SHP2 promotes sarcoidosis severity by inhibiting SKP2-targeted ubiquitination of TBET in CD8+ T cells.

Sarcoidosis is an interstitial lung disease (ILD) characterized by interferon-γ (IFN-γ) and T-box expressed in T cells (TBET) dysregulation. Although one-third of patients progress from granulomatous inflammation to severe lung damage, the molecular mechanisms underlying this process remain unclear. Here, we found that pharmacological inhibition of phosphorylated SH2-containing protein tyrosine phosphatase-2 (pSHP2), a facilitator of aberrant IFN-γ abundance, decreased large granuloma formation and macrophage infiltration in the lungs of mice with sarcoidosis-like disease. Positive treatment outcomes were dependent on the effective enhancement of TBET ubiquitination within CD8+ T cells. Mechanistically, we identified a posttranslational modification pathway in which the E3 F-box protein S-phase kinase-associated protein 2 (SKP2) targets TBET for ubiquitination in T cells under normal conditions. However, this pathway was disrupted by aberrant pSHP2 signaling in CD8+ T cells from patients with progressive pulmonary sarcoidosis and end-stage disease. Ex vivo inhibition of pSHP2 in CD8+ T cells from patients with end-stage sarcoidosis enhanced TBET ubiquitination and suppressed IFN-γ and collagen synthesis. Therefore, these studies provided new mechanistic insights into the SHP2-dependent posttranslational regulation of TBET and identified SHP2 inhibition as a potential therapeutic intervention against severe sarcoidosis. Furthermore, these studies also suggest that the small-molecule SHP2 inhibitor SHP099 might be used as a therapeutic measure against human diseases linked to TBET or ubiquitination.

Radiation therapy after radical surgery in prostate cancer.

Radiation therapy plays a key role in the treatment of prostate cancer on its own. For higher risk diseases, the risk of recurrence following single modality therapy increases and a combination of treatment modalities may be necessary to achieve optimal results. We review clinical outcomes of adjuvant and salvage radiotherapy following radical prostatectomy, including disease-free survival, cancer-specific survival and overall survival. We also discuss when best to intervene with post-prostatectomy radiotherapy.

Image Fusion Involving Real-Time Transabdominal or Endoscopic Ultrasound for Gastrointestinal Malignancies: Review of Current and Future Applications.

Image fusion of CT, MRI, and PET with endoscopic ultrasound and transabdominal ultrasound can be promising for GI malignancies as it has the potential to allow for a more precise lesion characterization with higher accuracy in tumor detection, staging, and interventional/image guidance. We conducted a literature review to identify the current possibilities of real-time image fusion involving US with a focus on clinical applications in the management of GI malignancies. Liver applications have been the most extensively investigated, either in experimental or commercially available systems. Real-time US fusion imaging of the liver is gaining more acceptance as it enables further diagnosis and interventional therapy of focal liver lesions that are difficult to visualize using conventional B-mode ultrasound. Clinical studies on EUS guided image fusion, to date, are limited. EUS-CT image fusion allowed for easier navigation and profiling of the target tumor and/or surrounding anatomical structure. Image fusion techniques encompassing multiple imaging modalities appear to be feasible and have been observed to increase visualization accuracy during interventional and diagnostic applications.

Penile melanoma: a 20-Year analysis of six patients at the National Cancer Institute of Peru, Lima.

