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Perez-Gracia J.L.,University of Navarra | Gurpide A.,University of Navarra | Ruiz-Ilundain M.G.,Clinica Ubarmin | Alegria C.A.,University of Navarra | And 3 more authors.
Clinical and Translational Oncology | Year: 2010

Systematic collection of phenotypes and their correlation with molecular data has been proposed as a useful method to advance in the study of disease. Although some databases for animal species are being developed, progress in humans is slow, probably due to the multifactorial origin of many human diseases and to the intricacy of accurately classifying phenotypes, among other factors. An alternative approach has been to identify and to study individuals or families with very characteristic, clinically relevant phenotypes. This strategy has shown increased efficiency to identify the molecular features underlying such phenotypes. While on most occasions the subjects selected for these studies presented harmful phenotypes, a few studies have been performed in individuals with very favourable phenotypes. The consistent results achieved suggest that it seems logical to further develop this strategy as a methodology to study human disease, including cancer. The identification and the study with high-throughput techniques of individuals showing a markedly decreased risk of developing cancer or of cancer patients presenting either an unusually favourable prognosis or striking responses following a specific treatment, might be promising ways to maximize the yield of this approach and to reveal the molecular causes that explain those phenotypes and thus highlight useful therapeutic targets. This manuscript reviews the current status of selection of extreme phenotypes in cancer research and provides directions for future development of this methodology. © 2010 Feseo.

Alonso S.,MD Anderson International Espana | Lapuente F.,MD Anderson International Espana | Gonzalez-Martin A.,MD Anderson International Espana | Chiva L.,MD Anderson International Espana
Current Women's Health Reviews | Year: 2011

Endometrial cancer is the most common gynecologic malignancy in western countries. In United States, 42000 estimated new cases were diagnosed in 2009, approximately 7780 women died from this cancer last year. This malignancy has a five year survival rate around 80%, thanks to its early diagnosis. The surgical management of endometrial cancer includes hysterectomy as main surgical procedure. The role of lymphadenectomy, pelvic and para aortic is still controversial. The authors discuss in this article the risk factors for lymph node metastases and recurrence for endometrial cancer by reviewing the international literature. Conclusions: Lymphadenectomy is a crucial surgical procedure for an adequate staging of endometrial cancer. It is necessary a to evaluate the prognostic factors of this disease in order to properly select the most adequate adjuvant therapy. Since last trials on lymphadenectomy in endometrial cancer have not been convincing, further studies are warranted. © 2011 Bentham Science Publishers.

Rojo A.,MD Anderson International Espana | Sancho P.,MD Anderson International Espana | Alonso O.,MD Anderson International Espana | Encinas S.,MD Anderson International Espana | And 2 more authors.
Clinical and Translational Oncology | Year: 2010

Surgery for rectal cancer continues to develop towards improving local control and overall survival, maintaining quality of life and preserving sphincter, genitourinary and sexual function. The multidisciplinary approach integrated in a team of different specialists ensures an individualised treatment for each patient with rectal cancer. Thus, the role of the pathologist has acquired an important relevance, not only in diagnosis, management and evaluation of the surgical specimen, but also for selection of the best adjuvant treatment. Parameters such as macroscopic quality of the mesorectum, status of the circumferential margin and lymph node harvest are considered basic criteria by current guidelines. Additionally, consistency in reporting based on the histologic classification proposed by the World Health Organization (WHO) is mandatory, along with inclusion into the pathologic report of current criteria for tumour node metastasis (TNM) staging, assessment of response to neoadjuvant chemoradiation therapy and clinically relevant molecular studies. Detection of defects in mismatch repair genes and mutational analysis of specific genes should be included as predictive markers for therapy.

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