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Gendrau‐Sanclemente N, Figueras A, Gracova K, Lahiguera Á, Alsina‐Sanchís E, Marín‐Jiménez JA, Vidal A, Matias‐Guiu X, Fernandez‐Gonzalez S, Barahona M, Martí L, Ponce J, Viñals F. Ovarian cancer relies on the PDGFRβ-fibronectin axis for tumorsphere formation and metastatic spread. Mol Oncol 2024; 18:136-155. [PMID: 38010623 PMCID: PMC10766197 DOI: 10.1002/1878-0261.13556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/10/2023] [Accepted: 11/21/2023] [Indexed: 11/29/2023] Open
Abstract
High-grade serous ovarian cancer (HGSOC) is the deadliest gynecological malignancy. The most common form of metastatic spread of HGSOC is transcoelomic dissemination. In this process, detached cells from the primary tumor aggregate as tumorspheres and promote the accumulation of peritoneal ascites. This represents an early event in HGSOC development and is indicative of poor prognosis. In this study, based on tumorspheres isolated from ascitic liquid samples from HGSOC patients, ovarian cancer spheroid 3D cultures, and in vivo models, we describe a key signal for tumorsphere formation in HGSOC. We report that platelet-derived growth factor receptor beta (PDGFRβ) is essential for fibronectin-mediated cell clustering of ovarian cancer cells into tumorspheres. This effect is mediated by the kinase NUAK family SNF1-like kinase 1 (NUAK1) and blocked by PDGFRβ pharmacological or genetic inhibition. In the absence of PDGFRβ, ovarian cancer cells can be provided with fibronectin by cancer-associated fibroblasts to generate chimeric spheroids. This work provides new insights that uncover potential targets to prevent peritoneal dissemination, the main cause of advanced disease in HGSOC patients.
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Affiliation(s)
- Núria Gendrau‐Sanclemente
- Program Against Cancer Therapeutic Resistance (ProCURE)Catalan Institute of Oncology (ICO), Hospital Duran i ReynalsBarcelonaSpain
- Oncobell ProgramInstitut d'Investigació Biomèdica de Bellvitge (IDIBELL)BarcelonaSpain
| | - Agnès Figueras
- Program Against Cancer Therapeutic Resistance (ProCURE)Catalan Institute of Oncology (ICO), Hospital Duran i ReynalsBarcelonaSpain
- Oncobell ProgramInstitut d'Investigació Biomèdica de Bellvitge (IDIBELL)BarcelonaSpain
| | - Kristina Gracova
- Program Against Cancer Therapeutic Resistance (ProCURE)Catalan Institute of Oncology (ICO), Hospital Duran i ReynalsBarcelonaSpain
- Oncobell ProgramInstitut d'Investigació Biomèdica de Bellvitge (IDIBELL)BarcelonaSpain
| | - Álvaro Lahiguera
- Program Against Cancer Therapeutic Resistance (ProCURE)Catalan Institute of Oncology (ICO), Hospital Duran i ReynalsBarcelonaSpain
- Oncobell ProgramInstitut d'Investigació Biomèdica de Bellvitge (IDIBELL)BarcelonaSpain
| | - Elisenda Alsina‐Sanchís
- Program Against Cancer Therapeutic Resistance (ProCURE)Catalan Institute of Oncology (ICO), Hospital Duran i ReynalsBarcelonaSpain
- Oncobell ProgramInstitut d'Investigació Biomèdica de Bellvitge (IDIBELL)BarcelonaSpain
| | - Juan A. Marín‐Jiménez
- Cancer Immunotherapy (CIT) Group‐ProCUREBellvitge Biomedical Research Institute (IDIBELL) – OncoBellBarcelonaSpain
- Department of Medical OncologyCatalan Institute of Oncology (ICO)BarcelonaSpain
| | - August Vidal
- Oncobell ProgramInstitut d'Investigació Biomèdica de Bellvitge (IDIBELL)BarcelonaSpain
- Department of PathologyUniversity Hospital of Bellvitge (IDIBELL)BarcelonaSpain
- CIBERONCInstituto de Salud Carlos IIIMadridSpain
| | - Xavier Matias‐Guiu
- Oncobell ProgramInstitut d'Investigació Biomèdica de Bellvitge (IDIBELL)BarcelonaSpain
- Department of PathologyUniversity Hospital of Bellvitge (IDIBELL)BarcelonaSpain
- CIBERONCInstituto de Salud Carlos IIIMadridSpain
| | | | - Marc Barahona
- Department of GynaecologyUniversity Hospital of Bellvitge (IDIBELL)BarcelonaSpain
| | - Lola Martí
- Department of GynaecologyUniversity Hospital of Bellvitge (IDIBELL)BarcelonaSpain
| | - Jordi Ponce
- Department of GynaecologyUniversity Hospital of Bellvitge (IDIBELL)BarcelonaSpain
| | - Francesc Viñals
- Program Against Cancer Therapeutic Resistance (ProCURE)Catalan Institute of Oncology (ICO), Hospital Duran i ReynalsBarcelonaSpain
- Oncobell ProgramInstitut d'Investigació Biomèdica de Bellvitge (IDIBELL)BarcelonaSpain
- Departament de Ciències FisiològiquesUniversitat de BarcelonaSpain
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Ponce J, Fernández S, Barahona M, Martínez JM, Ortega C, Martí L. Robotic-assisted para-aortic lymphadenectomy: Technique and indications in gynecological oncology. Best Pract Res Clin Obstet Gynaecol 2023; 91:102401. [PMID: 37678062 DOI: 10.1016/j.bpobgyn.2023.102401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/21/2023] [Accepted: 07/27/2023] [Indexed: 09/09/2023]
Abstract
The benefits of minimally-invasive surgeries have been documented, and they have been established as the preferred approach for gynecological surgeries. With the development of robotic surgery, many highly complex surgeries can benefit from these advantages. Due to the complexity of aortocaval lymphadenectomy, surgical technique protocols have been described to reduce risks by maximizing benefits. We describe the technique using five ports (4 robotic arms and an assistant) to work the upper abdominal field, and different instruments recommended in each of their positions to reduce errors and optimize surgical time. After the "step by step" description, we summarize indications of aortocaval lymphadenectomy for every gynecological cancer in different stages.
