RCAAP Repository

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Gastric carcinoma is one of the most common cancers worldwide. If the tumor is resectable, surgical approach is the only treatment which might have a curative intent. Even though, the majority of patients suitable for surgery will have recurrent disease, either as local recurrence or as distant metastasis. In order to improve the prognosis of these patients, there has been a crescent interest in the use of antineoplasic treatment before surgery. This article intends to review the evidence towards the use of chemotherapy, radiotherapy and chemoradiotherapy in the neoadjuvant setting.

Aim: Evaluate the quality of life (QoL), burden and distress of cancer patients’ caregivers in three stages of cancer treatment. Methods: Analytical study of 90 caregivers of patients in curative treatment, palliative chemotherapy and symptomatic. Scales used: Zarit Burden Interview, Caregiver QoL Index – Cancer (CQOLC) Scale and Distress Thermometer. Results: Caregiver profile: women, median age 45,5 years, spouse/daughter. Increase in burden and distress levels, and lower QoL as treatment progresses. Burden was moderate, QoL lower than reported in other studies and distress high, with a large component of emotional problems and physical problems in caregivers of patients in symptomatic treatment. Conclusion: Regular assessment of caregiver should be included in the treatment plan of the patient since the beginning of treatment.

Late Relapse of Germ Cell Malignancies (GCM) of the testicule is defined as relapse two years after complete response to adjuvant chemotherapy (CT), in the absence of a second primary tumor of the contralateral testicule. It’s a rare entity, and its primary treatment is surgery. The authors describe two clinical cases e revise related literature: 34 year-old male with a relapse of testicular GCM 11 years after initial diagnosis, treated with surgery and salvation CT; 47 year-old, with a relapse of GCM 18 and 20 years after initial diagnosis, treated initially with CT and on the second relapse with surgery. Currently both patients are at surveillance, without evidence of relapse. Late relapse of GCM of the testicule is a rare entity, that counteracts the good prognosis of this type of malignancy.

The association between better cancer detection and treatment techniques and the increase of incidence of cancer among younger patients have resulted in a bigger number of patients reaching reproductive age, which associated with the known gonadotoxic effects of cancer therapies raises issues about the reproductive health and fertility preservation in this patients.It is the purpose of this investigation to assess the knowledge and clinical practice of oncologists on the subject of fertility preservation. To do so, a questionnaire was sent by the Portuguese Society of Oncology to its associates. Thirty-five replies were obtained, and they showed that 97% of oncologists believe that more attention should be given to this topic and 52.4% mentioned already addressing the subject with the patients, despite of their limited knowledge on the available procedures. Only 5 out of 30 doctors stated giving written information and 44% never referred a patient to Reproductive Medicine. Training lectures and the establishment of Referral protocols between Oncology and Reproductive Medicine could be fruitful in the improvement of the approach to the oncological patient in reproductive age.

The authoress describes the clinical case of a patient with soft-tissue sarcoma initially diagnosed and treated as hematoma. This failure in the initial diagnosis resulted in a delay of several months, culminating in patient´s death. This case is an example that the possibility of a malignant tumour is to be always considered, when a presumptive hematoma follows an atypical clinical course, being the result of this suspicion further investigation with NMR and biopsy, if necessary.

We aimed to characterize the relation between the disease and treatment of cancer with fertility issues.It was applied a specific questionnaire to premenopausal patients with breast cancer. Based in our findings the importance of fertility is greatest for younger and/or still childless patients. The discussion about fertility is more frequent in earlier stages ofcancer and younger patients, but globally occurs in only 50%. The oncofertility knowledge and fertility preservation have evolved but can still be optimized, highlighting the necessity of routine discussion and earlier guidance of individual patients.

Introduction: Retroperitoneal soft tissue sarcomas have a wide range of histologic entities but they are frequently studied as a single disease. Being liposarcomas the most frequent histologic type, we’ve carried a retrospective analysis from a cohort of patients treated at a referral center to assess prognostic factors associated with demographic and therapeutic characteristics.Methods: A retrospective analysis of a single center cohort of adult patients who underwent surgical treatment for retroperitoneal liposarcomas between 2007 and 2013 was performed.Results: Fifty-five patients were included. Thirty-two (58%) were female. Median age was 62 years old (ranging from 19-84). Median size at diagnosis was 26.5 cm and most patients (76.4%) were symptomatic at diagnosis. Histology results were the following: 28 well differentiated liposarcomas, 11 dediferentiated liposarcomas, 9 myxoid and 7 high grade liposarcomas. Well differentiated histologies were more frequent among women and also occurred at a later age. Median follow up was 48 months and a specific disease survival (SDS) of 63% at 5 years was obtained.Prognosis was influenced by histology, gender, tumor grade and invasion of adjacent organ. . Macroscopic complete resection had significant impact on survival with no difference observed between R0 and R1 resections. Thirty-four patients had disease recurrence and all of them were reoperated. Surgical treatment was able to treat effectively these patients since no difference was observed in SDS when comparing patients with one versus multiple surgeries. Dedifferentiation at recurrence was not associated with a worse SDS.Conclusions: As expected, these patients present with large tumors at diagnosis. Female gender and low grade diseases were associated with a better prognosis. Regarding liposarcoma treatment, a macroscopic complete resection (with organ resection if needed) during the first surgery seems to be the most important therapeutic aspect impacting SDS. Although our results support the need for macroscopic complete resection as well as reoperations when disease recurs, new therapeutic options are needed to improve outcomes.

