News and updates in the treatment of localized stage triple-negative breast cancer

Compared to other breast cancer subtypes, triple-negative breast cancer presents a worse prognosis and higher mortality. Even in localized stages, the risk of relapse is high, especially in patients with ≥ cT2 and/or ≥ cN1. We know that those patients who achieve a complete pathologic response after neoadjuvant treatment have better disease-free survival. Therefore, many research efforts have been made to try to optimize neoadjuvant chemo/immunotherapy to increase pathologic complete response rates. The available evidence related to that subject matter is summarized in this article. In the field of adjuvant therapy, the challenge of improving disease-free survival in those patients who do not achieve pathologic complete response after neoadjuvant therapy stands out. The second part of this article will deal with the challenges inherent to this issue

Two-center experience comparing the use of the FLOT4 and CROSS schemes for patients with gastric, esophageal, and gastroesophageal junction adenocarcinoma

Introduction. Gastric (GAD), gastroesophageal junction (GEJA), and esophageal adenocarcinoma (EAD) share pathophysiological features. At localized stages, FLOT is used perioperatively for the treatment of GAD and GEJA and CROSS for EAD and some GEJA. Although both therapies have been compared with MAGIC, comparative randomized data on FLOT and CROSS are not yet available. Material andmethods. We retrospectively analyzed and compared 40 patients treated with FLOT and 16 patients treated with CROSS in terms of clinical features and neoadjuvant, surgical, adjuvant, and survival outcomes. Results. At the time of analysis, 65% of patients treated with FLOT4 and 56.3% with CROSS remained in complete remission. Those who progressed after FLOT4 did so mainly at the peritoneal level (25%) and after CROSS at the bone, lymph node, and peritoneal levels (12.5% respectively). Six patients (37.5%) died after CROSS (median OS of 17.5 months; 95% CI 2–41) and 10 (25%) after FLOT4 (median OS 16.5 months; 95% CI 11–22). For the living patients, the median numbers of months from diagnosis to the follow-up cutoff date were 47.5 (95% CI 11–67) and 27 (95% CI 14–44) for CROSS and FLOT4, respectively. There were no significant differences in median OS estimated by Kaplan Meier analysis [FLOT4: 50 ± 4.6 months (95% CI 40.9–59.2); CROSS: 51.2 ± 7 months (95% CI 37.4–65.0; p = 0.79)].  Conclusions. Although we obtained lower pCR rates; TNM downstaging after neoadjuvant therapy, R0 rates, tolerance, PFS, and OS were similar in both groups and comparable with trial results. The adjuvant compliance rate was high with FLOT4. CROSS allows sequencing with nivolumab in PD-L1+ tumors

Cobertura de la Dirección Nacional de Seguridad Ocupacional de la CSS de Panamá.

