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Piedra-Delgado L, Chambergo-Michilot D, Morante Z, Fairen C, Jerves-Coello F, Luque-Benavides R, Casas F, Bustamante E, Razuri-Bustamante C, Torres-Roman JS, Fuentes H, Gomez H, Narvaez-Rojas A, De la Cruz-Ku G, Araujo J. Survival according to the site of metastasis in triple-negative breast cancer patients: The Peruvian experience. PLoS One 2024; 19:e0293833. [PMID: 38300959 PMCID: PMC10833533 DOI: 10.1371/journal.pone.0293833] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/19/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Evidence regarding differences in survival associated with the site of metastasis in triple-negative breast cancer (TNBC) remains limited. Our aim was to analyze the overall survival (OS), distant relapse free survival (DRFS), and survival since the diagnosis of the relapse (MS), according to the side of metastasis. METHODS This was a retrospective study of TNBC patients with distant metastases at the Instituto Nacional de Enfermedades Neoplasicas (Lima, Peru) from 2000 to 2014. Prognostic factors were determined by multivariate Cox regression analysis. RESULTS In total, 309 patients were included. Regarding the type of metastasis, visceral metastasis accounted for 41% and the lung was the most frequent first site of metastasis (33.3%). With a median follow-up of 10.2 years, the 5-year DRFS and OS were 10% and 26%, respectively. N staging (N2-N3 vs. N0, HR = 1.49, 95%CI: 1.04-2.14), metastasis in visceral sites (vs. bone; HR = 1.55, 95%CI: 0.94-2.56), the central nervous system (vs. bone; HR = 1.88, 95% CI: 1.10-3.22), and multiple sites (vs. bone; HR = 2.55, 95%CI:1.53-4.25) were prognostic factors of OS whereas multiple metastasis (HR = 2.30, 95% CI: 1.42-3.72) was a predictor of MS. In terms of DRFS, there were no differences according to metastasis type or solid organ. CONCLUSION TNBC patients with multiple metastasis and CNS metastasis have an increased risk of death compared to those with bone metastasis in terms of OS and MS.
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Affiliation(s)
| | | | - Zaida Morante
- Departamento de Oncología Médica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú
| | - Carlos Fairen
- Boston Medical Center, Boston, Massachusetts, United States of America
| | | | | | - Fresia Casas
- Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | | | | | - Hugo Fuentes
- Departamento de Oncología Médica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú
| | - Henry Gomez
- Departamento de Oncología Médica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú
| | - Alexis Narvaez-Rojas
- Department of Surgical Oncology, Miller School of Medicine, University Of Miami, Miami, Florida, United States of America
| | | | - Jhajaira Araujo
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Chorrillos, Lima, Peru
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Valcarcel B, Torres-Roman JS, Enriquez D, Vidaurre T, De la Cruz-Ku G. Temporal Variation of Treatment Patterns and Survival Outcomes of Triple-Negative Breast Cancer Patients: A Real-World Experience From 2000 to 2014. Clin Breast Cancer 2023; 23:737-745.e5. [PMID: 37507258 DOI: 10.1016/j.clbc.2023.07.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/20/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Previous studies have reported a higher prevalence of triple-negative breast cancer (TNBC) in US Hispanic/Latina populations. However, survival outcomes and treatment approaches over time in Latin American females are scarcely reported. We aimed to evaluate the temporal variation in treatment patterns and overall survival (OS) outcomes of females with TNBC according to cancer stage. MATERIALS AND METHODS We performed a single-center retrospective cohort study on 1840 females from 2000 to 2014. Patients were classified in 3 calendar periods (2000-2004, 2005-2009, and 2010-2014). The Kaplan-Meier method and multivariable regression analyses were employed. RESULTS Stage III cancer was identified in half of the population. Five-year OS estimates for cancer stages I, II, and IV remained unchanged across all calendar periods. However, we found worsening 5-year OS estimates in stage III females (49% in 2000-2004 and 31% in 2010-2014; P < .001). Despite increased uptake of overall use of neoadjuvant therapy in stage III females, the time from diagnosis to treatment initiation (P = .013) and time to complete the planned cycles (P < .001) increased over time. Fifty-sex percent of stage IV patients were untreated. Females aged ≥70 years were less likely to receive treatment. CONCLUSIONS Survival estimates were lower than those reported in high-income countries. Most females were diagnosed with advanced disease, and the OS for stage III females worsened over time. Our outcomes show difficulties in delivering timely neoadjuvant therapy in an overwhelmed healthcare system. Public health authorities should improve screening practices, develop regional clinical guidelines, and expand trial enrollment.
