BACKGROUND & AIMS Malnutrition is one of the most prevalent problems among oncological patien... more BACKGROUND & AIMS Malnutrition is one of the most prevalent problems among oncological patients. It reduces the response to treatments and negatively impacts survival. In 2019, a consensus criteria for diagnosing malnutrition (GLIM criteria) were proposed by most scientific nutrition societies. The objective of our work is 1) to assess the diagnostic capacity of the GLIM criteria in ambulatory patients with cancer and 2) to compare the GLIM with the ESPEN criteria to evaluate the contributions of these new criteria with respect to the existing ones. METHODS Observational, cross-sectional, and single-center study carried out at the Medical Oncology Department in the Lozano Blesa Clinical Hospital in Zaragoza (Spain). One hundred and sixty-five outpatients with tumors in the upper gastrointestinal tract, head and neck, and colorectal locations were recruited. All of them received the MST, MUST, and Nutriscore screening tools along with the ESPEN and GLIM diagnostic criteria. RESULTS The prevalence of malnutrition was 46.7% according to the GLIM criteria and 21.2% using the ESPEN tool. Patients diagnosed by GLIM had a higher body mass index (BMI, 24.3 kg/m2) and muscle mass (MM, 16.1 kg/m2) than those diagnosed by ESPEN (21.2 kg/m2 and 14.3 kg/m2 respectively, both p = 0.001). The MST, MUST, and Nutriscore tools had a higher degree of concordance with GLIM compared to ESPEN (MST 0.53 vs 0.26; MUST 0.36 vs 0.66; Nutriscore 0.28 vs 0.54). CONCLUSIONS The found prevalence of malnutrition in cancer patients is higher using the GLIM instead of ESPEN criteria. This disparity can be explained at least in part by the difficulty of the ESPEN criteria for malnutrition to diagnose patients with high baseline BMI or MM. The use of criteria with greater sensitivity, such as the new GLIM criteria, could help early diagnosis and thus early intervention in cancer patients.
811 Background: T, A, and X have been shown to be very active drugs for the treatment of BC. Sequ... more 811 Background: T, A, and X have been shown to be very active drugs for the treatment of BC. Sequential administration of these chemotherapy agents has improved the toxicity profile versus concurrent administration. This study evaluated the safety profile of AT followed by sequential X in the adjuvant setting in patients with node-positive BC. Methods: Patients with histological diagnosis of stage II-III BC, positive regional lymph nodes, completed BC surgery, age ≥18 years, ECOG PS ≤ 2, and adequate bone marrow, renal, hepatic and cardiac function were included in the study. Prior chemotherapy, hormone therapy, and radiotherapy for BC were not allowed. Treatment: 6 courses of T 75 mg/m2 iv D1 and A 50 mg/m2 iv D1, every 21 days followed by 6 courses of X 2500 mg/m2/day po D1–14 and Vitamin B6 300 mg bid po D1–21 every 21- days. Results: Ninety-one of the 115 patients enrolled were included in this interim analysis. Median age:47 years (range 28–73), ECOG PS 0–1 100%, hormone receptor status was 64% ER/PR...
Renal cell carcinoma (RCC) is a complex disease characterized by mutations in several genes. Loss... more Renal cell carcinoma (RCC) is a complex disease characterized by mutations in several genes. Loss of function of the von Hippel-Lindau (VHL) tumour suppressor gene is a very common finding in RCC and leads to up-regulation of hypoxia-inducible factor (HIF)-responsive genes accountable for angiogenesis and cell growth, such as platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF). Binding of these proteins to their cognate tyrosine kinase receptors on endothelial cells promotes angiogenesis. Promotion of angiogenesis is in part due to the activation of the phosphatidylinositol-3-kinase (PI3K)/AKT/mechanistic target of rapamycin (mTOR) pathway. Inhibition of this pathway decreases protein translation and inhibits both angiogenesis and tumour cell proliferation. Although tyrosine kinase inhibitors (TKIs) stand as the main first-line treatment option for advanced RCC, eventually all patients will become resistant to TKIs. Resistance can be overcome by using...
