OBJECTIVE: To evaluate the overall survival of women with cervical cancer in a reference service in the South of Brazil.
METHODS: This retrospective cohort study was carried out at Santa Rita Hospital (Porto Alegre, Brazil) with women diagnosed with cervical cancer between 2005 and 2006. We analysed data from all patients with cervical cancer (ICD 10: C53) included in the hospital cancer register. Incidence and mortality data were collected on March 1st 2013. Variables such as age, stage and treatment type were used in the overall survival analysis. Mortality data were compared with the NIS/DAT/CEVS/SES/RS database.
RESULTS: A total of 269 analytical cases that had complete information on cancer staging were assessed between 2005 and 2006. The mean age was of 50 years old (SD= ±13); 71% were stage II-III in the beginning of the treatment. Epidermoid carcinoma was the most common histology (90%). By March 2013, 110 women (40.8%) died. The five-year survival rate decreased as the level of staging showing 83%, 74%, 51% e 23% for stages I, II, III, and IV, respectively.
CONCLUSION: Overall survival rate of cervical cancer patients was of 67. These results are similar to data from developed countries.
Keywords: Uterine cervical neoplasms; Early detection of cancer; Delayed diagnosis; Survival analysis
BACKGROUND: The addition of antiangiogenic therapies, such as bevacizumab and aflibercept, resulted in overall survival (OS) gain for patients with metastatic colorectal (mCRC). Recently the CORRECT trial demonstrated that regorafenib, an oral multi-kinase inhibitor, also led to improved OS in patients with refractory mCRC. However, the efficacy and safety of regorafenib has not been described in our region, as neither the outcomes following treatment with aflibercept. OBJECTIVE: To evaluate the overall treatment outcomes of Brazilian patients treated with regorafenib as well as according to type of prior antiangiogenic agent, aflibercept (Group A) or bevacizumab (Group B).
METHODS: Retrospective unicenter study of mCRC patients treated with regorafenibe within an Expanded Access Program.
RESULTS: We included 24 patients: 14 received B and 10, received A. Most patients had colon cancer and all had ECOG 0 or 1. Wild type RAS mCRC was present in 30% of Group A and in 42.8% of Group B. The best response by RECIST 1.1 was stable disease. Median OS times were 8.15 months in Group A, 5.8 months in Group B and 6.16 months for the whole group. Cavitation of pulmonary metastases (45% in Group B and 66%% in Group A) did not influence OS. Nearly 80% of Group A patients received post-progression treatments versus 35.7% in Group B. Fatigue, hand-foot skin reactions, elevated liver enzymes and arterial hypertension were the most common adverse events related to regorafenib, with grade 2/3 occurring in 90% of Group A and in 78.50% of Group B. There were no grade 4 toxicities.
CONCLUSION: In this retrospective series, the median OS of patients treated with regorafenib after bevacizumab was similar to that reported by phase III trials. For those previously treated with aflibercept, the median OS was numerically longer in comparison with the bevacizumab group, although this could be explained by selection bias. The toxicity profile of regorafenibe was also similar to that described in the literature except for less diarrhea, which was rare among Brazilian patients.
Keywords: Colorectal cancer; Aflibercept, Bevacizumab, Regorafenib, Antiangiogenic
Rosai–Dorfman disease (RDD) also known as histiocytosis with lymphadenopathy is an uncommon, often self-limiting benign, non–Langerhans-cell histiocytic proliferative disorder. It usually affects young adults and children, with no predilection by sex. More than 80% of patients present with painless cervical lymphadenopathy, with or without fever. Other presentation sites include upper aero-digestive tract, orbits and the paranasal sinuses. Extra nodal involvement occurs in up to 40% of cases and common sites of involvement include the skin, upper and lower respiratory tract, soft tissue, bones, kidney, liver, orbit and central nervous system. Treatment is not necessary in most instances, but some patients, when symptomatic, may require medical intervention. There is no established guideline for the management of this condition and various therapeutic modalities are used, including surgery, radiotherapy and or chemotherapy.
Keywords: Histiocytosis, sinus; Proliferative disorder; Radiotherapy; Surgery
Immunotherapy with nivolumab for second-line treatment for advanced lung cancer demonstrated lower toxicity and better outcomes compared to chemotherapy. When they occur, adverse events are usually immune-related, can occur in any organ, and most of the time they are manageable, although, in rare cases can be fatal. There are few reports in the literature of toxic epidermal necrolysis caused by nivolumab. The aim of the present case report is to describe the clinical history of a patient who developed this reaction after using this medication and to discuss a brief review of the literature on its etiology and therapeutic measures, considering its rarity and severity. Early detection of the symptoms/signs and their rapid management are an essential part of the treatment success.
Keywords: Immunotherapy; Nivolumab; Lung neoplasms; Stevens-Johnson Syndrome