Melanoma of the urogenital tract is extremely rare, accounting for less than 0.1% of melanoma cases. The global literature currently describes only 220 cases of penile melanoma, most commonly located on the glans penis. RESULTS: Penile melanoma accounts for 0.7% of penile cancers and 0.18% of melanoma cases. The average patient age for the six cases we reviewed was 44.5 years. Three of these cases (50%) involved ulceration, one case (16.7%) involved lymphovascular invasion, and three cases (50%) involved mitosis ≥ 1 mm2 (0.38-4.7 mm). The average depth of invasion (Breslow) in the five cases that reported this measure was 2.1 mm (0.38-4.7 mm). Applying the American Joint Committee on Cancer tumour, node, metastases (AJCC TNM) staging system, one case was Tx (16.7%), two cases were T1 (33.3%), one case was T2 (16.7%), one case was T3 (16.7%), and one case was T4 (16.7%). Five cases (83.3%) involved wide local resection, and only one case involved partial penile amputation. Four cases (66.7%) involved primary bilateral inguinocrural lymphadenectomy, and only one of those four cases involved lymphatic metastatic disease. One case (16.7%) involved lymphatic recurrence at 12 months in a patient who survived 38 months. One case (16.7%) involved local recurrence at 13 months in a patient who has survived 53 months. Eighty per cent of these patients remain alive, with no evidence of disease after an average follow-up of 96.7 months. CONCLUSION: Penile melanoma prognosis depends on the initial clinical stage of the disease. The risk of lymphatic involvement seems to be related to the same risk factors used to assess cutaneous melanoma. Clinicians can thus assess penile melanoma using the AJCC staging system. The use of sentinel lymph node biopsy to determine staging is also becoming more common and could replace prophylactic bilateral inguinal dissection.

[Pain during transrectal ultrasound guided needle biopsy of the prostate: comparison of the use or not of lidocaine gel]. / Dolor durante biopsia de próstata guiada por ultrasonografía transrectal: comparación del uso o no de xilocaína gel como anestésico local.

INTRODUCTION: The prostate biopsy guided by ultrasound is the method of choice for early diagnosis of prostate cancer, is a safe whose main trouble is that it feels discomfort during the procedure. MATERIAL AND METHODS: From July 2004 until March 2005 we prospectively studied 114 patients who underwent transrectal ultrasound guided needle biopsy of the prostate, they were divided in two groups: in one group we used lidocaina gel 2% inside the rectum before the procedure and in the other group we did not use it. We compared the pain that patients felt during the procedure with a pain scale. RESULTS: We did not find differences between both groups, but the patients in whom we used a new needle felt less pain than the patients in whom we used a re-esterilized one. CONCLUSIONS: The use of lidocaine gel intrarectal 2% before a prostate biopsy guided by ultrasound did not diminish the sensation of pain from the procedure in our patients, which was increased by the use of sterilized needles.

[Primary testicular lymphoma: experience at the Instituto Especializado de Enfermedades Neoplásicas, Lima-Peru]. / Linfoma testicular primario: experiencia en el Instituto Nacional de Enfermedades Neoplásicas, Lima-Perú.

INTRODUCTION: Testicular lymphoma is a rare illness with peculiar characteristics but with a poor prognosis. MATERIAL AND METHODS: We evaluated 32 patients retrospectively studying their epidemiologic characteristics, hematologic values, histologic type, metastasis sites, the treatment given and the survival. We compared our results with international reports and we think that prospective studies are needed for better conclusions. RESULTS: The average of age was 45-years-old, with more than the half of patients with clinical stage IV at the moment of the diagnosis, the histiocitic pathology was the most frequent, and the time of survival was 39,543 +/- 14,451 months and the time in which the 50% of the patients die is 15 +/- 7,025 months. CONCLUSIONS: This is a rare disease, with a very poor prognosis, with a time of survival of 39,543 +/- 14,451 months and the time in which the 50% of the patients die is 15 +/- 7,025 months.

[Gastric cancer in a general hospital. Santa Rosa Hospital. Experience]. / Cáncer gástrico en un hospital general: Hospital Santa Rosa.

PURPOSE: Determine the frequency of gastric cancer and its clinical and pathological characteristics, clinical stages, surgical treatment, morbimortality and survival in a general hospital. MATERIALS AND METHODS: Retrospective, descriptive study on 71 consecutive patients diagnosed with gastric cancer at the Santa Rosa Hospital from January 1, 2005 to January 31, 2008. RESULTS: During the study period, 71 cases of gastric adenocarcinoma were confirmed by histopathology. This disease is more frequent in men, with a 1.54 to 1 ratio, as compared to women. The most frequent age of appearance is between the fifth and seventh decades of life. Distal tumors (81.7%) are four times more common than proximal tumors (18,3%). The most common histological type was carcinoma in signet-ring cells (40.8%). The most frequent degree of differentiation was Undifferentiated (42.3%). A 62% (n=44) of patients entered the operating room. The resectability rate was 68% (n=30). The advanced stage was the most common form of presentation in patients (97.2%), while the early stage was rare (2.8%). The most frequent surgeries were the distal subtotal gastrectomy (73.3%) and the total gastrectomy (26.7%). The D2 (73.3%) dissection was performed. The mortality rate was 6.7% and the morbidity rate was 26.7%. Survival was better in patients who underwent resection than in patients who only underwent biopsy or were unresectable, evidencing statistical significance. CONCLUSION: Gastric cancer is diagnosed in a late stage and surgical treatment plays a pivotal role and, even in advanced cases, morbidity/mortality is acceptable for the initial experience at a third-level general hospital. It is necessary to carry out screening program to detect the disease in earlier stages.

