Browsing by Author "Acevedo Claros, Francisco Nicolás"

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    A nomogram for predicting serious complications in patients with solid tumors and apparently stable febrile neutropenia: prospective data on 781 consecutive episodes from the FINITE study
    (2014) Ghanem, Ismael; Rebollo, Maite Antonio; Garrido, Marcelo; Martínez, Jerónimo; Font, Carme; Ramchandani, Avinash; Biosca, Merce; Beato, Carmen; Martínez de Castro, Eva; Castanon, Eduardo; Virizuela Echaburu, Juan; Espinosa, Javier; Sevillano, Elena; Aragon Manrique, Isabel; Cardona, Merce; Mondejar, Rebeca; Baron, Francisco; Acevedo Claros, Francisco Nicolás; Jiménez-Fonseca, Paula; Carmona Bayonas, Alberto
    Background: An accurate estimate of the likelihood of serious complications in patients with otherwise apparently stable febrile neutropenia (FN) may assist in decision-making regarding individualized therapy. Our group has developed a prognostic score for predicting complications in patients with solid tumors and apparently stable episodes called CISNE (Clinical Index for Stable Febrile Neutropenia). The purpose of this study is to present a nomogram based on the previously mentioned index in a broader dataset of patients. Methods: FINITE is a prospective and multicenter study which aims to investigate prognostic factors and outcomes of FN episodes with clinical stability at first assessment, defined as events without acute organ dysfunction, vital signs abnormalities or major infections. We performed a nomogram based on the CISNE score which includes the following prognostic variables: ECOG PS≥2, chronic obstructive pulmonary disease, cardiovascular disease, mucositis NCI grade ≥2, monocytes <200/mm3 and stress-induced hyperglycemia. A calibration plot was used to analyze the accuracy of this multivariate nomogram. Results: From October 2012 to December 2013, 781 patients with apparently stable FN were recruited in 21 Spanish hospitals. The rate of infection-related complications and death was 15.6% (95% confidence interval [CI], 12.9-18.6%) and 1.7% (95% CI, 0.98%-3.01%). A nomogram was designed according to the CISNE score. The area under the ROC curve was 0.836 (95% CI, 0.808-0.861). The observed and predicted probabilities also matched closely. Conclusions: Our group has developed a user-friendly nomogram for predicting complications in patients with apparently stable FN. This nomogram may be particularly useful to prevent premature discharges of cancer patients starting inpatient management.
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    Access disparities and underutilization of germline genetic testing in Chilean breast cancer patients
    (2023) Acevedo Claros, Francisco Nicolás; Walbaum García, Benjamín Vicente; Camus Appuhn, Mauricio Gonzalo; Manzor Véliz, Manuel; Muñiz Muñoz, María Sabrina; Medina Araya, Lidia; Petric Guajardo, Militza Paulina; Reyes, Paula; Domínguez, Francisco; Puschel Illanes, Klaus; Merino Lara, Tomás Rodrigo; Bravo, M. Loreto; Pinto, Mauricio P.; Ibáñez, Carolina; Hughes, Kevin; Sánchez Rojel, César Giovanni
    Purpose Latin American reports on genetic cancer risk assessments are scarce. In Chile, current breast cancer (BC) guidelines do not define strategies for germline genetic testing. Our study sought to quantify the disparities in access to genetic testing in Chilean BC patients, according to international standards and their clinical characteristics to explore improvement strategies.Methods Retrospective analysis of invasive BC databases including patients treated in a Public Hospital (PH) and in an Academic Private Center (AC) in Santiago, Chile between 2012 and 2021.Results Of 5438 BC patients, 3955 had enough data for National Comprehensive Cancer Network (NCCN) categorization. From these, 1911 (48.3%) fulfilled NCCN criteria for germline testing, of whom, 300 were tested for germline mutations and 268 with multigene panels. A total of 65 pathogenic variants were found in this subset. As expected, BRCA1/2 mutations were the most frequent (17.7%). Access to genetic testing was higher in AC versus PH (19.6% vs. 10.3%, p = 0.0001). Other variables associated with germline genetic testing were BC diagnosis after 2018, being 45 years old or younger at diagnosis, BC family history (FH), FH of ovarian cancer, non-metastatic disease, and triple-negative subtype.Conclusion In our cohort, 15% of BC patients who met NCCN criteria for germline testing were effectively tested. This percentage was even lower at the PH. Current recommendations encourage universal genetic testing for BC patients; however, our findings suggest that Chile is far from reaching such a goal and national guidelines in this regard are urgently needed. To our knowledge, this is the first study of its kind in Chile and Latin America.
