Se estima que el 4% de la población mayor de 40 años tiene signos físicos compatibles con Nt, mientras que el 40% de la población en el mismo grupo etario tiene alguna anormalidad ultrasonográfica consistente con la definición de Nt.

Locally advanced breast cancer (LABC) cases have a varying five-year survival rate, mainly influenced by the tumor response to chemotherapy. Paclitaxel activity (response rate) varies across populations from 21.5% to 84%. There are some reports on genetic traits and paclitaxel; however, there is still considerable residual unexplained variability. In this study, we aimed to test the association between eleven novel markers and tumor response to paclitaxel and to explore if any of them influenced tumor protein expression. We studied a cohort of 140 women with LABC. At baseline, we collected a blood sample (for genotyping), fine needle aspirates (for Western blot), and tumor measurements by imaging. After follow-up, we ascertained the response to paclitaxel monotherapy by comparing the percent change in the pre-, post- tumor measurements after treatment. To allocate exposure, we genotyped eleven SNPs with TaqMan probes on RT-PCR and regressed them to tumor response using linear modeling. In addition, we compared protein expression, between breast tumors and healthy controls, of those genes whose genetic markers were significantly associated with tumor response. After adjusting for multiple clinical covariates, SNPs on the LPHN2, ROBO1, SNTG1, and GRIK1 genes were significant independent predictors of poor tumor response (tumor growth) despite paclitaxel treatment. Moreover, proteins encoded by those genes are significantly downregulated in breast tumor samples.

Introducción: Se ha observado un incremento mundial importante del cáncer diferenciado de tiroides. Suele presentarse clínicamente como nódulos en el cuello, y aunque la mayoría de estos son de naturaleza benigna, es importante la detección de malignidad en forma preoperatoria debido a que las lesiones malignas son las que requieren tratamiento quirúrgico. Existe todavía controversia respecto al manejo terapéutico por la falta de estudios controlados y existe además mucha heterogeneidad en la práctica clínica cotidiana. Objetivos: Esta guía de práctica clínica (GPC) contiene recomendaciones clínicas desarrolladas de forma sistematizada para asistir la toma de decisiones de médicos especialistas, pacientes, cuidadores de pacientes y elaboradores de políticas públicas involucrados en el tratamiento de pacientes con cáncer de tiroides en estadios tempranos, localmente avanzados y metastásicos.

14657 Background: Most patients with disseminated germ-cell tumor have an excellent prognosis with cisplatin-based combination chemotherapy, although there have been described certain subgroups with a worse prognosis. The presence of liver metastases (LM) represents an independent cause of poor prognosis. This study reviews the clinical course and treatment results of patients treated at Instituto Nacional de Cancerología de México (INCan-Mex). Methods: The records of all patients with germ-cell cancer and LM between 1992 and 2002 were reviewed. Age, primary site, metastases site, number of metastasis sites, histopathology type, serum tumor markers (STM) levels, liver functional assay, number of LM and used chemotherapy were examinated. The overall survival (OS) and disease free survival (DFS) were analized with Kaplan-Meier method and Log Rank test. Results: Of 32 reviewed patients, median age was 24 (range 18–42 y). The primary site was testis in 27 patients and retroperitoneal in 5 patients. The number of metastasis sites was > 3 en all cases. All patients had nonseminomatous component, predominating choriocarcinoma (82%) and seminoma (78%). The 60% of patients had STM of poor prognosis. 50% of the patients had abnormal liver functional assay. 25 cases (78%) had multiple LM. First line chemotherapy had complete response (CR) in 2 patients, partial response with STM negative (PRM-) in 12 cases, partial response with STM positive (PRM+) 8, and progression in 9 patients. All patients were treated with cisplatin-based chemotherapy. No prognostic factors of chemotherapy response were determined. Only 11 cases underwent to resection surgery of retroperitoneal or pulmonary residual. No patients underwent to liver surgery. Five year OS of 32 cases were 50%, 34% with DFS, between the patients with superior response to chemotherapy (RC + PRM-) the OS and DFS was better in relation with minor response or progression (p < 0.05). The cases with RC in liver (11) were 5-year OS 100% and DFS 66% (p < 0.05). Conclusions: The clinical course and results of treatment in the 32 cases of the INCan-Mex were similar to the literature. This study represents the greatest individual serie reported. These patients with poor prognosis are candidates to innovative treatment modalities. No significant financial relationships to disclose.