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Affiliation(s)
- Jordi Ponce
- Gynecologic Department, University Hospital of Bellvitge (IDIBELL), University of Barcelona, Spain.
| | - Sergi Fernández
- Gynecologic Department, University Hospital of Bellvitge (IDIBELL), University of Barcelona, Spain.
| | - Marc Barahona
- Gynecologic Department, University Hospital of Bellvitge (IDIBELL), University of Barcelona, Spain.
| | - José Manuel Martínez
- Gynecologic Department, University Hospital of Bellvitge (IDIBELL), University of Barcelona, Spain.
| | - Carlos Ortega
- Gynecologic Department, University Hospital of Bellvitge (IDIBELL), University of Barcelona, Spain.
| | - Lola Martí
- Gynecologic Department, University Hospital of Bellvitge (IDIBELL), University of Barcelona, Spain.
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3
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Herreros M, Martí L, Díaz N, Arnedo AR, Tió M, Díaz M, Guerrero J, Ortíz J, Ten J, Bernabeu R. Individual or group embryo culture? A pilot study and subsequent prospective randomized trial to evaluate blastocyst formation rate, quality and reproductive outcomes. Reprod Biomed Online 2022. [DOI: 10.1016/j.rbmo.2022.08.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2022]
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4
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Herreros M, Martí L, Díaz N, Tió MC, Rodriguez-Arnedo A, Guerrero J, Ortiz J, Ten J, Bernabeu R. O-063 Impact of group embryo culture vs individual embryo culture strategies on blastocyst rate and quality. Hum Reprod 2022. [DOI: 10.1093/humrep/deac104.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Does group embryo culture improve blastocyst formation compared to individual culture?
Summary answer
Individual culture provides an increased blastocyst formation rate.
What is known already
Embryo culture is one of the most important steps of an IVF treatment. Several studies pointed out that group embryo culture could help embryos with lower potential, through paracrine signaling, to achieve development and improve blastocyst formation rate. On the other hand, this issue continues to be controversial and other studies did not find differences in embryo development when using either method.
Study design, size, duration
A prospective randomized study was performed between January 2020 and December 2021. The data were obtained from 830 embryos that came from 103 egg donation treatments. We defined two groups: individual vs group culture. The number of embryos analyzed in the study was calculated to test a difference of 10% in the rate of blastocyst formation between the two groups.
Participants/materials, setting, methods
A total of 103 ICSI-egg donation cycles with normozoospermic males (fresh samples) were included. After fertilization assessment, zygotes were randomized into two groups; Group 1: individual culture (399 embryos), and Group 2: culture of 2-5 embryos per drop (431 embryos). The embryos were cultured in 35 µl drops of Global Total medium until day 5 when they were classified morphologically according to Gardner criteria (1998). The statistical analysis was performed using SPSS (version 20.0).
Main results and the role of chance
The rate of high-quality embryos on day 3 were similar in Group 1 compared to Group 2 (79.2% vs 81.4%, p = 0.432). However, we observed an increase in the blastocyst formation rate on day 5 (62.9% vs 56.1%, p = 0.048) and a trend for higher embryo quality (A/B blastocysts) (55.9% vs 52%, p = 0.266) in Group 1; compared to Group 2, respectively.
Our data suggest that individual culture increases blastocyst formation rate and may benefit embryo quality on day 5. Our results challenge previous reports suggesting that culture in groups can improve embryo development. As hypothesis, we argue that some of the components that the embryos release to the culture environment during their division may affect the quality of the cohort potentially compromising further development up to the blastocyst stage.
Limitations, reasons for caution
The study is focused on laboratory outcomes until the blastocyst stage. Clinical outcomes were not analyzed.
Wider implications of the findings
Finding the most appropriate embryo culture conditions is essential to improve ART results. Time-lapse systems should be adapted to the use of both individual and group culture dishes. Larger randomized studies are needed in order to reach robust conclusions on the subject.
Trial registration number
NA
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Affiliation(s)
- M Herreros
- Instituto Bernabeu, Reproductive Embriology , Alicante, Spain
| | - L Martí
- Instituto Bernabeu, Reproductive Embriology , Alicante, Spain
| | - N Díaz
- Instituto Bernabeu, Reproductive Embriology , Alicante, Spain
| | - M C Tió
- Instituto Bernabeu, Reproductive Embriology , Alicante, Spain
| | | | - J Guerrero
- Instituto Bernabeu, Reproductive Embriology , Alicante, Spain
| | - J Ortiz
- Instituto Bernabeu Biotech, Molecular Laboratory , Alicante, Spain
| | - J Ten
- Instituto Bernabeu, Reproductive Embriology , Alicante, Spain
| | - R Bernabeu
- Instituto Bernabeu, Reproductive Medicine , Alicante, Spain
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Fernandez-Gonzalez S, Ponce J, Martínez-Maestre MÁ, Barahona M, Gómez-Hidalgo NR, Díaz-Feijoo B, Casajuana A, Gracia M, Frias-Gomez J, Benavente Y, Costas L, Martí L, Melero L, Silvan JM, Beiro E, Lobo I, De la Rosa J, Coronado PJ, Gil-Moreno A. The Impact of Surgical Practice on Oncological Outcomes in Robot-Assisted Radical Hysterectomy for Early-Stage Cervical Cancer, Spanish National Registry. Cancers (Basel) 2022; 14:cancers14030698. [PMID: 35158966 PMCID: PMC8833333 DOI: 10.3390/cancers14030698] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/20/2022] [Accepted: 01/28/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Minimal invasive surgery (MIS) has been associated with lower disease-free survival than open surgery among women who underwent radical hysterectomy for early-stage cervical cancer. However, the mechanisms by which MIS increases mortality in cervical cancer remain uncertain. We aimed to determine if surgical practice among centers using robotic surgery has an impact on oncological outcomes. We evaluated 215 women with early-stage cervical cancer (≤IB1 or IIA1, FIGO 2009) who underwent robot-assisted radical hysterectomy in five Spanish tertiary centers between 2009 and 2018. A higher surgical volume, higher participation in clinical trials, higher rate of MRI use for diagnosis, greater use of sentinel lymph node biopsies, and a favorable learning curve with low rates of early recurrences were observed for the centers with better oncological outcomes. These factors might have a significant impact on oncological outcomes in all surgical approaches. Abstract This study aimed to assess whether surgical practice had a significant impact on oncological outcomes among women who underwent robot-assisted radical hysterectomy for early-stage cervical cancer (≤IB1 or IIA1, FIGO 2009). The secondary objective was to audit the pre-surgical quality indicators (QI) proposed by the European Society of Gynaecological Oncology (ESGO). The top 5 of 10 centers in Spain and Portugal were included in the analysis. The hospitals were divided into group A (n = 118) and group B (n = 97), with recurrence rates of <10% and >10%, respectively. After balancing both groups using the propensity score, the ORs for all events were higher and statistically significant for group B (recurrences OR = 1.23, 95% CI = 1.13–1.15, p-value = 0.001; death OR = 1.10, 95% CI = 1.02–1.18, p-value = 0.012; disease-specific mortality ORr = 1.11, 95% CI = 1.04–1.19, p-value = 0.002). A higher surgical volume, higher participation in clinical trials, higher rate of MRI use for diagnosis, greater use of sentinel lymph node biopsies, and a favorable learning curve with low rates of early recurrences were observed among the centers with better oncological outcomes. These factors might have a significant impact on oncological outcomes not only after robot-assisted surgery, but also after laparoscopies and open surgeries in the treatment of cervical cancer.
