Villafañe, A. (Amaya)
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- The ELECLA trial: A multicentre randomised control trial on outcomes of neoadjuvant treatment on locally advanced colon cancer(John Wiley & Sons, 2024) Pastor, C. (Carlos); Almeida, A. (Ana); Villafañe, A. (Amaya); Baixauli-Fons, J. (Jorge); Sanchez-Justicia, C. (C.); Tejedor, P. (Patricia); Arredondo, J. (Jorge); Simó, V. (Vicente); Rodríguez-Rodríguez, J. (Javier); Castañón, C. (Carmen)Background: Colon cancer (CC) is a public health concern with increasing incidence in younger populations. Treatment for locally advanced CC (LACC) involves oncological surgery and adjuvant chemotherapy (AC) to reduce recurrence and improve overall survival (OS). Neoadjuvant chemotherapy (NAC) is a novel approach for the treatment of LACC, and research is underway to explore its potential benefit in terms of survival. This trial will assess the efficacy of NAC in LACC. Methods: This is a multicentre randomised, parallel-group, open label controlled clinical trial. Participants will be selected based on homogenous inclusion criteria and randomly assigned to two treatment groups: NAC, surgery, and AC or surgery followed by AC. The primary aim of this study is to evaluate the 2-year progression-free survival (PFS), with secondary outcomes including 5-year PFS, 2- and 5-year OS, toxicity, radiological and pathological response, morbidity, and mortality. Discussion: The results of this study will determine whether NAC induces a clinical and histological tumour response in patients with CCLA and if this treatment sequence improves survival without increasing morbidity and mortality.
- Combined transanal minimally invasive surgery (TAMIS) and retroperitoneal laparoscopy for resection of lymph node recurrence of ovarian cancer(2018) Pastor, E. (Enrique); Fuentes, S. (Silvia); Diago, M. V.; Corona, A.; Lorenzo, E.; Villafañe, A. (Amaya); Padilla, L.; Lelpo, B. (Benedetto); Arredondo, J. (Jorge); Simó, V. (Vicente); Orille, V.To our knowledge no cases of transanal minimally invasive surgery (TAMIS) combined with retroperitoneal laparoscopy for resection of lymph node recurrence have been described in the literature. We report a case of resection of mesorectal and para-aortic lymph node recurrence of primary ovarian cancer performed with retroperitoneal laparoscopy and TAMIS. A 66-year-old female, diagnosed in December 2014 with stage IIa ovarian adenocarcinoma had cytoreductive surgery at that time, achieving a R0 resection (complete hysterectomy with bilateral ovariectomy, pelvic peritonectomy with standard lymphadenectomy and supramesocolic omentectomy). Surgery was followed by adjuvant treatment. On November 2017, a computed tomography scan revealed lymph node recurrence in the left para-aortic nodes (2.5 cm diameter on CT) and mesorectal space (2.8 cm diameter) at 10 cm from the anal verge. After a multidisciplinary session, both nodes were resected (see attached video). The para-aortic node was resected using retroperitoneal laparoscopy and the mesorectal node resected using a TAMIS approach [1,2,3]. The postoperative course was uneventful and the patient was discharged 5 days after surgery. Histopathological examination of the two nodes revealed undifferentiated serosal adenocarcinoma of the ovary. No recurrence was found at 1-year follow-up. Combination of different minimally invasive approaches is a safe alternative to conventional surgery for resection of lymph node recurrence that surgeons should be aware of.
- Rectal cancer treatment by transanal total mesorectal excision: Results in 100 consecutive patients(2019) Hernán, C. (Cristina); Pastor, E. (Enrique); Fernández, J. (Jesús); Villafañe, A. (Amaya); Lelpo, B. (Benedetto); Arredondo, J. (Jorge); Simó, V. (Vicente); Jiménez, L. M. (Luis Miguel)Introduction The aim of this study is to describe and evaluate our clinical short-term surgical results of laparoscopic transanal total mesorectal excision. Methods Analysis of 100 consecutive patients with mid and lower rectal cancer who underwent transanal total mesorectal excision from November 2013 to September 2018. Main outcomes described are operative data, morbidities, mortality and quality of the specimen. A comparative analysis was done between gender and simultaneous versus non simultaneous abdominal-perineal surgery. Results Mean patient age was 67 years (56–75), and 67% were male. On MRI, 50% were stage T3 tumors, and 52% had positive nodes. Mean distance of the tumor from anal verge was 4.9±1.3cm. A total of 58% underwent neoadjuvant treatment. Mean operative time was 262±40.7min; it was shorter in females (P<.001) and in simultaneous 2-field surgery. Median specimen distal free margin was 1.5cm (0.5–2.4). A total of 89% of the specimens were with complete mesorectum, with better results when a simultaneous approach was used (P=.047). The mean number of retrieved lymph-nodes was 15.2±11.6, and 26% of patients had positive nodes. Median length of stay was 5.5 days (4–8). Morbidities occurred in 36% of cases, and one patient died. Conclusions According to our experience, laparoscopic transanal total mesorectal excision is safe and effective with adequate circumferential and distal free margins and high quality of the resected mesorectum specimen. Post-operative morbidity is acceptable, according to the current literature.