Prognostic factors on 45 cases of phyllodes tumors

The authors, in order to obtain a diagnostic index for phyllodes tumors and identified histological parameters that will predict the clinical course of this neoplasm, developed a histological degree of aggressiveness based on specific histological parameters, including: stromal:gland ratio, tumor margins, mitotic index and degree of stromal pleomorphism. Three categories were established: benign, intermediate and malignant. The probability of recurrence was estimated by the relative risk and by a multivariate Cox analysis. A strong and significant association was observed between this histological index and recurrence. The relative risk was 6.0 for intermediate lesions and 11.4 for malignant lesions when compared with the benign category. The microscopic examination of all axillary lymph nodes was negative for metastatic disease. In the multivariate analysis, the stroma:gland ratio was the strongest predictor for recurrence. These results indicate that by assigning a numerical value to certain histopathologic variables a better correlation with the clinical outcome of the patient can be obtained.

Bioavailability of etoposide after oral administration of the solution marketed for intravenous use: therapeutic and pharmacoeconomic perspectives

BACKGROUND

Oral etoposide administration is a suitable alternative to the intravenous route; therefore, commercial capsules have been developed. Before these capsules were available in Mexico, we studied drug bioavailability after oral administration of the intravenous etoposide solution (IVES).

METHODS

Eight adult cancer patients received a 50-mg oral etoposide dose as IVES and blood samples were collected over a period of 24 h. Plasma etoposide concentration was determined by high-performance liquid chromatography, plasma concentration against time curves were constructed, and bioavailability parameters were calculated.

RESULTS

Oral IVES yielded an adequate bioavailability profile because Cmax was 2.38 +/- 0.30 micrograms/mL, AUC was 12.87 +/- 2.02 micrograms/mL and half-life was 6.72 +/- 0.97 h.

CONCLUSIONS

Considering that the pharmacokinetic aim is to maintain plasma concentrations between 0.5 and 1.0 microgram/mL for several hours while avoiding high concentrations, i.e., of 10 micrograms/mL or higher, oral administration of 50-mg etoposide as IVES appears to be a suitable dosing option. In addition, oral IVES is considerably less expensive than intravenous administration in terms of both drug presentation and administration.