Myoepithelial carcinoma, also known as malignant myoepithelioma, is considered an extremely rare (0.45–1%) malignant salivary gland neoplasm. Approximately 100 cases have been reported in the English-language literature on myoepithelial carcinoma. The majority of the myoepitheliomas described in the literature have been benign, and the malignant counterpart is considered rare (<1%). Such a tumor may appear de novo or rarely develop from a preexisting pleomorphic adenoma (<20%), and in exceedingly rare cases (<0.5%), it has arisen from a benign myoepithelioma (i.e., plasmacytoid myoepithelioma). To our knowledge, no case of myoepithelial carcinoma of the parotid gland arising in a plasmacytoid myoepithelioma synchronized with melanoma has been reported to date. The treatment of myoepithelial carcinoma has been mainly surgical, including wide excision with free margins, with or without nodal dissection. The roles of chemotherapy and radiotherapy have not yet been established. We report a case of myoepithelial carcinoma of the parotid gland arising in a plasmacytoid myoepithelioma synchronized with melanoma in a 40-year-old woman. In our case, a complete response was achieved with surgery followed by adjuvant chemotherapy based on carboplatin and paclitaxel concurrent with radiotherapy.

Introduction. The prognostic nutritional index (PNI) is a convenient and accessible tool that reflects the nutritional and immunological conditions of patients with solid tumors. PNI is calculated based on the total lymphocyte count and serum albumin level. There is not an optimal well established cutoff value. Low PNI has been associated with lower overall and disease-free survival (OS and DFS) in breast cancer patients, however, there is no information regarding this prognostic value in patients from Mexico. The aim of this study was to analyze the association between PNI and survival of breast cancer patients from Mexico. Methods. We retrospectively analyzed medical records of patients with histologically confirmed breast cancer treated at Medica Sur Oncology Center in Mexico City between January 2008 to December 2019. PNI was calculated using the following formula: 10 × serum albumin value (g/dL) + 0.005 × total lymphocyte count (mm3). Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal PNI cutoff value. The primary endpoint was OS. The secondary endpoint was DFS. Statistical analysis was performed with SPSS v25, the associations between PNI and clinicopathologic characteristics were analyzed using Pearson's χ2 test, survival curves were calculated with Kaplan-Meier method, and comparison among groups with log-rank. Proportional Cox model was used to perform multivariate analysis. A p value &lt;0.05 was significant. Results. A total of 110 patients were included in the analysis, and classified into two groups: low and high PNI (ROC curve analysis showed an optimal cutoff value of 32.1). Median follow-up was 65 months. Mean PNI at diagnosis was 39.3 (SD 6.7). All patients had infiltrating ductal carcinoma, 15.5% had metastatic disease, 18.2% had triple negative breast cancer, 23.6% had HER 2 overexpression, and around 51% where positive for hormone receptors. Mean PNI in patients with locally advanced disease was significantly lower than in patients with localized disease, (p= 0.044), no other statistically significant associations were found between mean PNI and clinical characteristics. Median OS was not reached in the high PNI group vs 48.5 months (mo) in the low PNI group, while 5 -year OS rates were 89% and 41%, respectively (p= 0.03). The high PNI group had better DFS than the low PNI group (median DFS 65 mo vs 22.5 mo, 5-year DFS rates 65% vs 45% (p = 0.024). In univariate and multivariate analysis, triple negative histological subtype and low PNI were independent prognostic indicators for poor survival. Conclusion. High PNI in breast cancer patients is associated with superior DFS and OS. PNI is an independent prognostic factor for DFS and OS. PNI is an accessible prognosis factor that uses only regular laboratory assessment in patients with cancer. Citation Format: Pamela Denisse Soberanis-Piña, Edgar Varela-Santoyo, Andres Mauricio Arroyave-Ramirez, Hector Hugo Buerba-Vieregge, Daniel Motola-Kuba. Association of the prognostic nutritional index and survival of patients with breast cancer in a third-level care hospital in Mexico [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS6-57.

Breast metastasis from gastric signet ring cell carcinoma is extremely rare in clinical practice. The estimated incidence is 0.5–1.3%. There are few cases reported in the literature (approx. less than 60) of breast metastasis from gastric signet ring cell carcinoma, and due to the rare association between gastric cancer and its extension to the breast, it is difficult to establish the diagnosis. Clinical history, histological findings, and immunohistochemical markers are helpful in distinguishing primary breast cancer from breast metastasis of gastric cancer. The treatment for breast metastasis from gastric carcinoma remains controversial. The prognosis of breast metastasis from gastric carcinoma is generally poor. We report a case of breast metastasis of gastric signet ring cell carcinoma in a 38-year-old woman. She started chemotherapy with ramucirumab, paclitaxel, and irinotecan. Three months later, a combined 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography showed a complete response. This is the first reported case of breast metastasis from gastric signet ring cell carcinoma with a complete response.