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    Actinomycosis: a great pretender. Case reports of unusual presentations and a review of the literature.
    (2008) Acevedo Claros, Francisco Nicolás; Baudrand Biggs, René; Letelier Saavedra, Luz María; Pablo Gaete
    Actinomycosis is a rare, chronic disease caused by a group of anaerobic Gram-positive bacteria that normally colonize the mouth, colon, and urogenital tract. Infection involving the cervicofacial area is the most common clinical presentation, followed by pelvic region and thoracic involvement. Due to its propensity to mimic many other diseases and its wide variety of symptoms, clinicians should be aware of its multiple presentations and its ability to be a 'great pretender'. We describe herein three cases of unusual presentation: an inferior caval vein syndrome, an acute cholecystitis, and an acute cardiac tamponade. We review the literature on its epidemiology, clinical presentation, diagnosis, treatment, and prognosis.
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    Actividad física y cáncer de mama: un tratamiento dirigido
    (2017) Ramírez Parada, Karol Lilia; Acevedo Claros, Francisco Nicolás; Herrera, María Elisa; Ibáñez, Carolina; Sánchez, César
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    Acute myeloblastic leukemia in Chile: treatment and outcomes in patients admitted at the Hospital Clinico de la Pontificia Universidad Católica de Chile between 2010–2014
    (2014) Fuentes Arismendi, Mónica Paulina; Rojas, Patricio; Ernst Díaz, Daniel Matías; Acevedo Claros, Francisco Nicolás; Sarmiento Maldonado, Mauricio; Ocqueteau Tacchini, Mauricio Esteban; Bertin Cortes-Monroy, Pablo Alfonso; Ramírez, Pablo
    Introduction: Acute Myeloblastic Leukemia (AML) is the most frequent acute leukemia in the adults and its incidence increases with age. There are few studies about the demography and outcomes of AML patients in Chile and the only report belongs to a public hospital from 2000. We discuss the results of patients treated in our institution with AML non promyelocytic. Patients and Methods: Retrospective analysis of the epidemiologic, clinical and laboratory characteristics of diagnosis (cytology and flow cytometry) and treatment of AML non promyelocytic patients between 2010-2014. Statistical analysis of the data was performed using SPSS Statistics v21 software. Results: 63 patients were diagnosed with AML non M3, 52 males (66%), with a median age of 55.4 years (range: 16 - 89). Diagnosis laboratory tests (mean values and ranges) were: WBC 45.989/mm3 (range: 700 - 405.000); hemoglobin 9,1 g/dl (range: 5,2 - 14,1); platelets 75.548/mm3 (range: 10.000 - 454.000); peripheral blood blasts 38% (range 0 - 100); bone marrow blasts 74% (range 25 - 100%). The cytogenetic risk groups were: favorable (n=5, 8%), intermediate (n=33, 52%), adverse (n=8, 13%) and unknown (n=17, 27%). Of all the patients, 75% (n=47) received induction chemotherapy (CT) and 25% (n=16) palliative care. The mean age of the group with cytogenetic analysis was 51.2 years and only 8.6% did not receive consolidation CT. On the other hand, the group of patients with unknown cytogenetics had a mean age of 68 years and 57% did not receive consolidation CT. The mean survival of the CT group was 27.3 month (range: 0 - 53). By contrast, the mean survival in the palliative care group was 1 month (range: 0 - 6). The mean follow up in all patients was 13 months, (range: 1 - 55) and 17 months (range: 1 - 54) in the group that received CT. 87% (n=41) of patients with CT had febrile neutropenia with respiratory and intestinal focus most commonly identified. The induction mortality was 4,2% (n=2). Complete cytologic remission was achieved in 70% (n=33). The 3-year relapse free survival (RFS) and overall survival (OS) in the CT group were 25% and 31%, respectively. The multivariate survival analysis using Cox’s regression demonstrated that the variables that had significant impact in RFS and OS were: age at diagnosis (<60 years), achievement of disease remission and the use of induction and consolidation CT (high dose cytarabine versus others). In this analysis the cytogenetic risk did not have any impact in OS. The patients that only had induction CT (but not consolidation) had significantly better survival rates compared to the group in palliative care (6 months vs. 1 month, respectively, p=0.001). The mortality during the follow up of patients who had survived the induction CT was 47% (n=22), 2/3 of leukemia and 1/3 of infections. Conclusions: Our study shows that in our center, CR rates and OS rates after induction and consolidation chemotherapy are similar to those reported in international series, and are better than the data that was previously reported in our country. Low induction CT mortality, and the efficacy of CT in patients younger than 60 years old stand out in our report and validate the efficacy of intensive CT.