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Affiliation(s)
- Sergi Fernandez-Gonzalez
- Department of Gynecology, Bellvitge University Hospital, IDIBELL, L’Hospitalet de Llobregat, Universitat de Barcelona, 08907 Barcelona, Spain; (M.B.); (L.M.)
- Correspondence: (S.F.-G.); (J.P.)
| | - Jordi Ponce
- Department of Gynecology, Bellvitge University Hospital, IDIBELL, L’Hospitalet de Llobregat, Universitat de Barcelona, 08907 Barcelona, Spain; (M.B.); (L.M.)
- Correspondence: (S.F.-G.); (J.P.)
| | | | - Marc Barahona
- Department of Gynecology, Bellvitge University Hospital, IDIBELL, L’Hospitalet de Llobregat, Universitat de Barcelona, 08907 Barcelona, Spain; (M.B.); (L.M.)
| | - Natalia R. Gómez-Hidalgo
- Department of Gynecologic Oncology, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (N.R.G.-H.); (A.G.-M.)
| | - Berta Díaz-Feijoo
- Institute Clinic of Gynecology, Obstetrics and Neonatotlogy, Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Universitat de Barcelona, 08036 Barcelona, Spain;
| | - Andrea Casajuana
- Instituto de Salud de la Mujer (IdISSC), Hospital Clínico San Carlos, Universidad Complutense Madrid, 28040 Madrid, Spain; (A.C.); (M.G.); (P.J.C.)
| | - Myriam Gracia
- Instituto de Salud de la Mujer (IdISSC), Hospital Clínico San Carlos, Universidad Complutense Madrid, 28040 Madrid, Spain; (A.C.); (M.G.); (P.J.C.)
| | - Jon Frias-Gomez
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (J.F.-G.); (Y.B.); (L.C.)
| | - Yolanda Benavente
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (J.F.-G.); (Y.B.); (L.C.)
| | - Laura Costas
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (J.F.-G.); (Y.B.); (L.C.)
| | - Lola Martí
- Department of Gynecology, Bellvitge University Hospital, IDIBELL, L’Hospitalet de Llobregat, Universitat de Barcelona, 08907 Barcelona, Spain; (M.B.); (L.M.)
| | - Lidia Melero
- Department of Gynecology, Hospital Universitario Virgen del Rocio, 41001 Sevilla, Spain; (M.Á.M.-M.); (L.M.); (J.M.S.)
| | - Jose Manuel Silvan
- Department of Gynecology, Hospital Universitario Virgen del Rocio, 41001 Sevilla, Spain; (M.Á.M.-M.); (L.M.); (J.M.S.)
| | - Eva Beiro
- Department of Gynecology, Hospital Universitario de Basurto, 48013 Bilbao, Spain; (E.B.); (I.L.); (J.D.l.R.)
| | - Ignacio Lobo
- Department of Gynecology, Hospital Universitario de Basurto, 48013 Bilbao, Spain; (E.B.); (I.L.); (J.D.l.R.)
| | - Jesús De la Rosa
- Department of Gynecology, Hospital Universitario de Basurto, 48013 Bilbao, Spain; (E.B.); (I.L.); (J.D.l.R.)
| | - Pluvio J. Coronado
- Instituto de Salud de la Mujer (IdISSC), Hospital Clínico San Carlos, Universidad Complutense Madrid, 28040 Madrid, Spain; (A.C.); (M.G.); (P.J.C.)
| | - Antonio Gil-Moreno
- Department of Gynecologic Oncology, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (N.R.G.-H.); (A.G.-M.)
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6
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Ten J, Guerrero J, Rodríguez-Arnedo A, Martí L, Herreros M, Díaz N, Sellers R, Tió MC, Bernabeu A, Llácer J, Bernabeu R. P–162 Laser-assisted collapse of blastocysts prior to vitrification improves clinical outcomes. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
What is the effect of artificial laser-assisted collapse before vitrification on pregnancy and implantation rates after transfer of vitrified-warmed blastocysts?
Summary answer
The artificial shrinkage by laser-induced collapse before vitrification significantly increased the implantation and clinical pregnancy rates after single thawed embryo transfer.
What is known already
Freeze all, cycle segmentation and, in general, single embryo transfer (SET) strategies (for example trophectoderm biopsy-based aneuploidy testing) have targeted blastocysts vitrification as the best option for reproductive practice worldwide. Artificial shrinkage seems to be a pre-vitrification parameter associated with an increased embryo survival after warming and implantation rate. However, the available medical evidence shows controversial results with only a limited number of prospective studies assessing the subject.
Study design, size, duration
This prospective cohort study evaluated 394 women who underwent a frozen blastocyst transfer at Instituto Bernabeu between July and December 2020. All patients were prepared with substitutive cycle and received single blastocyst embryo transfers.
Participants/materials, setting, methods
Before embryo vitrification on day 5 of development, some expanded and/or early hatching blastocysts (A/B ASEBIR categories) were artificial laser-assisted collapsed. (n = 83, study group). 311 embryos of the same quality and day of development were not collapsed (control group). We compared the embryo survival rate, clinical, implantation and miscarriage rates between groups. The statistical analysis was performed using SPSS (version 20.0).
Main results and the role of chance
The two groups were comparable in terms of maternal age (39.79 ± 3.83, control group; 40.21 ± 4.45, study group; p = 0.341). Embryo survival rate resulted in 100% in both groups.
Regarding clinical outcomes, collapsed blastocysts significantly increased the positive pregnancy test and the clinical pregnancy and implantation rate compared to the control group, respectively (positive test: 69,9% vs 43,4%, p = 0.000018, odds ratio (OR)= 3.02 [95% CI 1.80–5.08]; clinical pregnancy and implantation: 56,6% vs 35,4%, p = 0.000041, OR = 2.39 [95% CI 1.46–3.90]). The miscarriage rate was not affected by the blastocyst collapse effect (23,6% in the control group vs 27,6% in the study group, p = 0.593, OR = 1.23 [95% CI 0.57–2.68]).
