Background While the significance of CEA, LDH and KRAS status as individual prognostic factors for patients with metastatic colorectal cancer has been addressed, the relationship and interdependence between these prognostic factors on survival is limited. Methods Patients with unresectable colorectal liver metastases with known KRAS status, and with baseline CEA and LDH levels who were treated with hepatic arterial infusion and systemic chemotherapy were identified. Patients were divided into two groups: hepatic-only disease and extra-hepatic disease. Results A total of 193 patients were included: 121 with hepatic-only and 72 with extra-hepatic disease. In the hepatic-only group, median overall survival (OS) was 55 months. On multivariate analysis, KRAS mutated tumors [HR 1.7, p<0.05], LDH >200 U/L [HR 2.0, p<0.05] and prior chemotherapy [HR 2.1, p<0.05] had lower OS. In patients with extra-hepatic disease, median OS was 32 months. On multivariate analysis, baseline CEA >200 ng/ml [HR 2.1, p=0.051], LDH >200 U/L [HR 3.8, p<0.05] and right-sided tumors [HR 2.8, p<0.05] had lower OS. Conclusions This analysis verifies two distinct patterns in terms of biomarkers in patients with unresectable colorectal liver metastases. In patients with hepatic-only disease, KRAS mutation and elevated LDH negatively influenced survival. In patients with extra-hepatic disease, elevated LDH negatively impacted survival.

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La dermatomiositis paraneoplásica es una enfermedad inflamatoria del tejido conectivo que responde a eventos inmunológicos ocasionados por la presencia de tumores malignos. Es más frecuente en mujeres de mediana edad y está ligada a cáncer de ovario, páncreas, estómago, colon y linfoma no Hodgkin. Presentamos dos casos de dermatomiositis de inicio amiopático asociados a cáncer de mama. El primero como parte de la progresión de la enfermedady el segundo como detonante para la búsqueda de un tumor oculto. Abstract:Paraneoplastic dermatomyositis is an inflammatory disease of the connective tissue that is caused by inmmunologic events in the presence of malignant tumors. It is more likely to happen in middle aged women and is related to ovarian, pancreatic, stomach and colon cancer and non Hogdkin lymphoma. We present two cases of dermatomyositis, with amyopathic origin associated to breast cancer. The first case occurs as the neoplasia evolves and thesecond one as an initial manifestation that leads to the search and subsequent diagnosis of cancer.

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