Population-Based Analysis of Trends in Incidence and Survival of Human Papilloma Virus-Related Oropharyngeal Cancer in a Low-Burden Region of Southern Europe.

Introduction: Human papilloma virus (HPV)-related oropharyngeal carcinoma (OPC) can be considered a new subtype of cancer with different clinical characteristics and prognosis than that related to tobacco. Its incidence is increasing worldwide. Its epidemiology has been widely studied in areas such as North America and Northern Europe, but less is known in Southern Europe. Methods: We analyzed the epidemiology of OPC using the database from Girona's population-based Cancer Registry, in the North-East of Spain, from 1994 to 2018. To analyze differences between neoplasms related to human papillomavirus or not, we determined the immunohistochemical expression of p16 in cases within four time periods: 1997-1999, 2003-2005, 2009-2011, and 2016-2018. Results: Oropharyngeal cancer incidence increased significantly from 2001 to 2018 with an Annual Percentage of Change (APC) of 4.1. OPC p16-positive cases increased with an APC of 11.1. In the most recent period, 2016-2018, 38.5% of OPC cases were p16-positive. European age-standardized incidence rate was 4.18 cases/100.000 inhabitants-year for OPC cancer and 1.58 for those p16-positive. Five-year observed survival was 66.3% for p16-positive OPC and 37.7% for p16-negative. Conclusions: Although with lower burden than in other regions, p16-positive oropharyngeal cancer is increasing in our area and has a better prognosis than p16-negative OPC.

Correlation between mutational status and survival and second cancer risk assessment in patients with gastrointestinal stromal tumors: a population-based study.

BACKGROUND: Gastrointestinal stromal tumors are sarcomas of the digestive tract characterized by mutations mainly located in the c-KIT or in the platelet-derived growth factor receptor (PDGFR)-alpha genes. Mutations in the BRAF gene have also been described. Our purpose is to define the distribution of c-KIT, PDGFR and BRAF mutations in a population-based cohort of gastrointestinal stromal tumors (GIST) patients and correlate them with anatomical site, risk classification and survival. In addition, as most of the GIST patients have a long survival, second cancers are frequently diagnosed in them. We performed a second primary cancer risk assessment. METHODS: Our analysis was based on data from Tarragona and Girona Cancer Registries. We identified all GIST diagnosed from 1996 to 2006 and performed a mutational analysis of those in which paraffin-embedded tissue was obtained. Observed (OS) and relative survival (RS) were calculated according to risk classifications and mutational status. Multivariate analysis of variables for observed survival and was also done. RESULTS: A total of 132 GIST cases were found and we analyzed mutations in 108 cases. We obtained 53.7% of mutations in exon 11 and 7.4% in exon 9 of c-KIT gene; 12% in exon 18 and 1.9% in exon 12 of PDGFR gene and 25% of cases were wild type GIST. Patients with mutations in exon 11 of the c-KIT gene had a 5-year OS and RS of 59.6% and 66.3%, respectively. Patients with mutations in exon 18 of the PDGFR gene had a 5-year OS and RS of 84.6% and 89.7%. In multivariate analysis, only age and risk group achieved statistical significance for observed survival. GIST patients had an increased risk of second cancer with a hazard ratio of 2.47. CONCLUSIONS: This population-based study shows a spectrum of mutations in the c-KIT and PDGFR genes in GIST patients similar to that previously published. The OS and RS of GIST with the exon 18 PDGFR gene mutation could indicate that this subgroup of patients may be less aggressive and have a good prognosis, although less sensitive to treatment at recurrence. In our study, GIST patients have an increased risk of developing a second neoplasm.

Soft-tissue tumors update: MR imaging features according to the WHO classification.

