Metaloptisis: ¿un nuevo caso con otra causa? / Metalloptysis: A new case with another cause?

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Análisis multicéntrico de supervivencia y factores pronósticos en el carcinoma no microcítico de pulmón en estadio I patológico según la nueva clasificación TNM de 2009 / Multicenter Analysis of Survival and Prognostic Factors in Pathologic Stage I Non-Small-Cell Lung Cancer According to the New 2009 TNM Classification

Introducción: La nueva clasificación TNM de 2009 ha introducido importantes modificaciones en la estadificacióndel cáncer de pulmón. El objetivo de este trabajo es validar nuestra serie de pacientes concarcinoma no microcítico de pulmón en estadio I patológico según la séptima edición de la clasificaciónTNM de los tumores malignos y analizar los factores relacionados con el pronóstico.Pacientes y métodos: Se realizó un estudio retrospectivo y multicéntrico. Para el análisis de supervivenciase utilizó el método de Kaplan-Meier y para el análisis multivariable, la regresión de Cox. Se analizaronlas siguientes variables: edad, sexo, estadio patológico, categoría T, tipo histológico, tipo de resección ytamaño tumoral.Resultados: Se incluyó a 402 pacientes con un seguimiento medio de 70,18 meses. La supervivencia globala los 5 años fue del 68%. Los varones y los pacientes mayores de 70 años tenían una menor supervivencia.El pronóstico empeoraba a medida que aumentaba el estadio patológico, la categoría T y el tamañotumoral. No encontramos diferencias pronósticas estadísticamente significativas en relación con el tipohistológico y el tipo de resección practicada. El análisis multivariable mostró que la edad, el sexo y elestadio patológico son factores pronósticos independientes.Conclusiones: Los resultados de supervivencia y el análisis de factores pronósticos de nuestra serie seajustan a los publicados en la nueva clasificación TNM de 2009. El factor pronóstico más importante esel estadio patológico. Otros factores pronósticos desfavorables son el sexo masculino y la edad mayor de70 años (AU)

Introduction: The new 2009 TNM classification introduced important modifications in lung cancer staging. The aim of this study is to validate our series of patients with pathologic stage I non-small-cell lung canceraccording to the 7th edition of the TNM classification of malignant tumors and to the factors related withprognosis.Patients and methods: A multicenter retrospective study was performed. Survival rates were calculated by the Kaplan-Meier method, and for multivariate analyses, Cox proportional hazards regression model was used. The following variables were analyzed: age, sex, pathologic stage, T category, histology, type of resection and tumor size. Results: A total of 402 patients were included. Mean follow-up was 70.18 months. Overall 5-year survivalwas 68%. Males and patients over 70 had lower survival. Prognosis worsened with increasing pathologicstage, T category and tumor size. We found no statistically significant differences in prognosis for histologyor type of resection. Multivariate analysis showed age, sex and pathologic stage to be independentprognostic factors.Conclusions: Survival results and the analysis of prognostic factors in our series are similar to those publishedin the new 2009 TNM classification. The most important prognostic factor is pathologic stage. Otheradverse prognostic factors include male sex and age over 70 (AU)

Multicenter analysis of survival and prognostic factors in pathologic stage I non-small-cell lung cancer according to the new 2009 TNM classification.

INTRODUCTION: The new 2009 TNM classification introduced important modifications in lung cancer staging. The aim of this study is to validate our series of patients with pathologic stage I non-small-cell lung cancer according to the 7th edition of the TNM classification of malignant tumors and to the factors related with prognosis. PATIENTS AND METHODS: A multicenter retrospective study was performed. Survival rates were calculated by the Kaplan-Meier method, and for multivariate analyses, Cox proportional hazards regression model was used. The following variables were analyzed: age, sex, pathologic stage, T category, histology, type of resection and tumor size. RESULTS: A total of 402 patients were included. Mean follow-up was 70.18 months. Overall 5-year survival was 68%. Males and patients over 70 had lower survival. Prognosis worsened with increasing pathologic stage, T category and tumor size. We found no statistically significant differences in prognosis for histology or type of resection. Multivariate analysis showed age, sex and pathologic stage to be independent prognostic factors. CONCLUSIONS: Survival results and the analysis of prognostic factors in our series are similar to those published in the new 2009 TNM classification. The most important prognostic factor is pathologic stage. Other adverse prognostic factors include male sex and age over 70.

Surgery of female genital tract tumour lung metastases.

