Rene Pareja - Academia.edu (original) (raw)

Papers by Rene Pareja

Research paper thumbnail of Quality of laparoscopic radical hysterectomy in developing countries: A comparison of surgical and oncologic outcomes between a comprehensive cancer center in the United States and a cancer center in Colombia

Gynecologic Oncology, 2012

Objective-To help determine whether global collaborations for prospective gynecologic surgery tri... more Objective-To help determine whether global collaborations for prospective gynecologic surgery trials should include hospitals in developing countries, we compared surgical and oncologic outcomes of patients undergoing laparoscopic radical hysterectomy at a large comprehensive cancer center in the United States and a cancer center in Colombia. Methods-Records of the first 50 consecutive patients who underwent laparoscopic radical hysterectomy at The University of Texas MD Anderson Cancer Center in Houston (between April 2004 and July 2007) and the first 50 consecutive patients who underwent the same procedure at the Instituto de Cancerología-Clínica las Américas in Medellín (between December 2008 and October 2010) were retrospectively reviewed. Surgical and oncologic outcomes were compared between the 2 groups. Results-There was no significant difference in median patient age (US 41.9 years [range 23-73] vs. Colombia 44.5 years [range 24-75], P=0.09). Patients in Colombia had a lower median body mass index than patients in the US (24.4 kg/m 2 vs. 28.7 kg/m 2 , P=0.002). Compared to patients treated in Colombia, patients who underwent surgery in the US had a greater median estimated

Research paper thumbnail of Safety of minimally invasive radical hysterectomy in cervical tumors 2 cm

International Journal of Gynecologic Cancer

Research paper thumbnail of Immediate radical trachelectomy versus neoadjuvant chemotherapy followed by conservative surgery for patients with stage IB1 cervical cancer with tumors 2 cm or larger: a literature review and analysis of oncological and obstetrical outcomes

Gynecologic oncology, Jan 28, 2015

Radical trachelectomy is the treatment of choice in women with early-stage cervical cancer wishin... more Radical trachelectomy is the treatment of choice in women with early-stage cervical cancer wishing to preserve fertility. Radical trachelectomy can be performed with a vaginal, abdominal, or laparoscopic/robotic approach. Vaginal radical trachelectomy (VRT) is generally not offered to patients with tumors 2 cm or larger because of a high recurrence rate. There are no conclusive recommendations regarding the safety of abdominal (ART) or laparoscopic radical trachelectomy (LRT) in such patients. Several investigators have used neoadjuvant chemotherapy in patients with tumors 2 to 4 cm to reduce tumor size so that fertility preservation may be offered. However, to our knowledge, no published study has compared outcomes between patients with cervical tumors 2 cm or larger who underwent immediate radical trachelectomy and those who underwent neoadjuvant chemotherapy followed by radical trachelectomy. We conducted a literature review to compare outcomes with these 2 approaches. Our main e...

Research paper thumbnail of Asociación de infección con virus epstein-barr y cáncer de cuello uterino en mujeres del departamento de antioquia