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Affiliation(s)
- Bryan Valcarcel
- Latin American Network for Cancer Research (LAN-CANCER), Lima, Peru; Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington DC.
| | - Junior Smith Torres-Roman
- Latin American Network for Cancer Research (LAN-CANCER), Lima, Peru; Cancer Research Networking, Universidad Científica del Sur, Lima, Peru
| | - Daniel Enriquez
- Universidad Privada San Juan Bautista, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | | | - Gabriel De la Cruz-Ku
- Latin American Network for Cancer Research (LAN-CANCER), Lima, Peru; Cancer Research Networking, Universidad Científica del Sur, Lima, Peru; University of Massachusetts, Worcester, MA
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De la Cruz-Ku G, Mallouh MP, Torres Roman JS, Linshaw D. Three-dimensional virtual reality in surgical planning for breast cancer with reconstruction. SAGE Open Med Case Rep 2023; 11:2050313X231179299. [PMID: 37325162 PMCID: PMC10262605 DOI: 10.1177/2050313x231179299] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
Breast surgery is performed to achieve local control in patients with breast cancer. Visualization of the anatomy with a virtual reality software platform reconstructed from magnetic resonance imaging data improves surgical planning with regards to volume and localization of the tumor, lymph nodes, blood vessels, and surrounding tissue to perform oncoplastic tissue rearrangement. We report the use and advantages of virtual reality added to the magnetic resonance imaging assessment in a 36-year-old woman with breast cancer who underwent nipple sparing mastectomy with tissue expander reconstruction.
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Affiliation(s)
- Gabriel De la Cruz-Ku
- Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA
- Universidad Científica del Sur, Lima, Perú
| | - Michael P Mallouh
- Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jr Smith Torres Roman
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Perú
| | - David Linshaw
- Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA
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Simbaña-Rivera K, Torres-Roman JS, Challapa-Mamani MR, Guerrero J, De la Cruz-Ku G, Ybaseta-Medina J, Martinez-Herrera JF. Regional disparities of prostate cancer mortality in Ecuador: an examination of trends and correlates from 2004 to 2019. BMC Public Health 2023; 23:992. [PMID: 37248460 DOI: 10.1186/s12889-023-15941-z] [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: 11/20/2022] [Accepted: 05/19/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Prostate cancer is the leading cause of cancer death in Ecuadorian men. However, there is a lack of information regarding the evolution of prostate cancer mortality rates in Ecuador and its regions in the last few decades. OBJECTIVE The aim of this study was to report prostate cancer mortality rates in Ecuador and its geographical areas and observe the evolution of these rates between 2004 and 2019. METHODS An observational ecological study was conducted, analysing data for prostate cancer deaths from 2004 to 2019 in Ecuador. Age standardized mortality rates (ASMR) were calculated per 100,000 men using the world standard population with the direct method proposed by SEGI. Joinpoint regression analysis was performed to examine mortality trends. We used a Cluster Map to explore relationships among regions between 2015 and 2019. RESULTS Ecuador reported 13,419 deaths by prostate cancer between 2004 and 2019, with the Coastal region accounting for 49.8% of the total deaths. The mean age at death was 79 years (± 10 years), 91.7% were elderly (more than 65 years old) and had primary education (53%). Deaths by prostate cancer were more frequently reported among mestizos (81.4%). There were no significant variations in these percentages in Ecuador and its regions during the study period. Carchi province had the highest mortality rate in 2005 and 2019 (> 13 deaths per 100,000). Heterogeneity in the evolution of mortality rates was reported among the provinces of Ecuador. Azuay decreased in the first few years, and then increased from 2010 to 2019, whereas Guayas and Pichincha decreased throughout the whole period. CONCLUSION Although prostate cancer mortality rates in Ecuador have remained stable over the past few decades, there are significant disparities among the different regions. These findings suggest the need for the development of national and provincial registration measures, integrated healthcare actions, and targeted interventions to reduce the burden of prostate cancer in the Ecuadorian population.
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Affiliation(s)
- Katherine Simbaña-Rivera
- Centro de Investigación para la Salud en América Latina (CISeAL), Facultad de Medicina, Pontificia Universidad Católica del Ecuador (PUCE), Quito, Ecuador
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria (ULPGC), Paseo Blas Cabrera s/n, Las Palmas de Gran Canaria, 35016, Spain
- Latin American Network for Cancer Research (LAN-CANCER), Lima, Peru
| | - J Smith Torres-Roman
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Ica, Filial Chincha, Perú.