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    Aplicación de tres modelos pronósticos en cáncer de mama precoz
    (2018) Sánchez R., César; Maldonado J., Daniela; Jans B., Jaime; Domínguez C., Francisco; Galindo A., Héctor; Camus A., Mauricio; Oddo B., David; Medina A., Lidia; Acevedo Claros, Francisco Nicolás
    Aplicar tres modelos pronósticos “online” (índice pronóstico de Nothingham (NPI), Adjuvantonline! (AO) y PREDICT utilizados en la práctica oncológica para estratificar a pacientes y definir el uso de terapias adyuvantes en pacientes con cáncer de mama (CM) precoz, para evaluar su correlación y predicción de sobrevida en nuestra población. Métodos: Obtuvimos datos clínicos de pacientes con CM invasor T1N0M0, tratados en el Centro de Cáncer de la Pontificia Universidad Católica de Chile, Santiago, Chile, desde enero de 1997 hasta diciembre de 2003. Resultados: Analizamos datos de 125 pacientes. Edad mediana fue 55 años (35-80). La mayoría de los tumores fueron carcinomas ductales infiltrantes (72,8%), receptor de estrógeno (RE) positivos (88,8%), 80% recibieron terapia endocrina (TE). El beneficio estimado de la TE y la quimioterapia (QT) en la sobrevida global (SG), determinadas según AO y PREDICT, no fueron significativamente diferentes (1,3% y 1% para QT, p = 0,13; 0,9% y 1% para TE, p = 0,8; respectivamente). El modelo NPI estimó una mediana de SG superior (96%) a la calculada por AO (90,9%) y PREDICT (92,5%). La mortalidad específica por CM fue de 3%, similar a lo observado (3,2%). La mediana de SG estimada por todos los modelos en el grupo de pacientes fallecidos no fue estadísticamente diferente al grupo de sobrevivientes (p = 0,85). Conclusión: Los modelos pronósticos predicen apropiadamente la SG en pacientes con CM precoz; sin embargo, en esta serie, no discriminaron pacientes de mal pronóstico.
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    Atypical ductal hyperplasia in men with gynecomastia: what is their breast cancer risk?
    (2019) Coopey, Suzanne B.; Kartal, Kinyas; Li, Clara; Yala, Adam; Barzilay, Regina; Faulkner, Heather R.; King, Tari A.; Acevedo Claros, Francisco Nicolás; Guidi, Anthony J.; Hughes, Kevin S.
    Purpose Atypical ductal hyperplasia (ADH) significantly increases the risk of breast cancer in women. However, little is known about the implications of ADH in men. Methods Review of 932 males with breast pathology was performed to identify cases of ADH. Patients were excluded if ADH was upgraded to cancer on excision, or if they had contralateral breast cancer. Cases were reviewed to determine whether any male with ADH developed breast cancer. Results Nineteen males were diagnosed with ADH from June 2003 to September 2018. All had gynecomastia. Surgical procedure was mastectomy in 8 patients and excision/reduction in 11. One patient had their nipple areola complex removed, and 1 required a free nipple graft. Median patient age at ADH diagnosis was 25 years (range 18–72 years). Of the 14 patients with bilateral gynecomastia, 10 had bilateral ADH and 4 had unilateral. Five cases of ADH were described as severe, bordering on ductal carcinoma in situ. No patient reported a family history of breast cancer. No patient took tamoxifen. At a mean follow-up of 75 months (range 4–185 months), no patient developed breast cancer. Conclusion Our study is the first to provide follow-up information for males with ADH. With 6 years of mean follow-up, no male in our series has developed breast cancer. This suggests that either ADH in men does not pose the same risk as ADH in women or that surgical excision of symptomatic gynecomastia in men effectively reduces the risk of breast cancer.