Revista Colombiana de Cancerología, 2013

ABSTRACT Introducción El virus del papiloma humano de alto riesgo (VPH-AR) es la causa necesaria ... more ABSTRACT Introducción El virus del papiloma humano de alto riesgo (VPH-AR) es la causa necesaria de cáncer cervicouterino (CACu). El virus Epstein-Barr (VEB) es considerado un carcinógeno para humanos y se ha detectado en biopsias de CaCu. Objetivo Estimar el riesgo de cáncer cervical asociado a la infección por virus de Epstein-Barr. Materiales y métodos Se incluyeron 96 mujeres con diagnóstico de CaCu obtenido mediante biopsia dirigida por colposcopia y 186 mujeres con citología normal o lesiones intraepiteliales de bajo grado, emparejadas con los casos por edad. Información sobre factores de riesgo (edad de la primera relación sexual, número de parejas sexuales, número de hijos, uso de anticonceptivos orales, historia de tabaquismo y el uso del condón) se recogió mediante cuestionario previamente estandarizado. El VPH se detectó con la PCR GP5+/GP6+ e hibridación inversa con sondas específicas para 40 genotipos. El VEB se detectó mediante PCR de un segmento de la región W BamHI que contiene parte del antígeno nuclear 2 de VEB. Razones de Odds (OR) y los intervalos de confianza (95%), del riesgo de CaCu asociado a la infección con VPH y VEB, se estimaron por regresión logística no ajustada y ajustada por los factores de riesgo mencionados. También se estimó el riesgo asociado a VEB, incluyendo solamente casos y controles VPH+. Resultados Se observó un mayor riesgo de CaCu asociado con el VPH (OR: 131, IC95%: 47,7–360) y EBV (OR: 6,1, IC95% 2,8–13,1). Restricción del análisis de regresión incluyendo casos y controles VPH+, también mostró un incremento estadísticamente significativo del riesgo asociado a la infección con VEB (OR: 7,13, IC95%, 0,92-150, p = 0,066). En el análisis no restringido, el riesgo asociado a la infección con VEB se redujo al ajustar por otras variables de riesgo. Las variables que tuvieron el mayor efecto sobre esta asociación fueron el número de parejas sexuales y la edad de la primera relación sexual (OR: 3,45: IC95%: 1,29–9,2). Este incremento del riesgo de CaCu asociado a infección con VEB también se observó cuando además de las variables anteriormente mencionadas se incluyó la infección de VPH en el modelo (OR: 3,37, IC95%: 0,72–15,64), pero este estimado no fue estadísticamente significativo. Conclusiones Se observó asociación entre la infección con el virus Epstein-Barr y CaCu, aun después de restringir el análisis entre casos y controles VPH+. Sin embargo el posible rol de cofactor del VEB debe ser evaluado con más detalle a la luz de su posible transmisión sexual.

Research paper thumbnail of Laparoscopic Radical Trachelectomy

JSLS, Journal of the Society of Laparoendoscopic Surgeons, 2012

The standard treatment for patients with early-stage cervical cancer has been radical hysterectom... more The standard treatment for patients with early-stage cervical cancer has been radical hysterectomy. However, for women interested in future fertility, radical trachelectomy is now considered a safe and feasible option. The use of minimally invasive surgical techniques to perform this procedure has recently been reported.

Research paper thumbnail of Robotic Radical Hysterectomy in the Management of Gynecologic Malignancies

Journal of Minimally Invasive Gynecology, 2008

Robotic surgery is being used with increasing frequency in gynecologic oncology. To date, 44 case... more Robotic surgery is being used with increasing frequency in gynecologic oncology. To date, 44 cases were reported in the literature of radical hysterectomy performed with robotic surgery. When comparing robotic surgery with laparoscopy or laparotomy in performing a radical hysterectomy, the literature shows that robotic surgery offers an advantage over the other 2 surgical approaches with regard to operative time, blood loss, and length of hospitalization. Future studies are needed to further elucidate the equivalence or superiority of robotic surgery to laparoscopy or laparotomy in performing a radical hysterectomy.

Research paper thumbnail of Quality of laparoscopic radical hysterectomy in developing countries: A comparison of surgical and oncologic outcomes between a comprehensive cancer center in the United States and a cancer center in Colombia

Gynecologic Oncology, 2012

Objective. To help determine whether global collaborations for prospective gynecologic surgery tr... more Objective. To help determine whether global collaborations for prospective gynecologic surgery trials should include hospitals in developing countries, we compared surgical and oncologic outcomes of patients undergoing laparoscopic radical hysterectomy at a large comprehensive cancer center in the United States and a cancer center in Colombia.

Research paper thumbnail of Unexpected inverse correlation between Native American ancestry and Asian American variants of HPV16 in admixed Colombian cervical cancer cases

Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases, 2014

European (E) variants of HPV 16 are evenly distributed among world regions, meanwhile Non-Europea... more European (E) variants of HPV 16 are evenly distributed among world regions, meanwhile Non-European variants such as European-Asian (EAs), Asian American (AA) and African (Af) are mostly confined to Eastern Asia, The Americas and African regions respectively. Several studies have shown that genetic variation of HPV 16 is associated with the risk of cervical cancer, which also seems to be dependent on the population. This relationship between ethnicity and variants have led to the suggestion that there is co-evolution of variants with humankind. Our aim was to evaluate the relationship between the individual ancestry proportion and infection with HPV 16 variants in cervical cancer. We examined the association between ancestry and HPV 16 variants in samples of 82 cervical cancer cases from different regions of Colombia. Individual ancestry proportions (European, African and Native American) were estimated by genotyping 106 ancestry informative markers. Variants were identified by PCR a...

