Biomedical subjects

S Labastida

Publications and source records attributed to S Labastida.

23 records · Page 2Linked to original sources

PubMedDate not supplied

Cancer of the larynx in Mexico: review of 357 cases.

Descriptions of the patient population suffering from carcinoma of the larynx are not common in Mexico. This article deals with the clinical features, treatment, and results of 357 cases of cancer of the larynx treated at the Hospital de Oncologia, Centro Medico Nacional, IMSS, during a 10-year period. In this series, 68% of the patients were in advanced stage (T3-T4) at the time of diagnosis; nevertheless, a combination of surgery and radiotherapy achieved an actuarial 5-year survival for the entire group of 77.5%. Metastatic cervical nodes and tracheotomy previous to the treatment were factors that influenced a poor prognosis (p = 0.01). The survival of cases in the early stages (T1-T2) of 95.2% is comparable to that reported by most authors. In 87.5% of the cases that develop recurrence, it appears during the first 24 months of control.

Adolescent↗

PubMedDate not supplied

Morbidity and mortality following abdominoperineal resection for low rectal adenocarcinoma.

BACKGROUND: Abdominoperineal resection (APR) has been the standard treatment of low rectal cancer, but it is associated with significant morbidity and mortality. AIM: To analyze the morbidity and mortality rates associated with this surgical procedure performed at a tertiary-level cancer center. MATERIALS AND METHODS: From 1995-1999, 137 patients with rectal cancer located between 0 and 8 cm from the anal verge underwent APR. Covariates were analyzed mean chi 2 and those favorable or adverse covariates affecting the perineal infection and recurrences were analyzed by logistic regression analysis. RESULTS: There were 78 males and 59 females, with a mean age of 57.4 +/- 14.6 years. Mean intraoperative hemorrhage was 739 +/- 547 mL; 51 (37.2%) patients received blood transfusion. Seventy-two patients received preoperative radiotherapy (PRT): 22, postoperative chemo-radiation therapy; 21, PRT + chemotherapy, and 22, APR only. Seventeen patients (12.4%) had major complications and 47 (34.3%) had minor complications. Twenty patients (14.6%) developed perineal wound infection. The main factors influencing these complications were administration of PRT +/- chemotherapy and age over 55 years. Operative mortality was 0.7%. Median follow-up was 32 months. Twelve patients (8.8%) had local recurrence and 35 (25.7%) had distant recurrence. Overall five-year survival was 75%. CONCLUSIONS: APR is a surgical procedure associated with significant morbidity but low postoperative surgical mortality. The main cause of morbidity was perineal would infection influenced by administration of PRT +/- chemotherapy and age over 55 years. However, this treatment association is linked with low rate of local recurrence.

Abdomen↗

PubMedDate not supplied

[The role of radical surgery in the treatment of epidermoid carcinoma of the anal canal].

In order to define the role of radical surgery in the actual treatment of epidermoid carcinoma of the anal canal (ECAC), we retrospectively reviewed the charts of patients with primary ECAC, treated with radical surgery in the Hospital de Oncología, National Medical Center IMSS. We analyzed the recurrence pattern, its treatment and the contemporary literature was reviewed. From 1975 to 1990, we treated 16 patients; 13 females, 3 males, mean age was 64 years. The presurgical stage was T2, 6; T3 7; T4, 3. An abdominoperineal resection was performed in 12 patients; a posterior pelvic exenteration in 3; a total pelvic exenteration in 1. Ten patients developed surgical complications, 4 of them were major, 2 required surgical reintervention. There was no operative mortality. We obtained local tumor control in 5/16 patients (32%); the local recurrence by stage were T2, 3/6 (50%); T3, 5/7 (71%); T4, 3/3 (100%) p = 0.04. Ten of them were located at the pelvis brim and 1 was located to the central pelvis (vagina, perineum), 9 were treated with radiation therapy (RT) a mean dose of 45 Gy, only the patient with central local recurrence obtained local tumor control. Regional recurrences were as follows: T2 patients, 1/6 (16%); T3, 2/7 (28%); T4, 2/3 (66%). The 2 patients with metachronous inguinal lymph node metastases were treated with a radical groin dissection, with tumor control. In conclusion, the radical surgical treatment is associated with a low loco-regional tumor control; the pelvic tumor relapses were located at the pelvis brim and with no response to RT. With the results herein obtained and the results with other treatment modalities such as RT and its associations with chemotherapy (C) in regard to local tumor control, the actual role of the radical surgical treatment in the salvage of central pelvic relapses to primary treatment with RT or C-RT.

