No abstract

Different gynecological neoplasms, regardless of the clinical stage, may present recurrence despite the established treatment and require ultraradical surgical rescue by pelvic exenteration, with a high percentage of complications and impairment of quality of life, and sometimes generate perineal defects that require immediate reconstruction. Because of this, different methods have been used for the closure of the perineal wound as primary closure and rotation of pedicled flaps. The goals in the reconstruction are: To improve the quality of life, symmetry and sensitivity and, if possible, sexual function, so as to diminish the in-hospital stay and time in rehabilitation for extensive wounds. The gracilis myocutaneous flap is possible because of its vascular pedicle based on the circumflex femoral medial artery with sensory innervation through the cutaneous femoral nerves or branches of the obturator nerve. The defect in vulvar or anal neoplasms requires a negative surgical margin with an extensive perineal dissection, and the coverage with a single flap is not enough, so in 1984 the first bilateral was described. These flaps can even preserve sensitivity and allow additional reconstruction with a neovagina, so the approach of these patients requires to be multidisciplinary. We present the case of a 57-year-old female patient, with stage II vulvar cancer, initially treated with chemotherapy and radiotherapy concomitant with local disease progression, for which total pelvic exenteration with vulvectomy and perineal reconstruction with flap was proposed. Bilateral gracilis muscle.

Rectal cancer is considered a major health issue in several countries that present advanced and metastatic stages and a limited response to standard treatments. Though the antineoplasic activity of cannabinoids has been documented in several studies, scarce information is available about the effect of these agents in cell lines of rectal cancer. In this work, we explored the antiproliferative effects of cannabinoid receptor agonists in rectal tumor cells. The effects of the three agonists anandamide, methanandamide and CP55940 were evaluated in the SW837 rectal tumor cell line. The three agents tested showed time and concentration dependent effects on cell viability, induction of cell death and morphological changes. The three agonists were effective to induce late apoptosis and necrosis and internucleosomal DNA fragmentation. In addition, we evaluated for the first time the patterns of CB1 and CB2 cannabinoid receptor expression in SW837. Though some differences in their effects were found, our data support the concept that these agents mostly share common antiproliferative/cell death mechanisms. Our results also confirm the antineoplasic potential of cannabinoids receptor agonists against rectal cancer, and suggest the design of cannabinoid based coadjutant therapies at the clinical level. Citation Format: Alette Ortega Gómez, Pedro Luna-Merlos, Victor Manuel García Hernández, Abelardo Meneses García, Horacio Astudillo- de la Vega, Eric Alejandro García López, Abel Santamaría Del Angel, Erika Betzabé Ruiz García. Antiproliferative effect of cannabinoid receptor agonists on rectal cancer lines [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1903.