Oncology Journal (Ecuador)

Evolution of Lung Cancer Management

Jorge Moncayo Cervantes — 2025-08-06

Lung cancer is the malignant neoplasm with the highest incidence worldwide according to the 2022 Globocan [1]. Of all malignant neoplasms, in men, it ranks first with 15.2%; in women, second with 9.4%, thus becoming a public health problem. Unfortunately, most of the patients are diagnosed at advanced and metastatic stages. The traditional view divided it into two major groups: Non-Small Cell Lung Cancer and Small Cell Lung Cancer. The first included squamous type, adenocarcinoma, and large cells. In this context, the treatment was based on systemic chemotherapy with platinum salts around 1978, and then other drugs such as taxanes, Gemcitabine, and Vinorelbine were added. By the year 2000, the median survival had increased from 4 to 10 months, and the overall survival rate reached only 5% at 5 years [2]. Later, better understanding of molecular biology allowed the discovery of certain genetic anomalies at the cellular level of adenocarcinoma-type tumors, such as mutations, rearrangements, and amplifications, which conferred specific characteristics to their biological behavior and enabled the use of targeted therapies according to the alterations presented.

Migration of an Implanted Venous Catheter Fragment as an Unexpected Cause of Cough: A Case Report

Walter Alexis Encalada Collahuazo — 2025-08-06

Introduction: Oncology patients use implantable central venous catheters for long-term venous access. Although generally safe, they may present mechanical complications such as fracture and migration, which can lead to atypical symptoms like chronic cough. Case report: We describe a patient with stage IIA infiltrating ductal carcinoma of the breast, Luminal B subtype, who first received neoadjuvant chemotherapy with doxorubicin and cyclophosphamide and then weekly paclitaxel before having a radical mastectomy. She later underwent a radical mastectomy. The central venous catheter, placed for treatment, fractured and migrated with an 11 cm fragment lodged in the right ventricle and atrium. The patient presented with chronic cough as the only symptom. The patient did not receive anticoagulation or undergo prior echocardiography. A right heart catheterization was carried out under neuroleptic sedation and local anaesthesia, successfully retrieving the fragment using a multi-snare loop catheter. Conclusion: Fracture and migration of central venous catheters are rare but potentially serious complications that should be considered in patients with nonspecific symptoms such as cough. Retrieval via cardiac catheterization is an effective and safe treatment.

Resection of Mandibular Tumor of Odontogenic Myxoma Type, A View on Modern Surgery: Case Report

Saulo Hernán Pineda Ovalle — 2025-08-06

Introduction: Odontogenic myxoma (OM) is a benign, locally invasive neoplasm that affects the maxillomandibular complex and has a high recurrence rate. It accounts for an average of 8.3% of odontogenic tumors. Its clinical course is usually asymptomatic in the early stages; however, it may present with pain, paresthesia, tooth mobility, and limitations in mastication and swallowing in more advanced stages. Diagnosis includes imaging studies such as computed tomography (CT) and magnetic resonance imaging (MRI), which typically reveal multilocular radiolucent lesions described as having a "soap bubble" or "honeycomb" appearance. Due to the asymptomatic nature of the lesion, diagnosis is often delayed. Case report: We report the case of a 15-year-old male patient with no relevant medical history, presenting with a space-occupying lesion in the right mandibular body and ramus. Imaging studies raised the diagnostic suspicion of a possible odontogenic myxoma. Histopathological examination revealed a low-grade spindle cell tumor with extensive myxoid transformation, focal atypia, and no necrosis. Given the extension of the tumor, age of the patient, and degree of invasion, a wide surgical resection with safety margins was performed, followed by mandibular reconstruction using a custom-designed prosthesis based on three-dimensional imaging and a vascularized free fibula flap. Discussion: Extensive mandibular myxomas require a multidisciplinary approach and meticulous, individualized preoperative planning aimed at achieving optimal functional, aesthetic, and oncologic outcomes. Conclusion: This case highlights the importance of applying three-dimensional imaging technologies in the reconstructive surgery of complex maxillofacial lesions.

Malnutrition Associated with Oncohematologic Diseases in Health Institutions of Ecuador

Dolores Rodríguez Veintimilla — 2025-08-06

Introduction: Malnutrition continues to be a common finding in hospitalized cancer patients in Ecuador. The objective of this study was to determine the magnitude of malnutrition associated with onco-hematological disease (OHD) in a series of hospitals in the country. Methodology: A cross-sectional prevalence study (Ecuadorian Study of Malnutrition in Oncology) was conducted in five hospitals in the provinces of Guayas (3), Manabí (1), and Azuay (1). A total of 390 patients with a confirmed diagnosis of cancer (63,6 % women; 36,4 % men) with a mean age of 55,3 ± 16,5 years were included; 47,2% were >= 60 years old. The most common tumor locations were: kidney and urinary tract, uterus, ovary, prostate, and testicle (18,7%); breast (16,1%); leukemia and lymphoma (15,1%); and large intestine/rectum and anus (15,1%). At the time of the survey, 42,8% pf the OHD patients were receiving chemotherapy. Each participant was interviewed, the Subjective Global Assessment (SGA) was applied, and anthropometric measurements were taken. All patients classified in categories B (moderate malnutrition/at risk) or C (severe malnutrition) of the SGS were considered malnourished. Results: The overall prevalence of malnutrition was 49,7% (n = 194); 14,4% (n = 56) corresponded to severe malnutrition (category C). No significant associations were observed between nutritional status and age, educational level, tumor location, or cytoreductive treatment (p > 0,05). Malnutrition was more common in men than in women. Conclusions: Approximately one in two cancer patients hospitalized in Ecuador has some degree of malnutrition, and one in seven has severe malnutrition. These findings highlight the need to establish systematic nutritional screening and dietetic support programs in the country's oncology services.