Many studies have assessed different malnutrition screening tools in oncologic patients. However,... more Many studies have assessed different malnutrition screening tools in oncologic patients. However, very few have been carried out using the new GLIM criteria for malnutrition. The objective of our study is to compare the most recommended screening tools with respect to the new GLIM criteria for malnutrition in cancer patients. Observational, cross-sectional, and single-center study carried out at the Medical Oncology Department at the Lozano Blesa Hospital in Zaragoza. We recruited 165 patients with tumors of the upper-gastrointestinal-tract, colorectal, and head-and-neck region undergoing outpatient treatment. All of them received MST, MUST, Nutriscore, MNA and CONUT screening tools, as well as the GLIM diagnostic criteria, which was used as the gold standard. MNA-SF showed the best sensitivity (0.99) and lowest specificity while CONUT had the best specificity (0.89) and lowest sensitivity to detect cancer-related malnutrition. We observed high variability in the diagnostic capabilities of Nutriscore when tumor location was considered, reducing sensitivity in patients with colorectal cancer compared to those with tumors of the upper-gastrointestinal-tract or head-and-neck location (0.25, 0.83, and 0.91 respectively). The highest index of agreement between the screening tools was found between MST, MUST and Nutriscore tests. Regarding the GLIM criteria, the highest agreement index was presented by MUST tool (0.66), while CONUT presented the lowest (0.12). Selecting the screening tool according to the type of cancer and its location may allow us to optimize its use and increase its performance, exploiting the advantages of each of them in the different populations.
Sunitinib and pazopanib are standard first-line treatments for patients with metastatic renal cel... more Sunitinib and pazopanib are standard first-line treatments for patients with metastatic renal cell carcinoma (mRCC). Nonetheless, as the number of treatment options increases, there is a need to identify biomarkers that can predict drug efficacy and toxicity. In this prospective study we evaluated a set of biomarkers that had been previously identified within a secretory signature in mRCC patients. This set includes tumor expression of c-Met and serum levels of HGF, IL-6, IL-8, CXCL9, CXCL10 and CXCL11. Our cohort included 60 patients with mRCC from 10 different Spanish hospitals who received sunitinib (n = 51), pazopanib (n = 4) or both (n = 5). Levels of biomarkers were studied in relation to response rate, progression-free survival (PFS) and overall survival (OS). High tumor expression of c-Met and high basal serum levels of HGF, IL-6, CXCL11 and CXCL10 were significantly associated with reduced PFS and/or OS. In multivariable Cox regression analysis, CXCL11 was identified as an ...
A correction to this paper has been published: https://doi.org/10.1007/s12094-021-02582-0
e16537Background: Renal cell carcinoma (RCC) have low prevalence but it incidence is increasing. ... more e16537Background: Renal cell carcinoma (RCC) have low prevalence but it incidence is increasing. For a correct therapeutic approach, it is important to carry out a correct prognostic stratification...
6047 Background: PBT is widely used as first line treatment in relapsed and/or metastatic HNC. Th... more 6047 Background: PBT is widely used as first line treatment in relapsed and/or metastatic HNC. Therefore, new non-platinum drugs need to be asses as second line treatment options. We proposed this study to evaluate activity and tolerability of capecitabine (X) when used as palliative monotherapy for relapsed HNC p previously treated with PBT. Methods: Forty patients (p) aged 18–75 years, ECOG PS 0–2, with advanced squamous HNC with locoregional and/or metastatic relapse previously treated with PBT and adequate bone marrow, renal and hepatic functions were included. X (1,250 mg/m2 BID) during 14 days was administered every 21 days, for at least 2 cycles. RECIST objective response rate (ORR) was assessed and toxicity following NCI-CTC v2 criteria. Results: Forty patients with median age 58 years old, all of them male, ECOG 0–2 (0:25%/1:70%/2:5%) and with squamous HNC, were analyzed. 34 p had local disease, 9 p regional disease and 19 p distant metastases(12 p lung). Median time since ...
e20706 Background: Normal human body temperature displays a circadian rhythm, ranging from 36.1 C... more e20706 Background: Normal human body temperature displays a circadian rhythm, ranging from 36.1 C or lower in predawn hours to 37.4 C or higher in the afternoon. Abnormal elevation of temperature occurs as a result of hyperthermia or fever. Cancer patients frequently experience fever. Nearly two-thirds of the cases of fever in patients with prolonged neutropenia could be attributed to infection, a major cause of morbidity in cancer patients. Purpose: The aim of our study is to evaluate the prevalence of cancer patients who were attended in the emergency room for fever, the diagnosis and clinical management. Methods: From October 2007 to October 2008, 560 cancer patients were seen in the emergency department of the University Hospital of Zaragoza. The purpose of this paper is to describe the characteristics of patients who presented with fever. Results: A total of 560 patients were seen. Ninety-eight (17.5%) presented with fever. 63% of patients were stage IV. Cancer tumor type, 35 h...
e20701 Background: High rates of mortality due to cancer make necessary improve oncologic treatme... more e20701 Background: High rates of mortality due to cancer make necessary improve oncologic treatments. Relationship between adverse events and chemotherapy schedule and dose is well known thanks to large observational studies. Our study´s objective is to estimate the prevalence of chemotherapy adverse events in oncologic patients attended in Emergency room. Methods: From October 2007 to October 2008 560 patients were recollected. It was revised tumors location and stage, chemotherapy schedule and date of the last treatment, diagnosis and therapheutic in Emergency. Results: 87 of the 560 patients (15%) were attended in Emergency room because of chemotherapy toxicity. The most common cause of consultation was fever (27 patients, 31%) followed by diarrhea (18 patients, 20.7%) and nausea-vomiting (12 patients, 13.8%). Most of the patients were being treated with classic chemotherapy schedules (70.1%). Comparing as a whole all the chemotherapy schedules there were not statistically signif...