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    Breast cancer and pregnancy: A comparative analysis of a Chilean cohort
    (2014) Sánchez, C.; Acevedo Claros, Francisco Nicolás; Medina, L.; Ibáñez, C.; Razmilic Valdés, Dravna Nichi; Navarro Ortega, María Elena; Camus, M.
    Introduction: Recent reports show that pregnancy-associated breast cancer (PABC) survival is similar to that of non-pregnant young patients. We evaluate the characteristics and prognosis of PABC patients treated in our cancer centre. Patients and methods: We identified patients with invasive PABC who were treated between 1999 and May 2013 and compared their characteristics with a no PABC cohort of similar age. Results: The prevalence of PABC was 1% (n = 17). The median age was 35 years (range: 29– 42 years). The initial tumour was suspected clinically in 93% of the cases. Total mastectomy rates were higher in women with PABC (78.6% versus 40.5%, p = 0.02), and more tumours in the PABC group were triple negative, epidermal growth factor type 2 (HER2)–positive, and at advanced stages; however, these differences were not statistically significant. While estimated overall survival at ten years was higher in the non-PABC group (75.5% versus 80.5%, p = 0.043), disease-specific survival (DSS) rate at ten years was not statistically different between groups (83.9% for PABC and 75.5% for unrelated pregnancy BC, p = 0.37). Conclusions: PABC is a rare event. In our cohort, it tended to be more aggressive. Compared with a similar age cohort, the DSS was not worse.
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    Breast cancer at extreme ages - A comparative analysis in Chile
    (2015) Acevedo Claros, Francisco Nicolás; Camus Appuhn, Mauricio Gonzalo; Sánchez Rojel, César Giovanni
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    Calorie Restriction and Time-Restricted Feeding: Effective Interventions in Overweight or Obese Patients Undergoing Radiotherapy Treatment with Curative Intent for Cancer
    (2024) Vega Huerta, Carmen Natalia; Barnafi Wittwer, Esteban Andrés; Sánchez Rojel, César Giovanni; Acevedo Claros, Francisco Nicolás; Walbaum García, Benjamín Vicente; Parada Daza, Alejandra Cristina; Rivas Segura, Nicolás Eduardo; Merino Lara, Tomás Rodrigo
    This study assesses the feasibility of calorie restriction (CR) and time-restricted feeding (TRF) in overweight and obese cancer patients who realized little to no physical activity undergoing curative radiotherapy, structured as a prospective, interventional, non-randomized open-label clinical trial. Of the 27 participants initially enrolled, 21 patients with breast cancer were selected for analysis. The participants self-selected into two dietary interventions: TRF, comprising a sugar and saturated fat-free diet calibrated to individual energy needs consumed within an 8 h eating window followed by a 16 h fast, or CR, involving a 25% reduction in total caloric intake from energy expenditure distributed across 4 meals and 1 snack with 55% carbohydrates, 15% protein, and 30% fats, excluding sugars and saturated fats. The primary goal was to evaluate the feasibility of these diets in the specific patient group. The results indicate that both interventions are effective and statistically significant for weight loss and reducing one’s waist circumference, with TRF showing a potentially stronger impact and better adherence. Changes in the LDL, HDL, total cholesterol, triglycerides, glucose and insulin were not statistically significant.
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    Can histological grade and mitotic index replace Ki67 to determine luminal breast cancer subtypes?