Limitations, reasons for caution
This is a non-randomized controlled study. Additional RCTs are warranted to corroborate our findings.
Wider implications of the findings: Considering the large number of blastocyst vitrification cycles that are carried out worldwide, artificial laser-assisted collapse before vitrification has the potential to increase the clinical results in benefit of many patients.
Trial registration number
Not applicable
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Affiliation(s)
- J Ten
- Instituto Bernabeu, Embriology Unit, Alicante, Spain
| | - J Guerrero
- Instituto Bernabeu, Embriology Unit, Alicante, Spain
| | | | - L Martí
- Instituto Bernabeu, Embriology Unit, Alicante, Spain
| | - M Herreros
- Instituto Bernabeu, Embriology Unit, Alicante, Spain
| | - N Díaz
- Instituto Bernabeu, Embriology Unit, Alicante, Spain
| | - R Sellers
- Instituto Bernabeu, Embriology Unit, Alicante, Spain
| | - M C Tió
- Instituto Bernabeu, Embriology Unit, Alicante, Spain
| | - A Bernabeu
- Instituto Bernabeu, Reproductive Medicine Unit, Alicante, Spain
| | - J Llácer
- Instituto Bernabeu, Reproductive Medicine Unit, Alicante, Spain
| | - R Bernabeu
- Instituto Bernabeu, Reproductive Medicine Unit, Alicante, Spain
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7
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Cabrera S, Barahona-Orpinell M, Almansa-González C, Padilla-Iserte P, Bebia V, Martí L, Tejerizo-García Á, Domingo S, Gil-Moreno A. Combined use of ICG and technetium does not improve sentinel lymph node detection in endometrial cancer: Results of the COMBITEC study. Gynecol Oncol 2021; 162:32-37. [PMID: 33992451 DOI: 10.1016/j.ygyno.2021.05.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/04/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE There is scarce evidence available about the benefit of combining technetium (99mTc) and indocyanine green (ICG) for sentinel lymph node (SLN) biopsy in endometrial cancer. The aim of this study was to compare the overall and bilateral pelvic detection rates of SLNs in two retrospective cohorts: ICG exclusive vs. combined ICG+99mTc. METHODS The COMBITEC study (COMBined ICG and Technetium for SLN detection in Endometrial Cancer) consisted of a multicentre retrospective study (February 2015-June 2020) including patients diagnosed with endometrial atypical hyperplasia or early-stage endometrial carcinoma who underwent SLN biopsy by cervical injection of ICG with or without 99mTc in four different referral centers in Spain. RESULTS A total of 180 patients were included, 51% (n = 92) in ICG group and 49% (n = 88) in ICG+99mTc group. Eighty-seven percent of the patients presented endometrioid histology, and over 99% of the procedures were performed by a minimally invasive approach. Both groups were comparable regarding their basal characteristics, except for a higher body mass index in ICG+99mTc group and a bigger proportion of robotic-assisted procedures in ICG group. Overall detection rate was 92.8% without significant differences between groups (ICG: 94.6% vs ICG+99mTc: 90.9%, p = .34). No significant differences were observed neither in bilateral pelvic nor aortic mapping rate. When 99mTc was used, surgical procedures were significantly longer. In 7.3% of mapped patients, at least one positive SLN was found (ICG: 10.3% vs ICG+99mTc: 3.9%, p = .109). Empty node packet rates and number of SLNs retrieved per patient were also similar between cohorts. CONCLUSION Combining preoperative 99mTc to intraoperative ICG did not improve SLN detection in endometrial cancer, but resulted in longer procedures.
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Affiliation(s)
- Silvia Cabrera
- Gynecologic Oncology Unit, University Hospital Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus and Autonomous University of Barcelona (UAB), Spain.
| | | | | | | | - Vicente Bebia
- Gynecologic Oncology Unit, University Hospital Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus and Autonomous University of Barcelona (UAB), Spain
| | - Lola Martí
- Gynecologic Oncology Unit, University Hospital of Bellvitge (IDIBELL), Barcelona, Spain
| | | | - Santiago Domingo
- Gynecologic Oncology Unit, University Hospital La Fe, Valencia, Spain
| | - Antonio Gil-Moreno
- Gynecologic Oncology Unit, University Hospital Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus and Autonomous University of Barcelona (UAB), Spain; CIBERONC, Barcelona, Spain
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8
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Barajas A, Pelaez T, González O, Usall J, Iniesta R, Arteaga M, Jackson C, Baños I, Sánchez B, Dolz M, Obiols JE, Haro JM, Ochoa S, Arranz B, Arteaga M, Asensio R, Autonell J, Baños I, Bañuelos M, Barajas A, Barceló M, Blanc M, Borrás M, Busquets E, Carlson J, Carral V, Castro M, Corbacho C, Coromina M, Dachs I, De Miquel L, Dolz M, Domenech MD, Elias M, Espezel I, Falo E, Fargas A, Foix A, Fusté M, Godrid M, Gómez D, González O, Granell L, Gumà L, Haro JM, Herrera S, Huerta E, Lacasa F, Mas N, Martí L, Martínez R, Matalí J, Miñambres A, Muñoz D, Muñoz V, Nogueroles R, Ochoa S, Ortiz J, Pardo M, Planella M, Pelaez T, Peruzzi S, Rivero S, Rodriguez MJ, Rubio E, Sammut S, Sánchez M, Sánchez B, Serrano E, Solís C, Stephanotto C, Tabuenca P, Teba S, Torres A, Urbano D, Usall J, Vilaplana M, Villalta V. Predictive capacity of prodromal symptoms in first-episode psychosis of recent onset. Early Interv Psychiatry 2019; 13:414-424. [PMID: 29116670 DOI: 10.1111/eip.12498] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 07/16/2017] [Accepted: 08/20/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Both the nature and number of a wide range of prodromal symptoms have been related to the severity and type of psychopathology in the psychotic phase. However, at present there is an incomplete picture focused mainly on the positive pre-psychotic dimension. AIM To characterize the prodromal phase retrospectively, examining the number and nature of prodromal symptoms as well as their relationship with psychopathology at the onset of first-episode psychosis. METHODS Retrospective study of 79 patients experiencing a first-episode psychosis of less than 1 year from the onset of full-blown psychosis. All patients were evaluated with a comprehensive battery of instruments including socio-demographic and clinical questionnaire, IRAOS interview, PANSS, stressful life events scale (PERI) and WAIS/WISC (vocabulary subtest). Bivariate associations and multiple regression analysis were performed. RESULTS Regression models revealed that several prodromal dimensions of IRAOS (delusions, affect, language, behaviour and non-hallucinatory disturbances of perception) predicted the onset of psychosis, with positive (22.4% of the variance) and disorganized (25.6% of the variance) dimensions being the most widely explained. CONCLUSION In addition to attenuated positive symptoms, other symptoms such as affective, behavioural and language disturbances should also be considered in the definitions criteria of at-high-risk people.