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BOOK REVIEW

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O breve romance Pic, de Jack Kerouac, tem como uma de suas características mais notáveis a voz do jovem protagonista, marcada pela oralidade informal e pela identidade negra desde as primeiras frases. A idiossincrasia da ortografia e da gramática empregadas ao longo do romance fazem de Pic um ponto de partida fértil para discussões acerca dos métodos e abordagens possíveis na tradução de variedades de língua não padrão. Este artigo propõe-se a discutir recursos como a oralidade fingida, o dialeto visual e a criação do conjunto de regras ortográficas e gramaticais que tiveram por objetivo conferir a Pic uma voz única na tradução para o português brasileiro. A abordagem proposta alinha-se com a teoria funcionalista e, para além de apresentar um estudo de caso, visa exemplificar procedimentos aplicáveis à resolução de problemas semelhantes e refletir sobre o papel do tradutor literário no processo editorial e na mediação intercultural.

Among the cultural fields censored under the Nazi rule of occupied Norway (1940-1945) during WWII, translated literature stands out as the most strictly controlled part of the literary field, censored by the Norwegian Literature and Library Office. Moreover, the Reich Commissariat (the highest German authority in occupied Norway) used the field of translated literature as a site forsoft propaganda, here understood as subtle messaging, in contrast to hard propaganda, which is cruder and more heavy-handed. Aiming to investigate how the Reich Commissariat influenced the field of translated literature, this article presents findings from archival research focused on correspondence directly or indirectly involving the Reich Commissariat, taking into consideration textual and contextual features of the books and authors discussed. The article concludes that the Reich Commissariat had various ways of influencing publications of translated literature, being both overtly and covertly involved in publishing processes.

A 79-year-old woman was admitted to our hospital so we could study the aetiology of pulmonary hypertension that had been suggested in an echocardiogram. She also had severe hypocalcaemia with an inappropriately low parathyroid hormone level. Computed tomography showed a paratracheal (46×32 mm) adenopathy and multiple abdominal adenopathies, which were surgically biopsied and corresponded to follicular lymphoma. No other causes were found for the pulmonary hypertension that was considered to be associated with lymphoproliferative disease – pulmonary hypertension type 5. Hypoparathyroidism was considered secondary to parathyroid infiltration.

Nowadays, the progressive increase in the life expectancy of children with cancer also leads to an increase in the incidence of chemotherapy potential side effects. Among these substances, anthracyclines are some of the most commonly used and have myocardial toxicity. Despite its improvement with the use of liposomal compounds, there is still a need for better screening methods and early treatment of this cardiotoxicity. We present the case of a child with myocardial dysfunction of probable mixed cause (septic shock and anthracyclines toxicity) with good recovery after early treatment and review the most recent developments regarding this subject.

Objective: To provide updated information about the preservation of reproductive potential in adult cancer based on the available evidence. Methods: A review of literature published after 2006 was performed using the Medline and PubMed. The evidence was analyzed by specialists from several medical societies; and reflected upon their onclinical practice. After discussion on several working groups, a series of recommendations were made. Results: Scientific literature was reviewed and analyzed, as well as the recommendations and / or guidelines published by international scientific societies. After reviewing the best scientific evidence, the selected panel of experts prepared the recommendations to be implemented in the Portuguese population. Recommendations 6 | RPO Vol 2 / N1 /Novembro 2016 Revista portuguesa de oncologia were reviewed by the participating medical societies, and comments incorporated when appropriate. Recommendations: All health professionals should address with cancer patients, the risk of infertility and preservation of their reproductive potential. The individual risk for reproductive funciton of each patient depends on the type of cancer, age and treatment plan. It is very important to define the infertility risk, and fertility evaluation before startingany preservation technique of reproductive potential. In men, the most common and most effective option is sperm cryopreservation, which can be obtained in 24-48 h. In women, the preferred option is cryopreservation of oocytes that can be completed in 2 two to 4 four weeks. Referral must take place as early as possible, right after a cancer diagnosis is established and the need to sue a treatment with potentially detrimental effects on reproductive function is considered.