Research paper thumbnail of Quality of laparoscopic radical hysterectomy in developing countries: A comparison of surgical and oncologic outcomes between a comprehensive cancer center in the United States and a cancer center in Colombia

Gynecologic Oncology, 2012

Objective-To help determine whether global collaborations for prospective gynecologic surgery tri... more Objective-To help determine whether global collaborations for prospective gynecologic surgery trials should include hospitals in developing countries, we compared surgical and oncologic outcomes of patients undergoing laparoscopic radical hysterectomy at a large comprehensive cancer center in the United States and a cancer center in Colombia. Methods-Records of the first 50 consecutive patients who underwent laparoscopic radical hysterectomy at The University of Texas MD Anderson Cancer Center in Houston (between April 2004 and July 2007) and the first 50 consecutive patients who underwent the same procedure at the Instituto de Cancerología-Clínica las Américas in Medellín (between December 2008 and October 2010) were retrospectively reviewed. Surgical and oncologic outcomes were compared between the 2 groups. Results-There was no significant difference in median patient age (US 41.9 years [range 23-73] vs. Colombia 44.5 years [range 24-75], P=0.09). Patients in Colombia had a lower median body mass index than patients in the US (24.4 kg/m 2 vs. 28.7 kg/m 2 , P=0.002). Compared to patients treated in Colombia, patients who underwent surgery in the US had a greater median estimated

Research paper thumbnail of Safety of minimally invasive radical hysterectomy in cervical tumors 2 cm

International Journal of Gynecologic Cancer

Research paper thumbnail of Immediate radical trachelectomy versus neoadjuvant chemotherapy followed by conservative surgery for patients with stage IB1 cervical cancer with tumors 2 cm or larger: a literature review and analysis of oncological and obstetrical outcomes

Gynecologic oncology, Jan 28, 2015

Radical trachelectomy is the treatment of choice in women with early-stage cervical cancer wishin... more Radical trachelectomy is the treatment of choice in women with early-stage cervical cancer wishing to preserve fertility. Radical trachelectomy can be performed with a vaginal, abdominal, or laparoscopic/robotic approach. Vaginal radical trachelectomy (VRT) is generally not offered to patients with tumors 2 cm or larger because of a high recurrence rate. There are no conclusive recommendations regarding the safety of abdominal (ART) or laparoscopic radical trachelectomy (LRT) in such patients. Several investigators have used neoadjuvant chemotherapy in patients with tumors 2 to 4 cm to reduce tumor size so that fertility preservation may be offered. However, to our knowledge, no published study has compared outcomes between patients with cervical tumors 2 cm or larger who underwent immediate radical trachelectomy and those who underwent neoadjuvant chemotherapy followed by radical trachelectomy. We conducted a literature review to compare outcomes with these 2 approaches. Our main e...

Research paper thumbnail of Asociación de infección con virus epstein-barr y cáncer de cuello uterino en mujeres del departamento de antioquia