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Affiliation(s)
- Ana Barajas
- Department of Research, Centre d'Higiene Mental Les Corts, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Hospital Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Esplugues de Llobregat, Barcelona, Spain.,Fundació Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain.,Department of Clinical and Psychology, School of Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Trinidad Pelaez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Olga González
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Judith Usall
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Raquel Iniesta
- Fundació Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Maria Arteaga
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Chris Jackson
- Birmingham Early Intervention Service, Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - Iris Baños
- Fundació Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Bernardo Sánchez
- Hospital Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Esplugues de Llobregat, Barcelona, Spain
| | - Montserrat Dolz
- Hospital Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Esplugues de Llobregat, Barcelona, Spain
| | - Jordi E Obiols
- Department of Clinical and Psychology, School of Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Josep M Haro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | | | - Susana Ochoa
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
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Jam R, Hernández O, Mesquida J, Turégano C, Carrillo E, Pedragosa R, Gómez V, Martí L, Vallés J, Delgado-Hito P. Nursing workload and adherence to non-pharmacological measures in the prevention of ventilator-associated pneumonia. A pilot study. Enferm Intensiva 2017; 28:178-186. [PMID: 28890209 DOI: 10.1016/j.enfi.2017.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 03/24/2017] [Accepted: 03/27/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To analyse whether adherence to non-pharmacological measures in the prevention of ventilator-associated pneumonia (VAP) is associated with nursing workload. METHODS A prospective observational study performed in a single medical-surgical ICU. Nurses in charge of patients under ventilator support were assessed. VARIABLES knowledge questionnaire, application of non-pharmacological VAP prevention measures, and workload (Nine Equivalents of Nursing Manpower Use Score). Phases: 1) the nurses carried out a educational programme, consisting of 60-minute lectures on non-pharmacological measures for VAP prevention, and at the end completed a questionnaire knowledge; 2) observation period; 3) knowledge questionnaire. RESULTS Among 67 ICU-staff nurses, 54 completed the educational programme and were observed. A total of 160 observations of 49 nurses were made. Adequate knowledge was confirmed in both the initial and final questionnaires. Application of preventive measures ranged from 11% for hand washing pre-aspiration to 97% for the use of a sterile aspiration probe. The Nine Equivalents of Nursing Manpower Use Score was 50±13. No significant differences were observed between the association of the nurses' knowledge and the application of preventive measures or between workload and the application of preventive measures. CONCLUSIONS Nurses' knowledge of VAP prevention measures is not necessarily applied in daily practice. Failure to follow these measures is not subject to lack of knowledge or to increased workload, but presumably to contextual factors.
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Affiliation(s)
- R Jam
- Área de Cuidados Críticos, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, España
| | - O Hernández
- Servicio de Atención Primaria, Vallés Occidental, Sabadell, Barcelona, España
| | - J Mesquida
- Área de Cuidados Críticos, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, España
| | - C Turégano
- Área de Cuidados Críticos, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, España
| | - E Carrillo
- Área de Cuidados Críticos, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, España
| | - R Pedragosa
- Área de Cuidados Críticos, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, España
| | - V Gómez
- Área de Cuidados Críticos, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, España
| | - L Martí
- Área de Cuidados Críticos, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, España
| | - J Vallés
- Área de Cuidados Críticos, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, España
| | - P Delgado-Hito
- Departamento de Enfermería Fundamental y Médico-Quirúrgica, Escuela de Enfermería, Universidad de Barcelona, Barcelona, España; Miembro del Grupo GRIN-IDIBELL.
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Alsina-Sanchís E, Figueras A, Lahiguera A, Gil-Martín M, Pardo B, Piulats JM, Martí L, Ponce J, Matias-Guiu X, Vidal A, Villanueva A, Viñals F. TGFβ Controls Ovarian Cancer Cell Proliferation. Int J Mol Sci 2017; 18:ijms18081658. [PMID: 28758950 PMCID: PMC5578048 DOI: 10.3390/ijms18081658] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 07/17/2017] [Accepted: 07/24/2017] [Indexed: 12/15/2022] Open
Abstract
There have been no major improvements in the overall survival of ovarian cancer patients in recent decades. Even though more accurate surgery and more effective treatments are available, the mortality rate remains high. Given the differences in origin and the heterogeneity of these tumors, research to elucidate the signaling pathways involved is required. The Transforming Growth Factor (TGFβ) family controls different cellular responses in development and cell homeostasis. Disruption of TGFβ signaling has been implicated in many cancers, including ovarian cancer. This article considers the involvement of TGFβ in ovarian cancer progression, and reviews the various mechanisms that enable the TGFβ signaling pathway to control ovarian cancer cell proliferation. These mechanistic explanations support the therapeutic use of TGFβ inhibitors in ovarian cancer, which are currently in the early phases of development.