Cáncer Gástrico en un Hospital General: Hospital Santa Rosa / Gastric cancer in a general hospital. Santa Rosa Hospital. experience

OBJETIVO: Determinar la frecuencia de cáncer gástrico y sus características clínico patológicas, estadios clínicos, tratamiento quirúrgico, morbimortalidad y sobrevida en un hospital general. MATERIALES Y MÉTODOS: Estudio retrospectivo, descriptivo, de 71 pacientes consecutivos diagnosticados con cáncer gástrico en el Hospital Santa Rosa desde el 1 de enero 2005 hasta el 31 de enero 2008. RESULTADOS: En el periodo de estudio se confirmaron por histopatologia 71 casos de adenocarcinoma gástrico. El sexo masculino es el más frecuente, con una relación de 1,54 a 1 con respecto al sexo femenino. La edad de presentación más frecuente se encuentra entre la 5ta y 7ma década de vida. Los tumores distales (81,7 por ciento) son cuatro veces más frecuentes que los proximales (18,3 por ciento). El tipo histológico más frecuente fue el carcinoma en células de anillo de sello (40,8 por ciento). El grado de diferenciación más frecuente fue el Indiferenciado (42,3 por ciento). El 62 por ciento (n=44) ingresó a sala de operaciones. La tasa de resecabilidad fue de 68 por ciento (n=30). El estadío clínico avanzado ha sido la forma depresentación más frecuente de los pacientes (97,2 por ciento), mientras que el estadío precoz ha sido raro (2,8 por ciento). La cirugía más frecuente fue la gastrectomía subtotal distal (73,3 por ciento) y gastrectomía total (26,7 por ciento). La disección realizada fue la D2 (73,3 por ciento). La tasa de mortalidadfue 6,7 por ciento y morbilidad de 26,7 por ciento. La sobrevida fue mejor en los pacientes que tuvieron resección frente a los que sólo se les realizó biopsia o fueron irresecables, evidenciandosignificancia estadística. CONCLUSIÓN: El cáncer gástrico se diagnóstica en etapa tardía y el tratamiento quirúrgicojuega un rol fundamental e incluso en casos avanzados, la morbimortalidad es aceptable para la experiencia inicial en un Hospital general de tercer nivel. Es necesario realizar programas de tamizaje para detectar la enfermedad en...

PURPOSE: Determine the frequency of gastric cancer and its clinical and pathological characteristics, clinical stages, surgical treatment, morbimortality and survival in ageneral hospital. MATERIALS AND METHODS: Retrospective, descriptive study on 71 consecutive patients diagnosed with gastric cancer at the Santa Rosa Hospital from January 1, 2005 to January 31, 2008. RESULTS: During the study period, 71 cases of gastric adenocarcinoma were confirmed by histopathology. This disease is more frequent in men, with a 1.54 to 1 ratio, as compared to women. The most frequent age of appearance is between the fifth and seventh decadesof life. Distal tumors (81.7 per cent) are four times more common than proximal tumors (18,3 per cent).The most common histological type was carcinoma in signet-ring cells (40.8 per cent). The mostfrequent degree of differentiation was Undifferentiated (42.3 per cent). A 62 per cent (n=44) of patients entered the operating room. The resectability rate was 68 per cent (n=30). The advanced stagewas the most common form of presentation in patients (97.2 per cent), while the early stage was rare (2.8 per cent). The most frequent surgeries were the distal subtotal gastrectomy (73.3 per cent) and the total gastrectomy (26.7 per cent). The D2 (73.3 per cent) dissection was performed. The mortality rate was 6.7 per cent and the morbidity rate was 26.7 per cent. Survival was better in patients who underwent resection than in patients who only underwent biopsy or were unresectable, evidencing statistical significance. CONCLUSIÓN: Gastric cancer is diagnosed in a late stage and surgical treatment playsa pivotal role and, even in advanced cases, morbidity/mortality is acceptable for the initial experience at a third-level general hospital. It is necessary to carry out screening program to detect the disease in earlier stages.