| | - Mabel R Challapa-Mamani
- Latin American Network for Cancer Research (LAN-CANCER), Lima, Peru
- Sociedad Cientifica de Estudiantes de Medicina de la Universidad César Vallejo, Trujillo, Perú
| | - Jhon Guerrero
- Latin American Network for Cancer Research (LAN-CANCER), Lima, Peru
- Scientific Association of Medical Students, Universidad Central del Ecuador, Quito, Ecuador
| | | | - Jorge Ybaseta-Medina
- Latin American Network for Cancer Research (LAN-CANCER), Lima, Peru
- Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | - José F Martinez-Herrera
- Latin American Network for Cancer Research (LAN-CANCER), Lima, Peru
- Cancer Center, Medical Center American British Cowdray, Mexico City, Mexico
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Torres-Roman JS, De la Cruz-Ku G, Juárez-Leon V, Calderón-Solano D, Bazalar-Palacios J, Vecchia CL, Pinheiro PS. Mortality trends and geographic distribution of kidney cancer in Peru: a secondary analysis. BMC Urol 2023; 23:51. [PMID: 36991482 DOI: 10.1186/s12894-023-01208-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 01/17/2023] [Accepted: 03/11/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND The incidence of kidney cancer has been increasing worldwide, with variable patterns in mortality due to improved diagnostic techniques and increased survival. The mortality rates, geographical distribution and trends of kidney cancer in South America remain poorly explored. This study aims to illustrate mortality by kidney cancer in Peru. METHODS A secondary data analysis of the Deceased Registry of the Peruvian Ministry of Health database, from 2008 to 2019 was conducted. Data for kidney cancer deaths were collected from health facilities distributed throughout the country. We estimated age-standardized mortality rates (ASMR) per 100,000 persons and provided an overview of trends from 2008 to 2019. A cluster map shows the relationships among 3 regions. RESULTS A total of 4221 deaths by kidney cancer were reported in Peru between 2008 and 2019. ASMR for Peruvian men ranged from 1.15 to 2008 to 1.87 in 2019, and from 0.68 to 2008 to 0.82 in 2019 in women. The mortality rates by kidney cancer rose in most regions, although they were not significant. Callao and Lambayeque provinces reported the highest mortality rates. The rainforest provinces had a positive spatial autocorrelation and significant clustering (p < 0.05) with the lowest rates in Loreto and Ucayali. CONCLUSION Mortality by kidney cancer has increased in Peru, being a trend that disproportionally affects more men than women. While the coast, especially Callao and Lambayeque, present the highest kidney cancer mortality rates, the rainforest has the lowest rates, especially among women. Lack of diagnosis and reporting systems may confound these results.
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Affiliation(s)
- J Smith Torres-Roman
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Filial Chincha, Ica, Peru.
| | | | - Valeria Juárez-Leon
- Universidad Científica del Sur, Lima, Perú
- Latin American Network for Cancer Research (LAN-CANCER), Lima, Peru
| | - Delahnie Calderón-Solano
- Universidad Científica del Sur, Lima, Perú
- Latin American Network for Cancer Research (LAN-CANCER), Lima, Peru
| | | | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Paulo S Pinheiro
- Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, USA
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Chambergo-Michilot D, De la Cruz-Ku G, Sterner RM, Brañez-Condorena A, Guerra-Canchari P, Stulak J. Clinical characteristics, management, and outcomes of patients with primary cardiac angiosarcoma: A systematic review. J Cardiovasc Thorac Res 2023; 15:1-8. [PMID: 37342661 PMCID: PMC10278191 DOI: 10.34172/jcvtr.2023.30531] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 02/10/2023] [Indexed: 06/23/2023] Open
Abstract
Primary cardiac angiosarcomas (PCA) are highly aggressive malignant heart tumors. Previous reports have shown a poor prognosis regardless of management, and no consensus or guidelines exist. It is necessary to clarify this information since patients with PCA have a short survival. Therefore, we aimed to systematically review clinical manifestations, management, and outcomes. We systematically searched in PubMed, Scopus, Web of Science, and EMBASE. We intended to include cross-sectional studies, case-control studies, cohort studies, and case series that reported clinical characteristics, management, and outcomes of patients with PCA. As a methodological approach, we used the Joanna Briggs Institute Critical Appraisal Checklist for Case Series and the Newcastle-Ottawa Scale for cohorts. We included six studies (five case series, one cohort). The mean/median age ranged from 39 to 48.9 years. Male sex was predominant. The most frequent manifestations were dyspnea (range: 50%-80%), pericardial effusion (29% & 56%), and chest pain (10%-39%). The mean tumor size ranged from 5.8 to 7.2 cm, with the majority of these localized in the right atrium (70-100%). The most common locations of metastasis were the lung (20%-55.6%), liver (10%-22.2%), and bone (10%-20%). Resection (22.9%-94%), and chemotherapy as neoadjuvant or adjuvant (30%-100%) were the most commonly used methods of treatment. Mortality ranged from 64.7% to 100%. PCA often presents late in its course and usually results in poor prognosis. We strongly recommend performing multi-institutional prospective cohorts to better study disease course and treatments to develop consensus, algorithms, and guidelines for this type of sarcoma.