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Affiliation(s)
- Elisenda Alsina-Sanchís
- Program Against Cancer Therapeutic Resistance (ProCURE), Institut Català d'Oncologia, Hospital Duran i Reynals, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - Agnès Figueras
- Program Against Cancer Therapeutic Resistance (ProCURE), Institut Català d'Oncologia, Hospital Duran i Reynals, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - Alvaro Lahiguera
- Program Against Cancer Therapeutic Resistance (ProCURE), Institut Català d'Oncologia, Hospital Duran i Reynals, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - Marta Gil-Martín
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Medical Oncology Department, Institut Català d'Oncologia, Hospital Duran i Reynals, IDIBELL, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - Beatriz Pardo
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Medical Oncology Department, Institut Català d'Oncologia, Hospital Duran i Reynals, IDIBELL, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - Josep M Piulats
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Medical Oncology Department, Institut Català d'Oncologia, Hospital Duran i Reynals, IDIBELL, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - Lola Martí
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Gynaecologic Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - Jordi Ponce
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Gynaecologic Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - Xavier Matias-Guiu
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Servei d'Anatomia Patològica, Hospital Universitari de Bellvitge, CIBERONC, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - August Vidal
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Servei d'Anatomia Patològica, Hospital Universitari de Bellvitge, CIBERONC, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Xenopat, Carrer de la Feixa Llarga S/N, L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
- Departament de Patologia i Terapèutica Experimental, Universitat de Barcelona, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
| | - Alberto Villanueva
- Program Against Cancer Therapeutic Resistance (ProCURE), Institut Català d'Oncologia, Hospital Duran i Reynals, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Xenopat, Carrer de la Feixa Llarga S/N, L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
| | - Francesc Viñals
- Program Against Cancer Therapeutic Resistance (ProCURE), Institut Català d'Oncologia, Hospital Duran i Reynals, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
- Departament de Ciències Fisiològiques, Universitat de Barcelona, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
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Ivars C, Martí L. Extrinsic airway compression secondary to massive emphysema after colangiopancreatography. Rev Esp Anestesiol Reanim 2016; 63:608-609. [PMID: 27178317 DOI: 10.1016/j.redar.2016.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 03/23/2016] [Accepted: 03/28/2016] [Indexed: 06/05/2023]
Affiliation(s)
- C Ivars
- Servicio de Anestesia y Reanimación, Hospital Francesc de Borja, Gandía, Valencia, España.
| | - L Martí
- Servicio de Medicina Digestiva, Hospital Francesc de Borja, Gandía, Valencia, España
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12
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Climent MJ, Corma A, Iborra S, Martí L. Process Intensification with Bifunctional Heterogeneous Catalysts: Selective One-Pot Synthesis of 2′-Aminochalcones. ACS Catal 2014. [DOI: 10.1021/cs5011713] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- M. J. Climent
- Instituto de Tecnología Química (UPV-CSIC), Universitat Politécnica de València, Avda dels Tarongers s/n, 46022 Valencia, Spain
| | - A. Corma
- Instituto de Tecnología Química (UPV-CSIC), Universitat Politécnica de València, Avda dels Tarongers s/n, 46022 Valencia, Spain
- King Fahd University of Petroleum and Minerals, P.O. Box 989, Dhahran 31261, Saudi Arabia
| | - S. Iborra
- Instituto de Tecnología Química (UPV-CSIC), Universitat Politécnica de València, Avda dels Tarongers s/n, 46022 Valencia, Spain
| | - L. Martí
- Instituto de Tecnología Química (UPV-CSIC), Universitat Politécnica de València, Avda dels Tarongers s/n, 46022 Valencia, Spain
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13
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Stefansson OA, Villanueva A, Vidal A, Martí L, Esteller M. BRCA1 epigenetic inactivation predicts sensitivity to platinum-based chemotherapy in breast and ovarian cancer. Epigenetics 2012; 7:1225-9. [PMID: 23069641 PMCID: PMC3499323 DOI: 10.4161/epi.22561] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Germline mutations in the BRCA1 or BRCA2 genes are associated with an increased risk of breast and ovarian cancer development. Both genes are involved in DNA repair, and tumors harboring genetic defects in them are thought to be more sensitive to DNA-damaging agents used in chemotherapy. However, as only a minority of breast and ovarian cancer patients carry BRCA1 or BRCA2 mutations, few patients are likely to benefit from these pharmacogenetic biomarkers. Herein, we show that, in cancer cell lines and xenografted tumors, BRCA1 CpG island promoter hypermethylation-associated silencing also predicts enhanced sensitivity to platinum-derived drugs to the same extent as BRCA1 mutations. Most importantly, BRCA1 hypermethylation proves to be a predictor of longer time to relapse and improved overall survival in ovarian cancer patients undergoing chemotherapy with cisplatin.
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Affiliation(s)
- Olafur A Stefansson
- Cancer Epigenetics and Biology Program, Bellvitge Biomedical Research Institute, Barcelona, Catalonia Spain
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14
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Stefansson OA, Villanueva A, Vidal A, Martí L, Esteller M. Re: A DNA repair pathway-focused score for prediction of outcomes in ovarian cancer treated with platinum-based chemotherapy. J Natl Cancer Inst 2012; 104:1514; author reply 1514-5. [PMID: 22923512 DOI: 10.1093/jnci/djs363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Vidal A, Muñoz C, Guillén MJ, Moretó J, Puertas S, Martínez-Iniesta M, Figueras A, Padullés L, García-Rodriguez FJ, Berdiel-Acer M, Pujana MA, Salazar R, Gil-Martin M, Martí L, Ponce J, Molleví DG, Capella G, Condom E, Viñals F, Huertas D, Cuevas C, Esteller M, Avilés P, Villanueva A. Lurbinectedin (PM01183), a new DNA minor groove binder, inhibits growth of orthotopic primary graft of cisplatin-resistant epithelial ovarian cancer. Clin Cancer Res 2012; 18:5399-411. [PMID: 22896654 DOI: 10.1158/1078-0432.ccr-12-1513] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Epithelial ovarian cancer (EOC) is the fifth leading cause of death in women diagnosed with gynecologic malignancies. The low survival rate is because of its advanced-stage diagnosis and either intrinsic or acquired resistance to standard platinum-based chemotherapy. So, the development of effective innovative therapeutic strategies to overcome cisplatin resistance remains a high priority. EXPERIMENTAL DESIGN To investigate new treatments in in vivo models reproducing EOCs tumor growth, we generated a preclinical model of ovarian cancer after orthotopic implantation of a primary serous tumor in nude mice. Further, matched model of acquired cisplatin-resistant tumor version was successfully derived in mice. Effectiveness of lurbinectedin (PM01183) treatment, a novel marine-derived DNA minor groove covalent binder, was assessed in both preclinical models as a single and a combined-cisplatin agent. RESULTS Orthotopically perpetuated tumor grafts mimic the histopathological characteristics of primary patients' tumors and they also recapitulate in mice characteristic features of tumor response to cisplatin treatments. We showed that single lurbinectedin or cisplatin-combined therapies were effective in treating cisplatin-sensitive and cisplatin-resistant preclinical ovarian tumor models. Furthermore, the strongest in vivo synergistic effect was observed for combined treatments, especially in cisplatin-resistant tumors. Lurbinectedin tumor growth inhibition was associated with reduced proliferation, increased rate of aberrant mitosis, and subsequent induced apoptosis. CONCLUSIONS Taken together, preclinical orthotopic ovarian tumor grafts are useful tools for drug development, providing hard evidence that lurbinectedin might be a useful therapy in the treatment of EOC by overcoming cisplatin resistance.
