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M J Roca

Publications and source records attributed to M J Roca.

12 recordsLinked to original sources

Factors causing early relapse after lung metastasis surgery.

Haematogenous lung metastases are usually considered a sign of widespread metastatic disease. However, in most primary cancers, the first filter for distant tumours are the lungs. In some patients, the metastatic process may stop at the lungs. In these selected patients, there are studies that have shown the benefits of metastasectomy. The objective of this paper is to analyse the morbidity and mortality of lung metastasectomy and determine the factors that predispose to early relapse. Forty-two patients operated on for lung metastases, and four were excluded as they were assessed intraoperatively to be unresectable, leaving 38 patients to be analysed. The variables analysed were: age, sex, primary tumour, disease-free interval, number of metastases, bilaterality, morbidity and mortality, relapse, reinterventions, relapse-free interval after metastasectomy and survival. The surgical technique was a posterolateral thoracotomy, and there were no perioperative deaths. Morbidity was 11% (n = 4), and surgical reintervention of the haemothorax was necessary. Survival after 1, 2 or 3 years was 87%, 61% and 25% respectively, and the percentage of relapse-free patients was 71%, 56% and 17% respectively. The main factors associated with early relapse were histological type of tumour (more relapse in sarcoma, and less in adenocarcinoma), the disease-free interval between the primary tumour and lung metastases, and the number of metastases. Surgery was required a second time in five patients who had relapsed lung metastases, but extirpation could be performed in only four patients, of whom three were relapse free after 6, 12 and 24 months respectively, and the fourth had relapsed lung metastases after 18 months. Resection of lung metastases can be performed with low morbidity and mortality. The main prognostic factors for survival are complete surgery, histological type, disease-free interval between the primary tumour and metastases, and the number of lung metastases.

Adult↗

Prognostic factors in thymic epithelial neoplasms.

OBJECTIVES: The primary thymic epithelial neoplasms (PTENs) are uncommon tumours with a broad spectrum of both biological and morphological features. The aim of this study is to analyse the prognostic factors that influence survival. METHODS: Forty-four patients with a complete follow-up were analysed. Nine patients (20.5%) were asymptomatic, the most common symptoms in the rest being myasthenia gravis and dyspnoea. All the patients underwent surgery, 30 cases (68.2%) receiving total thymectomy and the rest a partial resection or biopsy. Marino-Müller's histological classification showed the mixed type to be the most common (52.3%). Clinical staging was done according to the Masaoka classification, which gave the most common stage as stage III (34.1%). RESULTS: Twelve patients died during a mean follow-up of 8.2 +/- 3.5 years. The accumulated survival rate was 77% at 5 years and 60% at 10 years. Analysis of the survival curves shows significant differences (P<0.05) when considering surgical technique, clinical staging and histological subtype. The multivariate analysis shows the only parameters with prognostic significance in PTENs to be clinical staging and histological type (P<0.001). CONCLUSIONS: The most important prognostic factors in PTENs are Masaoka's clinical staging and Marino-Müller's histological subtype.

Adolescent↗

High-performance liquid chromatographic screening of chlorophyll derivatives produced during fruit storage.

Reversed-phase high-performance liquid chromatography with photodiode array and fluorescence detection was applied to the systematic screening of chlorophylls and derivative pigments. The chromatographic procedure proposed made it possible to successfully separate and identify eight chlorophyll derivatives (the a and b forms of chlorophyll, chlorophyllide, pheophytin and pheophorbide) by using a linear gradient of methanol, acetone and ammonium acetate. The method has been routinely applied to study chlorophyll degradation during the postharvest storage of cherimoya (Annona cherimola, Mill.) fruits. The brilliant green colour even at maturity, and its high chlorophyllase and Mg-dechelating activities, indicate that this plant material might be suitable for investigating the as yet not well known chlorophyll breakdown processes.

Chlorophyll↗

[Corynebacterium pseudotuberculosis adenitis in a shepherd].

Corynebacterium pseudotuberculosis causes suppurative lymphadenitis in sheep and other domestic animals. Human infection has been reported in few instances. We report on a case of Corynebacterium pseudotuberculosis lymphadenitis in a human being. A 34-years old previously healthy shepherd was attended for presenting a painful lymph node in right groin with one year of evolution. Cultures of an aspirate and ganglionar tissue yielded growth of Corynebacterium pseudotuberculosis in pure culture. Histological examination of the excised lymph node showed a suppurative granulomatous lymphadenitis with areas of necrosis in which there were clusters of bacillary organisms. After surgical excision and administration of erythromycin clinical signs disappeared without complications. We have carried out a review of the literature and we have found no case reported in Spain. Corynebacterium pseudotuberculosis lymphadenitis in human beings is a rare entity that principally affects persons in contact with animals, principally sheep. Most cases have been reported in Australia. In accordance with the reviewed literature this is the first time this disease is reported in Spain. Corynebacterium pseudotuberculosis infection should be considered in the differential diagnosis of localized granulomatous lymphadenitis.

Adult↗

[Traumatic hemothorax treated by video-assisted thoracoscopic surgery].

The introduction of video-assisted thoracic surgery (VTS) has significantly furthered the use of the thoracoscope in surgery. In the case we describe, a 79-years-old man at high risk for surgery came to our hospital with hemothorax due to trauma. The necessary procedure was performed successfully with VTS, which allowed for the repair of an acute condition that would otherwise have been treated conventionally by way of posterolateral thoracotomy. We conclude that VTS may play an important role in the diagnosis and treatment of certain thoracic injuries, so that surgery involving more extensive bleeding is rendered unnecessary.

Accidental Falls↗

[Primary thymic lymphomas].

INTRODUCTION: Primary thymic lymphomas (PTLs) are uncommon, and their prognosis is linked with early treatment. A review is carried out of this disease in our hospital in order to determine the best diagnostic-therapeutic management for these patients. MATERIAL AND METHODS: Ten LPTs--four Hodgkin's and six non-Hodgkin's (4 primary mediastinal B lymphomas [PMBLs] and 2 lymphoblastic T lymphomas [LTLs]--were reviewed. Most of the patients were females, with a mean age of 23 +/- 10 years. RESULTS: The initial diagnostic suspicion in the Hodgkin's lymphomas was thymoma in two cases and lymphoma in the other 2. All of them underwent surgery, including an intra-operative biopsy, which was completed with a thymectomy in the two in which thymoma was reported. They were treated with radio and chemotherapy. The response was partial in two cases, and treatment was completed with a bone marrow transplant (BMT) (one died and the other had active disease). The non-Hodgkin's lymphomas had large tumors and short evolution. All of them received surgery, with an intra-operative biopsy in four and a thymectomy in two. They were treated with chemotherapy, with associated radiotherapy in two. The response was total in three, with two recurring, who are in complete remission after a BMT. In the other three the response was partial. CONCLUSIONS: In a patient with thymic tumour with a preoperative or intraoperative study suspected of having a lymphoma, it is necessary to do a biopsy and not resective surgery, to avoid unnecessary resections and morbidity. PTLs are uncommon but aggressive, principally the non-Hodgkin's lymphomas. The main treatment is radio and chemotherapy, with associated bone marrow transplantation in selected cases.

Adolescent↗