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Affiliation(s)
- Diego Chambergo-Michilot
- Universidad Científica del Sur, Lima, Perú
- Department of Cardiology Research, Torres de Salud National Research Center, Lima, Perú
| | - Gabriel De la Cruz-Ku
- Universidad Científica del Sur, Lima, Perú
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
- Department of Surgery of the University of Massachusetts Medical School, Worcester, MA, USA
| | | | - Ana Brañez-Condorena
- Universidad Nacional Mayor de San Marcos, Facultad de Medicina, Lima, Perú
- Asociación de Investigación Estudiantil en Ciencias de la Salud, Lima, Perú
| | - Pedro Guerra-Canchari
- Universidad Nacional Mayor de San Marcos, Facultad de Medicina, Lima, Perú
- Sociedad Científica de San Fernando, Lima, Perú
| | - John Stulak
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
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7
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De la Cruz-Ku G, Chambergo-Michilot D, Perez A, Valcarcel B, Pamen L, Linshaw D, Chatterjee A, LaFemina J, Boughey JC. Outcomes of robotic nipple-sparing mastectomy versus conventional nipple-sparing mastectomy in women with breast cancer: a systematic review and meta-analysis. J Robot Surg 2023:10.1007/s11701-023-01547-5. [PMID: 36808041 DOI: 10.1007/s11701-023-01547-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 02/10/2023] [Indexed: 02/23/2023]
Abstract
The promising results of the robotic approach for multiple cancer operations has led to interest in the potential of robotic nipple-sparing mastectomy (R-NSM); however, further studies are required to compare the benefits and complications of this approach with those of conventional open nipple-sparing mastectomy (C-NSM). We performed a meta-analysis to compare surgical complications of R-NSM versus C-NSM. We performed a review of literature through June 2022 in PubMed, Scopus, and EMBASE. We included randomized controlled trials (RCTs), cohorts, case-control studies, and case series with > 50 patients comparing the two techniques. Separate meta-analyses were conducted according to study design. From 80 publications, we identified six studies. The sample size ranged from 63 to 311 mastectomies from 63 to 275 patients. The tumor size and disease stage were similar between groups. The positive margin rate was 0-4.6% in the R-NSM arm and 0-2.9% in the C-NSM arm. Four studies reported early recurrence data, which were similar between groups (R-NSM: 0%, C-NSM: 0-8%). The R-NSM group had a lower rate of overall complications compared to the C-NSM group in cohorts/RCTs (RR = 0.68, 95%CI 0.49-0.96). In case-control studies, rate of necrosis was lower with R-NSM. Operative time was significantly longer in the R-NSM group in cohort/RCTs. In early experience with R-NSM, R-NSM had a lower overall complication rate compared to C-NSM in cohorts/RCTs. While these data are promising, our results show variability and heterogeneity limiting definitive conclusions. Additional trials are needed to guide the role of R-NSM and its oncologic outcomes.
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Affiliation(s)
- Gabriel De la Cruz-Ku
- Department of Surgery, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA. .,Universidad Científica del Sur, Lima, Perú.
| | | | - Armando Perez
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | - Bryan Valcarcel
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Larissa Pamen
- Department of Surgery, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - David Linshaw
- Department of Surgery, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Abhishek Chatterjee
- Division of Surgical Oncology, Division of Plastic Surgery, Tufts Medical Center/Tufts School of Medicine, Boston, MA, USA
| | - Jennifer LaFemina
- Department of Surgery, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
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Rojas-Contreras C, De la Cruz-Ku G, Eyzaguirre-Sandoval ME, Chambergo-Michilot D, Torres-Roman JS. Fire burns matter: A case-control study of severe accidental burns in pediatric patients. ELECTRON J GEN MED 2023. [DOI: 10.29333/ejgm/12650] [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: 11/18/2022]
Abstract
<b>Objective: </b>We aimed to identify factors associated with severe accidental burns in patients ≤12 years old.<br />
<b>Materials and methods: </b>We conducted a matched case-control study, in which we retrospectively reviewed the medical records of children treated in a single institution from 2014-2016. We classified the cases (patients with severe burns) and controls (patients with non-severe burns) according to the criteria of the American Burn Association. We used multivariate conditional logistic regression analysis to identify the relationship between the etiology of burns and their severity.<br />
<b>Results: </b>We reviewed 180 cases and 90 controls. The most common etiology of burns was boiling water in both cases (65.6%) and controls (83.3%). Most burns occurred inside the home (84.1%) and in the afternoon (37.4%). Multivariate analysis identified that severe burns were mainly due to exposure to fire (odds ratio [OR]: 3.22, 95% confidence interval [CI]: 1.53-6.81). Similarly, these patients were more likely to live in a rural area (OR: 2.96, 95% CI: 1.17-6.19).<br />
<b>Conclusions: </b>In pediatric patients ≤12 years of age severe accidental burns are more likely to be caused by fire compared to boiling water. Public health interventions should focus on populations located in rural areas.