e20705 Background: Attending oncologic patients in emergency room because of a large variety of s... more e20705 Background: Attending oncologic patients in emergency room because of a large variety of symptoms due to treatments or tumor complications is very common. Our objective is to estimate the prevalence of dyspnea in oncologic patients and its etiology. Methods: From October 2007 to October 2008 we recollected 560 oncologic patients who were seen on Emergency room. It was revised cause of consultation, tumors´ location and stage, active or palliative care, diagnosis and treatment. Results: 71 of the 560 patients (12.7%) related dyspnea as cause of consultation, being the third cause of attendance in Emergency room after pain (126 patients, 22.5%) and fever (98 patients, 17.5%). The most common tumor´s location was lung in 38 of the 71 patients (53.52%), followed by colorectal cancer (11.3%) and breast (9.9%). 76.8% were advanced oncologic patients (stage IV). Diagnosis was respiratory infection in 19 patients (26.8 %) followed by malignant pleural bleeding (10 patients, 14.1%), d...
e20748 Background: Cancer is a very frequent pathology with a gradual increase of its prevalence.... more e20748 Background: Cancer is a very frequent pathology with a gradual increase of its prevalence. Oncologic patients are exposed to suffer many complications which may need emergency attention. The aim of this study is to describe patients which consult in the emergency room and frecuency of different causes of complaint. Methods: Between October 2007 and October 2008, we collected all oncologic patients who consulted in our emergency room. We describe tumor location and causes of complaint. Results: 560 oncologic patients were attended in 12 months (median 12 per week). By tumor location, 134 (23,9%) patients had not small cell lung cancer (NSCLC), 101 (18%) colorrectal cancer, 64 (11.4%) breast cancer, and 261 (53%) other malignancies. Of all patients, 440 (82.7%) had stage IV disease and 318 (56.8%) were receiving chemotherapy treatment The most common causes to complaint were oncologic pain (22.5%), fever (17.5%), dysphnea (12.7%), neurologic symptoms (9.1%), and asthenia (8.6%)...
e20714 Background: Anemia is a very common diagnosis in oncologic patients and it can be produced... more e20714 Background: Anemia is a very common diagnosis in oncologic patients and it can be produced by different causes. The aim of this study is to describe the prevalence and causes of anemia in oncologic patients who consults in the emergency room. Methods: From October 2007 to October 2008, all oncologic patiens who consulted in the emergency room were collected. We analyze the prevalence of anemia and its causes. Tumor location is described too. Results: Of the 560 patients collected, 223 (39.82%) were diagnosed of anemia. 64 of them (28.7%) had lung cancer, 33 (14.8%) breast cancer, 32 (14.3%) colon cancer, 15 (6.7%) bladder cancer, 15 (6.7%) prostate cancer, 13 (5.8%) head and neck cancer, and 51 (22.5%) other malignancies. Median haemoglobin level was 10 (range 4.2–11.9). As etiology was identified chemotherapy toxicity in 113 patients (50.7%), anemia of chronic disease in 65 (29.1%), tumoral bleeding in 41 (18.4%), and non-tumoral upper gastrointestinal bleeding in 4 (1.8%). ...
6039 Background: Sequential treatment with induction CT followed by CT/RT is highly active and un... more 6039 Background: Sequential treatment with induction CT followed by CT/RT is highly active and under study in ongoing randomized trials. We started a pilot phase II trial to explore the efficacy, toxicity profile and organ preservation of a modified neoadjuvant TPF to concurrent CT/RT in both resectable (R) and unresectable (UR) LAHNC. Methods: One hundred seventy patients(p) with stage III-IV, PS ECOG 0–2, were included to receive 3 cycles of docetaxel 75 mg/m2 iv day(d) 1, cisplatin(P) 75 mg/m2 iv d2 and 5-FU 750 mg/m2 iv continuous infusion d2–5, every 3 weeks with prophylactic ciprofloxacin 500 mg twice daily from d6–15 of each cycle and granulocyte colony-stimulating factor as secondary or primary setting, followed by P 100 mg/m2 iv d1, 22, 43 concomitant with RT (66–70 Gy, conventional fractionation). Neck dissection was planned for p with stage N2–3 after induction CT or salvage surgery for resectable p with persistent disease at the end of treatment. Results: Main p characte...