Revista Colombiana de Cancerología, 2013

ABSTRACT Introducción El virus del papiloma humano de alto riesgo (VPH-AR) es la causa necesaria ... more ABSTRACT Introducción El virus del papiloma humano de alto riesgo (VPH-AR) es la causa necesaria de cáncer cervicouterino (CACu). El virus Epstein-Barr (VEB) es considerado un carcinógeno para humanos y se ha detectado en biopsias de CaCu. Objetivo Estimar el riesgo de cáncer cervical asociado a la infección por virus de Epstein-Barr. Materiales y métodos Se incluyeron 96 mujeres con diagnóstico de CaCu obtenido mediante biopsia dirigida por colposcopia y 186 mujeres con citología normal o lesiones intraepiteliales de bajo grado, emparejadas con los casos por edad. Información sobre factores de riesgo (edad de la primera relación sexual, número de parejas sexuales, número de hijos, uso de anticonceptivos orales, historia de tabaquismo y el uso del condón) se recogió mediante cuestionario previamente estandarizado. El VPH se detectó con la PCR GP5+/GP6+ e hibridación inversa con sondas específicas para 40 genotipos. El VEB se detectó mediante PCR de un segmento de la región W BamHI que contiene parte del antígeno nuclear 2 de VEB. Razones de Odds (OR) y los intervalos de confianza (95%), del riesgo de CaCu asociado a la infección con VPH y VEB, se estimaron por regresión logística no ajustada y ajustada por los factores de riesgo mencionados. También se estimó el riesgo asociado a VEB, incluyendo solamente casos y controles VPH+. Resultados Se observó un mayor riesgo de CaCu asociado con el VPH (OR: 131, IC95%: 47,7–360) y EBV (OR: 6,1, IC95% 2,8–13,1). Restricción del análisis de regresión incluyendo casos y controles VPH+, también mostró un incremento estadísticamente significativo del riesgo asociado a la infección con VEB (OR: 7,13, IC95%, 0,92-150, p = 0,066). En el análisis no restringido, el riesgo asociado a la infección con VEB se redujo al ajustar por otras variables de riesgo. Las variables que tuvieron el mayor efecto sobre esta asociación fueron el número de parejas sexuales y la edad de la primera relación sexual (OR: 3,45: IC95%: 1,29–9,2). Este incremento del riesgo de CaCu asociado a infección con VEB también se observó cuando además de las variables anteriormente mencionadas se incluyó la infección de VPH en el modelo (OR: 3,37, IC95%: 0,72–15,64), pero este estimado no fue estadísticamente significativo. Conclusiones Se observó asociación entre la infección con el virus Epstein-Barr y CaCu, aun después de restringir el análisis entre casos y controles VPH+. Sin embargo el posible rol de cofactor del VEB debe ser evaluado con más detalle a la luz de su posible transmisión sexual.

Research paper thumbnail of Laparoscopic Radical Trachelectomy

JSLS, Journal of the Society of Laparoendoscopic Surgeons, 2012

The standard treatment for patients with early-stage cervical cancer has been radical hysterectom... more The standard treatment for patients with early-stage cervical cancer has been radical hysterectomy. However, for women interested in future fertility, radical trachelectomy is now considered a safe and feasible option. The use of minimally invasive surgical techniques to perform this procedure has recently been reported.

Research paper thumbnail of Robotic Radical Hysterectomy in the Management of Gynecologic Malignancies

Journal of Minimally Invasive Gynecology, 2008

Robotic surgery is being used with increasing frequency in gynecologic oncology. To date, 44 case... more Robotic surgery is being used with increasing frequency in gynecologic oncology. To date, 44 cases were reported in the literature of radical hysterectomy performed with robotic surgery. When comparing robotic surgery with laparoscopy or laparotomy in performing a radical hysterectomy, the literature shows that robotic surgery offers an advantage over the other 2 surgical approaches with regard to operative time, blood loss, and length of hospitalization. Future studies are needed to further elucidate the equivalence or superiority of robotic surgery to laparoscopy or laparotomy in performing a radical hysterectomy.

Research paper thumbnail of Quality of laparoscopic radical hysterectomy in developing countries: A comparison of surgical and oncologic outcomes between a comprehensive cancer center in the United States and a cancer center in Colombia

Gynecologic Oncology, 2012

Objective. To help determine whether global collaborations for prospective gynecologic surgery tr... more Objective. To help determine whether global collaborations for prospective gynecologic surgery trials should include hospitals in developing countries, we compared surgical and oncologic outcomes of patients undergoing laparoscopic radical hysterectomy at a large comprehensive cancer center in the United States and a cancer center in Colombia.

Research paper thumbnail of Unexpected inverse correlation between Native American ancestry and Asian American variants of HPV16 in admixed Colombian cervical cancer cases

Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases, 2014

European (E) variants of HPV 16 are evenly distributed among world regions, meanwhile Non-Europea... more European (E) variants of HPV 16 are evenly distributed among world regions, meanwhile Non-European variants such as European-Asian (EAs), Asian American (AA) and African (Af) are mostly confined to Eastern Asia, The Americas and African regions respectively. Several studies have shown that genetic variation of HPV 16 is associated with the risk of cervical cancer, which also seems to be dependent on the population. This relationship between ethnicity and variants have led to the suggestion that there is co-evolution of variants with humankind. Our aim was to evaluate the relationship between the individual ancestry proportion and infection with HPV 16 variants in cervical cancer. We examined the association between ancestry and HPV 16 variants in samples of 82 cervical cancer cases from different regions of Colombia. Individual ancestry proportions (European, African and Native American) were estimated by genotyping 106 ancestry informative markers. Variants were identified by PCR a...