepididymitis. Diagnosis was based on physical examination and confirmed by ultrasound. 40% of the patients underwent surgery and the remainder received conservative treatment without evidence of complications on follow-up. CONCLUSIONS: Due to the benign character and good evolution of all cases of epididymal cysts treated conservatively and the absence of benefit after surgical treatment, we believe that management should be conservative with clinical and ultrasound controls, leaving surgery for cysts with complications. The frequent association between epididymal cysts and varicocele is related to coincidence of both pathologies in the prepuberal age
Subject(s)
Child , Humans , Epididymitis/congenital , Epididymitis/diagnosis , Epididymitis/pathology , Epididymitis/therapy , Epididymis , Testicular Diseases , Cysts , Retrospective StudiesABSTRACT
OBJECTIVES: To perform a descriptive analysis of 57 cases of renal adenocarcinoma treated in our department, trying to identify those variables that modify survival, and to evaluate the impact of incidental diagnosis on survival. METHODS: 57 cases of renal cell carcinoma treated in our department from 1996 to 2001 were retrospectively reviewed. Mean follow-up time was 30 months. The impact on survival of incidental diagnosis, stage, and other variables was evaluated. We used the chi-square test to study the association between qualitative variables, and the prevalence proportion with 95% confidence intervals to quantify the magnitude of the association. RESULTS: Mean age on presentation was 63 +/- 12.57 yr. The most frequent histological type was classic renal cell carcinoma (83.6%). hematuria was the presenting sign in most cases. 19.3% were incidentally diagnosed with a 24 month survival was 100% in comparison to 59% of the patients presenting with clinical signs/symptoms (p = 0.0218); 24 month survival rates for stages I-II was 95.83% in comparison to 48.48% for stage III-IV. CONCLUSIONS: Renal cell adenocarcinoma is an aggressive tumor with a variety of clinical presentations which delay its diagnosis. Tumor stage is one of the main prognostic factors. Nowadays, the greater availability of radiological tests, mainly ultrasounds, has resulted on an increase in the number of incidental diagnosis and therefore a greater number of early stages; it is advisable to perform a renal pathology screening on every patient who undergoes abdominal ultrasound for any other reason.
Subject(s)
Adenocarcinoma , Kidney Neoplasms , Adenocarcinoma/diagnosis , Adenocarcinoma/mortality , Adult , Aged , Aged, 80 and over , Female , Humans , Kidney Neoplasms/diagnosis , Kidney Neoplasms/mortality , Male , Middle Aged , Neoplasm Staging , Prognosis , Retrospective Studies , Survival Rate , Time FactorsABSTRACT
OBJETIVOS: Realizar el análisis descriptivo de los 57 casos de carcinoma de células renales tratados en nuestro servicio identificando aquellas variables que modifican la supervivencia y evaluar el impacto del diagnóstico incidental en la supervivencia. MÉTODOS: Se ha llevado a cabo el estudio retrospectivo de 57 casos de car. de céls. renales, tratados en nuestro servicio en el periodo de tiempo comprendido entre 1996-2001 con un tiempo de seguimiento medio de 30 meses. Se evaluó el impacto en la supervivencia del diagnóstico incidental y el estadio así como otras variables. Utilizamos el test de la chi-cuadrado para el estudio de la asociación entre variables cualitativas y la razón de prevalencia con intervalos de confianza al 95 por ciento para cuantificar la magnitud de la asociación. RESULTADOS: La edad media de presentación fue de 63+/- 12,57 años.El tipo histológico más frecuente fue el carcinoma de céls. renales clásico (83,6 por ciento).La presentación clínica mayoritaria fue la hematuria. El 19,3 por ciento fueron incidentales y la supervivencia a los 24 meses fue del 100 por ciento frente al 59 por ciento de los que presentaron clínica (p= 0,0218); la tasa de supervivencia a los 24 meses para los estadios I-II fue del 95,83 por ciento frente al 48,48 por ciento de los estadios III-IV.CONCLUSIONES: El adenocarcinoma de céls. renales es un tumor agresivo con gran variedad de manifestaciones clínicas que demoran su diagnóstico, siendo el estadio uno de sus principales factores pronósticos. Actualmente la mayor disponibilidad de técnicas radiológicas sobre todo las ultrasónicas, ha propiciado un incremento en el diagnóstico incidental y por lo tanto un mayor número de estadios precoces; es por todo ello que sería aconsejable realizar un despistaje de patología renal a todos los pacientes a los que se realizara una ecografía abdominal por cualquier motivo (AU)