Adult↗

PubMedDate not supplied

[The mechanisms of the dissemination and the treatment of ovarian metastases in colonic adenocarcinoma].

OBJECTIVE: The aims of this study are: 1) To known the frequency of ovarian metastasis, 2) to define the role of the surgical therapy and 3) to establish the mechanism of spread of colorectal cancer to the ovaries. MATERIAL AND METHODS: Between 1989 and 1993 624 patients with colorectal adenocarcinoma; were treated, 19 (7.7%) had ovarian metastasis; they were divided in 2 groups according to the diagnostic time: A) synchronous; B) metachronous. In most patients a peritoneal lavage were performed; the primary tumor was resected. RESULTS: The median age was 41.4 years. In group A: there were 9 patients; in 3 of them underwent elective surgery and in 6 an exploratory celiotomy due to colonic obstruction or perforation. The primary tumor was located in the sigmoid in 8 patients and in cecum in 1; the stage of the primary tumor was follows: B1, 2; B2, 3; C2, 4. The ovarian metastasis were located in the left ovary in 6; right, 2, and bilateral 1. The peritoneal lavage was positive in 6, and negative in 3. In group B: there were 10 patients; one underwent elective surgery and 9 exploratory celiotomy. The primary tumor was located in the sigmoid in 9, caecum in 1. The stage of the primary tumors were: B2, 4; C2 4; D, 2. The ovarian metastasis were located: left, 5; right, 1; bilateral, 4. The peritoneal lavage was positive in 6, negative in 2. The 5-year survival in group A was 16% in group B, 0%. CONCLUSION: Ovarian metastasis were associated with advanced metastatic diseases. The treatment of synchronous ovarian metastasis is the resection of primary tumor plus bilateral oophorectomy, and in metachronous metastasis it is palliative. The mechanism of spread to the ovaries is by direct implantation and hematogenous.

Adenocarcinoma↗

PubMedDate not supplied

[Identification of sentinel lymph node with patent blue V in patients with cutaneous melanoma].

Regional lymphadenectomy in patients with cutaneous malignant melanoma in stages I-U AJC/UICC has not demonstrated improvement either in loco-regional control or in survival. The results of the lymphatic mapping technique have demonstrated that on identifying the sentinel node, the group of patients with microscopic nodal metastases can be selected for regional treatment. We performed the intraoperative lymphatic mapping technique with 1 ml of blue patent V by intradermal injection just around the primary melanoma; after injecting the dye we incised the nodal skin region, identifying the sentinel node by its blue color. The histologic examination, by frozen section of this node, determines whether or not to proceed with a formal lymphadenectomy. We calculated the sensitivity of the dye for the identification of the sentinel node and the Pearson's test was performed between the intraoperative histologic study and the definite pathological result. Thirty one lymphatic mappings were performed in 29 patients with stages I-II malignant cutaneous melanoma. The sentinel node was found in 26/31 explored lymphatic zones, and in 5, it was not found, sensitivity of 84%; 23/26 sentinel nodes were negative and only 3/26 were metastatic in frozen section. The Pearson's test result was 0.78 with a predictive value of 92%. The blue patent V intraoperative lymphatic mapping technique in patients with malignant cutaneous melanoma provided a great sensitivity to identify the sentinel node and allows the identification of patients with high risk of microscopic nodal metastases.

Adult↗