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Affiliation(s)
| | | | | | | | - J Smith Torres-Roman
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, PERU
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9
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Araujo JM, De la Cruz-Ku G, Cornejo M, Doimi F, Dyer R, Gomez HL, Pinto JA. Prognostic Capability of TNBC 3-Gene Score among Triple-Negative Breast Cancer Subtypes. Cancers (Basel) 2022; 14:cancers14174286. [PMID: 36077821 PMCID: PMC9454544 DOI: 10.3390/cancers14174286] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Triple-negative breast cancer (TNBC) is a complex and molecularly heterogeneous entity, with the poorest outcome compared with other breast cancer subtypes. Previously, we developed a TNBC 3-gene score with a significant prognostic capability. This study aims to test the 3-gene score in the different TNBC subtypes. Methods: Data from 204 TNBC patients treated with neoadjuvant chemotherapy were retrieved from public datasets and pooled (GSE25066, GSE58812, and GSE16446). After removing batch effects, cases were classified into Lehman’s TNBC subtypes and then the TNBC 3-gene score was used to evaluate the risk of distant recurrence in each subgroup. In addition, the association with tumor-infiltrating lymphocyte (TILs) levels was evaluated in a retrospective group of 72 TNBC cases. Results: The TNBC 3-gene score was able to discriminate patients with different risks within the pooled cohort (HR = 2.41 for high vs. low risk; 95%CI: 1.50−3.86). The score showed predictive capability in the immunomodulatory subtype (HR = 4.16; 95%CI: 1.63−10.60) and in the mesenchymal stem-like subtype (HR = 18.76; 95%CI: 1.68−208.97). In the basal-like 1, basal-like-2, and mesenchymal subtypes, the observed differential risk patterns showed no statistical significance. The score had poor predictive capability in the luminal androgen receptor subtype (p = 0.765). In addition, a low TNBC 3-gene score was related to a high level of TIL infiltration (p < 0.001). Conclusions: The TNBC 3-gene score is able to predict the risk of distant recurrence in TNBC patients, specifically in the immunomodulatory and mesenchymal stem-like subtype. Despite a small sample size in each subgroup, an improved prognostic capability was seen in TNBC subtypes with tumor-infiltrating components.
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Affiliation(s)
- Jhajaira M. Araujo
- Centro de Investigación Básica y Traslacional, AUNA Ideas, Lima 15036, Peru
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima 15067, Peru
| | - Gabriel De la Cruz-Ku
- Department of Surgery, University of Massachusetts, Worcester, MA 01604, USA
- Universidad Cientifica del Sur, Lima 15067, Peru
| | - Melanie Cornejo
- Centro de Investigación Básica y Traslacional, AUNA Ideas, Lima 15036, Peru
| | - Franco Doimi
- Departamento de Patología, Oncosalud-AUNA, Lima 15036, Peru
| | - Richard Dyer
- Departamento de Patología, Oncosalud-AUNA, Lima 15036, Peru
| | - Henry L. Gomez
- Departamento de Medicina Oncológica, Oncosalud-AUNA, Lima 15036, Peru
| | - Joseph A. Pinto
- Centro de Investigación Básica y Traslacional, AUNA Ideas, Lima 15036, Peru
- Correspondence: ; Tel.: +51-1-5137900 (ext. 2231)
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Cornejo J, Cornejo-Aguilar JA, Vargas M, Helguero CG, Milanezi de Andrade R, Torres-Montoya S, Asensio-Salazar J, Rivero Calle A, Martínez Santos J, Damon A, Quiñones-Hinojosa A, Quintero-Consuegra MD, Umaña JP, Gallo-Bernal S, Briceño M, Tripodi P, Sebastian R, Perales-Villarroel P, De la Cruz-Ku G, Mckenzie T, Arruarana VS, Ji J, Zuluaga L, Haehn DA, Paoli A, Villa JC, Martinez R, Gonzalez C, Grossmann RJ, Escalona G, Cinelli I, Russomano T. Anatomical Engineering and 3D Printing for Surgery and Medical Devices: International Review and Future Exponential Innovations. Biomed Res Int 2022; 2022:6797745. [PMID: 35372574 PMCID: PMC8970887 DOI: 10.1155/2022/6797745] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/16/2022] [Accepted: 02/24/2022] [Indexed: 12/26/2022]
Abstract
Three-dimensional printing (3DP) has recently gained importance in the medical industry, especially in surgical specialties. It uses different techniques and materials based on patients' needs, which allows bioprofessionals to design and develop unique pieces using medical imaging provided by computed tomography (CT) and magnetic resonance imaging (MRI). Therefore, the Department of Biology and Medicine and the Department of Physics and Engineering, at the Bioastronautics and Space Mechatronics Research Group, have managed and supervised an international cooperation study, in order to present a general review of the innovative surgical applications, focused on anatomical systems, such as the nervous and craniofacial system, cardiovascular system, digestive system, genitourinary system, and musculoskeletal system. Finally, the integration with augmented, mixed, virtual reality is analyzed to show the advantages of personalized treatments, taking into account the improvements for preoperative, intraoperative planning, and medical training. Also, this article explores the creation of devices and tools for space surgery to get better outcomes under changing gravity conditions.
