Objectives: In many cases, the socioeconomic status of patients diagnosed with metastatic renal cell carcinoma (mRCC) in developing countries could limit their access to the best available therapeutic options. We aimed to describe the clinical characteristics and access to treatment of Mexican patients with mRCC. Materials and methods: We performed a retrospective analysis of all patients with a histopathologically confirmed diagnosis of renal cell carcinoma treated at an oncology referral center in Northeast Mexico over a 5-year period. Results: We included 233 patients in the analysis, of whom 63% were men. The mean age at diagnosis was 58.2 years; 87% of the tumors were histopathologically classified as clear cell carcinoma. Regarding laterality, 54% of the tumors originated from the right kidney. The distribution of cases by clinical stage (CS) was as follows: CS I 15%, CS II 8%, CS III 17%, and CS IV 60%. In terms of access to first-line systemic management in the 139 patients with advanced kidney cancer who were candidates for treatment, 29% received treatment with a single-drug tyrosine kinase inhibitor (TKI), 4% were treated with combined or single-drug immunotherapy (IO), and 12% were treated with TKI combined with IO. Fifty-five percentages of patients with the advanced disease did not have access to standard first-line therapy, and the rate of loss to medical follow-up was 69% of cases. Conclusions: Despite the proven oncological benefit of the latest generation of therapies based on IO/IO or IO/TKI for mRCC, access to first-line standard management is still poor in our country.
Managing recurrent cutaneous squamous cell carcinoma (cSCC) usually requires a multidisciplinary approach. A 74-year-old male presented a nodular lesion on the posterior skull. The lesion was resected, and the specimen was classified as a cSCC. Posteriorly, the patient presented recurrent disease. He underwent a craniectomy and a skin flap that was taken from the dorsal skin. Due to adverse pathological characteristics, a radiotherapy regimen consisting of 66 Gy in 33 fractions was administered. After radiotherapy, a complete clinical response was documented. These promising novel treatments for recurrent cSCC still need to be explored in prospective clinical trials.
Primary sarcomas of the cervix are rare neoplasms. Of all diagnosed cervical sarcomas, leiomyosarcomas correspond to 21% of cases. A 43-year-old woman presented with vaginal bleeding, and a pelvic ultrasound showed an image suggestive of a myoma during her approach. She underwent hysterectomy plus salpingo-oophorectomy, and the pathology study reported a high-grade leiomyosarcoma originating from the endocervix. Management with adjuvant radiotherapy was decided on, and 12 months later, she presented a recurrence of the disease, and chemotherapy was started. There is no established optimal treatment, and the available evidence is scarce.
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