Peritoneal sarcomatosis is a rare malignant disease with a poor prognosis, secondary to peritoneal dissemination of abdominopelvic soft tissue sarcomas. Its rarity, together with the characteristic histological heterogeneity and the historically poor response to systemic treatments, has prevented the establishment of widely accepted treatment criteria with curative intent. In this sense, radical cytoreductive surgery (CRS) with peritonectomy procedures and hyperthermic intraperitoneal chemotherapy (HIPEC), widely used in peritoneal carcinomatosis with excellent results, have not had the same evolutionary development in patients with peritoneal sarcomatosis. A multidisciplinary working group of experts in sarcomas and peritoneal oncological surgery established a series of recommendations based on current scientific evidence for the management of peritoneal sarcomatosis, taking into account the different histological subgroups of abdominopelvic sarcomas that can cause it depending on their origin: retroperitoneal sarcomas, uterine sarcomas, and visceral/peritoneal sarcomas of GIST (gastrointestinal stromal tumor) and non-GIST origin. This article shows the results of sarcoma experts’ voting on the recommendations presented during the I Ibero-American Consensus on the Management of Peritoneal Sarcomatosis, which took place during the recent celebration of the III Hispanic-Portuguese Meeting for Updates on the Treatment of Sarcomas.

PURPOSE: To better understand immigration disparities among a Spanish Early-Onset Colorectal Cancer (SECOC) subset, according to the country of origin. PATIENTS AND METHODS: We selected 250 consecutive participants from the SECOC consortium. Data on baseline patient and tumor characteristics, family history of colorectal cancer (CRC), and follow-up were collected. The presence of mismatch repair deficiency was also assessed. Special data regarding country of origin, time of stay in Spain in case of other different country, and a 10-year cutoff that specifies the obtaining of Spanish nationality defined the variables of interest for comparison. RESULTS: Seventy-five percent of patients with early-onset CRC (EOCRC) (188) were born in Spain, whereas the other 25% were born outside of Spain. The mean time of living in Spain until the EOCRC diagnosis was 16.5 years. Comparatively, most of the analyzed features showed equivalent proportions between cohorts. Only Spanish patients appeared to have more familial cancer component in first degree in general (32.3%; P = .01), compared with non-Spaniards, which showed a predominant sporadic component (56.4%; P < .001). Among immigrants, those patients living in Spain before CRC diagnosis ≤10 years were younger at diagnosis (39.1 v 42.5), more frequently male (77.8 v 47.7), were in more advanced stages (88.8% diagnosed at stage III and IV [ P = .01]), and had a worse prognosis regarding recurrence rates (29.4% v 6.3%). CONCLUSION: Although there were few differences between Spanish and non-Spanish EOCRC, the most remarkable difference was that linked with the situation of those immigrants who have recently arrived in Spain, in relation to their lower health coverage, which could be associated with the delay in the diagnosis and their subsequent worse prognosis.

El tratamiento quirúrgico durante la pandemia de COVID-19 es controvertido. Actualmente, la mayoría de las guías clínicas recomiendan posponer la cirugía a los pacientes durante la pandemia de COVID-19, aunque los datos de apoyo son escasos. Asumimos que un hospital sin COVID-19, apoyado en fuertes medidas de aislamiento y exámenes de detección específicos, podría reducir las complicaciones y nos permitiría continuar tratando a pacientes de alto riesgo. Estudio prospectivo con análisis retrospectivo de 355 pacientes sometidos a cirugía oncológica no diferible entre el 16 de marzo de 2020 y el 14 de abril de 2020 en nuestra institución. El objetivo del estudio fue valorar la reestructuración hospitalaria y de los protocolos quirúrgicos para poder manejar con seguridad las cirugías no diferibles durante la primera ola de pandemia por COVID-19. Implementamos cambios estructurales y un protocolo anestésico-quirúrgico actualizado para aislar a los pacientes con COVID-19 de otros pacientes quirúrgicos. Se realizó una evaluación exhaustiva dirigida a detectar pacientes con COVID-19. Se solicitaron pruebas de PCR para pacientes sospechosos de COVID-19. Analizamos la mortalidad y las complicaciones relacionadas tanto con la cirugía como con la COVID-19 durante el ingreso hospitalario y también a los 15 días y al mes de la cirugía. Comparamos nuestros resultados con una muestra de pacientes similar en el periodo pre-pandemia. De los 355 pacientes incluidos en nuestro estudio, 21 fueron eliminados debido a la infección por COVID-19, lo que deja un total de 334 pacientes en nuestro análisis final. Se encontraron complicaciones postoperatorias en 37 pacientes (11,07%). Dos pacientes fallecieron tras la cirugía (0,6%). Al final del estudio se detectaron resultados adversos relacionados con COVID-19 en 6 pacientes (1,79%). Al comparar las complicaciones de nuestra muestra original con las que ocurrieron en la era pre-COVID-19, no encontramos diferencias estadísticamente significativas. Nuestros resultados muestran que el tratamiento quirúrgico de los pacientes oncológicos durante la pandemia de COVID-19 es seguro, siempre que el hospital realice cirugías bajo estrictas medidas de aislamiento y un método de detección robusto. Es necesario seleccionar hospitales libres de COVID-19 con este objetivo en esta y futuras pandemias.