Correlación entre características clinicopatológicas e inmunohistoquímicas del cáncer de mama en mujeres argentinas / Correlation between clinicopathological and immunohistochemical characteristics of breast cancer in Argentine women

Introducción: El cáncer de mama se clasifica en 4 subgrupos moleculares de tumores. Estos factores biológicos junto al grado histológico, han tomado importancia en la nueva clasificación TNM ya que permite establecer pronósticos de sobrevida. Objetivo: Analizar la correlación entre los distintos subtipos moleculares de los carcinomas de mama con factores clínico-patológico, la presencia de metástasis axilares y en la re-estadificación de los tumores según la nueva Clasificación TNM de la AJCC. Material y método: Estudio observacional y descriptivo de series de casos, registrados en Registro de Cáncer de Mama (RCM), en Argentina entre los años 2006 a 2016. Resultados: La mayoría de los tumores fueron Luminales. Los estadios avanzados fueron en edades tempranas. El mayor compromiso axilar perteneció a HER2 neu positivos. Se consiguió re estadificar las pacientes aumentando el número de pacientes con estadios IA y IB y descendiendo los estadios IIA, IIIA, IIIB y IIIC. Conclusiones: De los subtipos moleculares con factores clinicopatológicos más desfavorables fueron los Triples Negativos y Her2 neu. La importancia de los factores biológicos a la hora de re estadificar los pacientes según TNM 8° edición, favorece los tratamientos conservadores y específicos contra el tumor evitando el sobre tratamiento e implican menores costos que las plataformas genómcias.

Introduction: Breast cancer is classified into 4 molecular subgroups. These biological factors, together with the histological grade, are important factors in the 8th edition of the TNM Classification, and allow establishing survival prognoses in patients with breast cancer. Objetive: The main objetive was to analyse the correlation between different molecular subtypes of breast carcinomas, the presence of axillary metastases and the correlation of tumours in the new TNM Classification. Material and method: Observational and descriptive restrospective study of case series registred in RCM, in Argentina between 2006 and 2016. Results: Most of the tumours were Luminals. The clinical presentation of advanced stages was more frequent at early ages. The molecular subtypes with the highest axillary involvement were HER2 neu tumours. We managed to re-stage the patients to the TNM Classification 8th edition, increasing the number of patients with stages IA and IB and decreasing the stage IIA, IIIA, IIIB and IIIC. Conclusions: Triples negative tumours were diagnosed in more advanced stages, according to the new TNM Classification, than the Luminals. The surgical decision was not modified according to the molecular subtype. We conclude the importance of biological factors when re-staging patients according to the new TNM Classification 8th edition because it increases the number of conservative treatments, and more targets treatment.

Implementation of intensity modulated radiotherapy for prostate cancer in a private radiotherapy service in Mexico.

Intensity modulated radiation therapy (IMRT) allows physicians to deliver higher conformal doses to the tumour, while avoiding adjacent structures. As a result the probability of tumour control is higher and toxicity may be reduced. However, implementation of IMRT is highly complex and requires a rigorous quality assurance (QA) program both before and during treatment. The present article describes the process of implementing IMRT for localized prostate cancer in a radiation therapy department. In our experience, IMRT implementation requires careful planning due to the need to simultaneously implement specialized software, multifaceted QA programs, and training of the multidisciplinary team. Establishing standardized protocols and ensuring close collaboration between a multidisciplinary team is challenging but essential.

[Acute pancreatitis in intensive care unit: review and evolution of 36 cases Víctor Lazarte E. Hospital. Trujillo, Perú]. / Pancreatitis aguda en la unidad de cuidados intensivos e intermedios: revisión y evolución de 36 casos. Hospital Víctor Lazarte E.-Trujillo, Perú

INTRODUCTION: Acute pancreatitis is a local inflammatory process that could be generalized by producing mild to severe gastroenteral manifestations, like multiple organ dysfunction and death. OBJECTIVE: To describe epidemiological, clinical, therapeutical characteristics and evolution of patients with AP of our unit and to compare with other studies of Peru and other countries. MATERIALS AND METHODS: We realized a review of all cases with AP treated in ICU-INCU of Victor Lazarte Echegaray Hospital over 1 degrees January of 2004 to April, 30 of 2007. RESULTS: At the time of this study were admitted 40 patients with AP, just 36 clinics records were recovered, 24 of these were Severe Acute Pancreatitis (SAP) and 12 were Mild Acute Pancreatitis (MAP). Age mean was 55+/-16.7 years old (range 27-84 y.o.), male and female had equal predominance 18 (503). Biliar compliances were the most frequent etiology with 26 cases (72.2%). All patients (100%) had abdominal pain, 34 de 36 cases (94.4%) had nauseas and/or vomits. Seric amylase mean was 2580+/-1507.1 UA/L (range 380-6883 UA/L). Ranson score was 2.92+/-1.97 points (range 0-6 points) and APACHE II score was 11.86+/-8.27 points (range 0-31 points). Computed Tomography was realized in 22 patients with Tomography Severity Index mean was 4.41 +/- 2.79 points (range 0-10 points). Four patients with SAP (16.6%) developed pancreatic pseudocyst. Respiratory dysfunction was the systemic complication most frequent with 36.1% patients of all (13/36 cases), eight patients had multiple organ dysfunction. No patients with MAP dead. Eleven of 36 patients (30.6%) received prophylactic antibiotics. Length of stay in hospital and ICU-INCU were 7.7+/-5.3 days (range 1-26 days) y 14.8+/-9.7 days (range 1-53 days). Two patients with SAP were performed to surgery after AP was detected: one case was cholecystectomized for perfored pyocholecist and other one was cholecystectomized and drain of choledoco; no one of these dead. CONCLUSION: Epidemiological, clinical, therapeutical characteristics and evolution of the patients with AP were similar to the majority of national and international reports.