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Affiliation(s)
- August Vidal
- Department of Pathology, Hospital Universitari de Bellvitge, Spain
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Caballero Gine J, Navarro A, Borrat P, Muñoz A, Martí L, Gili J, Ristol J. VID-03.06 Treatment of Rectum-Urethral Fistula after Radical Prostatectomy with Gracilis Muscle Flap. Urology 2011. [DOI: 10.1016/j.urology.2011.07.487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Caballero JM, Borrat P, Paraira M, Martí L, Ristol J. [Extracorporeal high-intensity focused ultrasound: therapeutic alternative for renal tumors]. Actas Urol Esp 2010; 34:403-411. [PMID: 20470712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVES High intensity focused ultrasound (HIFU) is known to be used for the treatment of solid tumors in minimally invasive procedures. Transducers allowing for application of ultrasound from an extracorporeal focus have recently been developed. A review is provided of the development, physical principles, and current status of this therapy, and our early experience with it for the treatment of renal tumors is reported. MATERIALS AND METHODS Extracorporeal HIFU is currently being used for the treatment of tumors (mainly hepatic, gynecological, and bone tumors), and has been started to be used for renal tumors with good results. A literature review (structured search in the online MEDLINE electronic base) of the physical principles of this treatment and its biological action is provided. The therapeutic procedure used in the first few patients with renal carcinoma successfully treated with HIFU at our hospital is reported. RESULTS This therapy has been successfully used to treat solid tumors at several centers in Europe, America, and Asia. Our center has a wide experience in treatment of gynecological tumors using extracorporeal HIFU, and has already treated renal tumors with no complications, although follow-up is still short. CONCLUSIONS Extracorporeal use of this energy appears as a new option among non-invasive therapies for renal cancer in selected cases. A low complication rate has been noted, but much longer follow-up times are required for assessment of oncological results.
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Affiliation(s)
- J M Caballero
- Servicio de Urología, Hospital Mútua Terrassa, Terrassa, Barcelona, Spain.
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18
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Caballero J, Borrat P, Paraira M, Martí L, Ristol J. Ultrasonidos extracorpóreos de alta intensidad: alternativa terapéutica del tumor renal. Actas Urol Esp 2010. [DOI: 10.4321/s0210-48062010000500002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Caballero J, Borrat P, Paraira M, Martí L, Ristol J. Ultrasonidos extracorpóreos de alta intensidad: alternativa terapéutica del tumor renal. Actas Urol Esp 2010. [DOI: 10.1016/j.acuro.2010.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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20
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Oaknin AM, Romeo M, Pons F, Perez X, Barretina P, Vidal A, Martí L, Barahona M, Germá J, Ponce J. Behavior of borderline ovarian tumours (BOTs): Single institution experience. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e16560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e16560 Background: To provide useful material for discussion, we report an analysis of a retrospective accrued, single-institution population with BOTs. Methods: 99 consecutive patients treated between April 1989 and July 2008, were reviewed for clinical characteristics, histology, surgical types, recurrence, and prognosis. Results: Median age was 46 years (19–77). 90% of patients were diagnosed by vaginal ultrasound as complex adnexal mass. CA-125 and CA19.9 was elevated in 60% and 30% of patients respectively. Primary treatment was surgery: laparotomy and laparoscopy (LT/LC) approach in 78% and 22% of patients, respectively. 33 patients (34%) underwent comprehensive staging operation; fertility-sparing surgery was performed in 18 patients (18%), and an incomplete staging in 47 patients (48%). The pathology results were: clear cell BOTs 1 case (1%); serous 42 cases (42.4%); mucinous in 56 women (56.6%) (46 intestinal/10 mullerian). 2 out of 56 mucinous BOTs were associated with pseudomixoma peritonei. Cyst-rupture was found in 22.5% and 38.9% of patients with LT/LC approach. 91women (93.8%) had stage I; 2 (2%) had stage II; and 6 (4.2%) had stage III disease. We identified 6 patients (7.8%) with noninvasive implants involving abdominal peritoneum (1), pelvic peritoneum (1), omentum (2) and both pelvic peritoneum and omentum (2). With a median follow-up of 3.6 years (0–18.4), we observed 5 recurrences (2 in contralateral ovary, 1 ipsilateral, 1 invasive peritoneal implant, and 1 para-aortic node). All were stage I disease at diagnosis. 2 out of 5 had incomplete staging, 3 had conservative surgery.3 cases were serous type. Histology recurrences were: 2 borderline, 2 invasive ovarian cancer, and 1 unknown. All patients underwent secondary cytoreduction achieving an optimal debulking in 4. Only one patient received chemotherapy. Two women died of intercurrent disease and 1 woman died of disease. The 5-year overall survival rate for entire cohort was 98.5% (95.6%-100%; CI95%). Conclusions: Our results confirm published data. Overall BOTs have an excellent prognosis. Proper staging is the cornerstone of treatment. Laparoscopy approach is associated with higher cyst rupture. Recurrences are more frequent after incomplete or conservative surgery. No significant financial relationships to disclose.