Soft-tissue tumors are a large and heterogeneous group of neoplasms. Hence, classification is often difficult. The most effective management decisions are made when a working group participates in the same diagnostic standard criteria in the evaluation of soft-tissue tumors. The purpose of this pictorial review is to highlight the new and the less well-known features on magnetic resonance (MR) imaging of soft-tissue tumors according to the World Health Organization (WHO) classification established in 2002. The article depicts the major changes of the WHO classification since it was established in 2002 and the most significant findings on MR imaging, thereby providing an update.

Hemangioma from head to toe: MR imaging with pathologic correlation.

Hemangioma is a common benign vascular neoplasm that closely resembles normal vessels and can be found in all organs of the human body. Vascular lesions can be classified as infantile hemangiomas or vascular malformations on the basis of their natural history, location, cellular turnover, and histologic characteristics. The magnetic resonance (MR) imaging features of vascular malformations of the central nervous system depend on the pathologic subtype. Soft-tissue vascular malformations can be categorized with combined MR imaging and MR angiography as either high- or low-flow. Osseous vascular malformations commonly demonstrate a high-signal-intensity trabecular pattern at both T1- and T2-weighted MR imaging. A group of more aggressive vascular neoplasms, including hemangioendothelioma, hemangiopericytoma, and glomus tumor, have a nonspecific appearance at MR imaging. In the liver and spleen, hemangiomas are typically hyperintense at T2-weighted MR imaging, with a centripetal filling pattern after administration of gadopentetate dimeglumine. Vascular lesions can involve several organs or systems in angiomatous syndromes. MR imaging allows characterization of a hemangioma with typical features, which vary depending on anatomic location. Familiarity with these features facilitates diagnosis and management of these anomalies.

Valoración de la resonancia magnética de mama en un equipo de 0,5 T / Assessment of magnetic resonance imaging of the breast using 0.5 T equipment

Objetivo: Evaluar la eficacia de la técnica de resonancia magnética de mama en un equipo de medio campo (0,5 T). Material y método: Hemos evaluado las 191 exploraciones de resonancia magnética (RM) realizadas en nuestro centro en el período de marzo 1998 a marzo de 2001 utilizando un equipo RM de 0,5 T Signa Contour de General Electric. Se utilizó una bobina dedicada de mama bilateral. Se realizaron secuencias fast eco de gradiente potenciadas en T1 3D con saturación de la grasa en el plano coronal antes de la administración de gadolinio endovenoso y seis veces consecutivas tras la administración de contraste. El tiempo de adquisición de la secuencia fue de 7090 segundos. El posprocesado de las imágenes incluyó la técnica de sustracción y el análisis de las curvas de intensidad/tiempo sobre la región de interés (ROI) conjuntamente con la evaluación morfológica de la lesión. Se realizaron secuencias adicionales fast eco del espín potenciadas en T2 (FSE T2), eco del espín potenciadas en T1 (SE T1), FSE T2 con supresión de la grasa y STIR con saturación de agua para estudios de prótesis mamaria. Resultados: Las indicaciones clínicas para el estudio RM de mama fueron: masas (n = 79), microcalcificaciones (n = 7), asimetrías (n = 17), casos indeterminados, de riesgo (n = 7), control posquirúrgico (n = 51) y prótesis mamaria (n = 25). El diagnóstico histológico mostró 31 lesiones benignas y 73 de malignas. La sensibilidad, especificidad y fiabilidad de la RM de mama fueron del 93 por ciento, 81 por ciento y 89 por ciento respectivamente. Se hallaron neoplasias multicéntricas/multifocales en un 8 por ciento de pacientes y bilaterales en un 2 por ciento. La actitud terapéutica se modificó en un 18 por ciento de los pacientes con cáncer de mama como consecuencia de los hallazgos por RM. Conclusión: Los resultados confirman la utilidad de la RM en el manejo de los pacientes con cáncer de mama. Así mismo, el presente estudio demuestra que la RM de mama puede realizarse en equipos de medio campo con la misma fiabilidad que en alto campo siempre que se utilicen bobinas específicas de mama, secuencias rápidas 3D y procesado de las imágenes con un software adecuado. (AU)