Objective: Our aim was to provide practical recommendations on the management of patients with me... more Objective: Our aim was to provide practical recommendations on the management of patients with metastatic castration-resistant prostate cancer (mCRPC) who have progressed after docetaxel plus androgen-deprivation therapy (ADT) or abiraterone plus ADT. Methods: Systematic literature review (SLR), nominal group meeting, and Delphi process. A panel of 12 experts was established who defined the scope, users, and sections of the document. We performed an SLR in order to assess the efficacy and safety of available drugs in patients with mCRPC. s from the American Society of Oncology and European Society for Medical Oncology meetings were also examined. The results were discussed during an expert meeting in which 14 recommendations were generated. The level of agreement with the recommendations was also tested by 13 additional experts following the Delphi process. Recommendations were voted by means of scores ranging from 0 (total disagreement) to 10 (total agreement). We defined agreement...
4044 Background: The aim of this phase II trial was to assess the impact of preoperative external... more 4044 Background: The aim of this phase II trial was to assess the impact of preoperative external radiation therapy combined with Capecitabine and Oxaliplatin on pathologic tumor response, sphincter preservation and tumor control in patients with locally advanced rectal carcinoma. Methods: Sixty-seven patients with locally advanced rectal carcinoma (T3/T4 or N+) received radiotherapy (50.4 Gy/28 fractions) and chemotherapy with Capecitabine 825 mg/m2/12 hours on days 1–5 + Oxaliplatin 50 mg/m2 on day 1 every week (weeks 1–6). Surgery with TME was performed 6–7 weeks after the end of the treatment. Adjuvant chemotherapy was administered after surgery according investigator‘s crtiteria. Results: Patients have been recruited between February 2005 and June 2006. 47 male/20 female. Median age 67 years (range 38–79). Performance status (ECOG) 0 in 45 patients. Clinical stage (determined by EUS+CT or RMI): cT2 3p/cT3 58p/cT4 6p/cN+ 47p. Tumor location (from anal verge): = 5 cm in 27p. Medi...
13543 Background: Preoperative chemoradiotherapy has shown to improve local control and sphincter... more 13543 Background: Preoperative chemoradiotherapy has shown to improve local control and sphincter preservation with decreased acute toxicity compared with postoperative treatment in locally advanced rectal carcinoma. The primary endpoint of this phase II trial was pathologic tumor response. Secondary endpoints were sphincter preservation and toxicity. Methods: Inclusion criteria: rectal adenocarcinoma <12 cms from anal verge, clinical stage T3–4 and/or N+, adequate renal, hematological and liver function. Planned sample for this trial was 43 patients. Treatment scheme: pelvic radiotherapy (50.4 Gy/28 fractions) and chemotherapy: Capecitabine 825 mg/m2/12 hours on days 1–5 + Oxaliplatin 50 mg/m2 on day 1 every week (weeks 1–6). Surgery with TME was performed between 6–8 weeks after the end of the treatment. Adjuvant chemotherapy was administered after surgery according each center criteria. Results: 37 patients have been recruited between February and December 2005. 26 male/11 fem...
20119 Background: The activation of Tyrosin Kinase Receptors (RTKs) produces several effects abou... more 20119 Background: The activation of Tyrosin Kinase Receptors (RTKs) produces several effects about cellular response. These are membrane receptors that bind differentiation signals, grow factors and cellular mediators. The interaction with their ligand causes the phosphorilation and internalization in the endosome. By a metabolic way, these receptors are degradated into the proteasome to small peptides that are expressed over the cellular surface joined to MHC class I mollecules, getting a better immunogenic recognition of the tumor cells. It is known that the bigger expression of the tyrosin kinase receptors in tumors is associated with an aggressive phenotype. For example overexpression of ephA2 or EGFR. Our study is based in the demostration of the overexpression of other receptors in renal cell cancer, a tumour with a disappointing response with treatment in advanced stages. On this way we can use them as targets for monoclonal antibodies and for citotoxic lymphocites CD8 stimul...
10787 Background: Patients with breast cancer in which sentinel lymph node biopsy is histological... more 10787 Background: Patients with breast cancer in which sentinel lymph node biopsy is histologically negative for tumor cells, have a low probability of having involvement of additional regional lymph nodes. Lymph node dissection may be avoided in these cases. Methods: Ninety-six consecutive patients with invasive breast cancer and tumour size less than 2 centimeters by mammography, had lymphoscintigraphy with colloidal 99Tc and radioisotope-guided sentinel lymph node biopsy in the University Hospital of Zaragoza from 1999 to 2005.Pathological assessment included serial sections of the sentinel lymph node with immunohistochemistry for cytokeratins in selected cases. Results: Sentinel lymph node biopsy was negative in 57 patients. There were 56 females and 1 male. Median age was 57 years (range 24–87). Median pathological tumor size was 15 mm (range 5–31). Location of the sentinel lymph node was axillary in 47patients, internal mammary in 0 patients, and both in 10 patients. Median nu...