Mortality of Malignant Neoplasms of Digestive Organs in Ecuador, Period 2019-2023

Jhony Joe Real Cotto — 2025-08-27

Introduction: Mortality from malignant neoplasms of the digestive organs is a public health problem with a direct impact on health systems. Objective: To determine the mortality caused by malignant tumors of the digestive organs in Ecuador during the years 2019-2023. Materials and methods: An observational, descriptive, cross-sectional study was conducted using open data on deaths recorded by INEC between 2019 and 2023. Results: According to the ranking of the cumulative mortality rate, the most frequent malignant tumor was stomach cancer (39%), followed by liver and biliary tract cancer (18%), among others, with a 17% increase in colon cancer during the period, with a linear trend R2 of 86% (p: 0.02). A higher age-standardized mortality rate was obtained in men (60.74), mainly in those >= 75 years of age. The provinces with the highest mortality rates were Azuay with 200 deaths, followed by Loja with 187 deaths, and Imbabura with 183 deaths per 100,000 inhabitants. Conclusions: During the study period, mortality from digestive organ tumors was observed to be among the highest in Ecuador, varying according to sex, age, and province, with malignant neoplasms of the stomach and colon being the most representative.

Effect of Early Intervention from Physical Therapy and Health Education on Functional Recovery after Radical Mastectomy: A Systematic Review

Mauricio Rodas Quintero — 2025-09-03

Introduction: Radical mastectomy, used in the treatment of locally advanced breast cancer, is frequently associated with physical and functional sequelae such as lymphedema, pain, limited shoulder mobility, and impaired quality of life. Early intervention through physical therapy and health education has proven to be a key strategy for preventing complications, promoting functional recovery, and improving patient autonomy. Objective: The purpose of this study is to analyze the scientific evidence on the benefits of early physical therapy and health education for post-radical mastectomy patients. Methodology: A systematic review based on a comprehensive search for information on the effect of early intervention with physical therapy and health education on functional recovery after radical mastectomy. The databases reviewed were: PubMed, Physiotherapy Evidence Database (PEDro), Web of Science, Cochrane, Global Cancer Observatory, and Lilacs; publications correspond to the last 10 years. Results: Sixty full- text scientific articles were evaluated, of which 23 met the inclusion criteria related to physical therapy interventions, therapeutic exercises, and health education in post- mastectomy patients. Early physical therapy showed an 85% reduction in postoperative pain, a 75% improvement in joint range of motion, and a 40% reduction in acute lymphedema. Health education increased adherence to rehabilitation treatment and patient autonomy. Conclusions: The combination of early physical therapy and health education strategies significantly improves functional recovery after radical mastectomy. Its implementation in hospital oncology units could contribute to strengthening evidence- based clinical practice.

Disease-free Survival in Locally Advanced Breast Cancer According to Pathological Response to Neoadjuvant Treatment

José Luis Reyes Cáceres — 2025-09-08

Introduction: Neoadjuvant chemotherapy is the standard treatment for locally advanced breast cancer, as it increases rates of breast-conserving surgery and improves disease-free survival (DFS) in patients who achieve a complete pathological response. Methodology: A retrospective observational cohort study was conducted that included 31 patients with locally advanced breast cancer treated with neoadjuvant chemotherapy at the Solón Espinosa Ayala Oncology Hospital (SOLCA-Quito) between 2010 and 2014. Data were obtained from the Hospital Tumor Registry. The 5-year SLE was estimated using the Kaplan-Meier method, and prognostic factors were analyzed using logistic regression. Results: The mean age was 52.5 years. 93.5% presented invasive ductal carcinoma, with 48.5% showing moderate differentiation. The TAC regimen (docetaxel, doxorubicin, and cyclophosphamide) was administered to 96.8% of patients. Complete pathological response (Miller and Payne grade 5) was observed in 12.9%, while the most frequent partial response was grade 3 (48.4%). The 5-year SLE was 64.4%. A Ki-67 proliferation index greater than 14% was found to be associated with a lower SLE (OR: 0.067; 95% CI: 0.05-0.93; p<0.05). Conclusions: The 5-year SLE rate in this cohort was comparable to that reported in the literature. However, the limited sample size restricts the generalizability of- the results, so studies with a larger number of patients are needed to confirm these findings.