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Affiliation(s)
- José Cornejo
- Facultad de Ingeniería, Universidad San Ignacio de Loyola, La Molina, Lima 15024, Peru
- Department of Medicine and Biology & Department of Physics and Engineering, Bioastronautics and Space Mechatronics Research Group, Lima 15024, Peru
| | | | | | | | - Rafhael Milanezi de Andrade
- Robotics and Biomechanics Laboratory, Department of Mechanical Engineering, Universidade Federal do Espírito Santo, Brazil
| | | | | | - Alvaro Rivero Calle
- Department of Oral and Maxillofacial Surgery, Hospital 12 de Octubre, Madrid, Spain
| | - Jaime Martínez Santos
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
| | - Aaron Damon
- Department of Neurosurgery, Mayo Clinic, FL, USA
| | | | | | - Juan Pablo Umaña
- Cardiovascular Surgery, Instituto de Cardiología-Fundación Cardioinfantil, Universidad del Rosario, Bogotá DC, Colombia
| | | | - Manolo Briceño
- Villamedic Group, Lima, Peru
- Clínica Internacional, Lima, Peru
| | | | - Raul Sebastian
- Department of Surgery, Northwest Hospital, Randallstown, MD, USA
| | | | - Gabriel De la Cruz-Ku
- Universidad Científica del Sur, Lima, Peru
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | | | | | - Jiakai Ji
- Obstetrics and Gynecology, Lincoln Medical and Mental Health Center, Bronx, NY, USA
| | - Laura Zuluaga
- Department of Urology, Fundación Santa Fe de Bogotá, Colombia
| | | | - Albit Paoli
- Howard University Hospital, Washington, DC, USA
| | | | | | - Cristians Gonzalez
- Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut of Image-Guided Surgery (IHU-Strasbourg), Strasbourg, France
| | | | - Gabriel Escalona
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Catholic University of Chile, Santiago, Chile
| | - Ilaria Cinelli
- Aerospace Human Factors Association, Aerospace Medical Association, VA, USA
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11
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De la Cruz-Ku G, Rázuri C, Chambergo-Michilot D, Dongo P, Salinas G. Effect of Gastric Sleeve Surgery on Esophagitis in Obese Patients: A Pre-post Surgery Study. ELECTRON J GEN MED 2022. [DOI: 10.29333/ejgm/11883] [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: 11/21/2022]
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12
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Herrera R, Rojas-Contreras C, De la Cruz-Ku G, Eyzaguirre-Sandoval ME, Llanos K, Sotelo C, Alcantara JP, Toledo F, Gayoso M, Valcarcel-Valdivia B. [Purpura due to Strongyloides stercoralis in an immunocompetent patient]. Rev Chilena Infectol 2018; 35:445-447. [PMID: 30534933 DOI: 10.4067/s0716-10182018000400445] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 07/04/2018] [Indexed: 11/17/2022] Open
Abstract
Infection with Strongyloides stercoralis is a common parasitic infection in tropical and subtropical regions, including the Peruvian Amazon. The clinical manifestations are varied in patients with immunocompromised disease, and the systemic spread of the disease is frequent, compromising different organs and systems. Cutaneous manifestations are infrequent, being described in patients with some degree of immunosuppression. We present the case of an immunocompetent patient who developed a reactive purpura due to chronic Strongyloides stercoralis infection. Thus, skin involvement is possible in immunocompetent patients with systemic exacerbation due to this parasite.