<b><i>Background:</i></b> The treatment of kidney cancer usually involves surgery, and in some cases systemic therapy. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to control postsurgical pain in patients undergoing nephrectomy for renal cancer. Nevertheless, the association between these drugs and adverse postsurgical outcomes, including deterioration of renal function, is not fully established. <b><i>Methods:</i></b> This retrospective cohort study included patients &#x3e;18 years old with kidney cancer undergoing nephrectomy between January 2006 and January 2018. The primary endpoint was to determine the impact of postsurgical analgesic therapy (NSAIDs vs. acetaminophen) on renal function and postsurgical complications. This study was approved by our scientific and bioethical committee. <b><i>Results:</i></b> One hundred patients were included in the final analysis. Clear-cell renal-cell carcinoma was the most frequent histologic subtype. Adequate acute pain control was accomplished in 91% of the patients during hospitalization. Twenty percent of the patients presented postsurgical complications. Bleeding-related complications were the most frequent (9%), followed by surgical-site infection (6%) and acute renal injury (6%). The administration of NSAIDs was not related to any postsurgical complication in comparison with the use of acetaminophen (21.3 vs. 17.9%, respectively). The length of hospital stay did not differ between patients treated with NSAIDs and those treated with acetaminophen (the average stay was 4 days for both groups, <i>p</i> = 0.32). <b><i>Conclusion:</i></b> The use of NSAIDs was not related to acute kidney injury, postsurgical complications, or prolonged hospital stay in patients with renal cancer undergoing nephrectomy.

Background: Inflammatory serum markers (IBM) have emerged as prognostic factors in solid tumors. In breast cancer (BC) in particular, an elevated neutrophil to lymphocyte ratio (NLR) has been linked to lower overall survival (OS) and disease-free survival (DFS), although a standard cutoff value has not been established. In Mexico there is no information regarding NLR as a prognostic marker in BC. The aim of the present study was to assess NLR as prognostic factor in BC patients in a Mexican population. Methods: This single-center retrospective and descriptive study included patients, &gt;18 years old with histological diagnosis of BC who were treated at Medica Sur oncological center in Mexico City between January 2008 and December 2019. The patients were divided into two groups according to their NLR. NLR was calculated using the following formula: absolute neutrophil count / absolute lymphocyte count (mm3). NLR was considered as elevated (&gt;2), and as low (≤2) based on data from previous studies. The primary endpoint was OS. Statistical analysis was performed with SPSS v25. The associations between PNI and clinicopathologic characteristics were analyzed using Pearson's χ2 test. Kaplan-Meier and log-rank test methods were used for survival analysis. The prognostic value of the pre-treatment NLR was assessed by univariate and multivariate analysis. P&lt;0.05 was considered to indicate a statistically significant difference. This study was approved by our scientific and bioethical committee. Results: A total of 110 patients were included in the final analysis. All patients had infiltrating ductal carcinoma; 18.2% were triple negative, 23.6% over-expressed HER 2 and around 51% had hormone receptor expression. 15.5% had metastatic disease. Median follow-up was 65 months. Mean NLR at diagnosis was 2.82 (SD 2.59). Mean NLR in patients with triple negative BC (TNBC) was significantly higher than in patients with non TNBC (p= 0.055), no other statistically significant associations were found between mean NLR and clinical characteristics. Median OS was not reached in two groups, but the 100 months OS was higher in NLR ≤2 group vs NLR &gt; 2 group (90 vs 78%) (p= 0.079). In univariate and multivariate analysis, triple negative histological subtype and elevated NLR were independent prognostic indicators of poor survival. Conclusion: An elevated pretreatment NLR was an independent prognostic factor, associated with lower OS in patients with BC with local and advanced disease, although statistically significant association was not found. NLR is an accessible and minimally invasive marker with clinical value for evaluation of the prognosis of BC patients, especially in resource-limited settings. Citation Format: Andrés Mauricio Arroyave-Ramírez, Edgar Varela-Santoyo, Pamela Denisse Soberanis-Piña, Hector Hugo Buerba-Vieregge, Daniel Motola-Kuba. Prognostic value of neutrophil to lymphocyte ratio in patients with breast cancer in a Mexican population [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS6-42.