Background: Gastric cancer is the second leading cause of death by cancer worldwide. Endoscopic submucosal dissection (ESD) is a technique that allows en bloc resection of early lesions of the digestive tract. It has curative potential in selected patients and benefits over gastrectomy for the treatment of early gastric cancer (EGC). The aim of this study is to present the results of ESD for EGC in a high-volume center in Chile.Materials and Methods: Retrospective descriptive study of patients who underwent ESD for EGC at the Doctor Sótero del Río Hospital.Results: A total of 100 ESDs were performed in 96 patients between 2008 and 2020. Fifty-five percent were female patients, the average age was 68 years (range, 45 to 89 y). En bloc resection was achieved in 98% of cases and the rate of complications Clavien grade III or higher was 8.3%. There were no cases of perioperative mortality. Ninety-three percent of the dissections were classified as R0 and 83% met curative standards according to expanded criteria. The mean follow-up was 42 months (range, 1 to 144 mo). Overall survival was 97%. Cancer-specific survival was 100% and recurrencefree survival was 97%. Conclusions:The present study describes the largest series of ESD for the treatment of EGC reported in Latin America. Our results support the feasibility of implementing ESD in Chile and indicate good oncological outcomes comparable to those reported in the large Asian series published to date.

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El cáncer de esófago (CE) constituye la sexta causa de muerte por cáncer en el mundo. La disección endoscópica submucosa (DES) es una técnica que permite la resección en bloque de lesiones del tubo digestivo. Tiene rol curativo en pacientes seleccionados y potenciales ventajas sobre la esofagectomía.Objetivo: Describir los resultados peri-operatorios y oncológicos de la DES como tratamiento del CE en nuestro centro.Materiales y Métodos: Estudio retrospectivo de pacientes sometidos a DES por CE entre los años 2010-2020.Resultados: Diez pacientes fueron tratados con DES por CE entre los años 2010 y 2020. El 80% eran hombres y la edad promedio fue de 72 años (63-84). La resección en bloque fue lograda en todos los casos y no se presentó morbimortalidad perioperatoria. Todas las disecciones fueron R0 y el 90% cumplió con estándares de curación. El seguimiento promedio fue de 38 meses (3.5-123). La sobrevida global fue de 90%. La sobrevida específica por cáncer y libre de recurrencia fue de 100%.Discusión: La morbimortalidad asociada a la esofagectomía es alta. La DES sería una alternativa más segura, que permite lograr un R0 y eventualmente la curación en pacientes seleccionados con CE limitado a la mucosa o submucosa.Conclusión: La presente constituye la primera serie reportada de pacientes con cáncer esofágico sometidos a DES en nuestro país. Muestra excelentes resultados oncológicos y seguridad del procedimiento, comparables a las grandes series descritas en la literatura internacional.

satisfied the following criteria: for undocumented infection, discontinuation of probabilistic antibiotic therapy at 72 hours of apyrexia; for documented infection, continuation of documented antibiotic therapy, according to the recommendations of the local antibiotic guidelines. Results Ninety infectious episodes were studied. The study population comprised 49 men (54%) and 41 women (46%). Average age was 56 years. Cefepime or piperacillin/tazobactam were systematically introduced as probabilistic therapy. If the infection was undocumented (n=61/90), the duration of probabilistic antibiotic therapy conformed in 41% of cases (n=25/61). For clinical documentation (n=6/90), the conformity rate was 67% (n=4/ 6). For microbiological documentation (n=23/90), compliance rate was 74% (n=17/23). Conclusion and relevance For most undocumented infections, probabilistic antibiotic therapy was prescribed for too long. This may be explained by the fragility of haematology patients and the fear of being confronted with recurrence of infection. For documented infections, conformity was very satisfying, as haematologists have extensive knowledge of infectiology. In order to harmonise prescription duration and continue to prevent the emergence of bacterial resistance, a guide for correct use of antibiotics and a second prospective study should be considered.

Background and Importance Osimertinib is a tyrosine kinase inhibitor (TKI) indicated for the treatment of epidermal growth factor receptor mutated non-small-cell lung cancer (NSCLC). Despite a better safety profile than other TKIs for the same indication, osimertinib could produce some potentially fatal cardiotoxicity. However, the available evidence on cardiotoxicity in clinical practice is very limited. Aim and Objectives To analyse the incidence of cardiotoxicity associated with osimertinib in the real clinical practice. Material and MethodsWe conducted an observational crosssectional study in a third-level hospital in Spain. We included all adult patients diagnosed with NSCLC treated with osimertinib between February 2018 and May 2021. We collected socio-demographic data and treatment characteristics, as well as cardiological history, all events of cardiac toxicity during treatment and other comorbidities. Descriptive statistical analysis was performed. Results 33 patients were included, with a median age of 72.5 (interquartile range [IQR]= 62.2-81.0) years, and 63.6% were women. The indication for osimertinib was metastatic lung adenocarcinoma (32 patients, 96.7%) and epidermoid nonsmall-cell lung cancer (1 patient, 0.3%). It was used as the first-line of treatment in 39.4% of the patients and as the second-line or successive in 60.6% of them.At the start of treatment, 57.6% of the patients had cardiovascular comorbidities. The most frequent comorbidites were arterial hypertension (48.5%), dyslipidemia (36.4%), and diabetes mellitus (12.1%), and one patient was diagnosed with congestive heart failure.The median time on osimertinib treatment was 11.0 (IQR= 4.6-17) months. Of the 33 patients, 21.2% of patients had previous cardiac examinations before starting osimertinib treatment. During the treatment, 4 (12,1%) patients developed cardiac adverse reactions: 2 (6.1%) suffered a decrease in the Left Ventricular Ejection Fraction (LVEF), 1 (3.0%) experienced atypical chest pain, and 1 (3.0%) developed an increase in the D-dimer and hyperfibrinogenaemia. One of the patients with LVEF decreased required hospitalisation and invasive management. The rest of the cardiotoxicities were managed with dose reduction and conservative measures. Conclusion and Relevance More than 10% of osimertinibtreated patients had cardiotoxicity. Of these, 25% required hospitalisation. Oncologists should always assess cardiac function at the start of osimertinib and during the follow-up.