Dolor durante biopsia de próstata guiada por ultrasonografía transrectal: Comparación del uso o no de Xilocaína gel como anestésico local / Pain during transrectal ultrasound guided needle biopsy Of the prostate: comparison of the use or not of lidocaine Gel

Introducción: La biopsia de próstata guiada por ecografía es el método de elección para el diagnóstico precoz del cáncer de próstata, es un método seguro cuya principal molestia es el disconfort que se siente durante el procedimiento. Material y métodos: Desde julio del 2004 hasta marzo del 2005 se reclutaron 114 pacientes con indicación de biopsia de próstata bajo guía ecográfica los cuales se dividieron en dos grupos según la administración o no de xilocaína gel al 2%intrarrectal antes del procedimiento. Se comparó el dolor que sintieron durante la biopsia a través de una escala de dolor. Resultados: No hubo diferencia estadísticamente significativa entre los pacientes a quienes se administró anestésico local frente a quienes no se les administró. Por otro lado, el dolor fue mayor cuando se usó una aguja esterilizada que cuando se usó una aguja nueva. Conclusiones: El uso de xilocaína gel al 2% intrarrectal previa a la biopsia de próstata guiada por ecografía no disminuyó la sensación de dolor por el procedimiento en nuestros pacientes, el cual fue incrementado por el uso de agujas esterilizadas (AU)

Introduction: The prostate biopsy guided by ultrasound is the method of choice for early diagnosis of prostate cancer, is a safe whose main trouble is that it feels discomfort during the procedure. Material and methods: From July 2004 until March 2005 we prospectively studied 114 patients who underwent transrectal ultrasound guided needle biopsy of the prostate, they were divided in two groups: in one group we used lidocaína gel2% inside the rectum before the procedure and in the other group we did not use it. We compared the pain that patients felt during the procedure with a pain scale. Results: We did not find differences between both groups, but the patients in whom we used a new needle felt less painthan the patients in whom we used a re-esterilized one. Conclusions: The use of lidocaine gel intrarectal 2% before a prostate biopsy guided by ultrasound did not diminish the sensation of pain from the procedure in our patients, which was increased by the use of sterilized needles (AU)

Linfoma testicular primario: experiencia en el Instituto Nacionalde Enfermedades Neoplásicas. Lima-Perú / Primary testicular lymphoma: experience Instituto especializado de enfermedades neoplásicas. Lima-Peru

Introducción: El linfoma testicular es una enfermedad poco frecuente con características peculiares y un pronóstico pobre. Material y métodos: Evaluamos en forma retrospectiva 32 pacientes con este diagnóstico estudiando sus características epidemiológicas, valores hematológicos, tipo histológico, lugares de metástasis, tratamiento recibido y tiempo de sobrevida. Así mismo comparamos nuestros resultados con los reportes internacionales, haciendo énfasis en la necesidad de estudios prospectivos para obtener mejores conclusiones. Resultados: El promedio de edad fue de 45 años, con más de la mitad de los pacientes con estadío clínico IV al momento del diagnóstico, con la variedad histiocítica como la patología más frecuente, y con el tiempo promedio de sobrevida de39,543±14,451 meses, y el tiempo mediano (tiempo en el cual muere el 50% de pacientes) de 15±7,025 meses. Conclusiones: Enfermedad poco frecuente cuyo pronóstico es aún pobre, con una sobrevida promedio de 40 meses y tiempo mediano de 15 meses (AU)