Pancreatitis Aguda en la Unidad de Cuidados Intensivos e Intermedios: Revisión y evolución de 36 casos. Hospital Víctor Lazarte E. - Trujillo, Perú / Acute pancreatitis in the Intensive and Intermediate Care Unit: Review and evolution of 36 cases. Victor E. Lazarte Hospital - Trujillo, Peru

INTRODUCCIÓN. La pancreatitis aguda (PA) es un proceso inflamatorio localizado que puede generalizarse produciendo disfunción multiorgánica y fallecimiento del paciente. OBJETIVO. Describir las características epidemiológicas, clínicas, terapéuticas y evolución de los pacientes con PA de nuestra unidad y compararlos con los descritos en la literatura nacional e internacional. MATERIAL Y MÉTODOS. Se realizó una revisión de los casos de PA manejados en la UCI-UCIN del Hospital Víctor Lazarte Echegaray Hule durante el periodo 1° de Enero del 2004 al 30 de Abril del 2007. RESULTADOS. Se hospitalizaron 40 pacientes con PA, recuperando 36 historias clínicas, 24 tuvieron PA Grave (PAG) y 12 tuvieron PA Leve (PAL). La edad promedio de los pacientes fue 55 ± 16,7 años (27-84 años), siendo similar el número de pacientes varones y mujeres (18o). La etiología predominante fue biliar con 26 casos (72,2%). El 100% de los pacientes tuvo dolor abdominal estando en 94,4% (34/36 casos) asociado a nauseas y vómitos. El valor promedio de la amilasa sérica fue de 2580 ± 1507,1 UA/L (380-6883 UA/L). El score de Ranson promedio fue 2,92 ± 1,71 puntos (0-6 puntos) y el score APACHE II fue 11,86 ±8,27 puntos (0-31 puntos). La Tomografía contrastada fue realizada a 22 pacientes, el Índice de Severidad Tomográfica promedio fue 4,41 ± 2,79 puntos (0-10 puntos). Se identificó pseudoquiste pancreático en 4 pacientes con PAG (11,1 por ciento). La disfunción respiratoria fue la complicación sistémica más frecuentemente encontrada en 36,1% (13/36 casos). La disfunción multiorgánica (DMO) se encontró en 8 pacientes (22,2%), todos con PAG. La mortalidad fue de 4 casos (11,1%) de los 36 revisados; los 4 ingresaron con DMO de 4 a más órganos. CONCLUSIÓN. Las características epidemiológicas, clínicas, terapéuticas y evolución de los pacientes con PA fueron semejantes a los descritos en la mayoría de los reportes nacionales e internacionales.

INTRODUCTION. Acute pancreatitis is a local inflammatory process that could be generalizedby producing mild to severe gastroenteral manifestations, like multiple organ dysfunction anddeath. OBJECTIVE. To describe epidemiological, clinical, therapeutical characteristics and evolution ofpatients with AP of our unit and to compare with other studies of Peru and other countries. MATERIALS AND METHODS. We realized a review of all cases with AP treated in ICU-INCU ofVictor Lazarte Echegaray Hospital over 1° January of 2004 to April, 30 of 2007.RESULTS. At the time of this study were admitted 40 patients with AP, just 36 clinics records were recovered, 24 of these were Severe Acute Pancreatitis (SAP) and 12 were Mild AcutePancreatitis (MAP). Age mean was 55 ± 16,7 years old (range 27-84 y.o.), male and female had equal predominance 18 (503). Biliar compliances were the most frequent etiology with 26 cases(72,2%). All patients (100%) had abdominal pain, 34 de 36 cases (94,4%) had nauseas and/orvomits. Seric amylase mean was 2580 ± 1507,1 UA/L (range 380-6883 UA/L). . Two patients with SAP were performed to surgery after AP was detected: one casewas cholecystectomized for perfored pyocholecist and other one was cholecystectomizedand drain of choledoco; no one of these dead.CONCLUSIÓN. Epidemiological, clinical, therapeutical characteristics and evolution of thepatients with AP were similar to the majority of national and international reports.