ABSTRACT
The first confirmed case of coronavirus disease 2019 (COVID-19) in Brazil and Latin America was reported on February 26, 2020, in São Paulo. The outbreak of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has placed unprecedented strain on health-care services worldwide. Asymptomatic health-care workers (HCW) are a potential source of SARS-CoV-2 transmission, especially to immunocompromised Oncology patients. Screening of these HCWs may help contain transmission and isolate only those who require it. At Centro de Terapia Oncológica (CTO), an Oncology clinic in Petrópolis, RJ Brazil, all HCWs were screened for SARS-CoV-2 in order to isolate those who were asymptomatic/symptomatic and positive for the virus. They were all tested through IgM/IgG rapid testing and those who had symptoms were also tested with nasopharyngeal swabs for reverse transcription polymerase chain reaction (RT-PCR) tests besides IgM/IgG reactivity. Amongst the 60 tested employees, 4 were positive for SARS-CoV-2 and were isolated. This method may be useful for health-care services to detect asymptomatic HCW and maintain workers' and patients' health, as transmission probability could be reduced while avoiding becoming short-staffed during this time of crisis.
ABSTRACT
BACKGROUND: Peritoneal carcinomatosis is usually a terminal disease with short median survival in patients with gastric cancer. Systemic FOLFOX is one of the most used regimens in the first-line treatment of metastatic gastric cancer. However, there is scarce evidence that cytoreductive surgery (CRS) and intraperitoneal heated chemotherapy (HIPEC) improves oncological outcomes of patients with advanced gastric cancer. METHODS: Herein we present a case of a young woman with advanced gastric cancer with omental and peritoneal metastases who achieved an excellent response after 6 months of FOLFOX followed by CRS and HIPEC. RESULTS: A 53-year-old woman was diagnosed with advanced gastric carcinoma, with extensive omental caking and several peritoneal implants measuring 2 cm at the largest diameter. The patient received mFOLFOX6 for 6 months with excellent clinical and radiographic response. She was then submitted to a D2 total gastrectomy followed by CRS and HIPEC with mitomycin. The final pathology report showed a focal adenocarcinoma in the stomach measuring 0.4 mm with no residual tumor in the peritoneum (ypT1ypN0). The patient has been well and disease free for more than 4 years. CONCLUSION: While still controversial, CRS followed by HIPEC may be a curative therapeutic option for highly selected patients.