BACKGROUND & AIMS Malnutrition is one of the most prevalent problems among oncological patien... more BACKGROUND & AIMS Malnutrition is one of the most prevalent problems among oncological patients. It reduces the response to treatments and negatively impacts survival. In 2019, a consensus criteria for diagnosing malnutrition (GLIM criteria) were proposed by most scientific nutrition societies. The objective of our work is 1) to assess the diagnostic capacity of the GLIM criteria in ambulatory patients with cancer and 2) to compare the GLIM with the ESPEN criteria to evaluate the contributions of these new criteria with respect to the existing ones. METHODS Observational, cross-sectional, and single-center study carried out at the Medical Oncology Department in the Lozano Blesa Clinical Hospital in Zaragoza (Spain). One hundred and sixty-five outpatients with tumors in the upper gastrointestinal tract, head and neck, and colorectal locations were recruited. All of them received the MST, MUST, and Nutriscore screening tools along with the ESPEN and GLIM diagnostic criteria. RESULTS The prevalence of malnutrition was 46.7% according to the GLIM criteria and 21.2% using the ESPEN tool. Patients diagnosed by GLIM had a higher body mass index (BMI, 24.3 kg/m2) and muscle mass (MM, 16.1 kg/m2) than those diagnosed by ESPEN (21.2 kg/m2 and 14.3 kg/m2 respectively, both p = 0.001). The MST, MUST, and Nutriscore tools had a higher degree of concordance with GLIM compared to ESPEN (MST 0.53 vs 0.26; MUST 0.36 vs 0.66; Nutriscore 0.28 vs 0.54). CONCLUSIONS The found prevalence of malnutrition in cancer patients is higher using the GLIM instead of ESPEN criteria. This disparity can be explained at least in part by the difficulty of the ESPEN criteria for malnutrition to diagnose patients with high baseline BMI or MM. The use of criteria with greater sensitivity, such as the new GLIM criteria, could help early diagnosis and thus early intervention in cancer patients.
811 Background: T, A, and X have been shown to be very active drugs for the treatment of BC. Sequ... more 811 Background: T, A, and X have been shown to be very active drugs for the treatment of BC. Sequential administration of these chemotherapy agents has improved the toxicity profile versus concurrent administration. This study evaluated the safety profile of AT followed by sequential X in the adjuvant setting in patients with node-positive BC. Methods: Patients with histological diagnosis of stage II-III BC, positive regional lymph nodes, completed BC surgery, age ≥18 years, ECOG PS ≤ 2, and adequate bone marrow, renal, hepatic and cardiac function were included in the study. Prior chemotherapy, hormone therapy, and radiotherapy for BC were not allowed. Treatment: 6 courses of T 75 mg/m2 iv D1 and A 50 mg/m2 iv D1, every 21 days followed by 6 courses of X 2500 mg/m2/day po D1–14 and Vitamin B6 300 mg bid po D1–21 every 21- days. Results: Ninety-one of the 115 patients enrolled were included in this interim analysis. Median age:47 years (range 28–73), ECOG PS 0–1 100%, hormone receptor status was 64% ER/PR...
Renal cell carcinoma (RCC) is a complex disease characterized by mutations in several genes. Loss... more Renal cell carcinoma (RCC) is a complex disease characterized by mutations in several genes. Loss of function of the von Hippel-Lindau (VHL) tumour suppressor gene is a very common finding in RCC and leads to up-regulation of hypoxia-inducible factor (HIF)-responsive genes accountable for angiogenesis and cell growth, such as platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF). Binding of these proteins to their cognate tyrosine kinase receptors on endothelial cells promotes angiogenesis. Promotion of angiogenesis is in part due to the activation of the phosphatidylinositol-3-kinase (PI3K)/AKT/mechanistic target of rapamycin (mTOR) pathway. Inhibition of this pathway decreases protein translation and inhibits both angiogenesis and tumour cell proliferation. Although tyrosine kinase inhibitors (TKIs) stand as the main first-line treatment option for advanced RCC, eventually all patients will become resistant to TKIs. Resistance can be overcome by using...
