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Cerdán-Santacruz C, Cano-Valderrama Ó, Santos Rancaño R, Terés LB, Vigorita V, Pérez TP, Rosciano Paganelli JG, Paredes Cotoré JP, Carre MK, Flor-Lorente B, Antona FB, Martín EY, Tebar JC, Cao IA, Coltell ZB, Alonso MG, Paredes Cotoré JP, Prada López BL, Riesco AB, Cánovas NI, Sánchez CM, Serrat DR, Conde GA, Toscano MJ, Aira AC, Pérez MR, Petit NM, Espín Basany E, Carré MK, Pellino G, Retuerta JM, Saldaña AG, Laso CÁ, Allende IA, Álvarez DH, Cazador AC, Sánchez Bautista WM, Torres Sánchez MT, Bonito AC, Velázquez MC, Díaz OM, Fuentes NS, Olías MDCDLV, Pérez TP, Rosciano Paganelli JG, Lorente BF, Valderrama ÓC, Santos Rancaño R, Terés LB, Santacruz CC. "Long-term oncologic outcomes and risk factors for distant recurrence after pathologic complete response following neoadjuvant treatment for locally advanced rectal cancer. A nationwide, multicentre study". Eur J Surg Oncol 2023; 49:106962. [PMID: 37414628 DOI: 10.1016/j.ejso.2023.06.014] [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: 09/15/2022] [Revised: 04/09/2023] [Accepted: 06/15/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Pathologic complete response (pCR) after multimodal treatment for locally advanced rectal cancer (LARC) is used as surrogate marker of success as it is assumed to correlate with improved oncologic outcome. However, long-term oncologic data are scarce. METHODS This retrospective, multicentre study updated the oncologic follow-up of prospectively collected data from the Spanish Rectal Cancer Project database. pCR was described as no evidence of tumour cells in the specimen. Endpoints were distant metastases-free survival (DMFS) and overall survival (OS). Multivariate regression analyses were run to identify factors associated with survival. RESULTS Overall, 32 different hospitals were involved, providing data on 815 patients with pCR. At a median follow-up of 73.4 (IQR 57.7-99.5) months, distant metastases occurred in 6.4% of patients. Abdominoperineal excision (APE) (HR 2.2, 95%CI 1.2-4.1, p = 0.008) and elevated CEA levels (HR = 1.9, 95% CI 1.0-3.7, p = 0.049) were independent risk factors for distant recurrence. Age (years) (HR 1.1; 95%-CI 1.05-41.09; p < 0.001) and ASA III-IV (HR = 2.0; 95%-CI 1.4-2.9; p < 0.001), were the only factors associated with OS. The estimated 12, 36 and 60-months DMFS rates were 96.9%, 91.3%, and 86.8%. The estimated 12, 36 and 60-months OS rates were 99.1%, 94.9% and 89.3%. CONCLUSIONS The incidence of metachronous distant metastases is low after pCR, with high rates of both DMFS and OS. The oncologic prognosis in LARC patients that achieve pCR after neoadjuvant chemo-radiotherapy is excellent in the long term.
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Affiliation(s)
| | | | | | - Lara Blanco Terés
- Colorectal Surgery Department, Hospital de la Princesa, Madrid, Spain
| | - Vicenzo Vigorita
- Colorectal Surgery Department, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | | | | | - Jesús Pedro Paredes Cotoré
- Colorectal Surgery Department, Hospital Clínico Universitario de Santiago, Santiago de Compostela, La Coruña, Spain
| | | | - Blas Flor-Lorente
- Colorectal Surgery Department, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | | | | | | | - Inés Aldrey Cao
- Complejo Hospitalario Universitario de Ourense, Orense, Spain
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Alcoba M, de Castro MR, Guerra JM, Pérez MR, Carro JA, Martínez Y. [HIV infection in the health care are of Leon. Incidence from 1983-1997]. Enferm Infecc Microbiol Clin 1999; 17:19-23. [PMID: 10069108] [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: 02/11/2023]
Abstract
BACKGROUND The aim of the present work was to know the incidence of HIV infection in the sanitary area of León, and its tendency, throughout the period 1983-1997. MATERIAL AND METHODS A register of cases with the patients attended in the area hospitals, those detected in the Penitentiary Centre of León and notifications of cases of AIDS at a national level have been used. Only the patients residing in a municipality belonging to the area at the time of detection of the infection have been included. Age, sex, risk group, year of detection of the infection, development to AIDS and mortality were analysed. The Spearman coefficient correlation range has been used for the study of tendency. RESULTS 509 cases of HIV infection (374 males and 134 females) were detected in the area from 1983 to 1997. The accumulated incidence throughout the period of study was 1,368/million inhabitants. The annual incidence shows and upward phase until 1990, followed by another of plateau (1990-1993). In 1994-1995 there was a decrease, interrupted in 1996-1997. The curve as a whole doesn't reveal a descending tendency (p > 0.05). The annual incidence in the IDU follow a similar pattern to that of the complete group while the group of heterosexual transmission shows a tendency to increase (p < 0.025). 223 patients (43.8%) developed AIDS, 195 of whom we know the evolution. Of these, 139 have died and 56 are still alive. CONCLUSIONS There is no evidence that the incidence of HIV infection tends to decrease in the sanitary area of León at present. This is probably related to the behaviour of the two main risk groups: a tendency to stability in the case of IDU and to increase in heterosexual transmission. It is important to insist on the prevention campaigns, especially those directed towards avoiding heterosexual transmission.
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Affiliation(s)
- M Alcoba
- Servicio de Medicina Interna 2, Hospital de León
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Castiñeiras MJ, Boronat A, Itarte E, Guinovart JJ, Pérez MR. Frog liver glycogen synthase. In vitro and in vivo interconversions between I and D forms. Comp Biochem Physiol B 1978; 59:277-84. [PMID: 122565 DOI: 10.1016/0305-0491(78)90002-0] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
1. Frog liver has enzymatic systems able to interconvert glycogen synthase. 2. D to I conversion is achieved in vitro by incubation at 30 degrees C. ATP, ADP, inorganic phosphate and glycogen are inhibitors of this conversion, whereas glucose-6-P and Mg2+ stimulate it. 3. I to D conversion in vitro depends on ATP-Mg2+. Cyclic-AMP activates this conversion, while glucose-6-P inhibits it. 4. Injection of glucose, ribose, mannose, fructose, galactose, and cortisone into frogs increase liver percentage of I activity. 5. Glucagon and adrenaline decrease percentage of I activity.
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Affiliation(s)
- M J Castiñeiras
- Department of Biochemistry, University of Barcelona, School of Pharmacy, Spain
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