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Affiliation(s)
- Raul Herrera
- Servicio de Medicina Interna, Hospital Militar Central, Lima, Perú
| | | | | | | | - Keny Llanos
- Facultad de Medicina Humana, Universidad Ricardo Palma, Lima, Perú
| | - Carlos Sotelo
- Facultad de Medicina Humana, Universidad Privada Antenor Orrego, Trujillo, Perú
| | | | - Fabiola Toledo
- Servicio de Medicina Interna, Hospital Militar Central, Lima, Perú
| | - Milagros Gayoso
- Servicio de Medicina Interna, Hospital Militar Central, Lima, Perú
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13
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Rázuri C, De la Cruz-Ku G, Lujan M, Luque R, Dongo P, Salinas Sedó OG. How to Predict the Severity of Nonalcoholic Steatohepatitis in Obese Patients Undergoing Bariatric Surgery. J Am Coll Surg 2018. [DOI: 10.1016/j.jamcollsurg.2018.08.190] [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: 10/28/2022]
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14
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Rojas-Contreras C, Cruz-Ku GDL, Eyzaguirre-Sandoval ME, Valcarcel-Valdivia B. [Neonate with Ventriculitis caused by Empedobacter Brevis: Report of a case in Peru]. ACTA ACUST UNITED AC 2018; 35:326-332. [PMID: 30183909 DOI: 10.17843/rpmesp.2018.352.3099] [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] [Received: 09/03/2017] [Accepted: 03/21/2018] [Indexed: 11/06/2022]
Abstract
Infections caused by rare micro-organisms are the subject of research, as researchers are encouraged to find the necessary health measures to prevent and treat the disease, as well as the search for new insights into human-microbial interactions. This report describes the case of a newborn boy diagnosed with hydrocephalus and myelomeningocele who developed ventriculitis and sepsis from resistant Empedobacter brevis. This case highlights the unexpected identification of this bacterium in the cerebrospinal fluid and its multi-resistant pattern, which was crucial for proper therapeutic management. This bacterium shows a mixture of different etiologies in the analysis of cerebrospinal fluid.
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Affiliation(s)
| | - Gabriel De la Cruz-Ku
- Sociedad científica de estudiantes de Medicina Humana de la Universidad Científica del Sur, Universidad Científica del Sur. Lima, Perú
| | | | - Bryan Valcarcel-Valdivia
- Sociedad científica de estudiantes de Medicina Humana de la Universidad Científica del Sur, Universidad Científica del Sur. Lima, Perú
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15
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Rojas-Contreras C, Cruz-Ku GDL, Vilcarromero S, Ayllon RV, Valcarcel-Valdivia B. [Resistance to ganciclovir in cytomegalovirus infection after heart transplant: case report]. ACTA ACUST UNITED AC 2018; 35:145-149. [PMID: 29924261 DOI: 10.17843/rpmesp.2018.351.3562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 11/22/2017] [Indexed: 11/06/2022]
Abstract
Cytomegalovirus infection after a heart transplant is a recurrent medical condition. Its frequency increases when the donors are serum-positive, and the recipients are serum-negative to this virus. In the pediatric population, the infection only develops in a small percentage and the patients rarely present resistance to conventional treatment with ganciclovir and valganciclovir. We presented the first report of a pediatric case of the cytomegalovirus infection resistant to ganciclovir and valganciclovir after a heart transplant in a Peruvian public hospital with an unusual presentation. The resistance to these drugs was evident after 277 days of evolution of the disease considering the non-remission of the symptomatology and the persistence of an elevated viral load. The administration of foscarnet led to a clinical and laboratory improvement until remission of the disease.
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Affiliation(s)
| | - Gabriel De la Cruz-Ku
- Sociedad científica de estudiantes de medicina, Universidad Científica del Sur (UCSUR). Lima, Perú
| | | | | | - Bryan Valcarcel-Valdivia
- Sociedad científica de estudiantes de medicina, Universidad Científica del Sur (UCSUR). Lima, Perú
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16
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Rojas-Contreras C, De la Cruz-Ku G, Valcarcel-Valdivia B. Noninfectious and Infectious Complications and Their Related Characteristics in Heart Transplant Recipients at a National Institute. EXP CLIN TRANSPLANT 2017; 16:191-198. [PMID: 28952919 DOI: 10.6002/ect.2016.0264] [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: 11/05/2022]
Abstract
OBJECTIVES Complications, which affect the morbidity and mortality of patients after heart transplant, can be divided into infectious and noninfections com-plications. Here, we analyzed both infectious and noninfectious complications and their relation to clinical, laboratory, and surgical characteristics in a Latin American heart transplant population. MATERIALS AND METHODS Data were obtained from records of 35 heart transplant patients in the period from 2010 to 2015. Noninfectious and infectious complications were divided into 3 time intervals: within the first month, from month 2 to 6, and after month 6. Relations between complications and clinical, laboratory and surgical variables in different interval times were analyzed. RESULTS In our patient group, 70 infectious and 133 noninfectious complications were reported after heart transplant. Infectious complications occurred more often between months 2 and 6 after heart transplant, whereas noninfectious complications occurred more often during the first month. Bacteria were the most common microorganism, and acute graft rejection was the most common noninfectious complication. Moreover, infectious complications were statistically related to 5 factors at month 1 (intraoperative bleeding, normal postsurgery leukocyte level, mild malnutrition, severe malnutrition, and graft rejection), to 3 factors between months 2 and 6 (diabetes mellitus, stage 2 chronic kidney disease, and cryoprecipitate trans-fusions), and to 2 factors after month 6 (prothrombin time and psychologic diagnosis). CONCLUSIONS Our results demonstrated that noninfectious complications should be anticipated first in patients after heart transplant. In addition, there are characteristics associated with infectious complications that can be seen during a specific time period.