INTRODUCTION: Lung metastases originating from tumours of the female genital tract are rare. Due to this rarity and their variable histology, it has been difficult to compare different patient series. MATERIAL AND METHODS: A retrospective study of patients undergoing resection of lung metastases of female genital tract tumours (uterine and cervical cancer) during the period 01/01/1989 to 12/31/2006. Epidemiological, diagnostic and treatment data were collected. Non-parametric tests and survival analysis were performed using the Kaplan-Meier and log-rank test. RESULTS: A resection was performed on 27 patients during the study period. Disease-free interval (DFI) from initial diagnosis of lung metastases was 58 months (1-195 months). The median survival from diagnosis of metastases was 94 months. The overall survival at 5 years after diagnosis of metastasis was 84.1%. A second surgery of metastases was performed on 5 patients (18.5%). Survival after second surgery of metastases: 80.5 months. Survival from diagnosis of metastasis at five years: endometrial carcinoma 100%, cervical cancer 62.5%, uterine sarcoma 60%. Adjuvant hormonal therapy was prescribed in 15 out of 16 patients with endometrial carcinoma. There was a statistically significant difference in the survival depending on the histological type and disease free interval. CONCLUSION: Surgical treatment of lung metastases originating from female genital tract tumours (mainly endometrial carcinoma) is associated with a high long-term survival.

Cirugía de las metástasis pulmonares de tumores del tracto genital femenino / Surgery of female genital tract tumour lung metastases

IntroducciónLos tumores del tracto genital femenino constituyen una etiología poco frecuente de metástasis pulmonares. Debido a esto y a su variada histología, la comparación de resultados ha resultado complicada hasta la fecha.Material y métodosEstudio retrospectivo de pacientes intervenidos de metástasis pulmonares de tumores del tracto genital femenino (cuerpo, trompa y cuello de útero) en el periodo 01/01/1989–31/12/2006. Se recogen datos referentes a aspectos epidemiológicos, de diagnóstico y tratamiento. Se han utilizado tests no paramétricos, y el análisis de supervivencia se ha realizado con curvas de Kaplan-Meier y el log-rank test.ResultadosDurante el periodo descrito se ha intervenido a 27 pacientes. Intervalo libre de enfermedad (ILE) desde el diagnóstico inicial al de metástasis pulmonares 58 meses (1-195 meses). Mediana de supervivencia desde el diagnóstico de metástasis 94 meses. Supervivencia global tras diagnóstico de metástasis a 5 años: 84,1%. Segunda cirugía de metástasis: 5 pacientes (18,5%). Supervivencia tras segunda cirugía de metástasis: 80,5 meses. Supervivencia desde el diagnóstico de metástasis a 5 años: carcinoma de endometrio 100%; cáncer de cérvix 62,5%; sarcoma uterino 60%. Recibieron hormonoterapia adyuvante 15 de 16 pacientes con carcinoma de endometrio. Hallamos diferencias estadísticamente significativas en la supervivencia en función de: tipo histológico, e intervalo libre de enfermedad.ConclusiónEl tratamiento quirúrgico de las metástasis del tracto genital femenino (principalmente de las de carcinoma de endometrio) se asocia a una elevada supervivencia a largo plazo(AU)

IntroductionLung metastases originating from tumours of the female genital tract are rare. Due to this rarity and their variable histology, it has been difficult to compare different patient series.Material and MethodsA retrospective study of patients undergoing resection of lung metastases of female genital tract tumours (uterine and cervical cancer) during the period 01/01/1989 to 12/31/2006. Epidemiological, diagnostic and treatment data were collected. Non-parametric tests and survival analysis were performed using the Kaplan-Meier and log-rank test.ResultsA resection was performed on 27 patients during the study period. Disease-free interval (DFI) from initial diagnosis of lung metastases was 58 months (1-195 months). The median survival from diagnosis of metastases was 94 months. The overall survival at 5 years after diagnosis of metastasis was 84.1%. A second surgery of metastases was performed on 5 patients (18.5%). Survival after second surgery of metastases: 80.5 months. Survival from diagnosis of metastasis at five years: endometrial carcinoma 100%, cervical cancer 62.5%, uterine sarcoma 60%. Adjuvant hormonal therapy was prescribed in15 out of 16 patients with endometrial carcinoma. There was a statistically significant difference in the survival depending on the histological type and disease free interval.ConclusionSurgical treatment of lung metastases originating from female genital tract tumours (mainly endometrial carcinoma) is associated with a high long-term survival(AU)

Lung cancer surgery in the elderly.

Non-small cell lung cancer (NSCLC) is a typical disease of the elderly, and is becoming increasingly more common as a result of the gradual aging of the population. Although patient age is known to be an independent prognostic factor of postoperative survival, lung resection should not be denied on the basis of age alone. In patients of this kind, careful evaluation and selection is very important. In early-stage NSCLC, surgery is the treatment of choice. In the advanced stages of the disease treatment usually comprises primary radiotherapy or combined radio-chemotherapy. Preoperative preparation and postoperative care are very important in chest surgery, and particularly in elderly patients. The 5-year survival rate in octogenarians exceeds 40%, but is much lower in pneumonectomized patients (close to 10%). In conclusion, elderly patients should be offered the best treatment possible, bearing in mind that surgery offers the best results when the disease is resectable.