    (2018) Oddo Benavides, David; Pulgar, Dahiana; Peña, José; Acevedo Claros, Francisco Nicolás; Razmilic Valdés, Dravna Nichi; Navarro Ortega, María Elena; Camus Appuhn, Mauricio Gonzalo; Merino Lara, Tomas Rodrigo; Sánchez, César; Pérez Sepúlveda, Alejandra Andrea; Villarroel, Alejandra; Galindo, Héctor; Elgueta, Nicole; Retamal, Ignacio
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    Cáncer de mama avanzado receptor de estrógeno positivo: Manejo sistémico actual
    (2018) Sánchez Rojel, César Giovanni; Valenzuela Velasquez, Yasna Daniela; Pérez-Sepúlveda, Alejandra; Villarroel Pérez, María Alejandra; Medina Araya, Lidia; Camus Appuhn, Mauricio Gonzalo; Acevedo Claros, Francisco Nicolás
    El cáncer de mama es la primera causa de muerte por cáncer en mujeres chilenas. Mientras la mayoría de las personas logra curarse de esta enfermedad, un 5% de los casos se presenta inicialmente con enfermedad avanzada y hasta un 20-30% de pacientes con enfermedad localizada pueden sufrir recurrencias sistémicas. La mayoría de las neoplasias mamarias son dependientes del estímulo estrogénico, de allí que la deprivación de estrógenos es la principal estrategia terapéutica. Recientemente, el uso de terapias molecularmente dirigidas en combinación con la terapia endocrina ha logrado mejorar los resultados de sobrevida del cáncer de mama avanzado, con menos efectos colaterales que aquellos producidos por la quimioterapia convencional. El conocimiento de los mecanismos de acción de estas nuevas terapias, sus toxicidades, vías de resistencia y selección de pacientes para lograr los mejores beneficios terapéuticos son aspectos relevantes en el manejo de la enfermedad. Presentamos una revisión del estado actual del manejo del cáncer de mama metastásico hormonodependiente con enfásis en el uso de terapias endocrinas combinadas con terapias moleculares.
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    Cáncer de mama Her2-positivo: Terapias sistémicas actuales y experiencia local
    (2023) Walbaum García, Benjamín Vicente; Acevedo Claros, Francisco Nicolás; Carrillo Barrientos, Diego Ignacio; Camus Appuhn, Mauricio Gonzalo; Manzor V., Manuel; Martinez R., Raúl; Veglia Q., Paulina; Murature S., Geraldine; Salvado U., Valentina; Muñiz Muñoz, María Sabrina; Merino Lara, Tomás Rodrigo; Sanchez Rojel, César Giovanni
    Breast cancer (BC) is the leading cause of cancer death for women both worldwide and in Chile. Based on clinical, histological, and molecular features, studies have identified four BC subtypes that correlate with treatment sensitivity. Human Epidermal growth factor Receptor type 2-positive (HER2+) BC re-presents 15%-25% of newly diagnosed breast neoplasms; HER2+ BC is characterized by its aggressive behavior, early recurrence, and higher risk of brain metastasis. In recent years, HER2-targeted therapies have become the mainstay of treatment and have redefined the natural history of this subtype, reducing relapse rates for early-stage patients and increasing survival in advanced-stage patients. Herein we review novel treatment strategies and their mechanisms of action, along with clinical and real-world data. We also provide a summary of currently available treatments for this subtype and our local experience regarding the management of this disease.
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    Características clínico-patológicas y sobrevida de pacientes con cáncer de mama bilateral sincrónico
    (2014) Sánchez Rojel, César Giovanni; Acevedo Claros, Francisco Nicolás; Petric, M.; Domínguez Covarrubias, Francisco José; León Ramírez, Augusto; Razmilic Valdés, Dravna Nichi; Ceballos, C.; Espinoza, F.; Navarro Ortega, María Elena; Oddo Benavides, David; Camus, M.