Introduction: Testicular lymphoma is a rare illness with peculiar characteristics but with a poor prognosis. Material and methods: We evaluated 32 patients retrospectively studying their epidemiologic characteristics, hematologic values, histologic type, metastasis sites, the treatment given and the survival. We compared our results with international reports and we think that prospective studies are needed for better conclusions. Results: The average of age was 45 years old, with more than the half of patients with clinical stage IV at the moment of the diagnosis, the histiocitic pathology was the most frequent, and the time of survival was 39,543±14,451 months and the time in which the 50% of the patients die is 15±7,025 months. Conclusions: This is a rare disease, with a very poor prognosis, with a time of survival of 39,543±14,451 months and the time in which the 50% of the patients die is 15±7,025 months (AU)

Dolor trans biopsia de próstata guiada por ultrasonografía transrectal: comparación del uso o no de xilocaína gel como anestésico local: Instituto Especializado de Enfermedades Neoplásicas: Lima-Perú 2006 / Pain during transrectal ultrasound guided needle biopsy of the prostate: comparison of the use or not of lidocaine: Instituto Especializado de Enfermedades Neoplásicas: Lima-Perú

Desde julio de 2004 hasta marzo de 2005 se reclutaron 114 pacientes con indicación de biopsia de próstata bajo guía ecográfica los cuales se dividieron en dos grupos según la colocación o no de xilocaína gel al 2 por ciento intrarrectal antes del procedimiento. Se comparó el dolor que sintieron durante la biopsia a través de una escala de dolor. No hubo diferencia estadísticamente significativa entre los pacientes a quienes se colocó anestésico local frente a quienes no se les colocó. Por otro lado, el dolor fue mayor cuando se usó una aguja esterilizada que cuando se usó una aguja nueva.

From July 2004 until March 2005 we prospectively studied 114 patients who underwent transrectal ultrasound guided needle biopsy of the prostate. Patients were divided in two groups: intrarectal 2 percent lidocaine gel was used prior to biopsy in one of the groups. We compared the pain that patients felt during the procedure using a pain scale. We did not find differences between both groups, but the patients in whom we used a new needle felt less pain than the patients in whom we used a reesterilized one.

Sarcoma mixto paratesticular: liposarcoma - rabdomiosarcoma. Presentación de un caso y revisión de la literatura / Paratesticular mixed sarcoma: liposarcoma-rhabdomyosarcoma. Case report and bibliographic review

OBJETIVO: Los sarcomas que se originan en el tracto urinario son raros, representando menos del 2% de los tumores urológicos, siendo las de localización paratesticular menos frecuentes. Se describen casos de leiomiosarcoma, rabdomiosarcoma, liposarcoma, fibrohistiocitoma maligno, y otros. La combinación de dos o más variedades en un mismo tumor han sido reportadas excepcionalmente. Describimos el caso de un paciente con sarcoma mixto paratesticular y realizamos la revisión de la literatura. MÉTODOS: El paciente fue sometido a orquiectomía radical derecha y la pieza operatoria enviada a estudio anátomopatológico. RESULTADOS: No se reportan casos similares de presentación de un tumor paratesticular mixto con componentes de liposarcoma y rabdomiosarcoma. CONCLUSIONES: Los sarcomas del cordón espermático son neoplasias raras que deben ser sospechadas en el enfoque diagnóstico de las masas escrotales. Su manejo inicial es quirúrgico y el tratamiento complementario debe considerarse de forma individualizada en razón de la agresividad de este tumor (AU)

OBJECTIVE: Sarcomas arising from the urinary tract are rare, representing less than 2% of all urologic tumors. The paratesticular region is one of the most unfrequent locations. Leiomyosarcoma, rhabdomyosarcoma, liposarcoma, malignant fibrohistiocytoma, etc. and the combination of two or more histological types has exceptionally been reported . We describe the case of a patient with a mixed paratesticular sarcoma and perform a bibliographic review. METHODS: The patient underwent right radical orchyectomy and the surgical specimen was sent to pathologic study. RESULTS: There are no previous case reports in the literature of paratesticular mixed tumor with liposarcoma and rhabdomyosarcoma. CONCLUSIONS: Sarcomas of the spermatic cord are rare neoplasias and should be considered on the differential diagnosis of scrotal masses. The treatment of choice is surgical and adjuvant treatment must be individualized depending on tumor aggressiveness (AU)

[Paratesticular mixed sarcoma: liposarcoma-rhabdomyosarcoma. Case report and bibliographic review]. / Sarcoma mixto paratesticular: liposarcoma-rabdomiosarcoma. Presentación de un caso y revisión de la literatura.

