Person: Fernández Arancibia, Mario
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Fernández Arancibia
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Mario
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Mario Fernández Arancibia
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Publication Comparative Analysis of Very Reduced vs Full Dose BCG Treatment for High-RiskNon-Muscle Invasive Bladder Cancer:A Contemporary Experience from Chile(2023) Grajales, Valentina; Contieri, Roberto; Tan, Wei Shen; Flores, Marta; Schultz, Marcela; Pinochet, Rodrigo; Bustamante, Alberto; Kamat, Ashish; Mario Fernandez; Fernández Arancibia, MarioBACKGROUND:Adjuvant bacillus Calmette-Gu ́erin (BCG) is recommended for high-risk (HR) non-muscle invasivebladder cancer (NMIBC), but BCG shortages have led to exploration of reduced-dose regimens and shortened maintenancedurations out of necessity, with limited data on treatment efficacy in Latin America.OBJECTIVE:Oncological outcomes of HR-NMIBC patients treated with reduced (RD,1/4th dose) vs full dose (FD) BCGinstillations ofDanish Strain1331 BCG.METHODS:We performed a retrospective study of HR-NMIBC patients treated with BCG between 2003 and 2022 at ourcenter in Santiago Chile. We stratified patients according to either RD (1/4th dose) or FD BCG. Univariate and multivariableCox regression models were used to predict recurrence. Kaplan-Meier method was used to calculate survival estimates.RESULTS:Of a total of 200 patients, 116 (58%) had RD and 84 (42%) FD BCG. Median follow-up was 57 months (IQR:29–100). Patients who received FD BCG had a lower risk of recurrence (HR: 0.41, 95% CI 0.22–0.74) and high-grade(HG)-recurrence (HR: 0.30, 95% CI 0.15–0.61;p= 0.001). More patients in the RD vs FD group progressed to MIBC (10/84vs 2/116;p= 0.18). Additionally, patients were less likely to stop BCG treatment in the RD group compared to the FD groupdue to toxicity (5% vs 11%,p= 0.14).CONCLUSIONS:A 1/4th dose ofDanish Strain1331 BCG treatment was associated with worse recurrence free rate andHG-recurrence rate in our cohort. Patients with RD had lower discontinuation treatment rates due to a reduced toxicity profile.These findings would suggest that RD BCG would compromise oncological outcomes in HR-NMIBC patients.Publication Mortalidad por cáncer de próstata en Chile: tendencias del período 1955-2019(2022) López, J. Francisco; Fernández Arancibia, Mario; Coz, FernandoBackground: Prostate cancer is the tumor with the highest incidence among men and one of Chile's leading causes of death. Aim: To analyze temporal trends in prostate cancer mortality in Chile. Material and Methods: Mortality rates in Chile for the period between 1955 and 2019 were calculated. The number of deaths was obtained from the national demographic yearbooks and the Ministery of Health mortality registries. Population estimates from the demographic center of the Economic Commission for Latin America and the Caribbean of the United Nations were used. Chilean census population of 2017 was used as reference to calculate adjusted rates. Trends were analyzed using a join point regression. Results: Crude mortality rates of prostatic cancer increased between 1995 and 2012 in three different phases, namely between 1955 and 1989 with a 2.7% annual increase, between 1989 and 1996 at a 6.8% annual rate, and between 1996 to 2012 with a 2.8% annual increase. From 2012 the rate remained stable. Adjusted mortality rates increased slowly at a 1.7% rate from 1955 to 1993, accelerating between 1993 and 1996, when they increased 12.1% per year. From 1996 onwards there was a significant decrease in mortality at a 1.2% annual rate. This decrease was significant and observed within all age groups but more importantly at older ages. Conclusions: Prostate cancer mortality in Chile has decreased significantly during the last two decades, like that observed in developed nations.