Many studies have assessed different malnutrition screening tools in oncologic patients. However,... more Many studies have assessed different malnutrition screening tools in oncologic patients. However, very few have been carried out using the new GLIM criteria for malnutrition. The objective of our study is to compare the most recommended screening tools with respect to the new GLIM criteria for malnutrition in cancer patients. Observational, cross-sectional, and single-center study carried out at the Medical Oncology Department at the Lozano Blesa Hospital in Zaragoza. We recruited 165 patients with tumors of the upper-gastrointestinal-tract, colorectal, and head-and-neck region undergoing outpatient treatment. All of them received MST, MUST, Nutriscore, MNA and CONUT screening tools, as well as the GLIM diagnostic criteria, which was used as the gold standard. MNA-SF showed the best sensitivity (0.99) and lowest specificity while CONUT had the best specificity (0.89) and lowest sensitivity to detect cancer-related malnutrition. We observed high variability in the diagnostic capabilities of Nutriscore when tumor location was considered, reducing sensitivity in patients with colorectal cancer compared to those with tumors of the upper-gastrointestinal-tract or head-and-neck location (0.25, 0.83, and 0.91 respectively). The highest index of agreement between the screening tools was found between MST, MUST and Nutriscore tests. Regarding the GLIM criteria, the highest agreement index was presented by MUST tool (0.66), while CONUT presented the lowest (0.12). Selecting the screening tool according to the type of cancer and its location may allow us to optimize its use and increase its performance, exploiting the advantages of each of them in the different populations.
Sunitinib and pazopanib are standard first-line treatments for patients with metastatic renal cel... more Sunitinib and pazopanib are standard first-line treatments for patients with metastatic renal cell carcinoma (mRCC). Nonetheless, as the number of treatment options increases, there is a need to identify biomarkers that can predict drug efficacy and toxicity. In this prospective study we evaluated a set of biomarkers that had been previously identified within a secretory signature in mRCC patients. This set includes tumor expression of c-Met and serum levels of HGF, IL-6, IL-8, CXCL9, CXCL10 and CXCL11. Our cohort included 60 patients with mRCC from 10 different Spanish hospitals who received sunitinib (n = 51), pazopanib (n = 4) or both (n = 5). Levels of biomarkers were studied in relation to response rate, progression-free survival (PFS) and overall survival (OS). High tumor expression of c-Met and high basal serum levels of HGF, IL-6, CXCL11 and CXCL10 were significantly associated with reduced PFS and/or OS. In multivariable Cox regression analysis, CXCL11 was identified as an ...
A correction to this paper has been published: https://doi.org/10.1007/s12094-021-02582-0
e16537Background: Renal cell carcinoma (RCC) have low prevalence but it incidence is increasing. ... more e16537Background: Renal cell carcinoma (RCC) have low prevalence but it incidence is increasing. For a correct therapeutic approach, it is important to carry out a correct prognostic stratification...
6047 Background: PBT is widely used as first line treatment in relapsed and/or metastatic HNC. Th... more 6047 Background: PBT is widely used as first line treatment in relapsed and/or metastatic HNC. Therefore, new non-platinum drugs need to be asses as second line treatment options. We proposed this study to evaluate activity and tolerability of capecitabine (X) when used as palliative monotherapy for relapsed HNC p previously treated with PBT. Methods: Forty patients (p) aged 18–75 years, ECOG PS 0–2, with advanced squamous HNC with locoregional and/or metastatic relapse previously treated with PBT and adequate bone marrow, renal and hepatic functions were included. X (1,250 mg/m2 BID) during 14 days was administered every 21 days, for at least 2 cycles. RECIST objective response rate (ORR) was assessed and toxicity following NCI-CTC v2 criteria. Results: Forty patients with median age 58 years old, all of them male, ECOG 0–2 (0:25%/1:70%/2:5%) and with squamous HNC, were analyzed. 34 p had local disease, 9 p regional disease and 19 p distant metastases(12 p lung). Median time since ...
e20706 Background: Normal human body temperature displays a circadian rhythm, ranging from 36.1 C... more e20706 Background: Normal human body temperature displays a circadian rhythm, ranging from 36.1 C or lower in predawn hours to 37.4 C or higher in the afternoon. Abnormal elevation of temperature occurs as a result of hyperthermia or fever. Cancer patients frequently experience fever. Nearly two-thirds of the cases of fever in patients with prolonged neutropenia could be attributed to infection, a major cause of morbidity in cancer patients. Purpose: The aim of our study is to evaluate the prevalence of cancer patients who were attended in the emergency room for fever, the diagnosis and clinical management. Methods: From October 2007 to October 2008, 560 cancer patients were seen in the emergency department of the University Hospital of Zaragoza. The purpose of this paper is to describe the characteristics of patients who presented with fever. Results: A total of 560 patients were seen. Ninety-eight (17.5%) presented with fever. 63% of patients were stage IV. Cancer tumor type, 35 h...
e20701 Background: High rates of mortality due to cancer make necessary improve oncologic treatme... more e20701 Background: High rates of mortality due to cancer make necessary improve oncologic treatments. Relationship between adverse events and chemotherapy schedule and dose is well known thanks to large observational studies. Our study´s objective is to estimate the prevalence of chemotherapy adverse events in oncologic patients attended in Emergency room. Methods: From October 2007 to October 2008 560 patients were recollected. It was revised tumors location and stage, chemotherapy schedule and date of the last treatment, diagnosis and therapheutic in Emergency. Results: 87 of the 560 patients (15%) were attended in Emergency room because of chemotherapy toxicity. The most common cause of consultation was fever (27 patients, 31%) followed by diarrhea (18 patients, 20.7%) and nausea-vomiting (12 patients, 13.8%). Most of the patients were being treated with classic chemotherapy schedules (70.1%). Comparing as a whole all the chemotherapy schedules there were not statistically signif...