OBJECTIVE: Sarcomas arising from the urinary tract are rare, representing less than 2% of all urologic tumors. The paratesticular region is one of the most unfrequent locations. Leiomyosarcoma, rhabdomyo-sarcoma, liposarcoma, malignant fibrohistiocytoma, etc. and the combination of two or more histological types has exceptionally been reported. We describe the case of a patient with a mixed paratesticular sarcoma and perform a bibliographic review. METHODS: The patient underwent right radical orchyectomy and the surgical specimen was sent to pathologic study. RESULTS: There are no previous case reports in the literature of paratesticular mixed tumor with liposarcoma and rhabdomyosarcoma. CONCLUSIONS: Sarcomas of the spermatic cord are rare neoplasias and should be considered on the differential diagnosis of scrotal masses. The treatment of choice is surgical and adjuvant treatment must be individualized depending on tumor aggressiveness.

[Xanthogranulomatous pyelonephritis: clinical, radiological and pathologic characteristics]. / Pielonefritis xantogranulomatosa: características clínicas, radiológicas y anatomo-patológicas.

OBJECTIVES: Xanthogranulomatous pyelonephritis is an atypical chronic infection which simulates a malignant renal neoplasia, definitive diagnosis of which is obtained by pathologic study after surgical removal. In this paper we analyze our experience and compare it to that reported on the literature. METHODS: We performed a retrospective study of cases of xanthogranulomatous pyelonephritis diagnosed in the period from January 1945 to December 2000 at the Institute of Neoplastic Diseases, analyzing clinical, radiological, and surgical features documented in the medical records. RESULTS: There were 11 cases, 82% of them were females. The presence of signs and symptoms such as pain and abdominal mass appeared in 73%, accompanied by hematuria and fever. Most radiological tests showed destruction of the renal parenchyma with abnormalities in the collecting system and obstruction by lithiasis. 91% of the cases had positive urine cultures, being Escherichia coli, Proteus Mirabilis and Klebsiella the most frequent germs. Simple nephrectomy was the surgical treatment, and complications were minimal. CONCLUSIONS: Xanthogranulomatous pyelonephritis should be considered in the differential diagnosis of renal cancer because of its clinical features.

Pielonefritis xantogranulomatosa: características clínicas, radiológicas y anatomo-patológicas / Xanthogranulomatous pyelonephritis: clinical, radiological and pathologic characteristics

OBJETIVOS: La pielonefritis xantogranulomatosa es una infección crónica atípica que simula una neoplasia renal maligna y cuyo diagnóstico definitivo se obtiene del estudio anatomopatológico posterior a la resección quirúrgica. En el presente trabajo analizamos y comparamos nuestra experiencia con lo reportado en la literatura. MÉTODOS: Se realizó un estudio retrospectivo de los casos de pielonefritis xantogranulomatosa diagnosticados en el periodo comprendido de Enero de 1945 a Diciembre del 2000 en el Instituto de Enfermedades Neoplásicas, analizando los aspectos clínicos, radiológicos y quirúrgicos registrados en las historias clínicas. RESULTADOS: Se obtuvieron 11 casos de los cuales el 82 por ciento se presentaron en mujeres. La presencia de signos y síntomas como dolor y masa abdominal se presentó en un 73 por ciento, acompañados de hematuria y alza térmica. Las pruebas radiológicas describieron en su mayoría la destrucción del parénquima renal con alteraciones en el sistema colector y obstrucción del mismo por litiasis. El cultivo positivo de orina fue predominante en el estudio en un 91 por ciento de los casos, teniendo a Escherichia coli, Proteus mirabilis y Klebsiella como gérmenes más frecuentes. El tratamiento quirúrgico fue la nefrectomía simple y las complicaciones que se presentaron fueron mínimas. CONCLUSIONES: La pielonefritis xantogranolomatosa, por sus manifestaciones clínicas, debe considerarse en el diagnóstico diferencial del cáncer renal (AU)