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    Clinical characteristics, risk factors, and outcomes in Chilean triple negative breast cancer patients: a real-world study
    (2023) Acevedo Claros, Francisco Nicolás; Walbaum, Benjamin; Medina, Lidia; Merino Lara, Tomás Rodrigo; Camus Appuhn, Mauricio Gonzalo; Puschel Illanes, Klaus; Ramírez Parada, Karol Lilia; Manzor, Manuel; Veglia, Paulina; Martinez, Raul; Guerra, Constanza; Navarro, Marisel; Bauerle, Catherine; Domínguez Covarrubias, Francisco José; Sánchez Rojel, César Giovanni
    Background Latin American (LA) studies on triple-negative breast cancer (TNBC) and their characteristics are scarce. This forces physicians to make clinical decisions based on data obtained from studies that include non-Hispanic patients. Our study sought to obtain local epidemiological data, including risk factors and clinical outcomes from a Chilean BC registry. Methods This was a retrospective population-cohort study that included patients treated at a community hospital (mid-low income) or an academic private center (high income), in the 2010-2021 period. Univariate and multivariate analyses were performed to identify prognostic factors associated with survival. Results 647 out of 5,806 BC patients (11.1%) were TNBC. These patients were younger (p = 0.0001) and displayed lower rates of screening-detected cases (p = 0.0001) compared to non-TNBC counterparts. Among TNBC patients, lower income (i. e., receiving treatment at a community hospital) was associated with poorer overall survival (HR: 1.53; p = 0.0001) and poorer BC specific survival (HR: 1.29; p = 0.004). Other risk factors showed no significant differences between TNBC and non-TNBC. As expected, 5-year OS was significantly shorter on TNBC versus non-TNBC patients (p = 0.00001). In our multivariate analyses TNBC subtype (HR: 2.30), locally advanced stage (HR: 7.04 for stage III), lower income (HR: 1.64), or non-screening detected BC (HR: 1.32) were associated with poorer OS. Conclusion To the best of our knowledge, this is the largest LA cohort of TNBC patients. Interestingly, the proportion of TNBC among Chileans was smaller compared to similar studies within LA. As expected, TNBC patients had poorer survival and higher risk for early recurrence versus non-TNBC. Other relevant findings include a higher proportion of premenopausal patients among TNBC. Also, mid/low-income patients that received medical attention at a community hospital displayed lower survival versus private health center counterparts.
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    Clinicopathologic subtypes and compromise of lymph nodes in patients with breast cancer
    (2014) Jans B, J.; Escudero M, N.; Pulgar B, D.; Acevedo Claros, Francisco Nicolás; Sánchez R, C.; Camus Appuhn, Mauricio Gonzalo
    Breast cancer (BC) is currently a heterogeneous disease with variations in clinical behaviour. Classification according to subtypes has allowed progress in the individualisation of treatment. The objective of this study is to evaluate the risk of axillary node compromise in patients with BC, according to clinicopathologic subtypes. Materials and methods are a retrospective, descriptive-analytical study. All patients that had undergone surgery for invasive BC were included, with the study of sentinel lymph nodes (SLNs) at Hospital Clínico de la Pontificia Universidad Católica, between May 1999 and December 2012. The results showed 632 patients fulfilled the inclusion criteria, with the median age being 55 years (range: 28–95), and 559 (88.4%) patients presented with estrogen receptor and/or progesterone receptor positive tumours. Luminal A: 246 patients (38.9%), luminal B: 243 (38.4%), luminal not otherwise specified: 70 (11.1%) triple negative (TN): 60 (9.5%) and over expression of epidermal growth factor type 2 receptor (HER2 positive): 13 (2.1%). Luminal tumours displayed a greater risk of metastasis in the SLNs, but this difference was not statistically significant (p = 0.67). TN and HER2 positive tumours presented the greatest proportion of metastatic compromise in non-sentinel lymph nodes (non-SLNs) (57.1% and 50%, respectively). The presence of macrometastasis (MAM) in the SLN was associated with a greater risk of compromise of the non-SLN. Conclusions: Luminal tumours are the most frequent and present a greater proportion of axillary lymph node compromise, without being statistically significant. TN and HER2 positive tumours tend to have a higher axillary compromise; however, this was not statistically significant in either. Only the presence of MAM in SLNs displayed a statistically significantly association in the compromise of non-SLNs.