e20705 Background: Attending oncologic patients in emergency room because of a large variety of s... more e20705 Background: Attending oncologic patients in emergency room because of a large variety of symptoms due to treatments or tumor complications is very common. Our objective is to estimate the prevalence of dyspnea in oncologic patients and its etiology. Methods: From October 2007 to October 2008 we recollected 560 oncologic patients who were seen on Emergency room. It was revised cause of consultation, tumors´ location and stage, active or palliative care, diagnosis and treatment. Results: 71 of the 560 patients (12.7%) related dyspnea as cause of consultation, being the third cause of attendance in Emergency room after pain (126 patients, 22.5%) and fever (98 patients, 17.5%). The most common tumor´s location was lung in 38 of the 71 patients (53.52%), followed by colorectal cancer (11.3%) and breast (9.9%). 76.8% were advanced oncologic patients (stage IV). Diagnosis was respiratory infection in 19 patients (26.8 %) followed by malignant pleural bleeding (10 patients, 14.1%), d...
e20748 Background: Cancer is a very frequent pathology with a gradual increase of its prevalence.... more e20748 Background: Cancer is a very frequent pathology with a gradual increase of its prevalence. Oncologic patients are exposed to suffer many complications which may need emergency attention. The aim of this study is to describe patients which consult in the emergency room and frecuency of different causes of complaint. Methods: Between October 2007 and October 2008, we collected all oncologic patients who consulted in our emergency room. We describe tumor location and causes of complaint. Results: 560 oncologic patients were attended in 12 months (median 12 per week). By tumor location, 134 (23,9%) patients had not small cell lung cancer (NSCLC), 101 (18%) colorrectal cancer, 64 (11.4%) breast cancer, and 261 (53%) other malignancies. Of all patients, 440 (82.7%) had stage IV disease and 318 (56.8%) were receiving chemotherapy treatment The most common causes to complaint were oncologic pain (22.5%), fever (17.5%), dysphnea (12.7%), neurologic symptoms (9.1%), and asthenia (8.6%)...
e20714 Background: Anemia is a very common diagnosis in oncologic patients and it can be produced... more e20714 Background: Anemia is a very common diagnosis in oncologic patients and it can be produced by different causes. The aim of this study is to describe the prevalence and causes of anemia in oncologic patients who consults in the emergency room. Methods: From October 2007 to October 2008, all oncologic patiens who consulted in the emergency room were collected. We analyze the prevalence of anemia and its causes. Tumor location is described too. Results: Of the 560 patients collected, 223 (39.82%) were diagnosed of anemia. 64 of them (28.7%) had lung cancer, 33 (14.8%) breast cancer, 32 (14.3%) colon cancer, 15 (6.7%) bladder cancer, 15 (6.7%) prostate cancer, 13 (5.8%) head and neck cancer, and 51 (22.5%) other malignancies. Median haemoglobin level was 10 (range 4.2–11.9). As etiology was identified chemotherapy toxicity in 113 patients (50.7%), anemia of chronic disease in 65 (29.1%), tumoral bleeding in 41 (18.4%), and non-tumoral upper gastrointestinal bleeding in 4 (1.8%). ...
6039 Background: Sequential treatment with induction CT followed by CT/RT is highly active and un... more 6039 Background: Sequential treatment with induction CT followed by CT/RT is highly active and under study in ongoing randomized trials. We started a pilot phase II trial to explore the efficacy, toxicity profile and organ preservation of a modified neoadjuvant TPF to concurrent CT/RT in both resectable (R) and unresectable (UR) LAHNC. Methods: One hundred seventy patients(p) with stage III-IV, PS ECOG 0–2, were included to receive 3 cycles of docetaxel 75 mg/m2 iv day(d) 1, cisplatin(P) 75 mg/m2 iv d2 and 5-FU 750 mg/m2 iv continuous infusion d2–5, every 3 weeks with prophylactic ciprofloxacin 500 mg twice daily from d6–15 of each cycle and granulocyte colony-stimulating factor as secondary or primary setting, followed by P 100 mg/m2 iv d1, 22, 43 concomitant with RT (66–70 Gy, conventional fractionation). Neck dissection was planned for p with stage N2–3 after induction CT or salvage surgery for resectable p with persistent disease at the end of treatment. Results: Main p characte...