Leiomiosarcoma de vena renal. A propósito de un caso y revisión de la literatura / Leiomyosarcoma of renal vein. About a case and review of the literature

Los leiomiosarcomas de origen vascular son una patología rara y agresiva, siendo poco frecuente la presentación a nivel de la vena renal; reportándose 29 casos a nivel mundial. Describimos un caso de una mujer de 76 años, quien presentó 6 meses de dolor intermitente en flanco izquierdo, irradiado a región lumbar. Se realizó nefrectomía radical con resección en bloque de tumor para-aórtico. El examen microscópico de la pieza operatoria reportó leiomiosarcomas moderadamente diferenciado, originado en la pared de la vena renal. Recibió tratamiento adyuvante con quimioterapia y radioterapia. El tumor recurrió a nivel hepático. Luego de 24 meses de la primera cirugía, el paciente esta vivo con evidencia de múltiples metástasis a nivel hepático. Ella se encuentra actualmente bajo cuidado paliativo.

Las instilaciones endovesicales en la terapia del cáncer superficial de la vejiga / I manage of the armpit in cancer of suckles precocious: controversies

Las instalaciones endovesicales representan el más importante progreso en la terapia intravesical de los tumores de la vejiga en los últimos 20 años. esta terapia intravesical puede ser divida en quimioterapia (QT) e inmunoterapia (IT). La QT endovesical disminuye significativamente el riesgo de recurrencia. la inmunoterapia (IT) con BCG (instilaciones endovesicales de bacilo Camette-Guerin), disminuyen significativamente el riesgo de recidiva y de progresión. Estas instilaciones pueden estar asociada a un cierto número de complicaciones graves, que aunque raras merecen identificación temprana y tratamiento adecuado. es importante conocer la exacta indicación y contraindicaciones de su uso, como una forma de prevenir eventuales complicaciones y de vigilar atentamente su tolerancia y eficacia.

Morbilidad y mortalidad post operatorias por laparotomía exploratoria en cáncer gástrico avanzado / Morbilidad and mortality post operative for exploratory laparotomía in advanced gastric cancer

Objetivo: Analizar los factores relacionados a la morbilidad y mortalidad de la lapartomía exploratoria (LE) en pacientes con cáncer gástrico irresecable. Diseño del estudio: revisión rertospectiva de las historias clínicas de pacientes con cáncer gástrico irresecable a quienes no fue factible realizarles ningún procedimiento paliativo en el Instituto de Enfermedades Neoplásicas entre 1980 y 1993. Los factores analizados fueron: edad, sexo hemoglobina, albúmina, riesgo quirúrgico, ascitis, extensión de la enfermedad, tiempo operatorio y morbilidad y mortalidad post operatorias. Resultados: 234 pacientes con cáncer gástrico avanzado irresecable sólo tuvieron LE con una morbilidad y mortalidad de 11.5 por ciento y 9.0, respectivamente. La neumonía fue la principal causa de morbilidad y mortalidad post operatorías. La presencia de ascitis y de metástasis hepática demostraron ser factores asociados con la morbilidad post operatoria (p menor 0.05). Los factores de pronóstico de mortalidad post operatoria fueron el riesgo quirúrgico 3-5 y la presencia de ascitis (p menor 0.01). Conclusiones: la mortalidad post operatoria de la LE en pacientes con cáncer gástrico irresecable estuvo asociada al riesgo quirúrgico y a la presencia de ascitis.

Relación entre cáncer gástrico y grupo sanguíneo ABO / Relation between gastric cancer and ABO blood groups

Se revisan retrospectivamente 831 historias clínicas de pacientes con cáncer gástrico sometidos a algún tipo de procedimiento quirúrgico en el Instituto de Enfermedades Neoplásicas entre 1980 y 1990. Se analiza la relación entre los grupos sanguíneos ABO y cáncer gástrico, con respecto a edad, sexo y tipo histológico. Se encontró que el grupo sanguíneo predominante es el 0 (74 por ciento) y el grupo A sólo representó el 19 por ciento sin diferencia respecto a la población general (p >0.05). No se encontró relación entre los grupos sanguíneos ABO y la edad, el sexo y el tipo histológico de la neoplasia (p > 0.05).