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Affiliation(s)
- A. M. Oaknin
- Instituto Catalán de Oncología, Barcelona, Spain; Hospital Universitario de Bellvitge, Barcelona, Spain
| | - M. Romeo
- Instituto Catalán de Oncología, Barcelona, Spain; Hospital Universitario de Bellvitge, Barcelona, Spain
| | - F. Pons
- Instituto Catalán de Oncología, Barcelona, Spain; Hospital Universitario de Bellvitge, Barcelona, Spain
| | - X. Perez
- Instituto Catalán de Oncología, Barcelona, Spain; Hospital Universitario de Bellvitge, Barcelona, Spain
| | - P. Barretina
- Instituto Catalán de Oncología, Barcelona, Spain; Hospital Universitario de Bellvitge, Barcelona, Spain
| | - A. Vidal
- Instituto Catalán de Oncología, Barcelona, Spain; Hospital Universitario de Bellvitge, Barcelona, Spain
| | - L. Martí
- Instituto Catalán de Oncología, Barcelona, Spain; Hospital Universitario de Bellvitge, Barcelona, Spain
| | - M. Barahona
- Instituto Catalán de Oncología, Barcelona, Spain; Hospital Universitario de Bellvitge, Barcelona, Spain
| | - J. Germá
- Instituto Catalán de Oncología, Barcelona, Spain; Hospital Universitario de Bellvitge, Barcelona, Spain
| | - J. Ponce
- Instituto Catalán de Oncología, Barcelona, Spain; Hospital Universitario de Bellvitge, Barcelona, Spain
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Martí L, Del Olmo JA, Tosca J, Ornia E, García-Torres ML, Serra MA, Rodríguez F, Lluch P, Escudero A, Rodrigo JM. Clinical evaluation of drug-induced hepatitis. Rev esp enferm dig 2005; 97:258-65. [PMID: 15982181 DOI: 10.4321/s1130-01082005000400006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To ascertain the epidemiological characteristics, clinical symptoms, and evolution of drug-induced hepatitis over the last 22 years. EXPERIMENTAL DESIGN AND SUBJECTS: An observational, retrospective study between 1982 and 1993, and prospective study between 1994 and 2003. All patients in our department diagnosed with having drug-induced hepatitis were studied analyzing epidemiological (age, sex, cases per year, hospitalization) and clinical features (previous liver disease, hepatic symptoms, laboratory results), and follow-up (complete recovery or chronicity). RESULTS A total of 61 patients were diagnosed as having drug-induced hepatitis, 26 men and 35 women (57%), mean age 52.4 years +/- 17 years, of which 72.2% were older than 40 years. A total of 43% were admitted to hospital. In 87% of cases, two or more drugs were involved, the most frequent being antituberculosis (19 cases), psychotropic (26 cases), and non-steroidal anti-inflammatory drugs (45 cases). Evolution showed that 94% of patients recovered after the withdrawal of suspected causal drugs. CONCLUSIONS The incidence of drug-induced hepatitis is higher in patients over 40 years of age, it being more common in females. Non-steroidal anti-inflammatory, psychotropic, and anti-tuberculosis agents were the main drugs involved. Most patients made a complete recovery after withdrawal of the suspected causal drug.
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Affiliation(s)
- L Martí
- Service of Hepatology, Hospital Clínico Universiratio, Department of Medicine, Valencia, Spain
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Martí L, Moreno A, Filella X, Marín JL, Almela M, Benito N, Sánchez M, Gatell JM. [Cytokines value as a sepsis and mortality predictor in elderly patients with fever]. Med Clin (Barc) 2003. [PMID: 14565910 DOI: 10.1157/13052105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Proinflammatory cytokines (IL-1beta, IL-6, TNF-alpha) are excellent predictive factors of tissue damage, inflammation and infection. However, there is not sufficient data about their usefulness in elderly patients with acute septic pathology. Our objective was to identify the cytokines related to bacteremia and those that predicted a bad prognosis in elderly patients. PATIENTS AND METHOD Prospective study carried out during 1999. Patients aged >= 60 years with temperature >= 38 C admitted to the emergency ward. We determined IL-1beta, IL-6, TNF-alpha and C-reactive protein (CRP); cultures were done according to the infectious source. On the 4th day, cytokines and CRP were recorded again. The follow-up was completed until cure or death. RESULTS 50 patients were included (29 males). Median age was 75.6 (SD: 8.98). The etiology was infectious in 44 (88%): respiratory in 29 (66%), urinary in 8 (18%) and other sources in 7. Thirteen patients had bacteremia (32%): Escherichia coli (4), Streptococcus pneumoniae (5) and others (4). Ten patients died (20%). Median values on admission were CRP : 6.67 mg/dl (NV 0.8), TNF-alpha: 29 pg/ml (NV 0-20), IL-1beta: 7 pg/ml (NV 15) and IL-6: 121 pg/ml (NV 5). 4th day values were: 4.23 mg/dl, 22 pg/ml, 1 pg/ml and 41 pg/ml, respectively. The levels of IL-1b in the 2nd determination were significantly lower in females (p = 0.019). Initial TNF-alpha (p = 0.033), IL-1beta (p = 0.013) and IL-6 (p = 0.031) values were significantly higher in bacteremia patients. IL-6 values on the 4th day were higher in patients who died (p = 0.06). In patients who died, IL-6 levels were higher in the 2nd determination (p = 0.09). CONCLUSIONS Median values of all cytokines were higher in the bacteremia population. Patients who died showed higher levels of IL-6 on the 4th day.
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Affiliation(s)
- L Martí
- Servicio de Infecciones. Hospital Clínic. Barcelona. Spain
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Martí L, Moreno A, Filella X, Marín JL, Almela M, Benito N, Sánchez M, Gatell JM. Valor de las citocinas proinflamatorias como factor de predicción de sepsis y mortalidad en el anciano con fiebre. Med Clin (Barc) 2003; 121:361-6. [PMID: 14565910 DOI: 10.1016/s0025-7753(03)73952-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND OBJECTIVE Proinflammatory cytokines (IL-1beta, IL-6, TNF-alpha) are excellent predictive factors of tissue damage, inflammation and infection. However, there is not sufficient data about their usefulness in elderly patients with acute septic pathology. Our objective was to identify the cytokines related to bacteremia and those that predicted a bad prognosis in elderly patients. PATIENTS AND METHOD Prospective study carried out during 1999. Patients aged >= 60 years with temperature >= 38 C admitted to the emergency ward. We determined IL-1beta, IL-6, TNF-alpha and C-reactive protein (CRP); cultures were done according to the infectious source. On the 4th day, cytokines and CRP were recorded again. The follow-up was completed until cure or death. RESULTS 50 patients were included (29 males). Median age was 75.6 (SD: 8.98). The etiology was infectious in 44 (88%): respiratory in 29 (66%), urinary in 8 (18%) and other sources in 7. Thirteen patients had bacteremia (32%): Escherichia coli (4), Streptococcus pneumoniae (5) and others (4). Ten patients died (20%). Median values on admission were CRP : 6.67 mg/dl (NV 0.8), TNF-alpha: 29 pg/ml (NV 0-20), IL-1beta: 7 pg/ml (NV 15) and IL-6: 121 pg/ml (NV 5). 4th day values were: 4.23 mg/dl, 22 pg/ml, 1 pg/ml and 41 pg/ml, respectively. The levels of IL-1b in the 2nd determination were significantly lower in females (p = 0.019). Initial TNF-alpha (p = 0.033), IL-1beta (p = 0.013) and IL-6 (p = 0.031) values were significantly higher in bacteremia patients. IL-6 values on the 4th day were higher in patients who died (p = 0.06). In patients who died, IL-6 levels were higher in the 2nd determination (p = 0.09). CONCLUSIONS Median values of all cytokines were higher in the bacteremia population. Patients who died showed higher levels of IL-6 on the 4th day.
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Affiliation(s)
- L Martí
- Servicio de Infecciones. Hospital Clínic. Barcelona. Spain
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