Objective: Our aim was to provide practical recommendations on the management of patients with me... more Objective: Our aim was to provide practical recommendations on the management of patients with metastatic castration-resistant prostate cancer (mCRPC) who have progressed after docetaxel plus androgen-deprivation therapy (ADT) or abiraterone plus ADT. Methods: Systematic literature review (SLR), nominal group meeting, and Delphi process. A panel of 12 experts was established who defined the scope, users, and sections of the document. We performed an SLR in order to assess the efficacy and safety of available drugs in patients with mCRPC. s from the American Society of Oncology and European Society for Medical Oncology meetings were also examined. The results were discussed during an expert meeting in which 14 recommendations were generated. The level of agreement with the recommendations was also tested by 13 additional experts following the Delphi process. Recommendations were voted by means of scores ranging from 0 (total disagreement) to 10 (total agreement). We defined agreement...
4044 Background: The aim of this phase II trial was to assess the impact of preoperative external... more 4044 Background: The aim of this phase II trial was to assess the impact of preoperative external radiation therapy combined with Capecitabine and Oxaliplatin on pathologic tumor response, sphincter preservation and tumor control in patients with locally advanced rectal carcinoma. Methods: Sixty-seven patients with locally advanced rectal carcinoma (T3/T4 or N+) received radiotherapy (50.4 Gy/28 fractions) and chemotherapy with Capecitabine 825 mg/m2/12 hours on days 1–5 + Oxaliplatin 50 mg/m2 on day 1 every week (weeks 1–6). Surgery with TME was performed 6–7 weeks after the end of the treatment. Adjuvant chemotherapy was administered after surgery according investigator‘s crtiteria. Results: Patients have been recruited between February 2005 and June 2006. 47 male/20 female. Median age 67 years (range 38–79). Performance status (ECOG) 0 in 45 patients. Clinical stage (determined by EUS+CT or RMI): cT2 3p/cT3 58p/cT4 6p/cN+ 47p. Tumor location (from anal verge): = 5 cm in 27p. Medi...
13543 Background: Preoperative chemoradiotherapy has shown to improve local control and sphincter... more 13543 Background: Preoperative chemoradiotherapy has shown to improve local control and sphincter preservation with decreased acute toxicity compared with postoperative treatment in locally advanced rectal carcinoma. The primary endpoint of this phase II trial was pathologic tumor response. Secondary endpoints were sphincter preservation and toxicity. Methods: Inclusion criteria: rectal adenocarcinoma <12 cms from anal verge, clinical stage T3–4 and/or N+, adequate renal, hematological and liver function. Planned sample for this trial was 43 patients. Treatment scheme: pelvic radiotherapy (50.4 Gy/28 fractions) and chemotherapy: Capecitabine 825 mg/m2/12 hours on days 1–5 + Oxaliplatin 50 mg/m2 on day 1 every week (weeks 1–6). Surgery with TME was performed between 6–8 weeks after the end of the treatment. Adjuvant chemotherapy was administered after surgery according each center criteria. Results: 37 patients have been recruited between February and December 2005. 26 male/11 fem...
20119 Background: The activation of Tyrosin Kinase Receptors (RTKs) produces several effects abou... more 20119 Background: The activation of Tyrosin Kinase Receptors (RTKs) produces several effects about cellular response. These are membrane receptors that bind differentiation signals, grow factors and cellular mediators. The interaction with their ligand causes the phosphorilation and internalization in the endosome. By a metabolic way, these receptors are degradated into the proteasome to small peptides that are expressed over the cellular surface joined to MHC class I mollecules, getting a better immunogenic recognition of the tumor cells. It is known that the bigger expression of the tyrosin kinase receptors in tumors is associated with an aggressive phenotype. For example overexpression of ephA2 or EGFR. Our study is based in the demostration of the overexpression of other receptors in renal cell cancer, a tumour with a disappointing response with treatment in advanced stages. On this way we can use them as targets for monoclonal antibodies and for citotoxic lymphocites CD8 stimul...
10787 Background: Patients with breast cancer in which sentinel lymph node biopsy is histological... more 10787 Background: Patients with breast cancer in which sentinel lymph node biopsy is histologically negative for tumor cells, have a low probability of having involvement of additional regional lymph nodes. Lymph node dissection may be avoided in these cases. Methods: Ninety-six consecutive patients with invasive breast cancer and tumour size less than 2 centimeters by mammography, had lymphoscintigraphy with colloidal 99Tc and radioisotope-guided sentinel lymph node biopsy in the University Hospital of Zaragoza from 1999 to 2005.Pathological assessment included serial sections of the sentinel lymph node with immunohistochemistry for cytokeratins in selected cases. Results: Sentinel lymph node biopsy was negative in 57 patients. There were 56 females and 1 male. Median age was 57 years (range 24–87). Median pathological tumor size was 15 mm (range 5–31). Location of the sentinel lymph node was axillary in 47patients, internal mammary in 0 patients, and both in 10 patients. Median nu...
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Papers by J. Lambea