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    Correlation between Ki67 and histological grade in breast cancer patients treated with preoperative chemotherapy
    (2014) Petric Guajardo, Militza Paulina; Martínez Riquelme, Santiago Felipe; Acevedo Claros, Francisco Nicolás; Oddo Benavides, David; Artigas Barrenechea, Rocío; Camus Appuhn, Mauricio Gonzalo; Sánchez Rojel, César Giovanni
    Background and Aim: Breast cancer (BC) is a heterogeneous disease and cell proliferation markers may help to identify subtypes of clinical interest. We here analyzed the correlation between cell proliferation determined by Ki67 and HG in BC patients undergoing preoperative chemotherapy (PCT). Materials and Methods: We obtained clinical/pathological data from patients with invasive BC treated at our institution from 1999 until 2012. Expression of estrogen receptor (ER), progesterone receptor (PR), epidermal growth factor receptor type 2 (HER2) and Ki67 were determined by immuno-histochemistry (IHC). Clinicopathological subtypes were defined as: Luminal A, ER and/or PR positive, HER2 negative, HG 1 or 2; Luminal B, ER and/or PR positive, HER2 negative or positive and/or HG 3; triple negative (TN), ER, PR and HER2 negative independent of HG; HER2 positive, ER, PR negative and HER2 positive, independent of HG. By using Ki67, a value of 14% separated Luminal A and B tumors, independently of the histological grade. We analyzed correlations between Ki67 and HG, to define BC subtypes and their predictive value for response to PCT. Results: 1,560 BC patients were treated in the period, 147 receiving PCT (9.5%). Some 57 had sufficient clinicopathological information to be included in the study. Median age was 52 years (26-72), with 87.7% invasive ductal carcinomas (n=50). We performed IHC for Ki67 in 40 core biopsies and 50 surgical biopsies, 37 paired samples with Ki67 before and after chemotherapy being available. There was no significant correlation between Ki67 and HG (p=0.237), both categorizing patients into different subtypes. In most cases Ki67 decreased after PCT (65.8%). Only 3 patients had pathologic complete response (cPR). Conclusions: In our experience we did not find associations between Ki67 and HG. Determination of clinicopathological luminal subtypes differs by using Ki67 or HG.
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    Cost-minimization analysis of subcutaneous versus intravenous trastuzumab administration in Chilean patients with HER2-positive early breast cancer
    (2020) Rojas Orellana, Luis; Muniz, S.; Medina Araya, Lidia; Peña Durán, José Esteban; Acevedo Claros, Francisco Nicolás; Pinto Paganini, Mauricio Arturo; Sánchez Rojel, César Giovanni
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    Enfermedad periodontal en pacientes con síndrome coronario agudo
    (2005) Lim Shon, Jongsung; Pérez P., Luis; Guarda S., Eduardo; Fajuri N., Alejandro; Marchant D., Eugenio; Martínez S., Alejandro; Lazen Varas, Rosa de Andacollo; Del Valle Bastias Fernando Esteban; Hernandez Fortuno, Denisse Andrea; Casanegra R., Alejandra; Cereceda C., María Paz; Villalobos A., Ana María; Boncompte Guarda, Mariana Paz; Acevedo Claros, Francisco Nicolás
    Background: Epidemiological studies suggest an association between periodontal disease and coronary heart disease. It is possible that periodontal disease may contribute to plaque destabilization in patients with acute coronary syndrome. Aim: To assess the association between severity of periodontal disease, the number of acute plaques and extension of coronary artery disease in patients with acute coronary syndrome. Patients and methods: The severity of periodontal disease was assessed by skilled independent observers in patients with acute coronary syndrome subjected to coronary angiography. The periodental disease was classified as mild or severe. Acute plaques were defined on angiography as those with thrombi, ulcers or flow alterations. The extension of coronary disease was analyzed using the Sullivan score. Results: Forty three patients (35 males) aged 41 to 83 years, were studied. Mild and severe periodontal disease was present in 18 (42%) and 25 (58%) patients respectively. Seventy six percent of those with severe disease had two or more acute plaques, compared with 17% of those with mild disease (p<0.001). Median Sullivan score was 80.6 and 57.2 in patients with severe or mild periodontal disease respectively (p=0.001). Conclusions: Severe periodontal disease was associated with a higher number of acute coronary plasques and a higher extension of coronary artery disease, in patients with acute coronary syndromes
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    Entendiendo las terapias actuales en melanoma metastásico
    (2016) Rodríguez, Rocío; Parra, Angela; González Bombardiere, Sergio; Molgó Novell, Montserrat; Droppelmann, Nicolás; Acevedo Claros, Francisco Nicolás; Peña, José; Uribe González, Pablo Francisco