67 p.La presente investigación tiene como objetivo conocer la Cobertura de la Dirección Nacional de Seguridad Ocupacional de la CSS de Panamá como base para proponer estrategias que optimicen sus resultados en términos de la seguridad laboral de los trabajadores de las empresas públicas y privadas. Para cumplir con ello se ha realizado una descripción de la rendición de cuenta de esta dependencia y su funcionamiento a través de unidades operativas. Se aplicó también una encuesta a personal de las diferentes unidades para conocer sus opiniones en cuanto a los alcances de los servicios que prestan a los trabajadores. Esta investigación es de tipo mixto. Es decir se enfoca desde una complejidad que requiere de aspectos cualitativos y cuantitativos para alcanzar su objetivo, de conocer la cobertura de la Dirección Nacional de Seguridad Ocupacional de la CSS de Panamá. Se inicia con la descripción de los programas o áreas de atención de esta unidad y las actividades de prevención e intervención de la salud ocupacional que realizan para cumplir con su misión. A partir de estos hallazgos se realizará el análisis de las variables y dimensiones que inciden en su funcionalidad para finalmente comprender su alcance y dar respuesta a la interrogante de investigación que ha originado el presente estudio y su posterior alternativa de. Por último se clasificó la información seleccionada para la elaboración de las conclusiones y de la propuesta final. Palabras Claves: Dirección Nacional de Seguridad Ocupacional, Caja del Seguro Social de Panamá, Cobertura.The present investigation has as objective to know the Coverage of the National Direction of Occupational Security of the CSS of Panama as a base to propose strategies that optimize their results in terms of the labor security of the workers of the public and private companies. In order to comply with this, a description has been made of the accountability of this dependency and its operation through operational units. A survey was also applied to personnel of the different units to find out their opinions regarding the scope of the services they provide to the workers. This investigation is of a mixed type. That is, it is focused on a complexity that requires qualitative and quantitative aspects to achieve its objective, of knowing the coverage of the National Occupational Safety Directorate of the CSS of Panama. It begins with the description of the programs or areas of attention of this unit and the activities of prevention and intervention of the occupational health that they carry out to fulfill their mission. Based on these findings, an analysis of the variables and dimensions that affect its functionality will be performed to finally understand its scope and answer the research question that originated this study and its subsequent alternative. Finally, the information selected for the elaboration of the conclusions and the final proposal was classified KeyWords: National Directorate of Occupational Safety, Social Security Fund of Panama, Coverag

Cobertura de la Direcci?n Nacional de Seguridad Ocupacional de la CSS de Panam?.

67 p.La presente investigaci?n tiene como objetivo conocer la Cobertura de la Direcci?n Nacional de Seguridad Ocupacional de la CSS de Panam? como base para proponer estrategias que optimicen sus resultados en t?rminos de la seguridad laboral de los trabajadores de las empresas p?blicas y privadas. Para cumplir con ello se ha realizado una descripci?n de la rendici?n de cuenta de esta dependencia y su funcionamiento a trav?s de unidades operativas. Se aplic? tambi?n una encuesta a personal de las diferentes unidades para conocer sus opiniones en cuanto a los alcances de los servicios que prestan a los trabajadores. Esta investigaci?n es de tipo mixto. Es decir se enfoca desde una complejidad que requiere de aspectos cualitativos y cuantitativos para alcanzar su objetivo, de conocer la cobertura de la Direcci?n Nacional de Seguridad Ocupacional de la CSS de Panam?. Se inicia con la descripci?n de los programas o ?reas de atenci?n de esta unidad y las actividades de prevenci?n e intervenci?n de la salud ocupacional que realizan para cumplir con su misi?n. A partir de estos hallazgos se realizar? el an?lisis de las variables y dimensiones que inciden en su funcionalidad para finalmente comprender su alcance y dar respuesta a la interrogante de investigaci?n que ha originado el presente estudio y su posterior alternativa de. Por ?ltimo se clasific? la informaci?n seleccionada para la elaboraci?n de las conclusiones y de la propuesta final. Palabras Claves: Direcci?n Nacional de Seguridad Ocupacional, Caja del Seguro Social de Panam?, Cobertura.The present investigation has as objective to know the Coverage of the National Direction of Occupational Security of the CSS of Panama as a base to propose strategies that optimize their results in terms of the labor security of the workers of the public and private companies. In order to comply with this, a description has been made of the accountability of this dependency and its operation through operational units. A survey was also applied to personnel of the different units to find out their opinions regarding the scope of the services they provide to the workers. This investigation is of a mixed type. That is, it is focused on a complexity that requires qualitative and quantitative aspects to achieve its objective, of knowing the coverage of the National Occupational Safety Directorate of the CSS of Panama. It begins with the description of the programs or areas of attention of this unit and the activities of prevention and intervention of the occupational health that they carry out to fulfill their mission. Based on these findings, an analysis of the variables and dimensions that affect its functionality will be performed to finally understand its scope and answer the research question that originated this study and its subsequent alternative. Finally, the information selected for the elaboration of the conclusions and the final proposal was classified KeyWords: National Directorate of Occupational Safety, Social Security Fund of Panama, Coverag