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Affiliation(s)
- Christian Rojas-Contreras
- From the Infectious Diseases Specialist, Infectology Service at the National Cardiovascular Institute, Lima, Peru
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17
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Rojas C, De la Cruz-Ku G, Yassen A, Valcarcel-Valdivia B. High Survival and Mortality Characteristics in Heart Transplant Patients at a National Institute. EXP CLIN TRANSPLANT 2017; 16:68-74. [PMID: 28697718 DOI: 10.6002/ect.2016.0230] [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: 11/05/2022]
Abstract
OBJECTIVES The identification of variables related to the survival of heart transplant patients is vital for a good medical practice. Few studies have examined this issue in a Latin American population. Therefore, the aim of this study was to analyze, retrospectively, the survival and mortality characteristics of patients after heart transplant. MATERIALS AND METHODS Information on patients was obtained through review of medical records; we collected information on all patients who underwent this procedure from 2010 to 2015. Sociodemographic, clinical, and surgical characteristics associated with posttransplant mortality were analyzed. Survival over 5 years was determined with the Kaplan-Meier method. RESULTS The overall survival rate of the 35 patients who underwent heart transplant was 85%. Those with low total cholesterol values (< 160 mg/dL) had a lower survival at 5 years than patients with higher values (74% vs 100%; P = .044). The overall mortality was 14.3%, and the main cause of death was acutegraft rejection (40%). Lower total cholesterol level (< 160 mg/dL; P = .036), presence of chronic kidney disease stage 1 (P = .049), intraoperative bleeding (> 600 mL; P = .013), and number of sepsis incidents (P = .03) were more frequent in patients who died. CONCLUSIONS The survival in our institute at 5 years is higher than shown in the reported literature, and the mortality is lower. In addition, a low total cholesterol value negatively affects survival of heart transplant patients at 5 years.
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Affiliation(s)
- Christian Rojas
- From the Infectology Service at National Cardiovascular Institute, Lima, Peru
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18
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Rojas-Contreras C, De la Cruz-Ku G, Valcarcel-Valdivia B. [Cytomegalovirus disease in post-heart-transplant patients at a national reference center]. Rev Chilena Infectol 2017; 33:675-679. [PMID: 28146193 DOI: 10.4067/s0716-10182016000600010] [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] [Received: 07/14/2016] [Accepted: 09/29/2016] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Heart transplantation remains as the treatment of choice when the heart failure is refractory to the medical or surgical therapy. Therefore, cytomegalovirus disease is an important post-heart-transplant infectious complication. AIMS To describe the prevalence and clinical characteristics of the cytomegalovirus disease after heart transplant surgery. MATERIALS AND METHODS A retrospective, descriptive study was conducted. It enrolled 35 heart-transplant patients attended in the Cardiovascular National Institute (INCOR), between 2010 and 2015. The information was obtained through the review of medical records. The demographic and relevant clinical variables were analyzed for the cytomegalovirus disease cases. RESULTS The population mean age was 39.49 ± 15.07 years and most of them were male patients (63%). The prevalence of the cytomegalovirus disease was 5.7% (two patients), both were seronegative for cytomegalovirus before transplantation. One of the patients had the disease before finishing the valganciclovir prophylaxis and the other after the end of it. CONCLUSION The prevalence of the cytomegalovirus disease is slightly lower than in other studies. Moreover, the cytomegalovirus disease can remit with a prompt diagnosis and the proper medical treatment.
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19
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Matos-Tocasca M, De la Cruz-Ku G, Auccacusi E, Fernandez-Salas D, García-Ahuanari T, Valcarcel-Valdivia B. Extensively Drug-Resistant Tuberculosis: Report and Literature Review on Two Cases Requiring Prolonged Treatment. Am J Case Rep 2016; 17:819-826. [PMID: 27807339 PMCID: PMC5098927 DOI: 10.12659/ajcr.900001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/09/2022]
Abstract
BACKGROUND Extensively drug-resistant tuberculosis (XDR-TB) is a global problem due to the high morbidity and mortality it causes. Peru is one of the countries with the highest numbers of cases of XDR-TB, which increase every year. CASE REPORT We present the case of two siblings who developed XDR-TB, underwent surgery twice, and were in individualized treatment for more than 6 years. Finally they achieved remission of symptoms, despite not having standardized treatment schemes during their diagnosis period. CONCLUSIONS Extensively drug-resistant tuberculosis can be cured with a treatment that involves both medical care and patient actions to achieve remission of the disease.
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Affiliation(s)
| | | | - Erick Auccacusi
- , Medical Student at Universidad Científica del Sur (UCSUR), LimaLima-Perú, Peru
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